Journal of critical care
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Journal of critical care · Dec 2021
Randomized Controlled TrialPredicting successful continuous renal replacement therapy liberation in critically ill patients with acute kidney injury.
No standardized criteria for continuous renal replacement therapy (CRRT) liberation have been established. We sought to develop and internally validate prediction models for successful CRRT liberation in critically ill patients with acute kidney injury (AKI). ⋯ These validated models could assist the decision-making related to the CRRT liberation in critically ill patients with AKI.
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Journal of critical care · Dec 2021
Multicenter Study Observational StudyEffect of rapid fluid administration on the prognosis of septic shock patients with isolated hyperlactatemia: A prospective multicenter observational study.
We aimed to investigate the association between initial fluid resuscitation in septic shock patients with isolated hyperlactatemia and outcomes. ⋯ Initial fluid resuscitation of 30 mL/kg within 3 or 6 h was neither associated with an increased or decreased in-hospital mortality in septic shock patients with isolated hyperlactatemia.
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Journal of critical care · Dec 2021
Randomized Controlled TrialUtilization and effect of neuromuscular blockade in a randomized trial of high-frequency oscillation.
We evaluated characteristics associated with neuromuscular blockade (NMB) use, center-level variation, and whether NMB mediated excess mortality among patients assigned to high-frequency oscillatory ventilation (HFOV) in the OSCILLATE trial. ⋯ In OSCILLATE, receipt of post-randomization NMB was associated with worse outcomes, but NMB use did not mediate HFOV-associated higher mortality.
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Journal of critical care · Dec 2021
Acute hyperventilation increases oxygen consumption and decreases peripheral tissue perfusion in critically ill patients.
This study aimed to evaluate the effects of acute hyperventilation on central venous-to-arterial carbon dioxide tension difference (Pv-aCO2), central venous oxygen saturation (ScvO2), central venous-to-arterial CO2 difference/arterial-central venous O2 difference ratio (CO2GAP-Ratio), and peripheral perfusion index (PI) in hemodynamically stable critically ill patients. ⋯ Acute hyperventilation induced an increase in oxygen consumption and decreased peripheral tissue perfusion in patients. For critical care patients, it is necessary to pay attention to the influence of hyperventilation on peripheral tissue perfusion indices and oxygen consumption indices.
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Journal of critical care · Dec 2021
Observational StudyA radiological predictor for pneumomediastinum/pneumothorax in COVID-19 ARDS patients.
To determine whether Macklin effect (a linear collection of air contiguous to the bronchovascular sheath) on baseline CT imaging is an accurate predictor for subsequent pneumomediastinum (PMD)/pneumothorax (PNX) development in invasively ventilated patients with COVID-19-related acute respiratory distress syndrome (ARDS). ⋯ Macklin effect accurately predicts, 8.5 days in advance, PMD/PNX development in COVID-19 ARDS patients.