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
Multicenter Study Observational StudyImpact of Failure of Noninvasive Ventilation on the Safety of Pediatric Tracheal Intubation.
Noninvasive ventilation is widely used to avoid tracheal intubation in critically ill children. The objective of this study was to assess whether noninvasive ventilation failure was associated with severe tracheal intubation-associated events and severe oxygen desaturation during tracheal intubation. ⋯ Critically ill children are frequently exposed to noninvasive ventilation before intubation. Noninvasive ventilation failure was not independently associated with severe tracheal intubation-associated events or severe oxygen desaturation compared to primary tracheal intubation.
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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 StudyPrevalence and Course of Frailty in Survivors of Critical Illness.
Little is known about frailty that develops following critical illness. We sought to describe the prevalence of newly acquired frailty, its clinical course, and the co-occurrence of frailty with disability and cognitive impairment in survivors of critical illness. ⋯ Frailty is common among survivors of critical illness. In the majority, frailty is newly acquired. Roughly one in seven had frailty without co-occurring disability or cognitive impairment. Studies to understand outcomes of frailty that develops as the result of a critical illness and to identify modifiable risk factors for this potentially reversible syndrome are needed.