Journal of critical care
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Journal of critical care · Feb 2021
Meta AnalysisHypoalbuminemia is associated with increased risk of acute kidney injury in hospitalized patients: A meta-analysis.
Previous systematic review suggested that hypoalbuminemia is associated with increased risk of acute kidney injury (AKI). However, pooled sample size was small, and there was no universal definition for AKI. ⋯ Hypoalbuminemia is associated with AKI in hospitalized patients. However, the effect on mortality is subjected to publication bias.
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Journal of critical care · Feb 2021
Preventing infectious diseases in Intensive Care Unit by medical devices remote control: Lessons from COVID-19.
The management of COVID-19 patients in the ICUs requires several and prolonged life-support systems (mechanical ventilation, continuous infusions of medications and nutrition, renal replacement therapy). Parameters have to be entered continuously into the device user interface by healthcare personnel according to the dynamic clinical condition. ⋯ Cables and tubing extensions have been utilized to make certain devices usable outside the patient's room but at the cost of introducing further hazards. Remote control of these devices decreases the frequency of unnecessary interventions and reduces the risk of exposure for both patients and healthcare personnel.
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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
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.
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Journal of critical care · Feb 2021
Observational StudyDischarge from hospital with newly administered antipsychotics after intensive care unit delirium - Incidence and contributing factors.
Delirium in the intensive care unit (ICU) is often treated with haloperidol or atypical antipsychotics. Antipsychotic treatment can lead to severe adverse effects and excess mortality. After initiation in the ICU, patients are at risk of having their antipsychotics continued unnecessarily at ICU and hospital discharge. This study aims to determine the incidence of, and risk factors for antipsychotic continuation at hospital discharge after ICU delirium. ⋯ Approximately one in five patients were discharged from the hospital with continued antipsychotics. Hospital policies should implement strategies for systematic antipsychotic tapering and better follow-up of antipsychotics at transitions of care.