Journal of critical care
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Journal of critical care · Feb 2023
Multicenter Study Observational StudyDetermining respiratory rate using measured expiratory time constant: A prospective observational study.
Potential negative implications associated with high respiratory rate (RR) are intrinsic positive end-expiratory pressure (PEEPi) generation, cardiovascular depression and possibly ventilator induced lung injury. Despite these negative consequences, optimal RR remains largely unknown. We hypothesized that without consideration of dynamics of lung emptying (i.e., the expiratory time constant [RCEXP]) clinician settings of RR may exceed the frequency needed for optimal lung emptying. ⋯ Use of RRP based on measured RCEXP revealed that the clinician-set RR exceeded that predicted by RCEXP in the majority of patients. Measuring RCEXP appears to be a useful variable for adjusting the RR during mandatory mechanical ventilation.
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Journal of critical care · Feb 2023
Multicenter StudyAssociation between type II diabetes mellitus and 90-day mortality in a large multicenter prospectively collected cohort. A FROG ICU post-hoc study.
Factors associated with adverse outcomes in ICU patients with type II (T2DM) are poorly defined. The main goal of this study is to determine the impact of pre-existing T2DM on 90-day mortality post ICU admission. ⋯ In the present study, T2DM was not associated with 90-day mortality post ICU admission.
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Journal of critical care · Feb 2023
Randomized Controlled TrialThe clinical and paraclinical effectiveness of four-hour infusion vs. half-hour infusion of high-dose ampicillin-sulbactam in treatment of critically ill patients with sepsis or septic shock: An assessor-blinded randomized clinical trial.
This study was conducted to determine whether critically ill patients admitted to the intensive care unit (ICU) with sepsis and septic shock may benefit from extended infusion of ampicillin/sulbactam compared with those receiving intermittent infusion. ⋯ These data should be replicated in larger clinical trials before providing any recommendation in favor of this method of administration in clinical practice.
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Journal of critical care · Feb 2023
Observational StudyAssociation between metformin and survival outcomes in in-hospital cardiac arrest patients with diabetes.
Metformin has shown cardioprotective and neuroprotective effects in cardiac arrest and ischemia-reperfusion injury animal models. Therefore, this study aimed to determine the association between diabetes medication and survival outcomes in in-hospital cardiac arrest (IHCA) patients with type 2 DM (T2DM). ⋯ In IHCA patients with T2DM, administration of metformin within 24 h before IHCA was independently associated with survival to discharge.
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Journal of critical care · Feb 2023
The impact of language barriers & interpreters on critical care patient outcomes.
In a multicultural society, the impact of language proficiency and interpreter use on critical care patient outcomes is unknown. ⋯ Being identified as having a requirement for an interpreter was associated with improved outcomes for adults admitted to public hospital ICUs in Victoria. Interpreter services should be more readily available in the hospital setting. It is recommended that patients, family members and clinicians actively use interpreter services when English is not the preferred language of an ICU patient.