Journal of critical care
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Journal of critical care · Oct 2022
A critical care outreach team under strain - Evaluation of the service provided to patients with haematological malignancy during the Covid-19 pandemic.
Critical Care Outreach Teams (CCOTs) have been associated with improved outcomes in patients with haematological malignancy (HM). This study aims to describe CCOT activation by patients with HM before and during the Covid-19 pandemic, assess amny association with worse outcomes, and examine the psychological impact on the CCOT. ⋯ Despite the increase in total hospital referrals, the number of patients with HM that were reviewed during the surge periods decreased, as did their ICU admission rate and mortality. The quality of care provided was not impaired, as reflected by the number of patients receiving bedside reviews and the shorter-than-pre-pandemic response time.
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Journal of critical care · Oct 2022
Monitoring and auditing protocol adherence, data integrity and ethical conduct of a randomized clinical trial: A case study.
To categorize, quantify and interpret findings documented in feedback letters of monitoring or auditing visits for an investigator-initiated, peer-review funded multicenter randomized trial testing probiotics for critically ill patients. ⋯ Monitoring and auditing findings predominantly concerned missing documentation with minimal threats to data integrity, patient privacy or safety.
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Journal of critical care · Oct 2022
The possible predictive value of muscle ultrasound in the diagnosis of ICUAW in long-term critically ill patients.
Intensive Care Unit acquired weakness (ICUAW) occurs commonly. Muscular ultrasonography allows visualization and classification of muscle characteristics. The aims of this study were to evaluate peripheral and respiratory muscles, their changes during long-term ICU stays, and the possible diagnostic predictive value of ICUAW as compared to the Medical Research Council strength score (MRC-SS). ⋯ Quadriceps and respiratory muscles were altered within the first week of mechanical ventilation. The loss of pennation angle offers high diagnostic accuracy for ICUAW, allowing for an earlier diagnosis before patients became able to perform volitional tests.
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Journal of critical care · Oct 2022
Clinicopathological features and short outcomes of oliguric acute tubular injury.
To explore the clinicopathological features and analyze the relevant risk factors and short-term renal outcomes of acute tubular injury (ATI) patients. ⋯ Oliguric ATI patients had severe clinicopathological conditions. The severity of tubular lesions seriously influenced renal function recovery, demonstrating the importance of renal biopsy in assessing the prognosis of patients with kidney disease.
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Journal of critical care · Oct 2022
Impact of mean perfusion pressure and vasoactive drugs on occurrence and reversal of cardiac surgery-associate acute kidney injury: A cohort study.
Low cardiac output and kidney congestion are associated with acute kidney injury after cardiac surgery (CSA-AKI). This study investigates hemodynamics on CSA-AKI development and reversal. ⋯ Development and full recovery of CSA-AKI ≥2 are affected by mean perfusion pressure, independent of vaso-inotropic use. CVP had a significant effect on AKI development, while MAP on full AKI reversal.