Journal of critical care
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Journal of critical care · Oct 2024
Determinants of beta-lactam PK/PD target attainment in critically ill patients: A single center retrospective study.
We aimed to identify factors associated with achieving target BL plasma concentrations and describe real world data for therapeutic drug monitoring (TDM). ⋯ Achieving target BL plasma concentrations remains challenging in ICUs. Identifying predictive factors of BL target attainment would favor implementing rapid dosing optimization strategies in both under and overdosing high risk patients.
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Journal of critical care · Oct 2024
Association between comorbidities at ICU admission and post-Sepsis physical impairment: A retrospective cohort study.
Few studies have measured the association between pre-existing comorbidities and post-sepsis physical impairment. The study aimed to estimate the risk of physical impairment at hospital discharge among sepsis patients, adjusting for pre-existing physical impairment prior to ICU admission and in-hospital mortality. ⋯ Pre-existing comorbidities prior to ICU admission were not associated with an increased risk of physical impairment at hospital discharge among sepsis patients after adjusting for baseline covariates and in-hospital mortality.
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Journal of critical care · Oct 2024
Effectiveness of early high-flow nasal oxygen therapy after extubation of patients in the intensive care unit.
This study aimed to evaluate the impact of early high-flow nasal oxygen (HFNO) therapy initiation using a pre-determined respiratory rate‑oxygenation (ROX) index on reducing reintubation rates and duration of intensive care unit (ICU) stay in post-extubated patients. ⋯ Early initiation of HFNO guided by the ROX index threshold post-extubation in patients admitted to ICU is associated with reduced reintubation rates and shorter ICU stays.
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Trust is an essential element in the relationship between patients and intensive care unit (ICU) clinicians. Without a foundation of trust, communication is difficult, conflict is more likely, and even clinical outcomes can be affected. ⋯ Illness occurs suddenly, emotions can be charged, the environment is impersonal, and there is rarely a prior relationship between patients and their caregivers. Therefore, intensivists must have some understanding of the factors that impact patient and family trust, as well as the actions they can take to improve it.