Critical care medicine
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Critical care medicine · Oct 2020
Letter Randomized Controlled TrialAntioxidative Amino Acids in Early Enteral Versus Parenteral Nutrition Following Major Rectal Surgery.
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Critical care medicine · Oct 2020
Multicenter StudyEvaluation of Vasopressor Exposure and Mortality in Patients With Septic Shock.
The objectives of this study were to: 1) determine the association between vasopressor dosing intensity during the first 6 hours and first 24 hours after the onset of septic shock and 30-day in-hospital mortality; 2) determine whether the effect of vasopressor dosing intensity varies by fluid resuscitation volume; and 3) determine whether the effect of vasopressor dosing intensity varies by dosing titration pattern. ⋯ Increasing vasopressor dosing intensity during the first 24 hours after septic shock was associated with increased mortality. This association varied with the amount of early fluid administration and the timing of vasopressor titration.
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Critical care medicine · Oct 2020
Observational StudyFull Finger Reperfusion Time Measured by Pulse Oximeter Waveform Analysis in Children.
Capillary refill time is a noninvasive method to assess tissue perfusion to determine shock status. Capillary refill time is defined as the time required to regain skin color after blanching pressure is applied. Although common methods to measure capillary refill time depend on clinicians' visual assessment, a new approach using a pulse oximeter waveform analysis exists, referred to as full finger reperfusion time. We aim to evaluate reproducibility and validity of the novel full finger reperfusion time measurement using clinicians' visual capillary refill time assessment as a reference standard. ⋯ Full finger reperfusion time demonstrated good reproducibility. Full finger reperfusion time showed moderate correlation with clinician capillary refill time. Full finger reperfusion time was 1.14 seconds longer than capillary refill time. Future studies should focus on the clinical value of full finger reperfusion time as a monitoring device for hemodynamics in critically ill children.
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Critical care medicine · Oct 2020
A Time-Phased Machine Learning Model for Real-Time Prediction of Sepsis in Critical Care.
As a life-threatening condition, sepsis is one of the major public health issues worldwide. Early prediction can improve sepsis outcomes with appropriate interventions. With the PhysioNet/Computing in Cardiology Challenge 2019, we aimed to develop and validate a machine learning algorithm with high prediction performance and clinical interpretability for prediction of sepsis onset during critical care in real-time. ⋯ The proposed Time-phAsed machine learning model for Sepsis Prediction model is accurate and interpretable for real-time prediction of sepsis onset in critical care, which holds great potential for further evaluation in prospective studies.
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Critical care medicine · Oct 2020
Multicenter Study Observational StudyCentral Venous-to-Arterial PCO2 Difference and Central Venous Oxygen Saturation in the Detection of Extubation Failure in Critically Ill Patients.
To evaluate the ability of central venous-to-arterial carbon dioxide pressure difference, central venous oxygen saturation, and the combination of these two parameters to detect extubation failure in critically ill patients. ⋯ We found that Δ - ΔPCO2 and central venous oxygen saturation, during spontaneous breathing trials, were independent predictors of weaning outcomes. Combination analysis of both parameters enhanced their diagnostic performance and provided excellent predictability in extubation failure detection in critically ill patients.