Abstract:
BACKGROUND AND PURPOSE:Delirium is thought to be associated with systemic inflammatory response. However, its association with the most widely used inflammatory biomarker C-reactive protein (CRP) has not been well established. We aimed to examine whether CRP on intensive care unit (ICU) entry was associated with subsequent development of delirium. DESIGN AND SETTING:This prospective observational study was conducted in a mixed 24-bed ICU in a tertiary teaching hospital. METHODS:All patients admitted to the ICU from February 2011 to June 2012 were screened for eligibility. Demographic data and clinical characteristics of included patients were recorded. Patients were screened for the presence of delirium by using the tool Confusion Assessment Method for the ICU (CAM-ICU). C-reactive protein was obtained on ICU entry and 24 hours thereafter. Eligible patients were followed up for 28 days or until death. Univariate and multivariate analyses were performed to evaluate independent risk factors for delirium. Clinical outcome included the length of stay (LOS) in the ICU, 28-day mortality, and duration of mechanical ventilation. Two-tailed P < .05 was considered statistically significant. RESULTS:A total of 223 patients were included during study period. In univariate analysis, patients with delirium showed significantly higher CRP values than those without (120.5 vs 57.5 mg/L; P = .0001). By adjusting for confounding variables (including age, sex, Acute Physiology and Chronic Health Evaluation II, intubation, living alone, physical restraint, alcohol drinking, smoking, type of medical condition, and hospital LOS before ICU admission) in logistic regression model, CRP remained an independent predictor of delirium (odds ratio, 1.07; 95% confidence interval, 1.01-1.15). As compared with nondelirious patients, those with delirium showed longer LOS in ICU (13 vs 5 days; P < .001) and duration of mechanical ventilation (6 vs 1 days; P < .001). An increase in CRP greater than 8.1 mg/L within 24 hours was associated with 4-fold increase in the risk of delirium (odds ratio: 4.47, 95% confidence interval, 1.28-15.60). CONCLUSION:C-reactive protein measured on ICU entry and its changes within 24 hours are risk indicators of delirium. Further studies exploring the treatment of delirium according to CRP levels are warranted.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Zhang Z,Pan L,Deng H,Ni H,Xu Xdoi
10.1016/j.jcrc.2013.09.002subject
Has Abstractpub_date
2014-02-01 00:00:00pages
88-92issue
1eissn
0883-9441issn
1557-8615pii
S0883-9441(13)00319-5journal_volume
29pub_type
杂志文章abstract:PURPOSE:The maintenance of patient-specific optimal cerebral perfusion pressure (CPPopt) is crucial for patients with traumatic brain injury (TBI). The goal of the study was to explore the influence of CPP declination from CPPopt value on the TBI patients' outcome. METHODS:The CPP and cerebrovascular autoregulation (C...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.04.029
更新日期:2017-10-01 00:00:00
abstract:PURPOSE:We aimed to evaluate the effects of transjugular intrahepatic portosystemic stent shunt (TIPS) on systemic cardiocirculatory parameters in patients treated with TIPS for portal hypertension-associated complications. MATERIALS AND METHODS:This prospective study was conducted in an intensive care unit of a Germa...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.06.028
更新日期:2014-12-01 00:00:00
abstract::Patient ventilatory dyssynchrony (PVD) is a mismatch between the respiratory drive of the patient and ventilatory assistance. It is a complex event seen in almost all ventilated patients and at any ventilator mode, with uncertain significance and prognosis. Due to its different pathophysiological mechanisms, there is ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2020.07.016
更新日期:2020-12-01 00:00:00
abstract:PURPOSE:The aim of the study was to investigate predictors of post-intensive care unit (ICU) in-hospital mortality with special emphasis on the impact of sepsis and organ system failure. METHODS:This study is a subanalysis of the database from the observational Sepsis Occurrence in Acutely Ill Patients study conducted...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2007.09.006
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:Family needs and expectations are often unmet in the intensive care unit (ICU), leading to dissatisfaction. This study assesses cross-cultural adaptability of an instrument evaluating family satisfaction in the ICU. MATERIALS AND METHODS:A Canadian instrument on family satisfaction was adapted for German langu...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2006.12.008
