Critical care medicine
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Critical care medicine · Feb 2024
Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Critically Ill Patients: A Cluster Analysis According to Baseline Characteristics, Biological Features, and Chest CT Scan on Admission.
Inconsistent results from COVID-19 studies raise the issue of patient heterogeneity. ⋯ Three clusters with distinct characteristics and outcomes were identified. Such clusters could facilitate the identification of targeted populations for the next trials.
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Critical care medicine · Feb 2024
Observational StudyAssessment of the Readability of the Online Patient Education Materials of Intensive and Critical Care Societies.
This study aimed to evaluate the readability of patient education materials (PEMs) on websites of intensive and critical care societies. ⋯ Compared with the sixth-grade level recommended by the American Medical Association and the National Institutes of Health, the readability of PEMs in intensive and critical care societies is relatively high. PEMs in intensive and critical care societies should be prepared with attention to recommendations on readability.
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Critical care medicine · Feb 2024
Timely Cessation of Proton Pump Inhibitors in Critically Ill Patients Impacts Morbidity and Mortality: A Propensity Score-Matched Cohort Study.
Proton pump inhibitors (PPIs) are among the drugs most commonly used in critically ill patients. Although mainly applied temporarily for stress ulcer prophylaxis, their application is frequently not terminated. Potential adverse effects of PPI treatment could impact the outcome in case of unnecessary and, therefore, avoidable long-term continuation. We tested the hypotheses that nonindicated PPI therapy continued beyond hospital discharge is associated with increased morbidity, rehospitalization rate, and mortality. ⋯ These data demonstrate that an unnecessary continuation of PPI therapy after hospital discharge may significantly impact morbidity and mortality. To avoid potentially harmful overuse of a PPIs, intensivists should ensure timely cessation of a temporarily indicated PPI therapy.
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Critical care medicine · Feb 2024
Observational StudySurvival for Nonshockable Cardiac Arrests Treated With Noninvasive Circulatory Adjuncts and Head/Thorax Elevation.
Cardiac arrests remain a leading cause of death worldwide. Most patients have nonshockable electrocardiographic presentations (asystole/pulseless electrical activity). Despite well-performed basic and advanced cardiopulmonary resuscitation (CPR) interventions, patients with these presentations have always faced unlikely chances of survival. The primary objective was to determine if, in addition to conventional CPR (C-CPR), expeditious application of noninvasive circulation-enhancing adjuncts, and then gradual elevation of head and thorax, would be associated with higher likelihoods of survival following out-of-hospital cardiac arrest (OHCA) with nonshockable presentations. ⋯ These findings indicate that, compared with C-CPR, there are strong associations between rapid AHUP-CPR treatment and greater likelihood of patient survival, as well as survival with good neurological function, in cases of nonshockable OHCA.
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Critical care medicine · Feb 2024
Editorial CommentPrediction of Post-ICU Impairments-Is It Possible?
Mr Thompson is a 58-year-old male, admitted to the intensive care unit with severe community acquired pneumonia following an overseas holiday. He has acute respiratory failure, requiring mechanical ventilation and haemodynamic supports. Prior to his ICU admission he worked in a corporate job, lived with his wife, was otherwise fit and healthy, and enjoyed cycling 10km to and from work. ⋯ He is tearful, anxious, and depressed about his health state. His wife is finding it difficult to help him. They are unsure of where to get support in the community, whether he will be able to return to work, and what to expect for his recovery.