Journal of critical care
-
Journal of critical care · Jun 2021
Observational StudyMean amplitude of glycemic excursions in septic patients and its association with outcomes: A prospective observational study using continuous glucose monitoring.
To apply continuous glucose monitoring (CGM) and determine the mean amplitude of glycemic excursions (MAGE) in septic patients and to assess the associations of MAGE with outcomes and oxidative stress. ⋯ In the current study, MAGE for the first 48 h of treatment that was obtained by using CGM was associated with 90-day all-cause mortality, 90-day ICU-free days and urinary 8-isoprostaglandinF2α level in septic patients.
-
Journal of critical care · Jun 2021
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: A pilot ethnography.
The effect of communication between referring and accepting clinicians during patient transitions to the pediatric intensive care unit (PICU) on diagnostic quality is largely unknown. This pilot study aims to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. ⋯ Focused ethnography in the PICU is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
-
Journal of critical care · Jun 2021
Implementation of lung protective ventilation order to improve adherence to low tidal volume ventilation: A RE-AIM evaluation.
Lung protective ventilation (LPV), defined as a tidal volume (Vt) ≤8 cc/kg of predicted body weight, reduces ventilator-induced lung injury but is applied inconsistently. ⋯ We designed and implemented an LPV order that sustainably improved LPV adherence across diverse ICUs.
-
Journal of critical care · Jun 2021
Observational StudyCombination of delirium and coma predicts psychiatric symptoms at twelve months in critically ill patients: A longitudinal cohort study.
We aimed to determine any associations between delirium and comas during intensive care unit (ICU) stay, and long-term psychiatric symptoms and disability affecting activity of daily living (ADL). ⋯ In critically ill adults, combination of delirium and comas during ICU stay is a predictor of psychiatric symptoms or ADL disability.
-
Journal of critical care · Jun 2021
A preliminary cost-effectiveness analysis of lung protective ventilation with extra corporeal carbon dioxide removal (ECCO2R) in the management of acute respiratory distress syndrome (ARDS).
Mechanical ventilation (MV) is the cornerstone in the management of the acute respiratory distress syndrome (ARDS). Recent research suggests that decreasing the intensity of MV using lung protective ventilation (LPV) with lower tidal volume (Vt) and driving pressure (∆P) could improve survival. Extra-corporal CO2 removal (ECCO2R) precisely enables LPV by allowing lower Vt, ∆P and mechanical power while maintaining PaCO2 within a physiologic range. This study evaluates the potential cost-effectiveness of ECCO2R-enabled LPV in France. ⋯ ECCO2R-enabled LPV strategies might provide cost-effective survival benefit. Additional data from interventional and observational studies are needed to support this preliminary model-based analysis.