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Thromboelastometry/elastography (ROTEM/TEG) showed promising results for diagnosis of sepsis-induced coagulopathy, but their association with the outcome is unclear. Our aim was to assess any difference in ROTEM/TEG measurements between septic survivors and non-survivors. METHODS:Pubmed, Web of Science, Emb...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.09.034
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To describe the associations between right ventricular (RV) function and outcomes of patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS:This is a retrospective study, conducted 2006-2015 at an academic hospital in USA. We included patients with AKI requirin...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.11.022
更新日期:2020-11-30 00:00:00
abstract:PURPOSE:The prognostic value of hyperlactatemia in septic shock is unquestionable. However, as current definitions do not include hyperlactatemia as a mandatory criterion, some hypotensive patients may be diagnosed as having septic shock despite exhibiting normolactatemia. The significance of persistent sepsis-induced ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.09.007
更新日期:2011-08-01 00:00:00
abstract:INTRODUCTION:Percutaneous dilational tracheostomy (PDT) is routinely performed in the intensive care unit with bronchoscopic guidance. Recently, ultrasound (US) has emerged as a new safety adjunct tool to increase the efficacy of PDT. However, the available data are limited to case series without any control group. Hen...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.011
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To evaluate the predictive value of 6 different biomarkers in the development of multiple-organ failure (MOF) and mortality in a contemporary prospective cohort of acute respiratory distress syndrome (ARDS). METHODS:Patients with ARDS admitted to a tertiary referral center during an 8-month period were include...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.001
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS:We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2017.08.008
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS:We assessed 6929 consecutive patients...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.07.001
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:The purpose of the study was to investigate the pharmacokinetics of combined intravenous (i.v.) and intracerebroventricular (i.c.v.) vancomycin for patients with intracranial infections after craniotomy and to provide the basis for establishing the intracranial local administration criterion. METHODS:Fourtee...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.09.020
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:Increasingly, hospitals are engaging in continuous quality improvement (CQI) endeavors, aimed at optimizing patient care. Physician involvement is critical to the success of such initiatives. Little is known about any mediating factors that affect physician participation in these projects, though such knowledge...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1053/jcrc.2001.30165
更新日期:2001-12-01 00:00:00
abstract:BACKGROUND:The ICU is a scarce resource within a high-stress, high-stakes, time-sensitive environment where critically ill patients with life-threatening conditions receive expensive life-sustaining care under the guidance of expert qualified personnel. The implications of decisions such as suitability for admission in...
journal_title:Journal of critical care
pub_type:
doi:10.1016/j.jcrc.2018.11.027
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Platelets play a key role in the genesis of thrombosis. Plateletcrit (PCT) provides complete information on total platelet mass. The relationship between PCT values and long-term outcomes in patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary angioplasty is not known. We sought ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.07.001
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:The study aimed to determine whether improvements in intensive care unit (ICU) structural environment affect the incidence of ICU-acquired infections (IAIs), particularly those caused by multidrug-resistant pathogens. METHODS:The incidence of IAI and the number of infections caused by organisms during the 6 mo...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2012.12.013
更新日期:2013-08-01 00:00:00
abstract::Noninvasive positive pressure ventilation has been demonstrated to be of benefit in preventing endotracheal intubation and reducing mortality in specific patients in the setting of acute exacerbations of chronic obstructive pulmonary disease. The successful application of noninvasive positive pressure ventilation depe...
