Journal of critical care
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Journal of critical care · Aug 2023
Observational StudyLong-term physical impairments in survivors of COVID-19-associated ARDS compared with classic ARDS: A two-center study.
This work aimed to compare physical impairment in survivors of classic ARDS compared with COVID-19-associated ARDS (CARDS) survivors. ⋯ Both classic ARDS and CARDS survivors experienced long-term impairments in physical functioning, confirming that post-intensive care syndrome remains a major legacy of critical illness. Surprisingly, however, persisting disability was more common in survivors of classic ARDS than in CARDS survivors. In fact, muscle strength measured with HGD was reduced in survivors of classic ARDS compared to CARDS patients at both 6 and 12 months. The 6MWT was reduced and fatigue was more common in classic ARDS compared to CARDS at 6 months but differences were no longer significant at 12 months. Most patients in both groups regained independent function in ADLs at 6 months.
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Journal of critical care · Aug 2023
ReviewPhysiological and clinical effects of different infusion rates of intravenous fluids for volume expansion: A scoping review.
To assess the physiological and clinical effects of different rates of intravenous fluids for volume expansion of critically ill and perioperative patients. ⋯ In this scoping review, most studies showed that slower intravenous infusion rates result in a more efficient intravascular expansion, with a longer effect, and less edema than faster rates. Effects on clinical outcomes were inconsistent.
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Journal of critical care · Aug 2023
Echocardiographic profiles and hemodynamic response after vasopressin initiation in septic shock: A cross-sectional study.
Vasopressin, used as a catecholamine adjunct, is a vasoconstrictor that may be detrimental in some hemodynamic profiles, particularly left ventricular (LV) systolic dysfunction. This study tested the hypothesis that echocardiographic parameters differ between patients with a hemodynamic response after vasopressin initiation and those without a response. ⋯ Pre-drug echocardiographic profiles differed in hemodynamic responders after vasopressin initiation versus non-responders.
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Journal of critical care · Aug 2023
Diagnosing sepsis in the ICU: Comparison of a gene expression signature to pre-existing biomarkers.
We aimed to identify a gene signature that discriminates between sepsis and aseptic inflammation in patients administered antibiotics in the intensive care unit and compare it to commonly utilised sepsis biomarkers. ⋯ A gene expression signature was identified that accurately discriminates between sepsis and aseptic inflammation in patients given antibiotics in the intensive care unit.
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Journal of critical care · Aug 2023
Observational StudyIsolated diastolic dysfunction is associated with increased mortality in critically ill patients.
Left ventricular (LV) diastolic dysfunction is important in critically ill patients, but prevalence and impact on mortality is not well studied. We classified intensive care patients with normal left ventricular function according to current diastolic guidelines and explored associations with mortality. ⋯ Isolated diastolic dysfunction, assessed by a multi-parameter approach, is common in critically ill patients and is associated with mortality.