Journal of critical care
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Journal of critical care · Apr 2020
Developing the family support tool: An interactive, web-based tool to help families navigate the complexities of surrogate decision making in ICUs.
Although family members of incapacitated, critically ill patients often struggle in the role of surrogate decision maker, there are no low-cost, easily-scaled interventions to address this problem. ⋯ We successfully developed a web-based tool to help individuals navigate the complexities of surrogate decision making in ICUs that has high potential for scalability. Surrogates judged the tool to be usable, acceptable, and effective. These data support proceeding to test the tool in a pilot randomized clinical trial.
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Journal of critical care · Apr 2020
Observational StudyLow serum albumin levels and new-onset atrial fibrillation in the ICU: a prospective cohort study.
The aim was to determine if a low serum albumin (SA) level was associated with the occurrence of new onset atrial fibrillation (NOAF) during the first 48 h of intensive care unit (ICU) admission. ⋯ In this small hypothesis generating study low levels of SA were associated with the occurrence of NOAF. It remains to be shown if increasing SA levels lowers the incidence of NOAF.
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Journal of critical care · Apr 2020
Clinical TrialDynamic optic nerve sheath diameter changes upon moderate hyperventilation in patients with traumatic brain injury.
Sonographic assessment of optical nerve sheath diameter (ONSD) has the potential for non-invasive monitoring of intracranial pressure (ICP). Hyperventilation (HV) -induced hypocapnia is used in the management of patients with traumatic brain injury (TBI) to reduce ICP. This study investigates, whether sonography is a reliable tool to detect dynamic changes in ONSD. ⋯ We observed a dynamic decrease of ONSD during moderate HV. This suggests a potential use of serial ONSD measurements when applying HV in cases of suspected intracranial hypertension.
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Journal of critical care · Apr 2020
Muscle wasting associated co-morbidities, rather than sarcopenia are risk factors for hospital mortality in critical illness.
Low skeletal muscle mass on intensive care unit admission is related to increased mortality. It is however unknown whether this association is influenced by co-morbidities that are associated with skeletal muscle loss. The aim of this study was to investigate whether sarcopenia is an independent risk factor for hospital mortality in critical illness in the presence of co-morbidities associated with muscle wasting. ⋯ In critically ill patients with abdominal sepsis, muscle wasting associated co-morbidities rather than sarcopenia were risk factors for hospital mortality.
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Journal of critical care · Apr 2020
Impact of obstructive sleep apnea on the obesity paradox in critically ill patients.
Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients. ⋯ In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.