Journal of critical care
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Journal of critical care · Apr 2021
Frailty and long-term outcomes following critical illness: A population-level cohort study.
To provide population-level estimates of the association of frailty with one-year outcomes after critical illness. ⋯ Patients with pre-existing frailty who develop critical illness have higher rates of hospital readmission and death than patients without frailty, and age modifies these associations. These data highlight the importance of considering both frailty and age when seeking to identify at-risk patients who might benefit from closer follow-up after discharge.
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Journal of critical care · Apr 2021
Including urinary output to define AKI enhances the performance of machine learning models to predict AKI at admission.
Acute kidney injury (AKI) is a prevalent and detrimental condition in intensive care unit patients. Most AKI predictive models only predict creatinine-triggered AKI (AKICr) and might underperform when predicting urine-output-triggered AKI (AKIUO). We aimed to describe how admission AKICr prediction models perform in all AKI patients. ⋯ Ignoring urine output in the outcome during model training resulted in models that are unlikely to predict AKIUO adequately and may miss a substantial proportion of patients in practice.
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Journal of critical care · Apr 2021
Impact of therapeutic hypothermia on bleeding events in adult patients treated with extracorporeal life support peri-cardiac arrest.
Whether therapeutic hypothermia (TH) adds to the risk of bleeding in patients on extracorporeal life support (ECLS) peri-cardiac arrest remains unknown. ⋯ Bleeding complications were common in our study. However, TH (32-34 °C) was not associated with an increased risk of major bleeding in patients on ECLS peri-cardiac arrest.
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Journal of critical care · Apr 2021
Mortality and renal outcomes of patients with severe COVID-19 treated in a provisional intensive care unit.
COVID-19 has created an enormous health crisis and this spring New York City had a severe outbreak that pushed health and critical care resources to the limit. A lack of adequate space for mechanically ventilated patients induced our hospital to convert operating rooms into critical care areas (OR-ICU). A large number of COVID-19 will develop acute kidney injury that requires renal replacement therapy (RRT). ⋯ When defining renal recovery as a discharge serum creatinine within 150% of baseline, 68 of 78 survivors showed renal recovery (87.2%). Survival was similar to previous reports of patients with severe COVID-19 for patients cared for in provisional ICUs compared to standard ICUs. Most patients with severe COVID-19 and AKI are likely to recover full renal function.
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Journal of critical care · Apr 2021
Burnout, resilience and work engagement among Dutch intensivists in the aftermath of the COVID-19 crisis: A nationwide survey.
The COVID-19 crisis put a strain on intensive care resources everywhere in the world increasing the risk of burnout. Previously, the prevalence of burnout among Dutch intensivists was found to be low. Engagement and resilience among intensivists have not previously been studied quantitatively, however, both are related to burnout and provide a possible way to mitigate burnout. Our objective was to study burnout and its association with work engagement and resilience among Dutch intensivists in the aftermath of the COVID-19 crisis. ⋯ In the aftermath of the 2020 COVID-19 crisis, we found a raised prevalence of burnout among intensivists, however this is still low in international comparisons. Intensivists with burnout scored low on resilience and low on work engagement.