Journal of critical care
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Journal of critical care · Oct 2020
Observational StudyPsychotropic medication use in former ICU patients with mental health problems: A prospective observational follow-up study.
To describe the extent to which patients with mental health problems after admission to an Intensive Care Unit (ICU) initiate and use psychotropic medication. ⋯ Former ICU patients with mental health problems were almost four times more likely to use psychotropic medication than former ICU patients without these problems. Future research should investigate whether mental health problems are properly diagnosed and treated in former ICU patients.
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Journal of critical care · Oct 2020
Comparative StudyComparison of two frailty identification tools for critically ill patients: A post-hoc analysis of a multicenter prospective cohort study.
We aimed to describe the association of two frailty screening tools, the validated Clinical Frailty Scale (CFS) score and the recently described modified Frailty Index (mFI) in critically ill patients. ⋯ While the CFS and mFI showed low concordance, both showed good discrimination and predictive validity for hospital mortality. Both tools identify a subgroup of frail patients more likely to have worse clinical outcomes.
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Journal of critical care · Oct 2020
Case ReportsClinically significant anticardiolipin antibodies associated with COVID-19.
The novel coronavirus strain known as SARS-CoV-2 has rapidly spread around the world creating distinct challenges to the healthcare workforce. Coagulopathy contributing to significant morbidity in critically ill patients with SARS-CoV-2 has now been well documented. ⋯ Obtaining serial inflammatory markers in conjunction with anti-phospholipid antibody testing revealed clinically significant Antiphospholipid syndrome (APS). This case series reviews the details preceding APS observed in SARS-CoV-2 and aims to report findings that could potentially further our understanding of the disease.
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Journal of critical care · Oct 2020
Critical care guidelines on pain, agitation and delirium management: Which one to use? A systematic literature search and quality appraisal with AGREE II.
Clinical practice guidelines (CPGs) facilitate the provision of standardized, high-quality intensive care medicine. For the management of pain, agitation and delirium, several coexisting CPGs have been published. This study aims at the appraisal of CPGs on pain, agitation and delirium management in the intensive care unit to (a) identify high quality guidelines appropriate for clinical use and (b) identify potential areas for future improvement. ⋯ Three of the eight reviewed guidelines exceeded the quality threshold in all domains, while the overall guideline quality was also very high. Focusing on guideline applicability and identifying strategies to facilitate implementation can improve future CPGs.
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Journal of critical care · Oct 2020
Randomized Controlled Trial Observational StudyDeterminants of Total/ionized Calcium in patients undergoing citrate CVVH: A retrospective observational study.
To identify potential determinants of the Total/ionized Ca ratio (T/iCa), a marker of citrate accumulation. ⋯ Besides citrate dose, a high pH and high phosphate, albumin and APACHE are also associated with a rising T/iCa.