Critical care medicine
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Critical care medicine · Aug 2011
Multicenter Study Comparative StudyUnderstanding the potential role of statins in pneumonia and sepsis.
To examine the association of statin use with clinical outcomes and circulating biomarkers in community-acquired pneumonia and sepsis. ⋯ We found no evidence of a protective effect for statin use on clinical outcomes and only modest differences in circulating biomarkers in community-acquired pneumonia, perhaps as a result of healthy user effects and indication bias.
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Critical care medicine · Aug 2011
Comparative StudyHealth-related quality of life in Australian survivors of critical illness.
To document health-related quality of life of an Australian sample of intensive care unit survivors 6 months after intensive care unit discharge and compare this with preadmission health-related quality of life, health-related quality of life of national population norms, and international samples of intensive care unit survivors. ⋯ Although the majority of health-related quality of life domains did not differ between preadmission and 6-month follow-up, participants reported significant and clinically meaningful improvements in pain and mental health at follow-up. Critical illness survivors' health-related quality of life remained within 1 sd of Australian norms at follow-up and physical function health-related quality of life was most affected. Health-related quality of life in these Australian survivors of the intensive care unit was comparable with international survivors 6 months after intensive care unit admission.
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Critical care medicine · Aug 2011
Incidence and risk factors for health care-associated pneumonia in a pediatric intensive care unit.
To determine the incidence and risk factors for health care-associated pneumonia in a pediatric intensive care unit. ⋯ Identification of independent predictors of health care-associated pneumonia may inform preventive measures. Strategies to optimize use of sedatives/analgesics, reduce the use of gastric tubes, and reduce the time on ventilation should be considered for inclusion in future intervention studies.
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Critical care medicine · Aug 2011
Comparative StudyThe intraoperative decrease of selenium is associated with the postoperative development of multiorgan dysfunction in cardiac surgical patients.
The trace elements selenium, copper, and zinc are essential for maintaining the oxidative balance. A depletion of antioxidative trace elements has been observed in critically ill patients and is associated with the development of multiorgan dysfunction and an increased mortality. Cardiac surgery using cardiopulmonary bypass provokes ischemia-reperfusion-mediated oxidative stress. We hypothesized that an intraoperative decrease of circulating trace elements may be involved in this response. ⋯ Cardiac surgery using cardiopulmonary bypass resulted in a profound intraoperative decrease of whole blood levels of antioxidant trace elements. Low selenium concentrations at end of surgery were an independent predictor for the postoperative development of multiorgan failure.
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Critical care medicine · Aug 2011
Comparative StudyThe interobserver agreement of handheld dynamometry for muscle strength assessment in critically ill patients.
Muscle weakness often complicates critical illness and is associated with increased risk of morbidity, mortality, and limiting functional outcome even years later. To assess the presence of muscle weakness and to examine the effects of interventions, objective and reliable muscle strength measurements are required. The first objective of this study is to determine interobserver reliability of handheld dynamometry. Secondary objectives are to quantify muscle weakness, to evaluate distribution of muscle weakness, and to evaluate gender-related differences in muscle strength. ⋯ Handheld dynamometry is a tool with a very good interobserver reliability to assess limb muscle strength in awake and cooperative critically ill patients. Future studies should focus on the sensitivity of handheld dynamometry in longitudinal studies to evaluate predictive values toward patients' functional outcome.