Journal of critical care
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Journal of critical care · Feb 2020
Degree of hyperglycemia independently associates with hospital mortality and length of stay in critically ill, nondiabetic patients: Results from the ANZICS CORE binational registry.
Hyperglycemia (HG) in critically ill patients influences clinical outcomes and hospitalization costs. We aimed to describe association of HG with hospital mortality and length of stay in large scale, real-world scenario. ⋯ In this largest study of nondiabetic ICU patients, HG was associated with both study outcomes. This association was differential across ICUs and diagnostic categories.
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Journal of critical care · Feb 2020
Short, and long-term mortality among cardiac intensive care unit patients started on continuous renal replacement therapy.
Patients requiring continuous renal replacement therapy (CRRT) are at high risk of death. Predictors of hospital mortality and post-discharge survival in cardiac intensive care unit (CICU) patients requiring CRRT have not been reported. ⋯ Mortality is high among CICU patients requiring CRRT, and is predicted by the Braden score, RV dysfunction, respiratory failure and vasopressor load.
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Journal of critical care · Dec 2019
Quality of care and safety measures of acute renal replacement therapy: Workgroup statements from the 22nd acute disease quality initiative (ADQI) consensus conference.
There is wide variation in the practice of acute renal replacement therapy (RRT). Quality of care is suboptimal, and substantial knowledge-to-care gaps need to be addressed. The quality of care for patients receiving acute RRT has been recognized as a clinical and research priority. Quality indicators (QIs) can be implemented to measure the quality of care received by patients and further be used as targets for continuous quality improvement initiatives focused on the prescription, delivery, and monitoring of acute RRT care. ⋯ Currently, there remains few validated QIs for acute RRT. These need further evaluation, need benchmarks established, and ultimately require implementation into clinical practice.
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Journal of critical care · Dec 2019
Meta AnalysisNon-opioid analgesics as adjuvants to opioid for pain management in adult patients in the ICU: A systematic review and meta-analysis.
To identify the impact of non-opioid analgesics as adjuvants to opioid on opioid consumption and its side effects, as well as the analgesic effectiveness in adult patients in the ICU. ⋯ Non-opioid analgesics as adjuvants to opioid reduced the consumption and the side effects of opioids in adult surgical and Guillain-Barre syndrome patients in the ICU.
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Journal of critical care · Dec 2019
Review Case ReportsSepsis induced cardiomyopathy: Pathophysiology and use of mechanical circulatory support for refractory shock.
Sepsis remains a major cause of morbidity and mortality, and sepsis-induced cardiomyopathy (SCM) has been recognized as a relevant complication. In this article, the pathophysiology of SCM and the literature regarding the clinical care with a focus on the use of mechanical circulatory support for the rescue of patients with severe SCM are reviewed. Lastly, a pragmatic approach to the care of this complex patient population is provided using a representative case example.