Journal of critical care
-
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.
-
Journal of critical care · Feb 2022
Superficial placement of endotracheal tubes associated with unplanned extubation: A case-control study.
Unplanned extubations (UEs) refer to the inadvertent removal of endotracheal tubes (ETTs). Superficially placed ETTs anecdotally increases the risk of UEs. This study aims to assess the impact of ETT position as well as other factors that could be associated with risk of UEs. ⋯ UE and the need for reintubation is associated with worse outcomes. Distance of ETT tips to carina ≥6 cm may be associated with higher risks of UE. Further prospective studies are needed to establish the optimal position of ETT to prevent UE.
-
Journal of critical care · Feb 2022
Effect of sodium administration on fluid balance and sodium balance in health and the perioperative setting. Extended summary with additional insights from the MIHMoSA and TOPMAST studies.
We aimed to provide an extended analysis of the physiological handling of of the sodium burden induced by maintenance fluids. ⋯ Sodium administration induced by sodium-rich maintenance fluids leads, especially in the clinical setting, to prolonged fluid retention when compared with a regimen that resembles a healthy dietary sodium intake, even when kidney function is normal.
-
Journal of critical care · Feb 2022
Drastic changes in the practice of end-of-life care during the COVID-19 pandemic.
This article discusses drastic changes in the practice of end-of-life care during the COVID-19 pandemic. It reviews the ethical dilemmas of individual autonomy versus societal justice, human beneficence versus public health non-maleficence that arose during the pandemic due to prolonged, high acutity,= critical illness in the setting of a highly contageous respiratory virus, protective personal equipment shortages,m crisis standards of care to distribute scarce medical resources, and changes in interactions between treating clinicians, patients, and visitors. The lessons learned during the pandemic response will directly inform and impact the appraoch to future pandemic events.
-
Journal of critical care · Feb 2022
Real time wire localization by ultrasound during central line insertion improves accurate positioning in all upper torso sites.
To investigate whether point of care ultrasound can improve central venous catheter tip positioning. ⋯ Point of care ultrasound for guidewire identification and localization, while inserting central venous catheter from all upper torso sites, improves precision positioning.