Abstract：
PURPOSE:To find predictors of intensive care unit (ICU) requirement within the first 48 hours in newly diagnosed sepsis patients presenting at the emergency department. MATERIALS AND METHODS:Analysis of a prospective observational cohort was performed. We recruited new sepsis patients at the emergency department, and collected baseline characteristics and parameters. Variables were compared between patients: those that required ICU within 48 hours and those that did not. Multivariate analysis was performed to identify independent predictors. RESULTS:Out of 719 patients enrolled, 275 were confirmed to have sepsis. There were 107 patients (39%) that required ICU admission within 48 hours. Independent predictors for ICU requirement were: lower body temperature (P = .019), initial lactate (P = .02), 2-hour lactate clearance (P = .035), and the Sequential Organ Failure Assessment (SOFA) score without cardiovascular component (SOFA no CVS) (P < .001). The optimal cutoff values for the two strongest predictors were: SOFA no CVS ≥5 (adjusted OR, 5.3; 95% CI, 1.9-14.7) and initial lactate ≥1.9 mmol/L (adjusted OR, 3.3; 95% CI, 1.2-8.9). We also proposed a combined "LACTIC score" with higher predictive ability. CONCLUSIONS:We suggested a way to predict ICU requirement in sepsis patients and proposed a combined score that might be better than individual parameters. Further validation should be performed before using them clinically.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Junhasavasdikul D,Theerawit P,Ingsathit A,Kiatboonsri Sdoi
10.1016/j.jcrc.2016.01.019subject
Has Abstractpub_date
2016-06-01 00:00:00pages
71-7eissn
0883-9441issn
1557-8615pii
S0883-9441(16)00020-4journal_volume
33pub_type
杂志文章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：PURPOSE:The aim of this study was to validate and compare the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) IV in the Dutch intensive care unit (ICU) population to the APACHE II and Simplified Acute Physiology Score (SAPS) II. MATERIALS AND METHODS:This is a prospective study based on data...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.07.007
更新日期：2011-02-01 00:00:00
abstract：OBJECTIVES:In certain populations, social, legal, and religious factors may influence end-of-life decisions in ventilator-dependent patients. This study aims to evaluate attitudes of first-degree relatives of chronically ventilated patients in Israel, toward end-of-life decisions regarding their loved ones, themselves,...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2009.01.011
更新日期：2009-06-01 00:00:00
abstract：PURPOSE:The aims of the study were to assess opinions of caregivers, families, and patients about involvement of families in the care of intensive care unit (ICU) patients; to evaluate the prevalence of symptoms of anxiety and depression in family members; and to measure family satisfaction with care. MATERIALS AND ME...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2010.03.001
更新日期：2010-12-01 00:00:00
abstract：PURPOSE:Continuous electroencephalography (cEEG) improves monitoring of the brain in unconscious patients, but implementation at ICU is difficult. The present investigation shows a way to introduce cEEG at an anesthesiological ICU and discusses the first experiences. MATERIALS AND METHODS:The study analyzed the feasib...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.01.015
更新日期：2017-06-01 00:00:00
abstract：PURPOSE:To discharge a patient from the intensive care unit (ICU) is a complex decision-making process because in-hospital mortality after critical illness may be as high as up to 27%. Static C-reactive protein (CRP) values have been previously evaluated as a predictor of post-ICU mortality with conflicting results. Th...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.10.013
更新日期：2012-10-01 00:00:00
abstract：PURPOSE:To determine the neurologic outcome of patients with intracranial hypertension treated with barbiturate-induced coma. MATERIALS AND METHODS:The records of 49 patients who were admitted to a 31-bed medicosurgical intensive care unit over a 5-year period in whom a barbiturate coma was induced to control intracra...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2002.33032
更新日期：2002-03-01 00:00:00
abstract：PURPOSE:The purpose of this study is to determine the effect of postoperative fluid balance (FB) on subsequent outcomes in acute care surgery (ACS) patients admitted to the surgical intensive care unit (ICU). MATERIAL AND METHODS:Acute care surgery patients admitted to the surgical ICU from 06/2012 to 01/2013 were fol...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2014.06.023
