Intensive care medicine
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Intensive care medicine · Dec 2018
Multicenter Study Observational StudyAssociation of social deprivation with 1-year outcome of ICU survivors: results from the FROG-ICU study.
Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible for poor long-term outcomes would be beneficial in designing targeted interventions for at-risk populations. ⋯ A lower socioeconomic status was associated with lower self-reported physical component scores in the nondeprived patients. Psychiatric symptoms are frequently reported after an ICU stay, and subsequent interventions should target those fields.
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Intensive care medicine · Dec 2018
Randomized Controlled TrialRestricted fluid resuscitation in suspected sepsis associated hypotension (REFRESH): a pilot randomised controlled trial.
To determine if a regimen of restricted fluids and early vasopressor compared to usual care is feasible for initial resuscitation of hypotension due to suspected sepsis. ⋯ A regimen of restricted fluids and early vasopressor in ED patients with suspected sepsis and hypotension appears feasible. Illness severity was moderate and mortality rates low. A future trial is necessary with recruitment of high-risk patients to determine effects on clinical outcomes in this setting.
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Intensive care medicine · Dec 2018
Multicenter StudyUnrecognised myocardial infarction and its relationship to outcome in critically ill patients with cardiovascular disease.
To establish the incidence of myocardial infarction (MI) in ICU patients with co-existing cardiovascular disease (CVD), and explore its association with long-term survival. ⋯ Undiagnosed MI occurs in around a quarter of critically ill patients with co-existing CVD and is associated with lower long-term survival.
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Intensive care medicine · Dec 2018
Multicenter Study Observational StudyTiming of onset of persistent critical illness: a multi-centre retrospective cohort study.
Persistent critical illness has been described as a subtype of chronic critical illness, characterized as a transition after ICU admission where primary diagnosis and illness acuity are no better at predicting outcome than pre-hospital characteristics. Herein we describe the occurrence and outcomes associated with persistent critical illness in a large Canadian health region. ⋯ Persistent critical illness occurred in one in six patients admitted to Alberta ICUs and portended greater risk of death, prolonged ICU and hospital stay, and disproportionate use of health resources compared to patients without persistent critical illness.
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Intensive care medicine · Dec 2018
Randomized Controlled TrialTargeting two different levels of both arterial carbon dioxide and arterial oxygen after cardiac arrest and resuscitation: a randomised pilot trial.
We assessed the effects of targeting low-normal or high-normal arterial carbon dioxide tension (PaCO2) and normoxia or moderate hyperoxia after out-of-hospital cardiac arrest (OHCA) on markers of cerebral and cardiac injury. ⋯ ClinicalTrials.gov, NCT02698917. Registered on January 26, 2016.