Journal of critical care
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Journal of critical care · Feb 2022
Review Case ReportsCOVID 19 and the risk of gastro-intestinal perforation: A case series and literature review.
COVID19 is a viral disease with pneumonia as its most common presentation. Many presentations and complications have been reported, but gastro-intestinal perforation has not received much attention. ⋯ Gastro-intestinal perforation is a rare but dangerous complication of COVID19. Treatment with tocilizumab and steroids may both increase the risk of this complication, and hamper diagnosis.
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Journal of critical care · Feb 2022
A retrospective evaluation of three ethical triage tools for the allocation of ICU resources during the first wave of the COVID-19 pandemic.
To retrospectively evaluate the effect of ethical triage tools (ETT), designed to streamline the admission of patients during the first wave of the COVID-19 pandemic. We aimed to determine the characteristics and outcomes of the patients who would have been denied admission to the ICU according to these protocols, including the cumulative number of saved ICU days. ⋯ An ETT effectively reduces ICU bed occupancy but it does not accurately discriminate between survivors and non-survivors, as a substantial percentage of patients who are being denied admission to the ICU would eventually survive their hospital stay.
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Journal of critical care · Feb 2022
Observational Study1-hour t-piece spontaneous breathing trial vs 1-hour zero pressure support spontaneous breathing trial and reintubation at day 7: A non-inferiority approach.
Physiological data suggest that T-piece and zero pressure support (PS0) ventilation both accurately reflect spontaneous breathing conditions after extubation. These two types of spontaneous breathing trials (SBTs) are used in our Intensive Care Unit to evaluate patients for extubation readiness and success but have rarely been compared in clinical studies. ⋯ Our results suggest that successful 1-hour T-piece and 1-h PSO ZEEP SBTs are associated with similar reintubation rates at day 7.
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Journal of critical care · Feb 2022
Rapid prognostic stratification using Point of Care ultrasound in critically ill COVID patients: The role of epicardial fat thickness, myocardial injury and age.
The burden of critical COVID-19 patients in intensive care units (ICU) demands new tools to stratify patient risk. We aimed to investigate the role of cardiac and lung ultrasound, together with clinical variables, to propose a simple score to help predict short-term mortality in these patients. ⋯ A higher POCOVID score at ICU admission can be helpful to stratify critical COVID-19 patients with increased in-hospital mortality and to optimize medical resources allocation in more strict-resource settings.
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Journal of critical care · Feb 2022
Activation of the kynurenine pathway predicts mortality and neurological outcome in cardiac arrest patients: A validation study.
Activation of the kynurenine pathway (KP) has been shown to predict outcome in cardiac arrest (CA) patients. We validated these findings in a Swiss cohort. ⋯ Our findings validate a previous study and show associations of the activation of the KP with unfavorable outcomes after CA. Future studies should evaluate whether therapeutic modulation of the KP may impact clinical outcomes after CA.