更新日期：2014-12-01 00:00:00
abstract：PURPOSE:To explore the effect of emotion priming and physician communication behaviors on optimism bias. MATERIALS AND METHODS:We conducted a 5 × 2 between-subject randomized factorial experiment using a Web-based interactive video designed to simulate a family meeting for a critically ill spouse/parent. Eligibility i...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2015.11.015
更新日期：2016-04-01 00:00:00
abstract：PURPOSE:In mechanically ventilated patients, the endotracheal tube is an essential interface between the patient and ventilator, but inadvertently, it also facilitates the development of ventilator-associated pneumonia (VAP) by subverting pulmonary host defenses. A number of investigations suggest that bacteria coloniz...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2016.07.019
更新日期：2017-02-01 00:00:00
abstract：INTRODUCTION:The objective of the study to is to determine the characteristics associated with endotracheal intubation in septic shock patients. METHODS:This is a post hoc analysis of the database of the SEPSISPAM study, including patients with septic shock. RESULTS:Among the 776 patients, 633 (82%) were intubated wi...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jcrc.2015.08.018
更新日期：2015-12-01 00:00:00
abstract：BACKGROUND:Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI. METHODS:We performed a qualitative research study using grounded theory analyses of interviews with medical dir...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2012.07.010
更新日期：2012-12-01 00:00:00
abstract：PURPOSE:To evaluate the associations between strained ICU capacity and patient outcomes. METHODS:Multi-center population-based cohort study of nine integrated ICUs in Alberta, Canada. Path-analysis modeling was adopted to investigate direct and indirect associations between strain (available beds ≤1; occupancy ≥95%) a...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jcrc.2017.08.032
更新日期：2018-02-01 00:00:00
abstract：PURPOSE:We sought to investigate the relationship between high CVP, AKI, and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass. MATERIALS:All patients aged 18 years or older who underwent cardiac surgery with CPB were prospectively reviewed. Patients were excluded when renal artery were invo...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.08.034
更新日期：2018-12-01 00:00:00
abstract：BACKGROUND:Studies investigating the metabolic effects of citrate-based substitution fluids are lacking. This study aims to compare the effect of citrate- vs bicarbonate-based substitution fluid used during continuous venovenous hemofiltration (CVVH) for acute kidney injury on acid-base balance and electrolytes in crit...
journal_title：Journal of critical care
pub_type： 临床试验,杂志文章
doi：10.1016/j.jcrc.2009.02.013
更新日期：2010-03-01 00:00:00
abstract：PURPOSE:Closed endotracheal suctioning (CES) may impact ventilator-associated pneumonia (VAP) risk by reducing environmental contamination. In developing countries where resource limitations constrain the provision of optimal bed space for critically ill patients, CES assumes greater importance. MATERIALS AND METHODS:...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2010.10.002
更新日期：2011-10-01 00:00:00
abstract：PURPOSE:We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE). MATERIALS AND METHODS:We conducted an observational cohort study over a 3-year period in a 28-bed emergency intensive care unit (EICU) and prospectively included all consecutive patie...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2017.01.001
更新日期：2017-06-01 00:00:00
abstract：PURPOSE:This paper describes the methodology of a clinical trial of prone positioning in pediatric patients with acute lung injury (ALI). Nonrandomized studies suggest that prone positioning improves oxygenation in patients with ALI/acute respiratory distress syndrome without the risk of serious iatrogenic injury. It i...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jcrc.2005.12.004
更新日期：2006-03-01 00:00:00
abstract：PURPOSE:There is wide variation in the practice of acute renal replacement therapy (RRT). Quality of care is suboptimal, and substantial knowledge-to-care gaps need to be addressed. The quality of care for patients receiving acute RRT has been recognized as a clinical and research priority. Quality indicators (QIs) can...
