Critical care medicine
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Concise "synthetic" review of the state of the art of management of acute ischemic stroke. ⋯ Appropriate treatment of ischemic stroke is essential in the reduction of mortality and morbidity. Management of stroke involves a multidisciplinary approach that starts and extends beyond hospital admission.
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Critical care medicine · Nov 2020
Multicenter StudyGraph Convolutional Networks-Based Noisy Data Imputation in Electronic Health Record.
A deep learning-based early warning system is proposed to predict sepsis prior to its onset. ⋯ Using Physionet Challenge 2019, the proposed method can accurately and early predict the onset of sepsis. The proposed method can be a practical early warning system in the environment of real hospitals.
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Critical care medicine · Nov 2020
Multicenter StudyMyoclonus in Patients With Coronavirus Disease 2019: A Multicenter Case Series.
To describe the risk factors for and outcomes after myoclonus in a cohort of patients with coronavirus disease 2019. ⋯ Our findings suggest that myoclonus may be observed in severe acute respiratory syndrome coronavirus 2 infected patients, even in the absence of hypoxia. This association warrants further evaluation in larger cohorts to determine whether the presence of myoclonus may aid in the assessment of disease severity, neurologic involvement, or prognostication.
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Critical care medicine · Nov 2020
Observational StudyDoes Standard Physical Therapy Increase Quadriceps Strength in Chronically Ventilated Patients? A Pilot Study.
Physical therapy is standard care for mechanically ventilated patients, but there is no evidence, using nonvolitional, objective measurements, that physical therapy increases muscle strength in this population. The present study tested the hypothesis that 2 weeks of standard, conventional physical therapy provided at a ventilator weaning facility would increase quadriceps strength in mechanically ventilated patients. ⋯ Standard physical therapy delivered in a ventilator weaning facility failed to improve quadriceps leg strength in a majority of mechanically ventilated patients. The fact that mechanically ventilated patients fail to achieve high levels of muscle activation during physical therapy provides a potential explanation as to why physical therapy may often be ineffective. We speculate that use of novel methods which increase muscle activation during exercise may improve responses of mechanically ventilated patients to physical therapy.
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Critical care medicine · Nov 2020
National Trends and Variation of Functional Status Deterioration in the Medically Critically Ill.
Physical and psychologic deficits after an ICU admission are associated with lower quality of life, higher mortality, and resource utilization. This study aimed to examine the prevalence and secular changes of functional status deterioration during hospitalization among nonsurgical critical illness survivors over the past decade. ⋯ Following nonsurgical critical illness, the prevalence of functional status deterioration and magnitude increased in a nationally representative cohort, despite efforts to reduce ICU dysfunction over the past decade. Identifying the prevalence of functional status deterioration and primary etiologies associated with functional status deterioration will elucidate vital areas for further research and targeted interventions. Reducing ICU debilitation for key disease processes may improve ICU survivor mortality, enhance quality of life, and decrease healthcare utilization.