Journal of critical care
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Journal of critical care · Aug 2021
Observational StudyEvaluation of ventilator associated events in critically ill patients with invasive mechanical ventilation: A prospective cohort study at a resource limited setting in Northern India.
The primary aim of this study was to identify the modifiable risk factors for acquiring ventilator associated events (VAE). Secondary aims were to investigate the intensive care unit (ICU) course and impact of VAE on patient outcome. ⋯ Prospective intervention studies are needed to determine if targeting these risk factors can lower VAE rates in our setting.
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Journal of critical care · Aug 2021
Timing of continuous renal replacement therapy in severe acute kidney injury patients with fluid overload: A retrospective cohort study.
We aimed to evaluate the association of early versus late initiation of Continuous renal replacement therapy (CRRT) with mortality in patients with fluid overload. ⋯ Early initiation of CRRT was independently associated with survival benefits in severe AKI patients with fluid overload.
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Journal of critical care · Aug 2021
Multimodal intervention to reduce acquisition of carbapenem-non-susceptible Gram-negative bacteria in intensive care units in the National Referral Hospital of Indonesia: An interrupted time series study.
To evaluate a low-cost multimodal intervention on the acquisition of carbapenem-non-susceptible Acinetobacter baumannii, Klebsiella pneumoniae, and Pseudomonas aeruginosa by patients in low-resource intensive care units. ⋯ A multimodal intervention to prevent acquisition of resistant pathogens is feasible and may be effective in ICUs in lower-middle income countries.
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Journal of critical care · Aug 2021
Recall of clinical trial participation and attrition rates in survivors of acute respiratory distress syndrome.
To measure the rate of recall of study participation and study attrition in survivors of acute respiratory distress syndrome(ARDS). ⋯ One in 4 ARDS survivors do not recall their participation in a clinical trial during hospitalization 3 months following hospital discharge, which did not influence 6-month attrition. However, more patients recall study participation if reconsent is obtained.
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Journal of critical care · Aug 2021
Observational StudyPharmacokinetics of levetiracetam in neurosurgical ICU patients.
The pharmacokinetics (PK) of drugs is dramatically altered in critical illness. Augmented renal clearance (ARC), a phenomenon characterized by creatinine clearance (CrCl) greater than 130 ml/min/1.73m2, is commonly described in critically ill patients. Levetiracetam, an antiepileptic drug commonly prescribed for seizure prophylaxis in the neurosurgical ICU, undergoes predominant elimination via the kidneys. Hence, we hypothesize that current dosing practice of intravenous (IV) levetiracetam 500 mg twice daily is inadequate for critically ill patients due to enhanced drug elimination. The objectives of our study were to describe the population PK of levetiractam using a nonparametric approach to design an optimal dosing regimen for critically ill neurosurgical patients. ⋯ Our study examined the population PK of levetiracetam in a critically ill neurosurgical population. We found that this population displayed higher clearance and required higher doses to achieve target levels.