Journal of critical care
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Journal of critical care · Oct 2022
Multicenter StudyIn-hospital mortality of critically Ill patients with interactions of acute kidney injury and acute respiratory failure in the resource-limited settings: Results from SEA-AKI study.
Our goal was to describe clinical outcomes and explore the physiological interactions between acute kidney injury (AKI) and acute respiratory failure (ARF) in critically ill patients. ⋯ Critically ill patients with ARF and AKI are at higher risk of in-hospital death. Different patterns of AKI and ARF interaction result in unique clinical outcomes as well as risk factors.
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Journal of critical care · Oct 2022
LetterHeart rate variability and adrenal size provide clues to sudden cardiac death in hospitalized COVID-19 patients.
To examine the association between a measure of heart rate variability and sudden cardiac death (SCD) in COVID-19 patients. ⋯ Hospitalized patients with COVID-19 who experienced SCD had lower parasympathetic activity (RMSSD) and smaller sized adrenal glands. Further research is required to replicate these findings.
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Journal of critical care · Oct 2022
Time-dependent uncertainty of critical care transitions in very old patients - lessons for time-limited trials.
Prognostication for patients with critical conditions remains challenging, especially for very old individuals. Time-limited trials (TLT) are used to decrease prognostic uncertainty in the individual patient by monitoring the response to treatment over a pre-determined period of time. However, there are substantial difficulties with determining the length of that period. This study presents a probabilistic method to estimate a suitable duration of a TLT based on temporal profiles of uncertainty about critical care and outcome. ⋯ Time-dependent patterns of uncertainty concerning the response to critical care can inform decisions about the duration of TLTs which may last up to a week in very old patients.
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Journal of critical care · Oct 2022
Characterising acute kidney injury: The complementary roles of biomarkers of renal stress and renal function.
Although epidemiological studies have enhanced our understanding of acute kidney injury, defining the biologic processes corresponding to the clinical phenotype remains challenging. We have examined biomarkers associated with renal stress plus markers of glomerular function to assess whether this approach may aid prediction of AKI or other relevant endpoints. ⋯ The combination of cell-cycle arrest biomarkers, TIMP-2 and IGFBP7, with serum creatinine but not cystatin C or PENK improved risk stratification for the development of stage 2 or 3 AKI over [TIMP-2]·[IGFBP7] alone.
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Journal of critical care · Oct 2022
Clinicians' Views on the use of triggers for specialist palliative care in the ICU: A qualitative secondary analysis.
To understand clinicians' views regarding use of clinical criteria, or triggers, for specialist palliative care consultation in the ICU. ⋯ ICU and palliative care clinicians identified important issues to consider when implementing triggers for specialist palliative care consultation. Future research is needed to longitudinally examine the most appropriate triggers and best practices for trigger implementation.