Journal of critical care
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Journal of critical care · Jun 2024
Meta AnalysisContinuous renal replacement therapy and survival in acute liver failure: A systematic review and meta-analysis.
Acute liver failure (ALF) is a rare syndrome leading to significant morbidity and mortality. An important cause of mortality is cerebral edema due to hyperammonemia. Different therapies for hyperammonemia have been assessed including continuous renal replacement therapy (CRRT). We conducted a systematic review and meta-analysis to determine the efficacy of CRRT in ALF patients. ⋯ Use of CRRT in ALF patients is associated with improved overall and transplant-free survival compared to no CRRT.
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Journal of critical care · Jun 2024
Multicenter Study Clinical TrialMulticentre implementation of a quality improvement initiative to reduce delirium in adult intensive care units: An interrupted time series analysis.
The ABCDEF bundle may improve delirium outcomes among intensive care unit (ICU) patients, however population-based studies are lacking. In this study we evaluated effects of a quality improvement initiative based on the ABCDEF bundle in adult ICUs in Alberta, Canada. ⋯ An ABCDEF delirium initiative was implemented on a population-basis within adult ICUs and was successful at reducing the prevalence of delirium.
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Journal of critical care · Jun 2024
Meta AnalysisDifferent ventilation intensities among various categories of patients ventilated for reasons other than ARDS--A pooled analysis of 4 observational studies.
We investigated driving pressure (ΔP) and mechanical power (MP) and associations with clinical outcomes in critically ill patients ventilated for reasons other than ARDS. ⋯ This post hoc analysis was not registered; the individual studies that were merged into the used database were registered at clinicaltrials.gov: NCT01268410 (ERICC), NCT02010073 (LUNG SAFE), NCT01868321 (PRoVENT), and NCT03188770 (PRoVENT-iMiC).
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Journal of critical care · Jun 2024
Multicenter StudyPatient-important upper gastrointestinal bleeding in the ICU: A mixed-methods study of patient and family perspectives.
The objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial. ⋯ Survivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.
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Journal of critical care · Jun 2024
Practices surrounding antimicrobial use in patients managed with extracorporeal membrane oxygenation: An international survey.
This study aimed to survey critical care clinicians and characterize their perception of antimicrobial dosing strategies in patients receiving extracorporeal membrane oxygenation (ECMO). ⋯ Approaches to antimicrobial dosing strategies do not significantly differ among respondents between critically ill patients on ECMO support, compared to patients with equal severity of illness not receiving ECMO support. These findings were unexpected considering the added physiologic complexity of the ECMO circuit to critically ill adult patients and the need for well designed and adequately powered studies to inform empiric dosing guidance for ECMO-supported patients.