Journal of critical care
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Journal of critical care · Feb 2021
ReviewOutcomes of severe Legionella pneumonia requiring extracorporeal membrane oxygenation (ECMO).
Legionella pneumonia with acute respiratory failure may necessitate extracorporeal membrane oxygenation (ECMO). The medical literature in this area is comprised primarily of case reports and small case series. Our goal was to summarize published data and contribute our institutional experience regarding survival in severe Legionella pneumonia requiring ECMO. ⋯ Review of clinical experience with ECMO for severe Legionella pneumonia yields a survival rate of over 70%. The similarity in survival rates among all published cases (78.1%), case series reporting surviving and non-surviving patients (71.7%), our institutional experience (80%), and recently reported Extracorporeal Life Support Organization (ELSO) registry data (71%) supports the veracity of this encouraging survival rate.
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Journal of critical care · Feb 2021
ReviewA mixed methods study to effectively utilize trigger tools in the ICU.
This study aimed to create a trigger tool for our intensive care units (ICUs) to support our departmental quality improvement efforts. ⋯ We used the modified Delphi process to derive consensus-selected triggers to identify ICU specific adverse events with opportunity for improvement in local care. This methodology can be adopted by other centers looking to introduce trigger tools in a manner selective to their practice needs.
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Journal of critical care · Feb 2021
Observational StudyMicrocirculation alterations in severe COVID-19 pneumonia.
To assess the presence of sublingual microcirculatory and skin perfusion alterations in COVID-19 pneumonia. ⋯ COVID-19 patients showed an altered tissue perfusion. Sublingual microcirculation was characterized by decreases in the proportion of perfused vessel and flow velocity along with high vascular densities. This last finding might be related to enhanced angiogenesis or hypoxia-induced capillary recruitment.
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Journal of critical care · Feb 2021
Case ReportsThe clinical spectrum of pulmonary thromboembolism in patients with coronavirus disease-2019 (COVID-19) pneumonia: A European case series.
To describe the clinical characteristics and outcomes of coronavirus disease-2019 (COVID-19)-associated pulmonary thromboembolism (PTE). ⋯ PTE is a potential life-threatening complication, which occurs frequently in patients with COVID-19. Intermediate therapeutic dose of anticoagulants and extend thromboprophylaxis are necessary after meticulous risk-benefit assessment.
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Journal of critical care · Feb 2021
Association of gender, age, and race on renal outcomes and mortality in patients with severe sepsis and septic shock.
The association of age, gender and race with renal outcomes in patients with severe sepsis and septic shock (SEP) is not completely elucidated. We aimed to shed light on these relationships. ⋯ Female gender is associated with a lower risk of poor renal outcomes and death among patients with SEP, while AA race places patients at higher risk of poor outcomes in that setting. Increasing age is generally associated with adverse outcomes.