Journal of critical care
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Journal of critical care · Apr 2022
An international survey of adherence to Surviving Sepsis Campaign Guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock.
Our survey aimed to evaluate adherence to Surviving Sepsis Campaign (SSC) Guidelines 2016 among intensive care practitioners and to identify issues that remain controversial or lack clarity. ⋯ The use of vasopressors and fluid use in septic shock is largely compliant with current guidelines but several controversies should be addressed in future guideline iterations.
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Journal of critical care · Apr 2022
Time course of the Bioelectrical Impedance Vector Analysis and muscular ultrasound in critically ill patients.
Several different tools have been developed to integrate the clinical and biochemical nutritional evaluations in critical care patients. Aims of this study were to evaluate the changes in the Bioelectrical Impedance Vector Analysis (BIVA) and ultrasonographic features of the diaphragm (DTee) and rectus femoris (RFCSA) during the first week of ICU stay. ⋯ Body composition is significantly modified after one week of ICU stay. BIVA may be useful in the definition of hydration state, while it does not seem to track muscle mass. Different temporal trends of specific BIVA and muscle ultrasound parameters were found in patients with high or low severity of illness.
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Journal of critical care · Apr 2022
Transfusion and its association with mortality in patients receiving veno-arterial extracorporeal membrane oxygenation.
Patients receiving veno-arterial Extracorporeal Membrane Oxygenation (V-A ECMO) may require transfusion due to bleeding risk and desire to optimize oxygen delivery. The purposes of this study were to determine the transfusion requirements in patients receiving V-A ECMO and to determine if transfusion was associated with hospital mortality or complications. ⋯ Most patients receiving V-A ECMO are transfused multiple units of blood products. Receipt of transfusion or having a bleeding or ischemic complication was not associated with increased mortality.
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Journal of critical care · Apr 2022
Impact of hypoalbuminemia on mortality in critically ill patients requiring continuous renal replacement therapy.
This study aimed to assess the association of hypoalbuminemia with mortality in critically ill patients requiring continuous renal replacement therapy (CRRT). ⋯ Approximately three out of four patients had hypoalbuminemia (<3.5 g/dL) at CRRT initiation. However, only severe hypoalbuminemia <2.5 g/dL was significantly associated with higher mortality.
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Journal of critical care · Apr 2022
Clinical and organizational framework of repurposing pediatric intensive care unit to adult critical care in a resource-limited setting: Lessons from the response of an urban general hospital to the COVID-19 pandemic.
We aim to describe the action plan and clinical results of a COVID-19 unit for adult patient care in units intended for critically ill children, proposing a clinical/administrative framework. ⋯ We propose an organizational framework for the role of PICU in the hospital action plan to increase adult critical beds. The cohort of patients admitted to a PICU repurposed as a COVID-19 ICU had good outcomes. These data are valuable to plan coordinated actions of the healthcare system for future scenarios.