Journal of critical care
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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 StudyAcute circulatory failure in critically ill patients with hemophagocytic syndrome.
Hemophagocytic syndrome (HS) is a rare life-threatening condition that can lead to multi organ failure and shock. Acute circulatory failure in these patients has been poorly studied. Objectives of this study were to describe characteristics of HS patients with shock, prognostic factors and impact of etoposide infusion on hemodynamic parameters. This is a monocenter, retrospective, observational cohort study in a French tertiary intensive care unit (ICU). All adult critically ill patients with HS managed in the ICU between 2007 and 2017, requiring vasopressors (norepinephrine) and etoposide infusion. ⋯ Hospital mortality remains high in critically ill HS patients with shock, but a significant improvement of hemodynamic parameters is observed following etoposide infusion, suggesting that an aggressive initial supportive care is crucial in these patients.
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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.