Journal of critical care
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Journal of critical care · Dec 2022
Review Meta AnalysisWhat matters most to adults with a tracheostomy in ICU and the implications for clinical practice: a qualitative systematic review and metasynthesis.
Tracheostomy is a common surgical procedure in ICU. Whilst often life-saving, it can have important impacts on patients. Much of the literature on tracheostomy focuses on timing and technique of insertion, risk factors and complications. More knowledge of patient experience of tracheostomy in ICU is needed to support person-centred care. ⋯ Voice restoration should be given high priority in the management of adults with a tracheostomy in ICU. Staff training should focus on both technical skills and compassionate care to improve person-centred outcomes.
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Journal of critical care · Dec 2022
ReviewFasting practices of enteral nutrition delivery for airway procedures in critically ill adult patients: A scoping review.
There is limited understanding of fasting practices and reported safety concerns for airway procedures in critically ill adults. ⋯ In the reported literature, there is wide variation in EN fasting practices for airway procedures in critically ill patients with limited evidence to inform practice.
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Journal of critical care · Dec 2022
ReviewImmunotherapy to treat sepsis induced-immunosuppression: Immune eligibility or outcome criteria, a systematic review.
Sepsis-induced immunosuppression (SIS) is the target of multiple clinical studies testing immunotherapies. To date, most trials are performed on a heterogeneous and unselected population. Without any consensual definition of immunosuppression and therapeutic goals, results from these trials remain poorly transposable. ⋯ Only 13 studies selected patients suffering from immunosuppression based on immune biomarkers. Two immune criterias were commonly used: lymphocyte count and monocytic HLA-DR expression. This heterogeneity criteria in studies targeting SIS justify the conduct of a consensus process to define criteria to diagnose SIS and identify relevant outcomes markers.
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Journal of critical care · Dec 2022
Multicenter StudyCardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients.
To evaluate cardiac function in mechanically ventilated patients with COVID-19. ⋯ Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.