Journal of critical care
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Journal of critical care · Feb 2025
Higher doses of fluconazole are needed to ensure target attainment in critically ill adults on continuous Veno-venous hemodialysis.
Critically ill patients undergoing Continuous Renal Replacement Therapy (CRRT) are treated with higher doses of fluconazole based on the literature recommendations. However, clinical follow-up data demonstrating the effectiveness of this approach are lacking. ⋯ According to the results of the study, increasing the fluconazole dose to at least 400 mg twice daily is sufficient to reach the desired target in critically ill patients undergoing CVVHD.
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Journal of critical care · Feb 2025
Optimizing fosfomycin dosing regimens in critically ill patients with and without continuous renal replacement therapy.
To define the optimal fosfomycin dosing regimens for drug-resistant gram-negative bacteria in critically ill patients and those receiving continuous renal replacement therapy (CRRT) via Monte Carlo simulations. ⋯ Dosing regimens for bacteria with high MICs as 64 mg/L in these patients were 18-24 g/day. Dose adjustments were required in those undergoing CRRT. Clinical validation is strongly needed.
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Journal of critical care · Feb 2025
Shock prediction with dipeptidyl peptidase-3 and renin (SPiDeR) in hypoxemic patients with COVID-19.
Plasma dipeptidyl peptidase-3 (DPP3) and renin levels are associated with organ dysfunction and mortality. However, whether these biomarkers are associated with the subsequent onset of shock in at-risk patients is unknown. ⋯ In patients hospitalized with COVID-19 and hypoxemia without baseline hypotension, higher baseline plasma levels of DPP3 but not renin were associated with increased risk of subsequent shock and death.
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Journal of critical care · Feb 2025
Quantitative visualization of gastrointestinal motility in critically ill patients using a non-invasive single-channel electro amplifier: A prospective observational cohort feasibility study.
This study aimed to evaluate the feasibility of using electrogastrography (EGG)/electroenterography (EEnG) to quantitatively visualize gastrointestinal (GI) motor function in critically ill patients. ⋯ EGG/EEnG could enable quantitative visualization of GI motor function in critically ill patients. Larger studies can determine the association of GI symptoms with risk factors and prognostic factors.
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Journal of critical care · Feb 2025
Clinician assessment of kidney function from plasma creatinine values during critical illness: A scenario-based international multi-professional survey.
During critical illness interpretation of serum creatinine is affected by non-steady state conditions, reduced creatinine generation, and altered distribution. We evaluated healthcare professionals' ability to adjudicate underlying kidney function, based on simulated creatinine values. ⋯ Participants displayed marked variation in estimation of kidney function, suggesting difficulty in accounting for multiple confounders. There is need for alternative, unbiased measures of kidney function in critical illness to avoid misclassifying kidney disease.