Critical care medicine
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Critical care medicine · Jun 2021
Observational StudyEarly Seizures Are Predictive of Worse Health-Related Quality of Life at Follow-Up After Intracerebral Hemorrhage.
Early seizures are a common complication of intracerebral hemorrhage, occurring in ~10% of patients. However, the independent effect of early seizures on patient outcomes, particularly health-related quality of life, is unclear. Without a potential benefit to patient outcomes, the widespread use (~40%) of prophylactic seizure medications has no reasonable chance of improving patient outcomes. We tested the hypothesis that health-related quality of life at follow-up is different between patients with and without early seizures (and secondarily, with nonconvulsive status epilepticus) after intracerebral hemorrhage. ⋯ Early seizures and nonconvulsive status epilepticus were associated with lower health-related quality of life at follow-up in survivors of intracerebral hemorrhage.
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Critical care medicine · Jun 2021
Observational StudyPostoperative Cerebral Oxygen Saturation in Children After Congenital Cardiac Surgery and Long-Term Total Intelligence Quotient: A Prospective Observational Study.
During the early postoperative period, children with congenital heart disease can suffer from inadequate cerebral perfusion, with possible long-term neurocognitive consequences. Cerebral tissue oxygen saturation can be monitored noninvasively with near-infrared spectroscopy. In this prospective study, we hypothesized that reduced cerebral tissue oxygen saturation and increased intensity and duration of desaturation (defined as cerebral tissue oxygen saturation < 65%) during the early postoperative period, independently increase the probability of reduced total intelligence quotient, 2 years after admission to a PICU. ⋯ Increased dose of cerebral tissue oxygen saturation desaturation and reduced mean cerebral tissue oxygen saturation during the early postoperative period independently increase the probability of having a lower total intelligence quotient, 2 years after PICU admission.
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When patients lose the capacity to make their own decisions, current practice relies on their family and loved ones to try to identify the treatment course the patient would have chosen for themselves. The fact that this approach has remained essentially unchanged for over 40 years raises the question of whether it successfully provides care that is consistent with patients' treatment preferences. ⋯ Revisions to existing practice are needed to increase the extent to which surrogates are able to identify the treatment preferences of decisionally incapacitated patients. One possibility is to assess whether predicting patients' treatment preferences based on the preferences of similar patients might increase the extent to which patients are treated consistent with their preferences and thereby reduce the burden on their surrogates.
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Critical care medicine · Jun 2021
Efficacy of Serum Angiotensin II Levels in Prognosis of Patients With Coronavirus Disease 2019.
We aimed to determine serum angiotensin II levels in patients with coronavirus disease 2019 infection and to investigate the effect of these levels on the prognosis of the disease. ⋯ The serum angiotensin II levels decrease significantly in patients with coronavirus disease 2019, and this decrease is correlated with lung damage.