Critical care medicine
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Critical care medicine · Apr 2022
Multicenter Study Observational StudyBenchmarking Inpatient Mortality Using Electronic Medical Record Data: A Retrospective, Multicenter Analytical Observational Study.
To develop a model to benchmark mortality in hospitalized patients using accessible electronic medical record data. ⋯ Variables considered by traditional ICU prognostic models accurately benchmark patient mortality for patients receiving care in multiple hospital locations, not only the ICU. Unlike Acute Physiology and Chronic Health Evaluation, this model relies on electronic medical record data alone and does not require personnel to collect the independent predictor variables. Assessing the model's utility for benchmarking hospital performance will require prospective testing in a larger representative sample of hospitals.
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Critical care medicine · Apr 2022
Multicenter Study Comparative Study Observational StudyProne Position in Coronavirus Disease 2019 and Noncoronavirus Disease 2019 Acute Respiratory Distress Syndrome: An International Multicenter Observational Comparative Study.
Prone position is used in acute respiratory distress syndrome and in coronavirus disease 2019 acute respiratory distress syndrome. However, it is unclear how responders may be identified and whether an oxygenation response improves outcome. The objective of this study was to quantify the response to prone position, describe the differences between coronavirus disease 2019 acute respiratory distress syndrome and acute respiratory distress syndrome, and explore variables associated with survival. ⋯ Prone position, particularly when delivered early, achieved a significant oxygenation response in ~80% of coronavirus disease 2019 acute respiratory distress syndrome, similar to acute respiratory distress syndrome. This response was independently associated with improved survival.
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Critical care medicine · Apr 2022
Multicenter Study Observational StudyVasopressor Initiation Within 1 Hour of Fluid Loading Is Associated With Increased Mortality in Septic Shock Patients: Analysis of National Registry Data.
To investigate whether administration of a vasopressor within 1 hour of first fluid loading affected mortality and organ dysfunction in septic shock patients. ⋯ Vasopressor initiation within 1 hour of fluid loading was associated with higher 28-day mortality in patients with septic shock.
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Critical care medicine · Apr 2022
Multicenter Study Observational StudyUse of Antifibrinolytics in Pediatric Life-Threatening Hemorrhage: A Prospective Observational Multicenter Study.
To assess the impact of antifibrinolytics in children with life-threatening hemorrhage. ⋯ Administration of antifibrinolytic medications during the life-threatening event was independently associated with improved 6- and 24-hour survivals in bleeding children. Consideration should be given to use of antifibrinolytics in pediatric patients with life-threatening hemorrhage.