journal_title:Journal of critical care
pub_type: 指南,杂志文章,实务指引
doi:10.1016/j.jcrc.2004.04.006
更新日期:2004-06-01 00:00:00
abstract:PURPOSE:The purpose of the study is to reduce unnecessary ordering of routine-priority blood tests. METHODS:In this before-after study, we studied all patients admitted to a 15-bed tertiary intensive care unit (ICU) from July 1, 2011, to June 27, 2013. Based on input from intensivists, acceptable indications for order...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2015.09.013
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:Pneumothorax is present as a frequent complication in acute respiratory distress syndrome (ARDS). Persistent air leak (PAL) prolongs pneumothorax in 2% of cases of ARDS, increasing the rate of mortality by 26%. Pleurodesis using autologous blood (PAB) is an effective method in cases of oncological pulmonary s...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2005.10.003
更新日期:2006-06-01 00:00:00
abstract:PURPOSE:To examine the impact of the COVID-19 pandemic on the presentation and care provided to patients with acute ischemic stroke (AIS) at the emergency department (ED). METHOD:A retrospective-archive study was conducted between January-April 2020, compared with the parallel months in 2017-2019, in a comprehensive s...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2020.12.011
更新日期:2020-12-26 00:00:00
abstract:PURPOSE:The purpose of study was to evaluate the clinical results of early stabilization of spine fractures in polytrauma patients. MATERIALS AND METHODS:Between August 2003, and May 2012, 166 polytrauma patients with thoracolumbar spine fractures were included. Patients were divided into 2 groups according to injury-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2014.03.003
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:To assess the atrial systolic function and the contribution of atrial contraction to left ventricular (LV) filling in septic shock patients as compared with healthy volunteers. METHODS:Twenty-seven septic patients evaluated during first 48 h of ICU admission and compared with 27 healthy volunteers. Left atrial...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.09.006
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:Sepsis damages the endothelial glycocalyx, contributing to fluid extravasation, organ injury, and death. Our goal was to determine if syndecan-1 level is associated with the risk of intubation and modifying effect of intravenous fluids (IVFs) in these patients. METHODS:Syndecan-1 was measured at enrollment in ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2016.06.027
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To quantify resource requirements (additional beds and ventilator capacity), for critical care services in the event of pandemic influenza. MATERIALS AND METHODS:Cross-sectional survey about existing and potential critical care resources. Participants comprised 156 of the 176 Australasian (Australia and New...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2003.08.008
更新日期:2003-09-01 00:00:00
abstract:PURPOSE:In the vascularly isolated canine hemidiaphragm, we tested the hypothesis that alpha-adrenoreceptor stimulation may influence diaphragmatic function and O2 extraction during reductions in O2 delivery (QO2di). METHODS:The diaphragm was perfused using a constant flow pump with blood diverted from the left femora...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/s0883-9441(96)90016-7
更新日期:1996-03-01 00:00:00
abstract:PURPOSE:The aim of the present study was to explain why extravascular lung water index (EVLWI) is higher and why global end-diastolic blood volume index (GEDVI) is lower in young children when measured with the PiCCO system (Pulsion, Munich, Germany). MATERIALS AND METHODS:We pooled available data from literature from...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2010.10.014
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:Cervical spine (CS) injury in blunt trauma is a prevalent and devastating complication. Clearing CS injuries in obtunded patients is fraught with challenges, and no single imaging modality or algorithm is both safe and effective. Increased time in c-spine precautions is associated with greater patient morbidity...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
doi:10.1016/j.jcrc.2013.10.022
更新日期:2014-04-01 00:00:00
abstract:PURPOSE:To examine relationships between self-report and performance-based measures of physical function in ICU patients randomized to standardized rehabilitation therapy (SRT) or usual care (UC). METHODS:Physical function was assessed in 257 ICU patients using self-report (physical functioning scale of the SF-36 (SF-...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2019.01.020
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Continuous renal replacement therapy (CRRT) is an important tool in the care of critically ill patients. However, the impact of a specific CRRT machine type on the successful delivery of CRRT is unclear. The purpose of this study was to evaluate the effectiveness of CRRT delivery with an intensive care unit ...
journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.11.012
更新日期:2014-04-01 00:00:00