Journal of critical care
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Journal of critical care · Dec 2019
The incidence, predictors and outcomes of QTc prolongation in critically ill patients.
To study the incidence, predictors and outcomes of QTc prolongation (≥500 ms) during ICU admission. ⋯ A QTc ≥500 ms likely represents a marker of illness severity modulated by several risk factors, and carries no independent association with clinically-significant ventricular tachyarrhythmias. Thus, cessation of QT-prolonging medications to prevent arrhythmias may lack clinical benefit.
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Journal of critical care · Dec 2019
Safety of antimicrobial de-escalation for culture-negative severe pneumonia.
This study investigated the outcomes of antimicrobial de-escalation (ADE) based on mortality and the incidence of multi-drug resistant (MDR) pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis and septic shock. ⋯ We observed similar ICU mortality and MDR pathogen occurrence in patients with culture-negative pneumonia presenting with sepsis/shock regardless of whether they received ADE. Additionally, ADE lowered the antimicrobial burden.
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Journal of critical care · Dec 2019
Time of admission to intensive care unit, strained capacity, and mortality: A retrospective cohort study.
We sought to study the association between afterhours ICU admission and ICU mortality considering measures of strained ICU capacity. ⋯ Afterhours ICU admission and measures of strained ICU capacity were associated with crude but not adjusted ICU mortality.
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Journal of critical care · Dec 2019
Observational StudyRight ventricular dysfunction in neurologically deceased organ donors: An observational study in a tertiary-care organ donor referral centre.
Right ventricular RV dysfunction among transplant recipients correlates with transplant outcome, but its frequency in donors is unknown. The purpose of this study was to describe the epidemiology of RV dysfunction in potential heart donors." ⋯ We observed a high frequency of RV dysfunction in a sample of potential heart donors. However, the temporal evolution of RV dysfunction, the hemodynamic predictors of RV dysfunction, as well the link between donor RV dysfunction and recipient outcomes need to be assessed with further prospective studies.
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Journal of critical care · Dec 2019
Increased atrial contraction contribution to left ventricular filling during early septic shock.
To assess the atrial systolic function and the contribution of atrial contraction to left ventricular (LV) filling in septic shock patients as compared with healthy volunteers. ⋯ In septic shock patients, LA systolic function increased and greatly contributed to support LV filling. These results highlight the role of preserving atrial contraction on the hemodynamic resuscitation in early septic shock.