Critical care medicine
-
Critical care medicine · May 2013
Multicenter Study Comparative StudyDevelopment of a genomic metric that can be rapidly used to predict clinical outcome in severely injured trauma patients.
Many patients have complicated recoveries following severe trauma due to the development of organ injury. Physiological and anatomical prognosticators have had limited success in predicting clinical trajectories. We report on the development and retrospective validation of a simple genomic composite score that can be rapidly used to predict clinical outcomes. ⋯ A rapid genomic composite score obtained in the first 24 hours after trauma can retrospectively identify trauma patients who are likely to develop complicated clinical trajectories. A novel platform is described in which this genomic score can be obtained within 12 hours of blood collection, making it available for clinical decision making.
-
Critical care medicine · May 2013
Multicenter Study Comparative StudyMortality after hospital discharge in ICU patients.
To assess the mortality risk of ICU patients after hospital discharge and compare it to mortality of the general Dutch population. ⋯ In-hospital mortality underestimates the true mortality of ICU patients as the mortality in the first months after hospital discharge is substantial. Most ICU patients still have an increased mortality risk in the subsequent years after hospital discharge compared with the general Dutch population. The mortality after hospital discharge differs widely between ICU subgroups. Future studies should focus on the analysis of mortality after hospital discharge that is attributable to the former ICU admission.
-
Critical care medicine · May 2013
Comparative StudyFast-track failure after cardiac surgery: external model validation and implications to ICU bed utilization.
To facilitate the planning of perioperative care pathways, a fast-track failure prediction model has been developed in patients undergoing cardiac surgery. This study externally validated such a fast-track failure risk prediction model and determined the potential clinical consequences to ICU bed utilization. ⋯ As the performance of the final updated fast-track failure model was very good, it can be used to estimate the predicted probability of fast-track failure on individual patients. The clinical consequence of applying the final model appears substantial with regard to the potential increase in effective ICU bed utilization.
-
Critical care medicine · May 2013
Case ReportsReversing dabigatran in life-threatening bleeding occurring during cardiac ablation with factor eight inhibitor bypassing activity.
We report a case of a patient receiving dabigatran who developed a life-threatening bleeding complication during cardiac ablation that rapidly resolved after administration of Factor Eight Inhibitor Bypassing Activity (FEIBA). ⋯ This case report describes the potential ability of a low dose of the activated prothrombin complex concentrate, FEIBA, to reestablish hemostasis independent of the pharmacologic effects of dabigatran. Additional studies are warranted to confirm the findings of our observation.
-
Critical care medicine · May 2013
Comparative StudyCerebral Performance Category and long-term prognosis following out-of-hospital cardiac arrest.
Although measures of functional status are often advocated when assessing short-term survival following cardiac arrest, little is known about how these measures predict long-term prognosis. We sought to determine whether the Cerebral Performance Category (CPC) was associated with long-term outcome following resuscitation from out-of-hospital cardiac arrest. ⋯ The CPC at hospital discharge is a useful surrogate measure of long-term survival and can be an informative tool for programmatic evaluation and research of resuscitation.