Journal of critical care
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Journal of critical care · Apr 2019
Regional differences in the treatment of refractory vasodilatory shock using Angiotensin II in High Output Shock (ATHOS-3) data.
Despite international guidelines, regional differences in treatment of vasodilatory shock remain. We characterized these differences using data from Angiotensin II in High Output Shock (ATHOS-3) trial. ⋯ Management of vasodilatory shock differs globally with respect to utilization of steroids and vasopressors. This practice heterogeneity may influence shock trials interpretation and patient outcomes, though more definitive evidence would require larger prospective intervention data.
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Journal of critical care · Apr 2019
ReviewThe state of bereavement support in adult intensive care: A systematic review and narrative synthesis.
Despite advances in medical science, patient death and family bereavement are commonly encountered in adult intensive care units (ICUs). This is the first review to investigate the state of ICU bereavement support globally, and the availability and effectiveness of bereavement support interventions. ⋯ The reviewed evidence was weak, and findings were contextually bound. As such, it is difficult to make recommendations for the most acceptable and effective bereavement support intervention(s). Bereavement support in ICU needs further exploration and clinicians must be adequately trained and supported for the delivery of evidence-informed, culturally competent care.
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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
ReviewHemodynamic response to β-blockers in severe sepsis and septic shock: A review of current literature.
The administration of β-blockers in patients with sepsis is a trending topic in intensive care medicine since the landmark study by Morelli and colleagues, showing a striking decrease in 28-day mortality compared to standard care. While the available evidence suggests that the use of β-blockers in septic shock is safe, the effects on hemodynamics are controversial. In this paper, we review the effect of β-blockade in septic shock on hemodynamics from animal models to critically ill patients.
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Journal of critical care · Apr 2019
Multicenter Study Observational StudyEpidemiology of disseminated intravascular coagulation in sepsis and validation of scoring systems.
We investigated the epidemiology and outcome of disseminated intravascular coagulation (DIC) in patients with sepsis. ⋯ Patients with sepsis and DIC have high mortality. However, the DIC are not independently associated with in-hospital mortality.