Intensive care medicine
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Intensive care medicine · Sep 2021
Randomized Controlled TrialThe relationship between adrenocortical candidate gene expression and clinical response to hydrocortisone in patients with septic shock.
To determine if adrenocortical gene expression is associated with clinical outcomes or response to corticosteroid treatment in septic shock. ⋯ In patients with septic shock, there is no association between adrenocortical candidate gene expression and mortality. Patients with higher expression of GLCCI1 who received hydrocortisone achieved shock resolution faster than those receiving placebo; conversely, patients who had higher expression of BHSD1 who received hydrocortisone achieved shock resolution slower than those who received placebo. Variation in gene expression may be a mechanism for heterogeneity of treatment response to corticosteroids in septic shock.
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Intensive care medicine · Sep 2021
Meta AnalysisPharmacological and non-pharmacological interventions to prevent delirium in critically ill patients: a systematic review and network meta-analysis.
To compare the effects of prevention interventions on delirium occurrence in critically ill adults. ⋯ Compared to placebo and benzodiazepines, we found dexmedetomidine likely reduced the occurrence of delirium in critically ill adults. Compared to benzodiazepines, sedation-minimization strategies may also reduce delirium occurrence, but the evidence is uncertain.
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Intensive care medicine · Sep 2021
Multicenter Study Observational StudyManagement of arterial partial pressure of carbon dioxide in the first week after traumatic brain injury: results from the CENTER-TBI study.
To describe the management of arterial partial pressure of carbon dioxide (PaCO2) in severe traumatic brain-injured (TBI) patients, and the optimal target of PaCO2 in patients with high intracranial pressure (ICP). ⋯ Ventilation is manipulated differently among centers and in response to intracranial dynamics. PaCO2 tends to be lower in patients with ICP monitoring, especially if ICP is increased. Being in a centre which more frequently uses profound hyperventilation does not affect patient outcomes.
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Intensive care medicine · Sep 2021
Meta AnalysisAssociation between sepsis survivorship and long-term cardiovascular outcomes in adults: a systematic review and meta-analysis.
We aimed to determine the association between sepsis and long-term cardiovascular events. ⋯ Surviving sepsis may be associated with a long-term, excess hazard of late cardiovascular events which may persist for at least 5 years following hospital discharge.