Critical care medicine
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Critical care medicine · Nov 2024
Randomized Controlled TrialModulation of Metabolomic Profile in Sepsis According to the State of Immune Activation.
To investigate the metabolomic profiles associated with different immune activation states in sepsis patients. ⋯ Findings suggest distinct metabolic dysregulation patterns associated with different immune dysfunctions in sepsis: the strongest metabolic dysregulation is associated with MALS.
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Critical care medicine · Nov 2024
Multicenter Study Observational StudyThe Impact of Multi-Institution Datasets on the Generalizability of Machine Learning Prediction Models in the ICU.
To evaluate the transferability of deep learning (DL) models for the early detection of adverse events to previously unseen hospitals. ⋯ Our results emphasize the importance of diverse training data for DL-based risk prediction. They suggest that as data from more hospitals become available for training, models may become increasingly generalizable. Even so, good performance at a new hospital still depended on the inclusion of compatible hospitals during training.
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Critical care medicine · Nov 2024
Multicenter StudyParental Perspectives From the Survey of Sleep Quality in the PICU Validation Study on Environmental Factors Causing Sleep Disruption in Critically Ill Children.
Sleep promotion bundles being tested in PICUs use elements adapted from adult bundles. As children may react differently than adults in ICU environments, this study investigated what parents report disrupted the sleep of their child in a PICU. ⋯ There are multiple aspects of critical care environments that affect the sleep of children, which are different from that of adults, such as disruption to home schedules. Future interventional sleep promotion bundles should include sedated children and could be applicable in multicenter settings.
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Critical care medicine · Nov 2024
Moderate IV Fluid Resuscitation Is Associated With Decreased Sepsis Mortality.
Significant practice variation exists in the amount of resuscitative IV fluid given to patients with sepsis. Current research suggests equipoise between a tightly restrictive or more liberal strategy but data is lacking on a wider range of resuscitation practices. We sought to examine the relationship between a wide range of fluid resuscitation practices and sepsis mortality and then identify the primary driver of this practice variation. ⋯ Individual physician practice drives excess variation in the amount of IV fluid given to patients with sepsis. A moderate approach to IV fluid resuscitation is associated with decreased sepsis mortality and should be tested in future randomized controlled trials.
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Critical care medicine · Nov 2024
Observational StudyFrequency of and Risk Factors for Increased Healthcare Utilization After Pediatric Sepsis Hospitalization.
To determine the frequency of and risk factors for increased post-sepsis healthcare utilization compared with pre-sepsis healthcare utilization. ⋯ In this nationally representative cohort of children who survived sepsis hospitalization in the United States, nearly one in three had increased healthcare utilization in the 90 days after discharge. Children with hospitalizations longer than 30 days and complex chronic conditions were more likely to experience increased healthcare utilization.