Showing papers in "Journal of Critical Care in 2014"

TL;DR: The pathogenesis, diagnosis, and treatment of myocardial depression in sepsis is summarized and the cornerstone of management is control of the underlying infectious process and hemodynamic stabilization (fluids, vasopressor and inotropic agents).

TL;DR: Limited echocardiography-guided management following early resuscitation is associated with improved survival, less fluid, and increased inotropic prescription.

TL;DR: Neutrophil extracellular traps formed after major trauma and subsequent surgery contain mtDNA and represent a novel marker of heightened innate immune activation and could be considered when timing surgery after trauma to prevent systemic NET-induced inflammatory complications.

TL;DR: In this large, single-center study, routine care physical therapy interventions were safe for critically ill patients and required minimal additional treatment or cost, without additional length of stay.

TL;DR: The presence of new LV systolic dysfunction associated with sepsis and defined as low LVEF is neither a sensitive nor a specific predictor of mortality.

TL;DR: This article addresses what the authors know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research.

TL;DR: Low cholesterol and lipoprotein concentrations are detected in septic patients, especially in individuals with poor outcome, and high-density cholesterol concentration seems to be an early independent predictive marker of survival in severe sepsis.

TL;DR: Proton pump inhibitor therapy was an independent risk factor for CDAD in medical ICU patients and instead of routine PPI use for bleeding prophylaxis, further trials should investigate risk-adjusted algorithms, balancing benefits, and threats of PPI medication.

TL;DR: Critically ill patients having sepsis, edema, or receiving vasopressors were less likely to respond to NMES with an adequate quadriceps contraction, butNeuromuscular electrical stimulation is a safe intervention to be administered in the ICU.

TL;DR: Fluid resuscitation practice with HES as in the meta-analyzed studies is associated with increased an increase in AKI incidence, need of RRT, RBC transfusion, and 90-day mortality in patients with sepsis.

TL;DR: Surgical rib fixation resulted in a significant decrease in ventilator days and may represent a novel approach to decreasing morbidity in flail chest patients when used as a rescue therapy in patients with declining pulmonary status.

TL;DR: In ICU patients, serum suPAR concentrations have limited use for identifying sepsis, but their time course correlated with the degree of organ dysfunction, and they have prognostic value in septic and nonseptic populations.

TL;DR: Intensive care unit mortality rate was 55% in cancer patients, which suggests that patients with cancer can benefit from ICU admission, and four variables were independent predictors for ICU mortality in patients with solid tumors.

TL;DR: In patients with septic shock, oxidative stress was associated with mortality, and thiamine was not associated with oxidative stress or mortality in these patients, while in patients with vitamin B1 levels or GPx activity, protein carbonyl concentrations were associated with increased mortality.

TL;DR: It is found that among ED patients with suspected infection, intermediate lactate elevation is associated with a moderate to high risk of mortality, even among patients without hypotension, and Physicians should consider close monitoring and aggressive treatment for such patients.

TL;DR: It is demonstrated that intravenous selenium supplementation could promote antioxidant status and help protect against infection and organ failure, improving outcome in critically ill patients, in a systematic review and meta-analysis of randomized controlled trials.

TL;DR: An increase in plasma DD concentration in absence of other explaining pathology can be helpful in predicting an MO exchange in miniaturized heparin-coated ECMO systems.

TL;DR: It is concluded that pupillometry monitoring can serve as an important tool in the ICU because it had better precision and reproducibility compared with the manual pupillary examination.

TL;DR: In septic shock, reversible AKI within the first 24 hours of admission confers a survival benefit compared to no, new, or persistent AKI.

TL;DR: C-reactive protein measured on ICU entry and its changes within 24 hours are risk indicators of delirium, and further studies exploring the treatment ofDelirium according to CRP levels are warranted.

TL;DR: Frailty can be measured in older ICU survivors near hospital discharge and is associated with 6-month mortality in unadjusted analysis and larger studies to determine if frailty independently predicts outcomes are warranted.

TL;DR: Synthesis of a heterogeneous body of evidence shows transient effects of modest clinical significance for co-administration of albumin with furosemide in hypoalbuminemic patients as a strategy to overcome diuretic resistance.

TL;DR: The incidence of disarrangements consistent withcitrate accumulation in patients undergoing RCA-continuous venovenous hemodialysis was low, taking place exclusively in patients with severe lactic acidosis due to multiorgan failure, suggesting that the appearance of citrate accumulation is secondary to a severe failure of cellular respiration.

TL;DR: Literature suggests that organ dysfunction should be managed at its onset, whereas aggressive ICU management should be reappraised after a few days of full support, and a multidisciplinary treating team of physicians should aid in changing the goals from restorative to palliative care when there appears to be no possible benefit from any treatment.

TL;DR: The preliminary findings suggest that FES-cycling may improve function and reduce delirium in patients with sepsis ventilated for more than 48 hours and in the intensive care unit for at least 4 days.

TL;DR: In ALI survivors, patient-reported, postexubation dysphagia at hospital discharge was significantly associated with upper gastrointestinal comorbidity and a longer duration of oral endotracheal intubation during the first 6 days of intubations.

TL;DR: In a cohort of critically ill ACS patients, achieving FB (-) status early during surgical ICU admission was associated with a nearly 70% reduction in the risk for mortality.

TL;DR: The presepsin levels did not correlate significantly with Acute Physiology and Chronic Health Evaluation III scores and mortality rates on the 30th day, but showed significantly higher values in infection group than in noninfection group.

TL;DR: There exists Oxford level 2b, GRGrade C evidence in adults and level 4, GRADE C in pediatrics to support that ketamine does not increase ICP in nontraumatic neurological illness when patients are sedated and ventilated, and in fact may lower it in selected cases.

TL;DR: The use of NIV was found to be associated with clinical benefits in selected IPF patients, preventing the need for intubation and reducing the rate of complications/death.