Journal of critical care
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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
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
Association of early changes in arterial carbon dioxide with acute brain injury in adult patients with extracorporeal membrane oxygenation: A ten-year retrospective study in a German tertiary care hospital.
To assess the association between fluctuations of arterial carbon dioxide early after start of extracorporeal membrane oxygenation (ECMO) with intracranial hemorrhage (ICH) or ischemic stroke (IS). ⋯ Irrespective of the indication for ECMO, we did not find a significant association between the relative change in PaCO2 early after ECMO initiation and acute brain injury. Aside from early PaCO2 decline at cannulation, future studies should address fluctuations of PaCO2 throughout the course of ECMO support and their effect on acute brain injury.
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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
Influence of contrast medium on long-term renal function and outcomes in patients with septic acute kidney injury: A propensity-matched cohort study.
To investigate the relationship between contrast medium administration and long-term mortality and renal function in patients with septic acute kidney injury (AKI). ⋯ The administration of intravenous contrast medium was not associated with long-term mortality, deterioration of renal function, or dialysis in patients with septic AKI.