Journal of critical care
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Journal of critical care · Apr 2019
ReviewInterventions for the management and prevention of sarcopenia in the critically ill: A systematic review.
In the critically ill, sarcopenia is associated with a variety of adverse outcomes however there is no consensus regarding its management. This study aimed to systematically review the evidence for interventions for the management and prevention of sarcopenia in critically ill patients. ⋯ NMES and exercise-based interventions may preserve muscle mass and function in patients with critical illness. There is a lack of consistency seen in the effects of these interventions. Further, large, high quality RCTs are required.
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Journal of critical care · Apr 2019
Multicenter StudyFactors associated with mortality in severe community-acquired pneumonia: A multicenter cohort study.
Describe characteristics and outcomes of CAP admitted to public ICUs in Brazil. ⋯ CAP is associated with high mortality in patients admitted to public ICUs in Brazil. The current findings may help improve resource allocation and should aim at improving access to ICU care since delayed admission was associated with increased hospital mortality.
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Journal of critical care · Apr 2019
Airway pressure release ventilation does not increase intracranial pressure in patients with traumatic brain injury with poor lung compliance.
The use of Airway Pressure Release Ventilation (APRV) in patients with traumatic brain injury (TBI) remains controversial. Some believe that elevated mean airway pressures transmitted to the thorax may cause clinically significant increases in Central Venous Pressure (CVP) and intracranial pressure (ICP) from venous congestion. We perform a retrospective review from 2009 to 2015 of traumatically injured patients who were transitioned from traditional ventilator modes to APRV and also had an ICP monitor in place. ⋯ Individually, only 4 patients had ICP values >20 in the first hour after transitioning to APRV and the rate of ICP elevations was similar between the two modes of ventilation. These data show that APRV is a viable mode of ventilation in patients with TBI who have low lung compliance. The increased CVP of this mode of ventilation did not affect ICP or hemodynamic parameters.
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Journal of critical care · Apr 2019
ReviewOutcome of invasive mechanical ventilation in cancer patients: Intubate or not to intubate a patient with cancer.
The outcome of cancer patients who undergo mechanical ventilation has been grim. However, it has lately become more promising, creating hesitation when approaching the decision to intubate a cancer patient. Therefore, the main goal was to find some factors that could predict mortality. ⋯ The aforementioned predicting factors could be used when approaching the decision to intubate. When in doubt, we should give the benefit to the patient, proceed to intubate and reevaluate progress daily and in doing so, we would suggest to use the trends in SOFA score and weaning index to assess success or failure of invasive mechanical ventilation.
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Journal of critical care · Apr 2019
Multicenter Study Observational StudyIncidence and risk factors for alopecia in survivors of critical illness: A multi-centre observational study.
To investigate the incidence, nature and risk factors for patient-reported alopecia in survivors of critical illness. ⋯ Limited research exists examining the incidence, nature and risk factors for patient-reported alopecia in adult survivors of critical illness. The results of this study highlight the need to discuss the potential for alopecia with survivors of critical illness, who had sepsis / septic shock.