Critical care medicine
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Critical care medicine · Mar 2014
Comparative StudyB-Type Natriuretic Peptide and Risk of Acute Kidney Injury in Patients Hospitalized With Acute Coronary Syndromes.
To investigate whether admission B-type natriuretic peptide levels predict the development of acute kidney injury in acute coronary syndromes. ⋯ In patients hospitalized with acute coronary syndromes, B-type natriuretic peptide levels measured at admission are associated with acute kidney injury as well as its severity.
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Critical care medicine · Mar 2014
Comparative StudyRates and Timing of Central Venous Cannulation Among Patients With Sepsis and Respiratory Arrest Admitted by the Emergency Department.
Clinical guidelines for the acute management of emergency department patients with severe sepsis encourage the placement of central venous catheters. Data examining the timing of central venous catheter insertion among critically ill patients admitted from the emergency department are limited. We examined the hypothesis that prompt central venous catheter insertion during hospitalization among patients admitted from the emergency department acts as a surrogate marker for early aggressive care in the management of critically ill patients. ⋯ Central venous catheters are inserted earlier and more frequently among critically ill patients admitted from the emergency department. Earlier central venous catheter insertion may require systematic changes to meet increasing utilization and enhanced mechanisms to measure central venous catheter outcomes.
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Critical care medicine · Mar 2014
Multicenter Study Observational StudyImpact of Distinct Definitions of Acute Lung Injury on Its Incidence and Outcomes in Brazilian ICUs: Prospective Evaluation of 7,133 Patients.
Evaluation of prevalence and outcomes of acute lung injury in a large cohort of critically ill patients in Brazil and comparison of predictive receiver operating characteristic curve mortality of American European Consensus conference definition with new Berlin definition of acute respiratory distress syndrome. ⋯ In our population, prevalence of acute lung injury was low, most cases were diagnosed 2 days after ICU admission, and Berlin definition was not different from American European Consensus conference definition in predicting mortality. There are still several problems with the global epidemiology, definition, and mortality predictive indices that should be added to the classification of this still lethal syndrome to improve its predictive mortality power in the future.
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Critical care medicine · Mar 2014
Observational StudySerum Biomarkers of Brain Injury to Classify Outcome After Pediatric Cardiac Arrest.
Morbidity and mortality in children with cardiac arrest largely result from neurologic injury. Serum biomarkers of brain injury can potentially measure injury to neurons (neuron-specific enolase), astrocytes (S100b), and axons (myelin basic protein). We hypothesized that serum biomarkers can be used to classify outcome from pediatric cardiac arrest. ⋯ Preliminary data show that serum S100b, neuron-specific enolase, and myelin basic protein may aid in outcome classification of children surviving cardiac arrest.