Journal of critical care
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Journal of critical care · Oct 2022
Hypoxemia in the presence or absence of systemic inflammation does not increase blood lactate levels in healthy volunteers.
Elevated lactate levels are a sign of critical illness and may result from insufficient oxygen delivery. We investigated whether hypoxemia and/or systemic inflammation, results in increased lactate levels in healthy volunteers. ⋯ Hypoxemia, in the absence or presence of inflammation does not result in relevant increases of lactate. The small increases in lactate observed are likely to be due to hyperventilation-related decreases in glycolysis.
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Fluid resuscitation is a core component of emergency and critical care medicine. While the focus of clinicians has largely been on detecting patients who would respond to fluid therapy, relatively little work has been done on assessing patients' tolerance to this therapy. In this article we seek to review the concept of fluid tolerance, propose a working definition, and introduce relevant clinical signals by which physicians can assess fluid tolerance, hopefully becoming a starting point for further research.
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Journal of critical care · Oct 2022
LetterHeart rate variability and adrenal size provide clues to sudden cardiac death in hospitalized COVID-19 patients.
To examine the association between a measure of heart rate variability and sudden cardiac death (SCD) in COVID-19 patients. ⋯ Hospitalized patients with COVID-19 who experienced SCD had lower parasympathetic activity (RMSSD) and smaller sized adrenal glands. Further research is required to replicate these findings.
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Journal of critical care · Oct 2022
Development of a machine learning model for the prediction of the short-term mortality in patients in the intensive care unit.
The aim of this study was to develop and evaluate a machine learning model that predicts short-term mortality in the intensive care unit using the trends of four easy-to-collect vital signs. ⋯ This simple yet powerful new mortality prediction model could be useful for early detection of probable mortality and appropriate medical intervention, especially in rapidly deteriorating patients.