Journal of critical care
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Journal of critical care · Apr 2021
ReviewNeuroinflammation, neuronal damage or cognitive impairment associated with mechanical ventilation: A systematic review of evidence from animal studies.
Long-term cognitive impairment is a complication of critical illness survivors. Beside its lifesaving role, mechanical ventilation has potential complications. The aim of this study is to systematically review the evidence collected in animal studies that correlate mechanical ventilation with neuroinflammation, neuronal damage and cognitive impairment. ⋯ Preclinical evidence suggests that MV induces neuroinflammation, neuronal damage and cognitive impairment and these are worsened if sub-optimal MV settings are applied. Future studies, with appropriate methodology, are necessary to evaluate for serum monitoring strategies.
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Journal of critical care · Apr 2021
Observational StudyVeno-arterial CO2 difference and respiratory quotient after cardiac arrest: An observational cohort study.
To characterize venous-arterial CO2 difference (ΔpCO2) and the respiratory quotient (RQ) in post cardiac arrest patients and evaluate the association between these parameters and patient outcome. ⋯ RQ was associated with ICU mortality and ΔpCO2 identified elevated RQ in the early phase after cardiac arrest. However, ΔpCO2 were negatively associated with both ICU mortality and neurologic outcome.
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Journal of critical care · Apr 2021
New-onset atrial fibrillation in patients with acute kidney injury on continuous renal replacement therapy.
The mortality of critically ill patients with acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT) remains high. We assessed the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population and its impact on outcomes. ⋯ NOAF in critically ill patients with AKI receiving CRRT is common and carries an unfavorable prognosis. Prospective studies are required to elucidate modifiable risk factors for NOAF occurring on CRRT.
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Journal of critical care · Apr 2021
Burnout in ICU doctors and nurses in mainland China-A national cross-sectional study.
A national cross-sectional study was performed to investigate the severity of burnout and its associated factors among doctors and nurses in ICUs in mainland China. ⋯ The burnout rate of ICU doctors and nurses in mainland China is 69.7%. Our study provides baseline data about burnout among Chinese medical staff predating COVID-19, which could help in the analysis and interpretation of burnout during the COVID-19 pandemic.
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Journal of critical care · Apr 2021
Evaluation of dexmedetomidine withdrawal in critically ill adults.
Dexmedetomidine (DEX) withdrawal syndrome has been reported in the pediatric population, but literature describing DEX withdrawal in critically ill adults is limited. The purpose of this study was to determine the incidence of DEX withdrawal in adult patients and to identify factors associated with DEX withdrawal syndrome. ⋯ Development of DEX-associated withdrawal occurred in approximately 30% of adult patients, comparable to rates reported in pediatric literature. There appeared to be no correlation between dose, exposure, and weaning in the occurrence of withdrawal, but concomitant discontinuation of opioids or benzodiazepines as well as ICU admission type could highlight cases requiring closer monitoring.