Journal of critical care
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Journal of critical care · Oct 2022
Palliative and end-of-life care in intensive care units in low- and middle-income countries: A systematically constructed scoping review.
Death is common in intensive care units, and integrating palliative care enhances outcomes. Most research has been conducted in high-income countries. The aim is to understand what is known about the type and topics of research on the provision of palliative care within intensive care units in low- and middle-income countries MATERIALS AND METHODS: Scoping review with nine databases systematically searched for literature published in English on palliative care in intensive care units in low- and middle- income settings (01/01/1990 to 31/05/2021). Two reviewers independently checked search results and extracted textual data, which were analyzed and represented as themes. ⋯ Palliative care in intensive care units in low-and middle-income countries is understudied. Research focused on the specific needs of intensive care in low- and middle-income countries is required to ensure optimal patient outcomes.
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Journal of critical care · Oct 2022
Impact of cardiac surgery and neurosurgery patients on variation in severity-adjusted resource use in intensive care units.
The resource use of cardiac surgery and neurosurgery patients likely differ from other ICU patients. We evaluated the relevance of these patient groups on overall ICU resource use. ⋯ Cardiac and neurosurgery have major effects on the cost structure of multidisciplinary ICUs. Extending SRUR analysis to patient subpopulations facilitates comparison of resource use between ICUs and may help to optimize resource allocation.
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Journal of critical care · Oct 2022
Venoarterial extracorporeal membrane oxygenation flow or dobutamine to improve microcirculation during ECMO for refractory cardiogenic shock.
Venoarterial extracorporeal membrane oxygenation (VA ECMO) effectively supports refractory cardiogenic shock (rCS), and sustains macro- and microcirculations. We investigated the respective impact of increasing VA ECMO flow or dobutamine dose on microcirculation in stabilized VA ECMO-treated patients with rCS. ⋯ When macrocirculation has already been restored in patients with ECMO-supported rCS, increasing dobutamine (above 5 μg/kg/min) or ECMO flow did not further improve microcirculation.
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Journal of critical care · Oct 2022
Impact of intraabdominal hypertension on kidney failure in critically ill patients: A post-hoc database analysis.
To assess whether intraabdominal hypertension (IAH) may influence kidney failure as well as mortality. ⋯ This study suggest that duration as well as higher grades of IAH are associated with kidney failure and may increase mortality.