Annals of intensive care
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Annals of intensive care · Dec 2017
The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock.
Compliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department. ⋯ Implementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.
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Annals of intensive care · Dec 2017
Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study.
Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients. ⋯ This study suggested the changes in PtcO2 induced by volume expansion and a PLR test predicted fluid responsiveness in critically ill patients. Trial registration NCT02083757.
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Annals of intensive care · Nov 2017
Effects of combination therapy using antithrombin and thrombomodulin for sepsis-associated disseminated intravascular coagulation.
No single anticoagulant has been proven effective for sepsis-associated disseminated intravascular coagulation (DIC). Thus, the concomitant use of antithrombin concentrate and recombinant thrombomodulin has been conceived. This observational study was conducted to investigate the efficacy and safety of this combination therapy. ⋯ The current study demonstrated the potential benefit of adding recombinant thrombomodulin to antithrombin. The co-administration of these two anticoagulants was associated with reduced mortality among patients with sepsis-induced DIC without increasing the risk of bleeding.
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Annals of intensive care · Oct 2017
Heparin-binding protein (HBP) improves prediction of sepsis-related acute kidney injury.
Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI. ⋯ Plasma HBP adds predictive value to known clinical risk factors in septic AKI. Further studies are warranted to compare the predictive performance of plasma HBP to other novel AKI biomarkers.
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Annals of intensive care · Oct 2017
Prognostic implications of blood lactate concentrations after cardiac arrest: a retrospective study.
Elevated lactate concentration has been associated with increased mortality after out-of-hospital cardiac arrest (CA). We investigated the variables associated with high blood lactate concentrations and explored the relationship between blood lactate and neurological outcome in this setting. ⋯ High lactate concentrations on admission were an independent predictor of poor neurological recovery post-CA, but the time course was not related to outcome. Prolonged resuscitation, use of vasopressors, high PaO2 and altered renal function were predictors of high lactate concentrations.