Journal of critical care
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Journal of critical care · Apr 2020
Impact of obstructive sleep apnea on the obesity paradox in critically ill patients.
Patients admitted to an intensive care unit (ICU) frequently suffer from multiple chronic diseases, including obstructive sleep apnea (OSA). Until recently OSA was not considered as a key determinant in an ICU patient's prognosis. The objective of this study was to document the impact of OSA on the prognosis of ICU patients. ⋯ In general, known OSA did not increase the ICU stay except for patients with both OSA and morbid obesity.
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Journal of critical care · Apr 2020
Predicting mortality among critically ill patients with acute kidney injury treated with renal replacement therapy: Development and validation of new prediction models.
Severe acute kidney injury (AKI) is associated with a significant risk of mortality and persistent renal replacement therapy (RRT) dependence. The objective of this study was to develop prediction models for mortality at 90-day and 1-year following RRT initiation in critically ill patients with AKI. ⋯ Routinely collected variables at the time of RRT initiation have limited ability to predict mortality in critically ill patients with AKI who commence RRT.
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Journal of critical care · Apr 2020
Review Meta AnalysisPharmacological interventions to reduce edema following cardiopulmonary bypass: A systematic review and meta-analysis.
To compare the effectiveness of different types of pharmacological agents to reduce organ specific edema following cardiopulmonary bypass (CPB). ⋯ Overall, neutrophil inhibitors and direct modulators of endothelial barrier (PAR1, Tie2 signaling) most effectively reduced edema following CPB, in particular pulmonary edema. Future research should focus on a combination of these strategies to reduce edema and assess the effect on organ function and outcome following CPB.
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Journal of critical care · Apr 2020
Review Case ReportsFrom a pressure-guided to a perfusion-centered resuscitation strategy in septic shock: Critical literature review and illustrative case.
To support a paradigm shift in the management of septic shock from pressure-guided to perfusion-centered, expected to improve outcome while reducing adverse effects from vasopressor therapy and aggressive fluid resuscitation. ⋯ We propose focusing the hemodynamic management of septic shock on reversing organ hypoperfusion instead of attaining a predefined MAP target as the key strategy for improving outcome.