Journal of critical care
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Journal of critical care · Jun 2021
Positive fluid balance was associated with mortality in patients with acute-on-chronic liver failure: A cohort study.
We aimed to study the effect of FB in the outcomes of critically-ill patients with cirrhosis. ⋯ FB may be a therapeutic target that helps to improve the outcomes of patients with acute-on-chronic liver failure. This data may inform future clinical trials.
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Journal of critical care · Jun 2021
Observational StudyThe prevalence of serotonin syndrome in an intensive care unit: A prospective observational study.
In spite of life-threatening nature of serotonin syndrome (SS), it remains an under-diagnosed condition. The availability of epidemiological data about SS, especially in the ICU setting, may help physicians make early diagnoses and interventions. ⋯ SS is not uncommon in the ICU setting. There is a need to increase awareness among physicians.
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Journal of critical care · Jun 2021
Balanced crystalloids versus saline in critically ill adults with low plasma bicarbonate: A secondary analysis of a clinical trial.
We aimed to determine if balanced crystalloids compared with saline improve outcomes in critically ill adults admitted with low plasma bicarbonate. ⋯ Among critically ill adults presenting to the Emergency Department, initial plasma bicarbonate concentration does not appear to be a useful marker to guide the selection of balanced crystalloid versus saline.
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Journal of critical care · Jun 2021
Multicenter StudyAssessment of fluid resuscitation on time to hemodynamic stability in obese patients with septic shock.
Assess time to hemodynamic stability (HDS) in obese patients with septic shock who received <30 vs. ≥30 ml/kg of initial fluid resuscitation based on actual body weight (ABW). ⋯ Obese patients given ≥30 ml/kg based on ABW had a shorter time to HDS and a lower risk of in-hospital death. Exploratory results suggest improved outcomes resuscitating by ABW vs. IBW; ABW showed no strong benefit over AdjBW. Further prospective studies are needed to confirm the optimal fluid dosing in obese patients.
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Journal of critical care · Jun 2021
Observational StudyTranspulmonary pressure measurements and lung mechanics in patients with early ARDS and SARS-CoV-2.
Acute Respiratory Distress Syndrome (ARDS) secondary to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has demonstrated variable oxygenation and respiratory-system mechanics without investigation of transpulmonary and chest-wall mechanics. This study describes lung, chest wall and respiratory-system mechanics in patients with SARS-CoV-2 and ARDS. ⋯ Patients displayed normal chest-wall mechanics, with increased basal pleural pressure. Respiratory system and lung mechanics were similar to known existing ARDS cohorts. The wide range of respiratory system mechanics illustrates the inherent heterogeneity that is consistent with typical ARDS.