Journal of critical care
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Journal of critical care · Oct 2022
ReviewHospital-related costs of sepsis around the world: A systematic review exploring the economic burden of sepsis.
The aim of this study was to examine the quality of manuscripts reporting sepsis health care costs and to provide an overview of hospital-related expenditures for sepsis in adult patients around the world. ⋯ While general sepsis costs are high, there is considerable variability between countries regarding the costs of sepsis. Further studies examining the impact on sepsis costs, especially on the general ward, can help justify, design and monitor initiatives on prevention, diagnosis, and treatment of this time-critical and potentially preventable disease.
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Journal of critical care · Oct 2022
ReviewAgreement between subcostal and transhepatic longitudinal imaging of the inferior vena cava for the evaluation of fluid responsiveness: A systematic review.
Assessment of fluid-responsiveness is a key aspect of daily management in critically ill patients. Non-invasive evaluation of the variation of inferior vena cava (IVC) diameter during ventilation may provide useful information. However, a standard sagittal IVC visualization from the subcostal (SC) region is not always feasible. An alternative method to visualize the IVC is a coronal trans-hepatic (TH) approach. ⋯ An overview of the included studies suggests that longitudinal TH and SC assessment of IVC size and respiratory variation are not interchangeable. New studies with accurate data reporting and appropriate statistical analysis are needed to define proper cut-offs for fluid responsiveness when using TH approach for IVC visualization.
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Journal of critical care · Oct 2022
ReviewPitfalls and pearls with drug dosing in the critically ill obese patient: 10 statements to guide ICU practitioners.
Obesity is highly prevalent in ICU patients presenting a number of challenges, one of which is drug dosing. There are limited high-quality data describing drug dosing in obesity, which can lead to dosing strategies that are suboptimal. ⋯ A generalized framework for decision making specific for obese patients is available that describes a step-by-step approach for constructing dosing regimens. This manuscript will build on that framework by providing pitfalls and pearls for clinicians to consider when making dosing decisions in critically ill patients with severe obesity.
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Journal of critical care · Oct 2022
Observational StudyPropofol versus midazolam sedation in patients with cardiogenic shock - an observational propensity-matched study.
Benzodiazepines are recommended as first line sedative agent in ventilated cardiogenic shock patients, although data regarding the optimal sedation strategy are sparse. The aim of this study was to investigate the hemodynamic effects of propofol versus midazolam sedation in our cardiogenic shock registry. ⋯ In this observational cohort study, sedation with propofol in comparison to midazolam was linked to a reduced dose of catecholamines, decreased mortality and bleeding rates for patients with cardiogenic shock. Based on this study and in contrast to current recommendations, propofol should be given consideration for sedation in cardiogenic shock patients.
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Journal of critical care · Oct 2022
Multicenter StudyIn-hospital mortality of critically Ill patients with interactions of acute kidney injury and acute respiratory failure in the resource-limited settings: Results from SEA-AKI study.
Our goal was to describe clinical outcomes and explore the physiological interactions between acute kidney injury (AKI) and acute respiratory failure (ARF) in critically ill patients. ⋯ Critically ill patients with ARF and AKI are at higher risk of in-hospital death. Different patterns of AKI and ARF interaction result in unique clinical outcomes as well as risk factors.