Journal of critical care
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Journal of critical care · Apr 2022
An international survey of adherence to Surviving Sepsis Campaign Guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock.
Our survey aimed to evaluate adherence to Surviving Sepsis Campaign (SSC) Guidelines 2016 among intensive care practitioners and to identify issues that remain controversial or lack clarity. ⋯ The use of vasopressors and fluid use in septic shock is largely compliant with current guidelines but several controversies should be addressed in future guideline iterations.
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Journal of critical care · Apr 2022
Observational StudyRenal histopathology in critically ill patients with Septic Acute Kidney Injury(S-AKI).
To describe the kidney histopathology of patients with S-AKI and correlate the histological findings with AKI severity, presence of septic shock, and the degree of multiple organic dysfunction (MOD) using the SOFA score. ⋯ The main histopathological findings in kidney necropsies in patients with S-AKI KDIGO 3, showed nonspecific TI lesions, and TI necrosis was only observed in 30% of the cases; therefore, S-AKI cannot be considered to be synonymous with acute tubular necrosis (ATN).
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Journal of critical care · Apr 2022
Time course of the Bioelectrical Impedance Vector Analysis and muscular ultrasound in critically ill patients.
Several different tools have been developed to integrate the clinical and biochemical nutritional evaluations in critical care patients. Aims of this study were to evaluate the changes in the Bioelectrical Impedance Vector Analysis (BIVA) and ultrasonographic features of the diaphragm (DTee) and rectus femoris (RFCSA) during the first week of ICU stay. ⋯ Body composition is significantly modified after one week of ICU stay. BIVA may be useful in the definition of hydration state, while it does not seem to track muscle mass. Different temporal trends of specific BIVA and muscle ultrasound parameters were found in patients with high or low severity of illness.
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Journal of critical care · Apr 2022
Transfusion and its association with mortality in patients receiving veno-arterial extracorporeal membrane oxygenation.
Patients receiving veno-arterial Extracorporeal Membrane Oxygenation (V-A ECMO) may require transfusion due to bleeding risk and desire to optimize oxygen delivery. The purposes of this study were to determine the transfusion requirements in patients receiving V-A ECMO and to determine if transfusion was associated with hospital mortality or complications. ⋯ Most patients receiving V-A ECMO are transfused multiple units of blood products. Receipt of transfusion or having a bleeding or ischemic complication was not associated with increased mortality.
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Journal of critical care · Apr 2022
Peripheral blood neutrophil-to-lymphocyte ratio is associated with mortality across the spectrum of cardiogenic shock severity.
To evaluate the association between the neutrophil-to-lymphocyte ratio (NLR) and mortality across the cardiogenic shock (CS) severity spectrum, defined using the Society of Cardiovascular Interventions and Angiography (SCAI) shock stages. ⋯ Elevated NLR is associated with higher in-hospital mortality in CICU patients with or at risk for CS, emphasizing the importance of systemic inflammation as a determinant of outcomes in CS patients.