Journal of critical care
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Journal of critical care · Oct 2019
Multicenter StudySafety and efficacy of beta-blockers to improve oxygenation in patients on veno-venous ECMO.
Beta-blockers (BB) may improve oxygenation in patients on veno-venous extracorporeal membrane oxygenation (V-V ECMO). This study analyzed safety and efficacy of BB in hypoxemic patients on V-V ECMO. ⋯ In this study, use of BB in hypoxemic patients on V-V ECMO was safe and associated with a moderate increase in SaO2.
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Journal of critical care · Aug 2019
Multicenter Study Comparative Study Clinical TrialA comparison of very old patients admitted to intensive care unit after acute versus elective surgery or intervention.
We aimed to evaluate differences in outcome between patients admitted to intensive care unit (ICU) after elective versus acute surgery in a multinational cohort of very old patients (≥80 years; VIP). Predictors of mortality, with special emphasis on frailty, were assessed. ⋯ VIPs admitted to ICU after elective surgery evidenced favorable outcome over patients after acute surgery even after correction for relevant confounders. Frailty might be used to guide clinicians in risk stratification in both patients admitted after elective and acute surgery.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Multicenter StudyImmune function testing in sepsis patients receiving sodium selenite.
We examined in a longitudinal study the role of sodium selenite in sepsis patients in strengthening the immune performance in whole blood samples using immune functional assays. ⋯ Selenium has long been an adjuvant therapy in treating sepsis. Recently, it was proven to not have beneficial effects on the mortality outcome. Using data from our center in this sub-cohort study, we identified no relative improvement in cytokine release of stimulated blood immune cells ex vivo from patients with selenium therapy over a three-week period. This offers a potential explanation for the lack of beneficial effects of selenium in sepsis patients.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Multicenter Study Comparative StudyHigh versus low mean arterial pressures in hepatorenal syndrome: A randomized controlled pilot trial.
There is controversy regarding the mean arterial pressure (MAP) goals that should be targeted in the treatment of hepatorenal syndrome (HRS.) We conducted a study to assess different MAP targets in HRS in the intensive care unit (ICU).
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Journal of critical care · Aug 2019
Multicenter Study Observational StudyPsychocognitive sequelae of critical illness and correlation with 3 months follow up.
Over a third of critical illness survivors manifest significant psychocognitive impairments following discharge from the intensive care unit (ICU). It is not known which patient populations are at highest risk or if assessment at ICU discharge can guide outpatient treatment prioritization. ⋯ There was no significant difference in impairment by ICU type. Significant correlation between the initial assessment and follow-up scores suggests that early screening of high risk patients may identify those at greatest risk of sustained morbidity and facilitate timely intervention.