Critical care medicine
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Critical care medicine · Jul 2023
Meta AnalysisPredictors of Noninvasive Ventilation Failure in the Post-Extubation Period: A Systematic Review and Meta-Analysis.
To identify factors associated with failure of noninvasive ventilation (NIV) in the post-extubation period. ⋯ We identified several prognostic factors before and 1 hour after NIV initiation associated with increased risk of NIV failure in the post-extubation period. Well-designed prospective studies are required to confirm the prognostic importance of these factors to help further guide clinical decision-making.
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Critical care medicine · Jul 2023
Multicenter StudyDevelopment and External Validation of the International Early Warning Score for Improved Age and Sex Adjusted In-Hospital Mortality Prediction in the Emergency Department.
Early Warning Scores (EWSs) have a great potential to assist clinical decision-making in the emergency department (ED). However, many EWS contain methodological weaknesses in development and validation and have poor predictive performance in older patients. The aim of this study was to develop and externally validate an International Early Warning Score (IEWS) based on a recalibrated National Early warning Score (NEWS) model including age and sex and evaluate its performance independently at arrival to the ED in three age categories (18-65, 66-80, > 80 yr). ⋯ The IEWS substantially improves in-hospital mortality prediction for all ED patients greater than or equal to18 years.
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Critical care medicine · Jul 2023
ReviewHealth Disparities in Extracorporeal Membrane Oxygenation Utilization and Outcomes: A Scoping Review and Methodologic Critique of the Literature.
To map the scope, methodological rigor, quality, and direction of associations between social determinants of health (SDoH) and extracorporeal membrane oxygenation (ECMO) utilization or outcomes. ⋯ Associations between ECMO utilization and outcomes with SDoH are inconsistent, complicated by population heterogeneity and analytic shortcomings with limited consideration of systemic contributors. Findings and research gaps have implications for measuring, analyzing, and interpreting SDoH in ECMO research and healthcare.
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Critical care medicine · Jul 2023
The Effect of Time to Treatment With Antiarrhythmic Drugs on Survival and Neurological Outcomes in Shock Refractory Out-of-Hospital Cardiac Arrest.
Examining the association of time to treatment (drug or placebo) with survival to hospital discharge and neurologic outcome. ⋯ Survival and favorable neurologic outcomes decreased with longer times to drug administration. Amiodarone improved survival at all time points whereas lidocaine improved survival only at later time points, compared with placebo.