Journal of critical care
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Journal of critical care · Dec 2024
Indications, results and consequences of electroencephalography in neurocritical care: A retrospective study.
Electrocencephalography (EEG) is a tool to assess cerebral cortical activity. We investigated the indications and results of routine EEG recordings in neurocritical care patients and corresponding changes in anti-seizure medication (ASM). ⋯ All EEGs were performed to investigate the presence of (NC)SE or seizures. A slowed, but continuous background pattern was found in nearly all patients and (NC)SE and seizures were rarely diagnosed. Adjustments in ASM were made in approximately half of the patients.
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Journal of critical care · Dec 2024
Reducing plastic waste in intensive care from longer use of intravenous administration and invasive monitoring sets: A before-and-after study.
Intensive care unit (ICU) treatment carries a large environmental burden. Extending routine replacement of plastic line sets that belong to intravenous administration or invasive monitoring might lower waste from single-use plastics in ICUs. We extended the routine replacement interval of line sets from 4 to 7 days and assessed plastic waste reduction. ⋯ This study demonstrates the benefits of 7-day replacement intervals for intravenous administration and invasive monitoring sets. We established this in terms of waste reduction, patient safety and costs.
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Journal of critical care · Dec 2024
Preload responsiveness-guided fluid removal in mechanically ventilated patients with fluid overload: A comprehensive clinical-physiological study.
This study investigated fluid removal strategies for critically ill patients with fluid overload on mechanical ventilation. Traditionally, a negative fluid balance (FB) is aimed for. However, this approach can have drawbacks. ⋯ Additionally, FR group avoided metabolic problems like secondary alkalosis and potential hypokalemia seen in the negative FB group. FR-guided fluid-removal in fluid overloaded mechanically ventilated patients was a feasible, safe, and maybe superior strategy in facilitating weaning and disconnection from mechanical ventilation than negative FB-driven fluid removal. FR is a safe endpoint for optimizing cardiac function and preventing adverse consequences during fluid removal.
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Journal of critical care · Dec 2024
Practice survey on recent changes in post cardiac arrest care and temperature management in French intensive care units.
Recent guidelines for post-cardiac arrest (CA) management have undergone significant changes regarding targeted therapeutic management (TTM), transitioning from hypothermia to temperature control. We aimed to assess changes in post-CA management in French intensive care units following the new recommendations. ⋯ These surveys provide insights into post-resuscitation care and TTM practice in France. One year after their publication, the latest recommendations concerning TTM have not been fully implemented, as the majority of ICUs continue to use moderate hypothermia. They widely reported employing specific TTM, with the use of TTM with temperature feedback devices increasing significantly. Heterogeneity exists regarding the TTM systems used, with a significant proportion lacking temperature feedback. This aspect requires specific attention, depending on local constraints and devices costs.
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Journal of critical care · Dec 2024
One-year outcomes in COVID-19 and non-COVID-19 intensive care unit survivors.
To determine differences in one-year multi-domain health outcomes in COVID-19 and non-COVID-19 intensive care unit (ICU) survivors. ⋯ COVID-19 ICU survivors experience equal or less health problems but a greater decline in QoL one year after ICU admission compared to non-COVID-19 ARDS or pneumonia survivors.