Journal of critical care
-
Journal of critical care · Dec 2009
Actigraphic monitoring in critically ill patients: preliminary results toward an "observation-guided sedation".
The aim of this study is to evaluate continuous wrist actigraphy (measurement of limb movements) in intensive care unit patients as a neurologic status monitoring. ⋯ Patients' limb movements were significantly related to all studied neurologic status indexes. Continuous actigraphy measuring may become important as a clinical tool both to guide utilization of sedative drugs and to enhance early recognition and management of agitation.
-
Journal of critical care · Dec 2009
Safety of drotrecogin alfa (activated) in severe sepsis: data from adult clinical trials and observational studies.
Drotrecogin alfa (activated) (DrotAA), or recombinant human activated protein C, represents the only Food and Drug Administration-approved therapy for mortality reduction in adult patients with severe sepsis. Drotrecogin alfa (activated) has properties that address microvascular injury in severe sepsis through its direct effects on endothelial cells and leukocytes while also having antithrombotic and indirect profibrinolytic properties. ⋯ Bleeding is more common in DrotAA-treated patients; therefore, a careful assessment of bleeding risk and an understanding of the safety profile is required. This summary provides a detailed review of safety data and outcomes of patients treated with DrotAA in recent clinical studies enrolling more than 7000 adult patients.
-
Journal of critical care · Dec 2009
Epidemiology of Staphylococcus aureus nasal colonization and influence on outcome in the critically ill.
To determine the rate of Staphylococcus aureus nasal colonization at admission to intensive care units (ICU) and assess its effect on the development of an ICU-acquired S aureus infection. ⋯ Nasal colonization with S aureus is a significant risk factor for ICU-acquired S aureus infections, and strategies to control these infections should target both MSSA and MRSA colonization.
-
Journal of critical care · Dec 2009
Comparative StudyDopamine therapy in septic shock: detrimental effect on survival?
The aim of this study is to examine the potential impact of dopamine therapy on 28-day mortality in adult septic shock. ⋯ In our cohort study, dopamine use was linked to mortality as compared to other vasopressor therapies, particularly in patients with essential hypertension. Future randomized studies attempting to compare dopamine with other therapies in septic shock should pay attention to patients with essential hypertension.