Journal of critical care
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Journal of critical care · Oct 2024
Meta AnalysisPoint of care guided coagulation management in adult patients on ECMO: A systematic review and meta-analysis.
Despite the advancements in extracorporeal membrane oxygenation (ECMO) technology, balancing the prevention of thrombosis and the risk of bleeding in patients on ECMO is still a significant challenge for physicians. This systematic review and meta-analysis aimed to assess the efficacy and safety of viscoelastic point-of-care (POC)-guided coagulation management in adult patients on ECMO. ⋯ The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with registration ID CRD42023486294.
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Journal of critical care · Oct 2024
ReviewImproving sepsis classification performance with artificial intelligence algorithms: A comprehensive overview of healthcare applications.
This study investigates the potential of machine learning (ML) algorithms in improving sepsis diagnosis and prediction, focusing on their relevance in healthcare decision-making. The primary objective is to contribute to healthcare decision-making by evaluating the performance of various supervised and unsupervised models. ⋯ The study emphasizes the potential benefits of ML algorithms in sepsis management, advocating for ongoing research to optimize performance and ensure ethical utilization in healthcare decision-making. Ethical considerations, interpretability, and transparency are crucial factors in implementing these algorithms in clinical practice.
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Journal of critical care · Oct 2024
Multicenter StudyPhosphodiesterase 3 inhibitors do not influence lactate kinetics and clinical outcomes in patients with septic shock: A multicentre cohort study.
We investigated the association between the administration of phosphodiesterase 3 inhibitors (PDE3i) and lactate kinetics, resolution of organ failure, ICU and hospital length of stay (LOS) and hospital mortality in a retrospective cohort of patients with septic shock and persistently elevated lactate concentrations. ⋯ No association was found between the administration of PDE3i and lactate kinetics, resolution of organ failure, ICU or hospital LOS or hospital mortality.
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Journal of critical care · Oct 2024
Multicenter StudyThe interaction of net ultrafiltration rate with urine output and fluid balance after continuous renal replacement therapy initiation: A multi-Centre study.
During continuous renal replacement therapy (CRRT), a high net ultrafiltration rate (NUF) may worsen the decrease in urine output (UO) associated with starting CRRT. However, fluid balance (FB) may modulate this association. We aimed to examine the relationship between NUF, UO and FB at the start of CRRT. ⋯ A higher NUF rate was not significantly associated with a greater immediate and sustained reduction in UO after CRRT commencement. FB before CRRT was also not associated with a greater reduction in UO. These findings do not provide evidence for an effect of NUF on renal function.
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Journal of critical care · Oct 2024
Multicenter StudyThe impact of frailty on survival times up to one year among patients admitted to ICU with in-hospital cardiac arrest.
In-hospital cardiac arrest (IHCA) is a serious medical emergency. When IHCA occurs in patients with frailty, short-term survival is poor. However, the impact of frailty on long-term survival is unknown. ⋯ In this retrospective multicentre study, frailty was associated with poorer one-year survival in patients admitted to Australian ICUs following an IHCA.