Journal of critical care
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Journal of critical care · Oct 2024
Randomized Controlled TrialThe effect of high-dose selenium on mortality and postoperative organ dysfunction in post-cardiotomy cardiogenic shock patients supported with mechanical circulatory support - A post-hoc analysis of the SUSTAIN CSX trial.
Cardiac surgery, post-cardiotomy cardiogenic shock (PCCS), and temporary mechanical circulatory support (tMCS) provoke substantial inflammation. We therefore investigated whether a selenium-based, anti-inflammatory strategy would benefit PCCS patients treated with tMCS in a post-hoc analysis of the sustain CSX trial. ⋯ In this explorative study, a perioperative high-dose selenium-supplementation did not show beneficial effects on organ dysfunctions and mortality rates in patients with PCCS receiving tMCS.
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Journal of critical care · Oct 2024
Enhancing Sepsis prognosis: Integrating social determinants and demographic variables into a comprehensive model for critically ill patients.
The Sequential Organ Failure Assessment (SOFA) score monitors organ failure and defines sepsis but may not fully capture factors influencing sepsis mortality. Socioeconomic and demographic impacts on sepsis outcomes have been highlighted recently. ⋯ Adding patient-specific demographic and socioeconomic information to clinical metrics significantly improves sepsis mortality prediction. This suggests a more comprehensive, multidimensional prognostic approach is needed for accurate sepsis outcome predictions.
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Journal of critical care · Oct 2024
The ratio of parasternal intercostal muscle-thickening fraction-to-diaphragm thickening fraction for predicting weaning failure.
Diaphragm dysfunction is associated with weaning outcomes in mechanical ventilation patients, in the case of diaphragm dysfunction, the accessory respiratory muscles would be recruited. The main purpose of this study is to explore the performance of parasternal intercostal muscle thickening fraction in relation to diaphragmatic thickening fraction ratio (TFic1/TFdi2) for predicting weaning outcomes, and compare its accuracy with D-RSBI in predicting weaning failure. ⋯ The TFic/TFdi ratio predicted weaning failure with high accuracy and outperformed the D-RSBI.
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Journal of critical care · Oct 2024
Urea to creatinine ratio as a predictor of persistent critical illness.
Persistent critical illness (PCI) is a syndrome in which the acute presenting problem has been stabilized, but the patient's clinical state does not allow ICU discharge. The burden associated with PCI is substantial. The most obvious marker of PCI is prolonged ICU length of stay (LOS), usually greater than 10 days. Urea to Creatinine ratio (UCr) has been suggested as an early marker of PCI development. ⋯ In this single center retrospective cohort study, UCr was not found to be associated with PCI development.
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Journal of critical care · Oct 2024
LetterDriving pressure during routine ventilation in the ICU: Is the ICU-team as driven as they should be?
To evaluate the effect of structured staff training on the respiratory support provided. ⋯ These results suggest that ICU staff training could lead to more adequate respiratory support provided during controlled mechanical ventilation.