Journal of critical care
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Journal of critical care · Oct 2019
Observational StudyOptimal norepinephrine-equivalent dose to initiate epinephrine in patients with septic shock.
The specific norepinephrine dose at which epinephrine should be added in septic shock is unclear. This study sought to determine the norepinephrine-equivalent dose at epinephrine initiation that correlated with hemodynamic stability. ⋯ Initiation of epinephrine when patients were receiving norepinephrine-equivalent doses of 37-133 μg/min was associated with a higher rate of hemodynamic stability.
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Journal of critical care · Oct 2019
Risk factors for new-onset atrial fibrillation on the general adult ICU: A systematic review.
This study was performed to systematically review the available evidence for the risk factors for new-onset atrial fibrillation (NOAF) on the general adult intensive care unit (ICU) and provide a semi-quantitative evidence synthesis. ⋯ We provide the first systematic review with evidence synthesis of risk factors for NOAF on the general adult ICU. Evidence for modifiable risk factors was limited. Further research is therefore required and may contribute towards the evidence-based prevention and management of this important condition.
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Journal of critical care · Oct 2019
Multicenter StudySafety and efficacy of beta-blockers to improve oxygenation in patients on veno-venous ECMO.
Beta-blockers (BB) may improve oxygenation in patients on veno-venous extracorporeal membrane oxygenation (V-V ECMO). This study analyzed safety and efficacy of BB in hypoxemic patients on V-V ECMO. ⋯ In this study, use of BB in hypoxemic patients on V-V ECMO was safe and associated with a moderate increase in SaO2.
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Journal of critical care · Oct 2019
Observational StudyCentral venous-to-arterial carbon dioxide difference combined with arterial-to-venous oxygen content difference (PcvaCO2/CavO2) reflects microcirculatory oxygenation alterations in early septic shock.
To explore the relationship between central venous-to-arterial carbon dioxide difference (PcvaCO2), PcvaCO2/arterial-venous oxygen content difference ratio (PcvaCO2/CavO2) and the microcirculatory status, evaluated by using near-infrared spectroscopy, in septic shock patients. ⋯ In a population of early septic shock patients, increases in PcvaCO2 and PcvaCO2/CavO2 reflected different alterations at the microcirculatory level. While PcvaCO2 was related to global flow, the PcvaCO2/CavO2 ratio was associated to impaired local oxygen utilization and diminished microvascular reactivity.
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Journal of critical care · Oct 2019
Observational StudyEarly prediction of treatment failure in severe community-acquired pneumonia: The PRoFeSs score.
To identify a single/panel of biomarkers and to provide a point score that, after 48 h of treatment, could early predict treatment failure at fifth day of Intensive Care Unit (ICU) stay in severe community-acquired pneumonia (SCAP) patients. ⋯ In SCAP, a combination of biomarkers measured at admission and 48 h later may early predict treatment failure. PRoFeSs score may recognize patients with poor short-term prognosis.