Journal of critical care
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Journal of critical care · Feb 2021
EditorialOn predictions in critical care: The individual prognostication fallacy in elderly patients.
Predicting the future course of critical conditions involves personal experience, heuristics and statistical models. Although these methods may perform well for some cases and population averages, they suffer from substantial shortcomings when applied to individual patients. ⋯ This notably applies to triage situations in response to a lack of healthcare resources. We will discuss these issues and argue that analysing longitudinal data obtained from time-limited trials in intensive care can provide a more robust approach to individual prognostication.
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To document the equipment, resource and bed capacity of Intensive Care Units (ICUs) in the Republic of Ghana. ⋯ Ghana has a significant shortage of critical care beds that are inequitably distributed across the country and a shortfall of intensivists to staff ICUs. A holistic approach that focuses on the key bottlenecks to quality improvement would be required to improve the capacity and quality of critical care delivery.
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Journal of critical care · Feb 2021
Fatal cerebral edema in patients with decompensated cirrhosis: A case series.
Unlike patients with acute liver failure, patients with cirrhosis are not traditionally thought to be at risk for developing cerebral edema. In the largest case series to date, we document clinical characteristics of cirrhotic patients who develop cerebral edema. ⋯ ACLF patients with neurological decompensation exhibit distinct clinical changes. Noninvasive bedside techniques may serve as surrogate measures for ICP.
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Journal of critical care · Feb 2021
Safety of the endotracheal tube for prolonged mechanical ventilation.
The endotracheal tube (ETT) is the most common route for invasive mechanical ventilation (MV) yet controversy attends its long-term safety. ⋯ The safety of ETT compared with TT beyond short-term MV (≤9-days) is uncertain and requires prospective evaluation with additional data.