Critical care medicine
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Critical care medicine · Nov 2011
Multicenter StudyAssociation of prehospitalization aspirin therapy and acute lung injury: results of a multicenter international observational study of at-risk patients.
To evaluate the association between prehospitalization aspirin therapy and incident acute lung injury in a heterogeneous cohort of at-risk medical patients. ⋯ After adjusting for the propensity to receive aspirin therapy, no statistically significant associations between prehospitalization aspirin therapy and acute lung injury were identified; however, a prospective clinical trial to further evaluate this association appears warranted.
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Critical care medicine · Nov 2011
Comparative StudyIntensive care unit renal support therapy volume is not associated with patient outcome.
Evidence suggests that patients requiring high-risk procedures benefit from care at institutions providing a large volume of these procedures. Our objective was to determine whether there is a volume-outcome relationship among intensive care unit patients receiving renal support therapy in two different healthcare systems (France and the United States). ⋯ There is a large variation in annual renal support therapy volume across intensive care units in France and the United States but no association of higher volumes with improved outcomes.
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Critical care medicine · Nov 2011
Development and validation of a model that uses enhanced administrative data to predict mortality in patients with sepsis.
We aimed to determine whether a sepsis risk-adjustment model that uses only administrative data could be used when other intensive care unit risk-adjustment methods are unavailable. ⋯ A sepsis mortality model using detailed administrative data has discrimination similar to and calibration superior to those of existing severity scores that require chart review. This model may be a useful alternative method of severity adjustment for benchmarking purposes or for conducting large, retrospective epidemiologic studies of sepsis patients.
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Critical care medicine · Nov 2011
Efficacy of ventilator waveforms observation in detecting patient-ventilator asynchrony.
The value of visual inspection of ventilator waveforms in detecting patient-ventilator asynchronies in the intensive care unit has never been systematically evaluated. This study aims to assess intensive care unit physicians' ability to identify patient-ventilator asynchronies through ventilator waveforms. ⋯ The ability of intensive care unit physicians to recognize patient-ventilator asynchronies was overall quite low and decreased at higher prevalence; expertise significantly increased sensitivity for breath-by-breath analysis, whereas it only produced a trend toward improvement for report analysis.
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Critical care medicine · Nov 2011
Delayed neurological recovery after decompressive craniectomy for severe nonpenetrating traumatic brain injury.
This study aimed to assess the incidence and factors associated with delayed neurologic recovery after decompressive craniectomy for severe nonpenetrating traumatic brain injury. ⋯ Delayed neurologic recovery after decompressive craniectomy for severe nonpenetrating traumatic brain injury was very common; absence of nonevacuated intracerebral hematoma and a high admission Glasgow Coma Scale were associated with a higher chance of delayed neurologic recovery after decompressive craniectomy.