Critical care medicine
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Accurate diagnosis of sepsis is difficult in patients post burn due to the large inflammatory response produced by the major insult. We aimed to estimate the values of serum N-terminal pro-B-type natriuretic peptide and procalcitonin and the changes in hemodynamic variables as markers of sepsis in critically ill burn patients. ⋯ Serum N-terminal pro-B-type natriuretic peptide levels and certain hemodynamic changes can be used as an early indicator of sepsis in patients with burn injury. Procalcitonin did not assist in the early diagnosis of sepsis.
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Critical care medicine · Sep 2014
Do-Not-Resuscitate Status and Observational Comparative Effectiveness Research in Patients With Septic Shock.
To assess the importance of including do-not-resuscitate status in critical care observational comparative effectiveness research. ⋯ Among patients with septic shock, do-not-resuscitate status acts as a strong confounder that may inform past discrepancies between observational and randomized studies of activated protein C. Inclusion of early do-not-resuscitate status into more administrative databases may improve observational comparative effectiveness methodology.
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Critical care medicine · Sep 2014
The Effect of Acute Kidney Injury and Discharge Creatinine Level on Mortality Following Cardiac Surgery.
Acute kidney injury after cardiac surgery is associated with increased operative and late mortality. The objective was to determine if short and long term mortality are systematically improved with completeness of postoperative acute kidney injury reversal or with amount of residual renal function. ⋯ Acute kidney injury was associated with higher operative and late mortality. Lesser amounts of residual renal function were associated with increased late mortality.
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Critical care medicine · Sep 2014
Inhibition of Neogenin Dampens Hepatic Ischemia-Reperfusion Injury.
Liver ischemia and reperfusion injury is a common source of significant morbidity and mortality following liver transplantation, hemorrhagic shock, or major hepatic surgery. Based on studies showing a critical role for the neuronal guidance receptor neogenin (Neo1) outside the nervous system in mediating tissue adaption during acute inflammation, we hypothesized that Neo1 enhances hepatic ischemia and reperfusion injury. ⋯ These data provide a unique role for Neo1 in the development of hepatic ischemia and reperfusion injury and identified Neo1 as a potential target to prevent liver dysfunction in the future.