Journal of critical care
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Journal of critical care · Dec 2022
ReviewFasting practices of enteral nutrition delivery for airway procedures in critically ill adult patients: A scoping review.
There is limited understanding of fasting practices and reported safety concerns for airway procedures in critically ill adults. ⋯ In the reported literature, there is wide variation in EN fasting practices for airway procedures in critically ill patients with limited evidence to inform practice.
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Journal of critical care · Dec 2022
Multicenter StudyCardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients.
To evaluate cardiac function in mechanically ventilated patients with COVID-19. ⋯ Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
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Journal of critical care · Dec 2022
Dynamic changes of pulse pressure but not of pulse pressure variation during passive leg raising predict preload responsiveness in critically ill patients with spontaneous breathing activity.
To evaluate whether the changes in arterial pulse pressure (PP) and/or pulse pressure variation (PPV) during passive leg raising (PLR) can be used to evaluate preload responsiveness in patients with spontaneous breathing activity. ⋯ ClinicalTrials.gov (NCT04369027).
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Journal of critical care · Dec 2022
ReviewImmunotherapy to treat sepsis induced-immunosuppression: Immune eligibility or outcome criteria, a systematic review.
Sepsis-induced immunosuppression (SIS) is the target of multiple clinical studies testing immunotherapies. To date, most trials are performed on a heterogeneous and unselected population. Without any consensual definition of immunosuppression and therapeutic goals, results from these trials remain poorly transposable. ⋯ Only 13 studies selected patients suffering from immunosuppression based on immune biomarkers. Two immune criterias were commonly used: lymphocyte count and monocytic HLA-DR expression. This heterogeneity criteria in studies targeting SIS justify the conduct of a consensus process to define criteria to diagnose SIS and identify relevant outcomes markers.
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Journal of critical care · Dec 2022
Co-designed and consensus based development of a quality improvement checklist of patient and family-centered actionable processes of care for adults with persistent critical illness.
Few quality improvement tools specific to patients with persistent or chronic critical illness exist to aid delivery of high-quality care. Using experience-based co-design methods, we sought consensus from key stakeholders on the most important actionable processes of care for inclusion in a quality improvement checklist. ⋯ Using a highly collaborative and methodologically rigorous process, we generated a quality improvement checklist of actionable processes to improve patient and family-centred care considered important by key stakeholders. Future research is needed to understand optimal implementation strategies and impact on outcomes and experience.