Journal of critical care
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Journal of critical care · Apr 2021
Observational StudyIntermittent versus continuous neuromuscular blockade during target temperature management after cardiac arrest: A nationwide observational study.
Whether intermittent or continuous neuromuscular-blocking agents (NMBAs) would be appropriate during target temperature management (TTM) after cardiac arrest remains unclear. ⋯ This large retrospective study did not suggest that intermittent NMBAs may be inferior to continuous NMBAs in terms of mortality reduction in the overall population receiving TTM for cardiac arrest. However, continuous NMBAs may be inferior to intermittent NMBAs for reducing mortality in elderly patients.
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Journal of critical care · Apr 2021
Development of a machine learning algorithm to predict intubation among hospitalized patients with COVID-19.
The purpose of this study is to develop a machine learning algorithm to predict future intubation among patients diagnosed or suspected with COVID-19. ⋯ In patients diagnosed or under investigation for COVID-19, machine learning can be used to predict future risk of intubation based on clinical data which are routinely collected and available in clinical setting. Such an approach may facilitate identification of high-risk patients to assist in clinical care.
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Journal of critical care · Apr 2021
Frailty and long-term outcomes following critical illness: A population-level cohort study.
To provide population-level estimates of the association of frailty with one-year outcomes after critical illness. ⋯ Patients with pre-existing frailty who develop critical illness have higher rates of hospital readmission and death than patients without frailty, and age modifies these associations. These data highlight the importance of considering both frailty and age when seeking to identify at-risk patients who might benefit from closer follow-up after discharge.
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Journal of critical care · Apr 2021
Evaluation of dexmedetomidine withdrawal in critically ill adults.
Dexmedetomidine (DEX) withdrawal syndrome has been reported in the pediatric population, but literature describing DEX withdrawal in critically ill adults is limited. The purpose of this study was to determine the incidence of DEX withdrawal in adult patients and to identify factors associated with DEX withdrawal syndrome. ⋯ Development of DEX-associated withdrawal occurred in approximately 30% of adult patients, comparable to rates reported in pediatric literature. There appeared to be no correlation between dose, exposure, and weaning in the occurrence of withdrawal, but concomitant discontinuation of opioids or benzodiazepines as well as ICU admission type could highlight cases requiring closer monitoring.
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Journal of critical care · Apr 2021
The use of automated pupillometry in critically ill cirrhotic patients with hepatic encephalopathy.
To evaluate whether pupillary abnormalities would correlate with the severity of encephalopathy in critically ill cirrhotic patients. ⋯ Pupillary function assessed by the automated pupillometry was poorly associated with encephalopathy scales in cirrhotic patients.