Journal of critical care
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Journal of critical care · Jun 2022
Multicenter StudyPerformance of renal Doppler to predict the occurrence of acute kidney injury in patients without acute kidney injury at admission.
This study aimed at evaluating the performance of Doppler-based resistive index (RI) and semi-quantitative evaluation of renal perfusion using color-Doppler (SQP) to predict de novo AKI in the subgroup of critically ill patients without AKI at admission. ⋯ These results confirm the poor performance of Doppler-based indices in predicting renal prognosis of ICU patients.
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Journal of critical care · Jun 2022
Development of an electronic Poor Outcome Screening (ePOS) Score to identify critically ill patients with potential palliative care needs.
To develop and validate an electronic poor outcome screening (ePOS) score to identify critically ill patients with potentially unmet palliative care (PC) needs at 48 hours after ICU admission. ⋯ The ePOS score can easily be implemented in EHR and can be used for automated screening and stratification of ICU patients, pinpointing those in whom a comprehensive PC assessment should be performed. However, it should not replace clinical judgement.
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Journal of critical care · Jun 2022
LetterHigh flow nasal cannula improves breathing efficiency and ventilatory ratio in COPD patients recovering from an exacerbation.
High flow nasal cannula (HFNC) may improve CO2 elimination by washing out CO2 from the upper airways. This study aimed at assessing the effect of HFNC on minute ventilation and ventilatory ratio (VR), a surrogate of dead space, in patients hospitalized for acute hypercapnic COPD exacerbation. ⋯ In patients recovering from acute COPD exacerbation, the use of HFNC reduced RR, minute ventilation, PaCO2 and VR compared to standard oxygen. These changes are consistent with a decrease in physiologic dead space with HFNC.
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Journal of critical care · Jun 2022
The impact of obesity on outcomes of patients admitted to intensive care after cardiac arrest.
Studies examining the association between obesity and mortality in cardiac arrest patients have been conflicting which might either be due to residual confounding, or a reliance on estimating the conditional effects rather than the marginal (causal) effects of obesity. We estimated the conditional and causal effects of obesity on mortality in cardiac arrest patients using the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD). ⋯ After adjustment, there was no association between obesity and outcomes in cardiac arrest patients admitted to ICU.
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To evaluate the effect of renin-angiotensin system (RAS) inhibiting medications prior to admission on the severity of kidney injury in patients presenting with sepsis-associated acute kidney injury (SA-AKI). ⋯ Patients receiving RAS inhibition (vs. those not) prior to an admission with SA-AKI presented with more severe AKI on admission and during the first week. Hospital mortality and kidney function at discharge were similar between groups.