Intensive care medicine
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Intensive care medicine · Jun 2020
Retraction Of PublicationRetraction Note to: The impact of fluid therapy on microcirculation and tissue oxygenation in hypovolemic patients: a review.
The Editor-in-Chief has retracted this article [1] because a number of studies included in this review [2, 3, 4] (originally cited as references 24, 49, 51) have subsequently been retracted. This has rendered the content of the review unreliable.
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Intensive care medicine · Jun 2020
Review Meta AnalysisDiagnosis of ventilator-associated pneumonia in critically ill adult patients-a systematic review and meta-analysis.
The accuracy of the signs and tests that clinicians use to diagnose ventilator-associated pneumonia (VAP) and initiate antibiotic treatment has not been well characterized. We sought to characterize and compare the accuracy of physical examination, chest radiography, endotracheal aspirate (ETA), bronchoscopic sampling cultures (protected specimen brush [PSB] and bronchoalveolar lavage [BAL]), and CPIS > 6 to diagnose VAP. We searched six databases from inception through September 2019 and selected English-language studies investigating accuracy of any of the above tests for VAP diagnosis. ⋯ CPIS > 6 had a sensitivity of 73.8% (95% CI 50.6-88.5) and specificity of 66.4% (95% CI 43.9-83.3). Classic clinical indicators had poor accuracy for diagnosis of VAP. Reliance upon these indicators in isolation may result in misdiagnosis and potentially unnecessary antimicrobial use.
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Intensive care medicine · Jun 2020
Multicenter StudyHigh risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study.
Little evidence of increased thrombotic risk is available in COVID-19 patients. Our purpose was to assess thrombotic risk in severe forms of SARS-CoV-2 infection. ⋯ Despite anticoagulation, a high number of patients with ARDS secondary to COVID-19 developed life-threatening thrombotic complications. Higher anticoagulation targets than in usual critically ill patients should therefore probably be suggested.