Showing papers in "Journal of Critical Care in 2017"

TL;DR: A scoping review of the peer‐reviewed and gray literature was undertaken to assemble existing models for ICU stratification and present a proposed definition and classification of ICUs.

TL;DR: Major bleeding events were very common in all studies with a summary prevalence of 27%, and significant between‐study heterogeneity limits any recommendations for the optimal strategy of anticoagulation further clinical trials are needed to examine this question.

TL;DR: In this paper, the effects of dexmedetomidine and propofol sedation on outcomes in adult patients after cardiac surgery were compared in 8 randomized controlled trials and a total of 969 patients in 8 studies met the selection criteria, and the results revealed that dexmedeteromidine was associated with a lower risk of delirium (risk ratio, 0.40;95% confidence interval [CI], 0.24-0.64; P =.0002), a shorter length of intubation (hours; mean difference, -0.26 to -

TL;DR: A systematic review and meta‐analysis of studies comparing clinical outcomes among critically ill adults treated with continuous renal replacement therapy, intermittent hemodialysis or sustained low efficiency dialysis to treat acute kidney injury found no patient or kidney survival advantage for any of the modalities.

TL;DR: Bacterial reservoir inside erythrocytes provides the long‐term survival of bacteria and is the cause of ineffectiveness of antibiotics and host immune reactions.

TL;DR: High‐density lipoprotein cholesterol was greatly decreased in patients who developed MODS and/or died and remained stable over the first week of admission, and was the best prognostic marker for adverse outcomes in a suspected sepsis cohort.

TL;DR: In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events, and a large multicenter randomized trial should conclusively confirm these findings.

TL;DR: Occupational therapy is effective in decreasing duration and incidence of delirium in nonventilated elderly patients in the intensive care unit and improved functionality at discharge.

TL;DR: IVC collapsibility, as measured by POCUS, performs well in distinguishing fluid responders from non‐responders, and may be used to guide IVF resuscitation among spontaneously breathing critically‐ill patients.

TL;DR: Almost half of the patients in Portuguese ICUs are at high nutritional risk, and NUTRIC score was strongly associated with main clinical outcomes, including mortality from all causes at 28 days after admission.

TL;DR: Dynamic course of lactate during ECMO therapy is a valuable tool to assess effective circulatory support and is superior to single lactate measurements as a predictive marker for 30‐day mortality.

TL;DR: The evidence does not support the use of routine bronchoscopy guidance or laryngeal masks during the procedure, and proper prior training is as important or even a more significant factor in reducing complications than the technique used.

TL;DR: Neurogenic stunned myocardium resulting from subarachnoid hemorrhage (SAH) is a challenging pathology due to its diagnostic uncertainty and the need to accurately diagnose and treat NSM.

TL;DR: An introduction to microbiome concepts and terminology is provided and a roadmap for future studies in the field for transforming critical care from its current isolated focus on the host to a more personalized paradigm addressing both human and microbial contributions to critical illness is proposed.

TL;DR: It was apparent that during mechanical ventilation, dental plaque represents a source of potential VAP pathogens.

TL;DR: VAE is an important and underappreciated complication of surgery, anesthesia and medical procedures and an organized team approach to treatment including clinical simulation can facilitate preparedness for VAE.

TL;DR: All cases of this Guillain‐Barré syndrome outbreak had a recent history ZIKV infection, reinforcing existing evidence for the association between GBS and ZikV.

TL;DR: Rank analysis showed that levosimendan had the highest probability of being the best treatment among several regimens for pharmacological cardiovascular support in septic patients, regimens based on inodilators have thehighest probability of improve survival.

TL;DR: TheqSOFA score had a modest ability to predict mortality of both septic and nonseptic patients; combining qSOFA with plasma lactate had a predictive ability comparable to the standard SOFA score.

TL;DR: A hospital‐wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis, with significant reductions in mortality, length of stay, and mechanical ventilation use.

TL;DR: A review of the existing literature examining circadian desynchronization in critically ill patients is offered, highlighting contributing factors identified by scholars, and circadian abnormalities observed in these patients.

TL;DR: Improved intensive care unit (ICU) environment would enhance sleep quality, assessed by polysomnography (PSG), in critically ill mechanically ventilated patients but characteristics of normal sleep were absent in many of the PSG recordings in these critically ill patients.

TL;DR: In this article, a study was conducted to determine whether quick sequential organ failure assessment (qSOFA) has prognostic value when compared to systemic inflammatory response syndrome (SIRS) in predicting organ failure in patients with a suspected infection in an emergency department.

TL;DR: The improved risk model developed in this study showed excellent discrimination and calibration and when validated on a different period of time and across different types of critical care unit allows improved accuracy of comparisons between UK critical care providers.

TL;DR: The epidemiology of sepsis‐associated in‐hospital cardiac arrest in adults and children, the relevant physiology responsible for its pathogenesis and poor outcomes, and potential therapeutic interventions based on this pathophysiology are discussed.

TL;DR: The current diagnostic and therapeutic approach to acute liver failure is reviewed, especially in the intensive care unit setting, to improve patients' outcomes and selection of patients for liver transplantation.

TL;DR: Assessment of the association of tidal volume, level of PEEP and driving pressure with the development of ARDS in a population of patients with brain injury found a high driving pressure was associated to a higher probability for AR DS in patients with critical neurologic illnesses.

TL;DR: A high 90‐day prevalence of post‐intensive care symptoms among 143 relatives of critically ill patients was confirmed, and feeling overburdened and experiencing acute stressors may be related to negative psychological outcomes.

TL;DR: Neuromuscular electrical stimulation and personalized physiotherapy in ICU survivors did not result in greater improvement of muscle strength and functional status at hospital discharge, however, in patients with ICU‐aw NMES may be effective.

TL;DR: Oral decontamination with 2% compared to 0.2% chlorhexidine is a more effective method in the prevention of VAP and reduction of oropharyngeal colonization (especially gram‐positive).