Journal of critical care
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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
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
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
Observational StudyThe impact of eligibility for primary attendings and nurses on PICU length of stay.
To examine whether primary attendings and/or nurses impact pediatric intensive care unit (PICU) length of stay (LOS) in long-stay patients (LSP). ⋯ The findings of lower LOS in LSP who were eligible for primary practices should induce more rigorous research on the impact of these primary practices.
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Journal of critical care · Apr 2021
Short-and long-term outcomes of sustained low efficiency dialysis vs continuous renal replacement therapy in critically ill patients with acute kidney injury.
Sustained low efficiency dialysis (SLED) has emerged as an alternative to continuous renal replacement therapy (CRRT) for the treatment of acute kidney injury (AKI) in critically ill patients. However, there is limited information on the short- and long-term outcomes of SLED compared to CRRT. ⋯ Among critically ill patients with acute kidney injury, mortality at 90 days and one year was not different among patients initiating SLED as compared to CRRT.