Journal of critical care
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Journal of critical care · Oct 2021
Definition and incidence of hypotension in intensive care unit patients, an international survey of the European Society of Intensive Care Medicine.
Although hypotension in ICU patients is associated with adverse outcome, currently used definitions are unknown and no universally accepted definition exists. ⋯ An absolute MAP threshold of 65 mmHg is most frequently used to define hypotension in ICU patients. In neuro(trauma) patients a higher threshold was reported. The majority of ICU patients are estimated to endure hypotension during their ICU admission for a considerable amount of time, with nurses reporting a higher estimated incidence and time spent in hypotension than physicians.
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Journal of critical care · Oct 2021
Observational StudyManagement of SARS-CoV-2 pneumonia in intensive care unit: An observational retrospective study comparing two bundles.
To compare the effects of two therapeutic bundles of management in SARS-CoV2 ICU patients. ⋯ Within the limitations of our study, changes in therapeutic bundles for SARS-Cov-2 ICU patients might have no effect on in-hospital mortality but were associated with less exposure to mechanical ventilation and reduced hospital length of stay.
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Journal of critical care · Oct 2021
Observational StudyHelmet and face mask for non-invasive respiratory support in patients with acute hypoxemic respiratory failure: A retrospective study.
Non-invasive respiratory support could reduce the incidence of intubation in patients with Acute Hypoxemic Respiratory Failure (AHRF). The optimal interface or modality of non-invasive respiratory support is debated. We sought to evaluate the differences between patients who succeeded or failed non-invasive respiratory support, with a specific focus on the type of non-invasive respiratory support (i.e. helmet CPAP versus face mask NIV). ⋯ Helmet CPAP and a lower fluid balance were independent predictors of a lower intubation rate in AHRF patients in ICU. Prospective studies aimed at identifying the optimal interface and modality of non-invasive respiratory support in AHRF patients are needed.
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Journal of critical care · Oct 2021
Clinical TrialDynamic inhomogeneity of aeration along the vertical axis of the lung may predict weaning failure regardless of diaphragm dysfunction.
This study aimed to investigate dynamic changes of lung aeration during a spontaneous breathing trial (SBT) in patients with diaphragm dysfunction (DD) and to predict weaning failure using electrical impedance tomography (EIT). ⋯ Dynamic inhomogeneity of aeration along the vertical axis of the lung as assessed using TSA predicts SBT failure regardless of DD.
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Journal of critical care · Oct 2021
Case ReportsSuccessful treatment of acute spleno-porto-mesenteric vein thrombosis after ChAdOx1 nCoV-19 vaccine. A case report.
Several cases of deep venous thrombosis in people who had recently received Vaxzevria (previously known as COVID-19 Vaccine AstraZeneca) have recently been reported, mainly presenting as cerebral vein/cerebral venous sinus thrombosis. This syndrome has been termed "vaccine-induced immune thrombotic thrombocytopenia (VITT)". ⋯ We describe a case of concomitant thrombosis of portal, superior mesenteric and splenic veins in a young female patient with no other risk factors who received Vaxzevria (previously ChAdOx1 nCoV-19 vaccine, AstraZeneca) 17 days before. The diagnostic workup and the successful endovascular treatment and systemic anticoagulation management is reported.