Journal of critical care
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Journal of critical care · Sep 2024
A tidal volume of 7 mL/kg PBW or higher may be safe for COVID-19 patients.
The novel coronavirus disease (COVID-19) has revived the debate on the optimal tidal volume during acute respiratory distress syndrome (ARDS). Some experts recommend 6 mL/kg of predicted body weight (PBW) for all patients, while others suggest 7-9 mL/kg PBW for those with compliance >50 mL/cmH2O. We investigated whether a tidal volume ≥ 7 ml/kg PBW may be safe in COVID-19 patients, particularly those with compliance >50 mL/cmH2O. ⋯ A tidal volume ≥ 7 (up to 9) mL/kg PBW was associated with lower ICU mortality in these COVID-19 patients, including those with compliance <40 mL/cmH2O. This finding should be interpreted cautiously due to the retrospective study design.
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Journal of critical care · Sep 2024
Analysis of factors associated with favorable neurological outcomes in patients with initial PEA who underwent ECPR - A secondary analysis of the SAVE-J II study.
This study aimed to investigate the factors of favorable neurological outcomes in patients with initial pulseless electrical activity (PEA) who underwent extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ This study provides an overview of patients with PEA who underwent ECPR. Since several factors are associated with favorable neurological outcomes, patients with PEA may be candidates for ECPR if these factors are met.
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Journal of critical care · Sep 2024
Malnutrition in survivors of critical illness and long-term survival outcomes: A cohort study.
This study aimed to determine the prevalence of malnutrition and associated risk factors among intensive care unit (ICU) survivors and to investigate whether malnutrition after ICU admission is associated with long-term survival outcomes. ⋯ Malnutrition within 1 year of ICU admission was reported in 8.1 % of survivors. Notably, malnutrition after ICU admission was associated with an increased risk of mortality between 1 and 5 years after ICU admission among ICU survivors.
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Journal of critical care · Sep 2024
Feasibility of estimating tidal volume from electrocardiograph-derived respiration signal and respiration waveform.
Estimating tidal volume (VT) from electrocardiography (ECG) can be quite useful during deep sedation or spinal anesthesia since it eliminates the need for additional monitoring of ventilation. This study aims to validate and compare VT estimation methodologies based on ECG-derived respiration (EDR) using real-world clinical data. ⋯ Although EDR-based VT estimation is promising, current methodologies are limited by noisy ICU ECG signals, but controlled environment data showed significant short-term correlations with measured respiration waveforms. Future studies should develop reliable EDR extraction procedures and improve predictive models to broaden clinical applications.
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Journal of critical care · Sep 2024
Sex dependent effects of cardiovascular agents on hemoglobin oxygen affinity - An ex-vivo experiment.
Hemoglobin‑oxygen (Hb-O2) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O2 affinity. ⋯ All investigated agents decreased Hb-O2 affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.