Journal of critical care
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Journal of critical care · Dec 2020
Observational StudyAssessment of electrical impedance tomography to set optimal positive end-expiratory pressure for veno-venous ECMO-treated severe ARDS patients.
Ultra-protective ventilation with low tidal volume is used in severe acute respiratory distress syndrome (ARDS) patients under extracorporeal membrane oxygenation (ECMO). However, the optimal positive end-expiratory pressure (PEEP) is unknown. The aim of our study was to assess electrical impedance tomography's (EIT) ability to choose the best PEEP for these patients. ⋯ Ultra-protective ventilation with low tidal volume is used in severe acute respiratory distress syndrome patients under extracorporeal membrane oxygenation (ECMO), but the optimal positive end-expiratory pressure is unknown. This trial shows that electrical impedance tomography may be an interesting non-invasive bedside tool to provide real-time monitoring of PEEP impact in severe ARDS patients under ECMO. The Pulmovista® electrical impedance tomography was provided by Dräger (Lübeck, Germany) during the study period. Dräger had no role in the study design, collection, analysis and interpretation of the data, writing the article, or the decision to submit the article for publication.
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Journal of critical care · Dec 2020
Observational StudyCOVID-19 in critically ill patients in North Brabant, the Netherlands: Patient characteristics and outcomes.
Since the SARS-CoV-2 pandemic, countries are overwhelmed by critically ill Coronavirus disease 2019 (COVID-19) patients. As ICU capacity becomes limited we characterized critically ill COVID-19 patients in the Netherlands. ⋯ The survival rate of COVID-19 critically ill patients in our population is considerably better than previously reported. Thrombotic complications are commonly found and merit clinical attention.
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Journal of critical care · Dec 2020
ReviewPrediction on critically ill patients: The role of "big data".
Accurate outcome prediction in Intensive Care Units (ICUs) would allow for better treatment planning, risk adjustment of study populations, and overall improvements in patient care. In the past, prognostic models have focused on mortality using simple ordinal severity of illness scores which could be tabulated manually by a human. With the improvements in computing power and proliferation of electronic medical records, entirely new approaches have become possible. Here we review the latest advances in outcome prediction, paying close attention to methods which are widely applicable and provide a high-level overview of the challenges the field currently faces.