Journal of critical care
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Journal of critical care · Aug 2022
Insulin therapy associated relative hypoglycemia during critical illness.
In critically ill diabetes patients, relative hypoglycemia (RH) (a decrease in glucose ≥30% below pre-admission levels, as estimated by HbA1c) is associated with greater mortality and absolute hypoglycemia. We investigated the epidemiology and outcomes of RH when it was associated with insulin therapy. ⋯ ITARH is common in insulin treated critically ill diabetes patients and associated with poorer glycemic control. Unlike reports of RH in general, it is not associated with mortality, suggesting that the prognostic implications of RH differ according to its context.
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Journal of critical care · Aug 2022
Comparing continuous versus categorical measures to assess and benchmark intensive care unit performance.
To compare categorical and continuous combinations of the standardized mortality ratio (SMR) and the standardized resource use (SRU) to evaluate ICU performance. ⋯ The categorical combination of metrics is easy to interpret but limits statistical inference for benchmarking. The continuous combination offers appropriate statistical properties for evaluating performance when metrics are positively correlated.
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Journal of critical care · Aug 2022
LetterShunt in critically ill Covid-19 ARDS patients: Prevalence and impact on outcome (cross-sectional study).
To examine critical Covid-19-acute respiratory distress syndrome (C-ARDS) patients requiring mechanical ventilation (MV), using transthoracic echocardiography (TTE) coupled with bubble test (BT), in order to search a right/left shunt. ⋯ A right/left shunt was detected in a third of studied patients similarly between PFO and TPBT without significant impact on P/F ratio or outcome.
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Journal of critical care · Aug 2022
Observational StudyLow tidal volume ventilation is associated with mortality in COVID-19 patients-Insights from the PRoVENT-COVID study.
Low tidal volume ventilation (LTVV) is associated with mortality in patients with acute respiratory distress syndrome. We investigated the association of LTVV with mortality in COVID-19 patients. ⋯ In this cohort of invasively ventilated COVID-19 patients, approximately a third of patients received LTVV. Use of LTVV was independently associated with reduced 28-day mortality. The initial tidal volume and continuous muscle paralysis were potentially modifiable factors associated with use of LTVV. These findings are important as they could help clinicians to recognize patients who are at risk of not receiving LTVV.
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Journal of critical care · Aug 2022
Observational StudyIncidence and determinats of augmented renal clearance in traumatic brain injury: A prospective observational study.
To characterize the incidence, timing, and predictors of augmented renal clearance (ARC) in patients with traumatic brain injury (TBI). ⋯ ARC is very common and has an early appearance in patients with TBI. Young age is its main determinant.