Journal of critical care
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Journal of critical care · Dec 2020
Multicenter StudyTiming of resumption of beta-blockers after discontinuation of vasopressors is not associated with post-operative atrial fibrillation in critically ill patients recovering from non-cardiac surgery: A retrospective cohort analysis.
Post-operative atrial fibrillation is a complication with high morbidity. In patients on prior-to-admission beta-blockers, early post-operative beta-blockade reduces atrial fibrillation risk; however, this benefit is not studied in hemodynamically unstable patients requiring vasopressors. ⋯ In patients requiring postoperative vasopressors, early beta-blockade did not protect against postoperative atrial fibrillation.
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Journal of critical care · Dec 2020
ReviewLinking of global intensive care (LOGIC): An international benchmarking in critical care initiative.
Benchmarking is a common and effective method for measuring and analyzing ICU performance. With the existence of national registries, objective information can now be obtained to allow benchmarking of ICU care within and between countries. ⋯ We showed large differences in the utilization of ICU as well as resources and in outcomes. Despite the need for careful interpretation of differences due to variation in definitions and limited risk adjustment, LOGIC is a growing worldwide initiative that allows access to insightful epidemiologic data from ICUs in multiple databases and registries.
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Journal of critical care · Dec 2020
Multicenter Study Clinical TrialTherapy limitation in octogenarians in German intensive care units is associated with a longer length of stay and increased 30 days mortality: A prospective multicenter study.
The approach to limit therapy in very old intensive care unit patients (VIPs) significantly differs between regions. The focus of this multicenter analysis is to illuminate, whether the Clinical Frailty Scale (CFS) is a suitable tool for risk stratification in VIPs admitted to intensive care units (ICUs) in Germany. Furthermore, this investigation elucidates the impact of therapeutic limitation on the length of stay and mortality in this setting. ⋯ In German ICUs, any limitation of life-sustaining therapy in VIPs is associated with a significantly increased ICU length of stay and mortality. CFS reliably predicts the outcome.
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Journal of critical care · Dec 2020
Case ReportsReflux events detected by multichannel bioimpedance smart feeding tube during high flow nasal cannula oxygen therapy and enteral feeding: First case report.
The use of high flow nasal cannula (HFNC) oxygen therapy is common in patients with respiratory distress to prevent intubation or ensure successful extubation. However, these critical patients also need medical nutritional support and practitioners are often reluctant to prescribe oral or enteral feeding, leading to a decrease in energy and protein intake. ⋯ A new technology detecting the presence and duration of gastro-esophageal reflux and preventing aspiration in real-time has been developed and our case shows how HFNC oxygen therapy exposes patients to significantly more reflux events as compared to mechanical ventilation. This is the first description of this technique observed in critical care.
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Journal of critical care · Dec 2020
Randomized Controlled TrialThe effect of small versus large clog size on emergency response time: A randomized controlled trial.
To assess the effect on healthcare professional emergency response time and safety of small compared to large clog size. ⋯ European size 38 clogs lead to faster emergency response times than size 47 clogs.