journal_title：Journal of critical care
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jcrc.2019.07.003
更新日期：2019-12-01 00:00:00
abstract：PURPOSE:The purpose of this study is to assess lipid metabolism at the tissue level in critically ill subjects. MATERIALS AND METHODS:We studied 182 patients with systemic inflammatory response syndrome/severe sepsis or shock during the acute (day 1) and subacute phase of critical illness (day 6). All subjects had a t...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2014.06.003
更新日期：2014-12-01 00:00:00
abstract：PURPOSE:A volume challenge is useful for determining whether cardiac output will respond to further volume loading by the Frank-Starling mechanism. To properly test this mechanism, there must be an increase in right atrial pressure (Pra) but this requires variable amounts of normal saline. The purpose of this study was...
journal_title：Journal of critical care
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0883-9441(99)90030-8
更新日期：1999-12-01 00:00:00
abstract：PURPOSE:There is a paucity of literature to support undertaking emergency laparotomy when indicated in patients supported on ECMO. Our study aims to identify the prevalence, outcomes and complications of this high risk surgery at a large ECMO centre. MATERIALS AND METHODS:A single centre, retrospective, observational ...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2019.06.021
更新日期：2019-10-01 00:00:00
abstract：PURPOSE:Pediatric venous thromboembolism (VTE) is becoming an increasingly recognized morbidity associated with critical illness. The objective of this survey is to identify the patient factors and radiological features that pediatric intensivists consider more or less likely to make a venous thrombosis (VTE) clinicall...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2005.09.012
更新日期：2005-12-01 00:00:00
abstract：PURPOSE:The Fas ligand (FasL)/Fas system is an apoptosis induction system that plays an important role in homeostasis and biophylaxis. We measured tumor necrosis factor alpha (TNF-alpha), soluble FasL (sFasL), and soluble Fas (sFas) in patients with acute hepatic failure to determine the relation between such failure a...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1053/jcrc.2001.25470
更新日期：2001-06-01 00:00:00
abstract：PURPOSE:The ratio of right ventricular end-diastolic diameter (EDD) to left ventricular EDD (RV/LV) is a measure predictive of right ventricular failure. We hypothesized that an increase in RV/LV would be associated with poor prognosis in severe sepsis and septic shock. MATERIALS AND METHODS:This is a retrospective ch...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2018.09.025
更新日期：2018-12-01 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：BACKGROUND:Thoracic surgery patients are at high-risk for adverse pulmonary outcomes. Heated humidified high-flow nasal cannula oxygen (HHFNC O2) may decrease such events. We hypothesized that patients randomized to prophylactic HHFNC O2 would develop fewer pulmonary complications compared to conventional O2 therapy. ...
journal_title：Journal of critical care
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jcrc.2017.04.023
更新日期：2017-08-01 00:00:00
abstract：PURPOSE:The purpose of this narrative review is to provide practical and useful guidance for clinicians considering the use of intravenous ketamine for its analgosedative properties in adult, critically ill patients. METHODS:MEDLINE was searched from inception until January 2016. Articles related to the pharmacologica...
journal_title：Journal of critical care
pub_type： 杂志文章,评审
doi：10.1016/j.jcrc.2016.05.016
更新日期：2016-10-01 00:00:00
abstract：PURPOSE:Family-clinician communication in the intensive care unit (ICU) about withholding and withdrawing life support occurs frequently, yet few data exist to guide clinicians in its conduct. The purpose of this study was to develop an understanding of the way this communication is currently conducted. METHODS:We ide...
journal_title：Journal of critical care
pub_type： 杂志文章,多中心研究
doi：10.1053/jcrc.2002.35929
更新日期：2002-09-01 00:00:00
abstract：PURPOSE:The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with p...
journal_title：Journal of critical care
pub_type： 杂志文章
doi：10.1016/j.jcrc.2011.07.073
更新日期：2012-06-01 00:00:00
