Journal of critical care
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Journal of critical care · Apr 2021
Including urinary output to define AKI enhances the performance of machine learning models to predict AKI at admission.
Acute kidney injury (AKI) is a prevalent and detrimental condition in intensive care unit patients. Most AKI predictive models only predict creatinine-triggered AKI (AKICr) and might underperform when predicting urine-output-triggered AKI (AKIUO). We aimed to describe how admission AKICr prediction models perform in all AKI patients. ⋯ Ignoring urine output in the outcome during model training resulted in models that are unlikely to predict AKIUO adequately and may miss a substantial proportion of patients in practice.
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Journal of critical care · Apr 2021
Comparison of shock reversal with high or low dose hydrocortisone in intensive care unit patients with septic shock: A retrospective cohort study.
This study aims to describe differences in shock reversal between hydrocortisone 200 mg and 300 mg per day dosing regimens in patients with septic shock. ⋯ Low and high dose hydrocortisone have similar rates of shock reversal in septic shock patients. Hydrocortisone 100 mg every 8 h may reduce rates of recurrence of shock and reduce the need for additional vasopressors.
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Journal of critical care · Apr 2021
Short-and long-term outcomes of sustained low efficiency dialysis vs continuous renal replacement therapy in critically ill patients with acute kidney injury.
Sustained low efficiency dialysis (SLED) has emerged as an alternative to continuous renal replacement therapy (CRRT) for the treatment of acute kidney injury (AKI) in critically ill patients. However, there is limited information on the short- and long-term outcomes of SLED compared to CRRT. ⋯ Among critically ill patients with acute kidney injury, mortality at 90 days and one year was not different among patients initiating SLED as compared to CRRT.
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Journal of critical care · Apr 2021
Observational StudyIntra-abdominal hypertension, fluid balance, and adverse outcomes after orthotopic liver transplantation.
Intra-abdominal hypertension (IAH) is frequently encountered in critically ill surgical patients. We aimed to evaluate the incidence of IAH after orthotopic liver transplant (OLT) and its impact on organ function, hospital length-of-stay (LOS), and death. ⋯ After OLT, nearly half of the patients presented IAH, that was associated with unfavorable outcomes.
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Journal of critical care · Apr 2021
Multicenter StudyImpact of early ICU admission for critically ill cancer patients: Post-hoc analysis of a prospective multicenter multinational dataset.
Early intensive care unit (ICU) admission, in Critically Ill Cancer Patients (CICP), is believed to have contributed to the prognostic improvement of critically ill cancer patients. The primary objective of this study was to assess the association between early ICU admission and hospital mortality in CICP. ⋯ In this cohort, early ICU admission was not associated with a better outcome after adjustment for confounder and center effect. The uncertainty with regard to the beneficial effect of early ICU on hospital mortality suggests the need for an interventional study.