Journal of critical care
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Journal of critical care · Jun 2023
ReviewNon-pharmacological interventions for self-management of fatigue in adults: An umbrella review of potential interventions to support patients recovering from critical illness.
Fatigue is a common symptom after critical illness. However, evidence-based interventions for fatigue after critical illness are lacking. We aimed to identify interventions to support self-management of fatigue caused by physical conditions and assess their effectiveness and suitability for adaptation for those with fatigue after critical illness. ⋯ Self-management can be effective at reducing fatigue symptoms and improving quality of life for physical conditions and has clear potential for supporting people with fatigue after critical illness, but more conclusive data on effectiveness and clearer definitions of self-management are required.
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Journal of critical care · Jun 2023
Multicenter StudyDefinitions, rates and associated mortality of ICU-acquired pneumonia: A multicenter cohort study.
We aimed to analyze intensive care unit (ICU)-acquired pneumonia according to 7 definitions, estimating associated hospital mortality. ⋯ Rates of ICU-acquired pneumonia vary by definition and are associated with differential increased risk of death.
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Journal of critical care · Jun 2023
Refractory septic shock and alternative wordings: A systematic review of literature.
We reviewed the different studies using the terms "refractory septic shock" and/or "catecholamine resistance" and/or "high dose norepinephrine" so as to highlight the heterogeneity of the definitions used by authors addressing such concepts. ⋯ Marked inconsistencies were identified in the usage of the terms for refractory septic shock. There is a pressing need to determine consensus definitions so as to establish a common language in the medical literature and to harmonize future studies.
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Journal of critical care · Jun 2023
Observational StudyReverse triggering neural network and rules-based automated detection in acute respiratory distress syndrome.
Dyssynchrony may cause lung injury and is associated with worse outcomes in mechanically ventilated patients. Reverse triggering (RT) is a common type of dyssynchrony presenting with several phenotypes which may directly cause lung injury and be difficult to identify. Due to these challenges, automated software to assist in identification is needed. ⋯ Automated detection of RT demonstrated good performance, with the potential application of these programs for research and clinical care.
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Journal of critical care · Jun 2023
Assessing a standardized decision-making algorithm for blood culture collection in the intensive care unit.
Blood cultures are commonly ordered for patients with low risk of bacteremia. Indications for obtaining blood cultures are often broad and ill defined, and decision algorithms for appropriate blood cultures have not been comprehensively evaluated in critically-ill populations. ⋯ In a cohort of critically-ill patients, inappropriate blood cultures were common. The indications for blood cultures are often not evidence-based, and evidence-based algorithms to guide the collection of blood cultures may offer a way to decrease inappropriate culture orders.