Critical care medicine
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Critical care medicine · Dec 2024
Racial Equity in Family Approach for Patients Medically Suitable for Deceased Organ Donation.
To conduct a contemporary analysis of the association between family approach of medically suitable potential organ donors and race/ethnicity. ⋯ Findings indicate racial equity in OPO family approach rates among patients who were medically suitable for organ donation.
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Critical care medicine · Dec 2024
Observational StudyHigh-Density Lipoprotein Anti-Inflammatory Capacity and Acute Kidney Injury After Cardiac and Vascular Surgery: A Prospective Observational Study.
Acute kidney injury (AKI) predicts death after cardiac and vascular surgery. Higher preoperative high-density lipoprotein (HDL) concentrations are associated with less postoperative AKI. In animals, HDL's anti-inflammatory capacity to suppress endothelial cell adhesion molecule expression reduces kidney damage due to ischemia and hemorrhagic shock. The objective of this study is to evaluate the statistical relationship between HDL anti-inflammatory capacity and AKI after major cardiac and vascular surgery. ⋯ Patients with chronic kidney disease undergoing cardiac and vascular surgery who have dysfunctional, pro-inflammatory HDL have a higher risk of postoperative AKI compared with patients with anti-inflammatory HDL. Conversely, a higher HDL anti-inflammatory capacity is associated with a lower risk of postoperative AKI, independent of HDL concentration. Higher long-term statin dose is associated with higher HDL anti-inflammatory capacity.
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Critical care medicine · Dec 2024
Adjudication of Codes for Identifying Sepsis in Hospital Administrative Data by Expert Consensus.
Refine the administrative data definition of sepsis in hospitalized patients, including less severe cases. ⋯ Compared with other code-based algorithms, AlgorithmL includes more infection and organ dysfunction codes. AlgorithmL incidence rates are higher; hospital mortality rates are lower. AlgorithmL may more fully encompass the full range of sepsis severity.