Journal of critical care
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Journal of critical care · Dec 2019
Optimal vancomycin dosing regimens for critically ill patients with acute kidney injury during continuous renal replacement therapy: A Monte Carlo simulation study.
This study aims to determine the optimal vancomycin dosing in critically ill patients with acute kidney injury receiving continuous renal replacement therapy (CRRT) using Monte Carlo simulation. ⋯ A higher dose of vancomycin than the current literature-based recommendation was needed in CRRT patients.
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Journal of critical care · Dec 2019
Patient characteristics, ICU-specific supports, complications, and outcomes of persistent critical illness.
The primary objective was to identify the proportion of patients on mechanical ventilation (MV) beyond day 10, the recently defined time of onset of Persistent Critical Illness (PerCI). The secondary objective was to identify underlying diagnoses, intensive care unit (ICU) based therapies, relevant complications, and outcomes of patients with PerCI. ⋯ Mechanical ventilation beyond day 10 affected only two thirds of PerCI patients. However, VAP was a key complication in such patients. Discharge to chronic care facilities and hospital mortality were more common in PerCI patients.
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Journal of critical care · Dec 2019
Activation of pituitary axis according to underlying critical illness and its effect on outcome.
Critical illness is a life threatening condition inducing a severe acute physical stress. The aim of the study was to investigate the activation of pituitary axis early after ICU admission in patients with critical illnesses of different etiology and its association with outcome. ⋯ Pituitary axis function is frequently altered early after ICU admission, the magnitude of hormonal response being different according to the underlying critical illness. The activation of the hypothalamic pituitary adrenal axis was a strong predictor of ICU mortality.
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Journal of critical care · Dec 2019
Acute critically ill elderly patients: What about long term caregiver burden?
Acute critical illness induce a high caregivers burden in the young population, however data in the older population are lacking. The objectives of this study were to evaluate caregiver burden in a critically ill old population and to assess factors associated with mild to severe burden level. ⋯ In our study, functional status and mental health at 6 months were associated with mild to severe burden unlike age and admission in ICU.
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Journal of critical care · Dec 2019
Cardiac output during targeted temperature management and renal function after out-of-hospital cardiac arrest.
After resuscitation from out-of-hospital cardiac arrest (OHCA), renal injury and hemodynamic instability are common. We aimed to assess the association between low cardiac output during targeted temperature management (TTM) and acute kidney injury (AKI) after OHCA. ⋯ Blood pressure, heart rate and lactate, but not cardiac output, during 24 h of TTM were associated with AKI in comatose OHCA-patients.