Journal of critical care
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Journal of critical care · Oct 2022
Review Meta AnalysisSleep assessment in critically ill adults: A systematic review and meta-analysis.
To systematically review sleep evaluation, characterize sleep disruption, and explore effects of sleepdisruption on outcomes in adult ICU patients. ⋯ Sleep in critically ill patients is severely disturbed, and actigraphy and RCSQ seem reliable alternatives to PSG. Future studies should evaluate impact of sleep disruption on outcomes.
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Journal of critical care · Oct 2022
Meta AnalysisAssociation between timing of intubation and clinical outcomes of critically ill patients: A meta-analysis.
Optimal timing of intubation is controversial. We attempted to investigate the association between timing of intubation and clinical outcomes of critically ill patients. ⋯ Avoiding late intubation may be associated with lower mortality in critically ill patients without COVID-19.
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Journal of critical care · Oct 2022
Palliative and end-of-life care in intensive care units in low- and middle-income countries: A systematically constructed scoping review.
Death is common in intensive care units, and integrating palliative care enhances outcomes. Most research has been conducted in high-income countries. The aim is to understand what is known about the type and topics of research on the provision of palliative care within intensive care units in low- and middle-income countries MATERIALS AND METHODS: Scoping review with nine databases systematically searched for literature published in English on palliative care in intensive care units in low- and middle- income settings (01/01/1990 to 31/05/2021). Two reviewers independently checked search results and extracted textual data, which were analyzed and represented as themes. ⋯ Palliative care in intensive care units in low-and middle-income countries is understudied. Research focused on the specific needs of intensive care in low- and middle-income countries is required to ensure optimal patient outcomes.
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Journal of critical care · Oct 2022
Impact of cardiac surgery and neurosurgery patients on variation in severity-adjusted resource use in intensive care units.
The resource use of cardiac surgery and neurosurgery patients likely differ from other ICU patients. We evaluated the relevance of these patient groups on overall ICU resource use. ⋯ Cardiac and neurosurgery have major effects on the cost structure of multidisciplinary ICUs. Extending SRUR analysis to patient subpopulations facilitates comparison of resource use between ICUs and may help to optimize resource allocation.
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Journal of critical care · Oct 2022
Time-dependent uncertainty of critical care transitions in very old patients - lessons for time-limited trials.
Prognostication for patients with critical conditions remains challenging, especially for very old individuals. Time-limited trials (TLT) are used to decrease prognostic uncertainty in the individual patient by monitoring the response to treatment over a pre-determined period of time. However, there are substantial difficulties with determining the length of that period. This study presents a probabilistic method to estimate a suitable duration of a TLT based on temporal profiles of uncertainty about critical care and outcome. ⋯ Time-dependent patterns of uncertainty concerning the response to critical care can inform decisions about the duration of TLTs which may last up to a week in very old patients.