Journal of critical care
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Journal of critical care · Jun 2022
LetterHigh flow nasal cannula improves breathing efficiency and ventilatory ratio in COPD patients recovering from an exacerbation.
High flow nasal cannula (HFNC) may improve CO2 elimination by washing out CO2 from the upper airways. This study aimed at assessing the effect of HFNC on minute ventilation and ventilatory ratio (VR), a surrogate of dead space, in patients hospitalized for acute hypercapnic COPD exacerbation. ⋯ In patients recovering from acute COPD exacerbation, the use of HFNC reduced RR, minute ventilation, PaCO2 and VR compared to standard oxygen. These changes are consistent with a decrease in physiologic dead space with HFNC.
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Journal of critical care · Jun 2022
Observational StudyIs hypocapnia a risk factor for non-invasive ventilation failure in cardiogenic acute pulmonary edema?
The impact of hypocapnia in the prognosis of cardiogenic acute pulmonary edema (CAPE) has not been sufficiently studied. The aim of this study was to analyse whether hypocapnia is a risk factor for non-invasive ventilation (NIV) failure and hospital mortality, in CAPE patients CAPE. ⋯ Hypocapnia in patients with CAPE is associated with NIV failure and a greater in-hospital mortality.
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To evaluate the effect of renin-angiotensin system (RAS) inhibiting medications prior to admission on the severity of kidney injury in patients presenting with sepsis-associated acute kidney injury (SA-AKI). ⋯ Patients receiving RAS inhibition (vs. those not) prior to an admission with SA-AKI presented with more severe AKI on admission and during the first week. Hospital mortality and kidney function at discharge were similar between groups.
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Journal of critical care · Jun 2022
Observational StudyFeasibility of non-invasive respiratory drive and breathing pattern evaluation using CPAP in COVID-19 patients.
Increased respiratory drive and respiratory effort are major features of acute hypoxemic respiratory failure (AHRF) and might help to predict the need for intubation. We aimed to explore the feasibility of a non-invasive respiratory drive evaluation and describe how these parameters may help to predict the need for intubation. ⋯ Non-invasive assessment of respiratory drive was feasible in patients with AHRF and showed an increased P0.1, although it was not predictive of intubation.
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Journal of critical care · Jun 2022
LetterIn-hospital cardiac arrests admitted alive in intensive care units: Insights from the CubRéa database.
In-hospital cardiac arrest(IHCA) has received little attention compared with out-of-hospital cardiac arrest. ⋯ Occurrence of IHCA increased over time but remains an uncommon reason for being admitted to ICU. From 1997 to 2015, we observed a change in patient profile, with older and more critically ill patients, despite which in-ICU mortality has substantially decreased in IHCA patients, likely resulting from a global improvement in the process of care and more widespread implementation of rapid response teams.