Current opinion in critical care
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Curr Opin Crit Care · Jun 2019
ReviewAn international, consensus-derived Core Outcome Set for Cardiac Arrest effectiveness trials: the COSCA initiative.
Accurate and relevant assessment is essential to determining the impact of ill-health and the relative benefit of healthcare. This review details the recent development of a core outcome set for cardiac arrest effectiveness trials - the COSCA initiative. ⋯ The COSCA recommendation describes a small group of outcomes that should be reported as a minimum across large, randomized clinical effectiveness trials for cardiac arrest.
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Impaired neurocognitive function is common in cardiac arrest survivors and the use of specific neurocognitive assessments are recommended in both clinical trials and daily practice. This review examines the most recent evidence to guide in the selection of neurocognitive outcome assessment tools after cardiac arrest. ⋯ Neurocognitive assessments after cardiac arrest are important and the approach should differ depending on the clinical situation. Large, prospective, well designed studies, to guide the selection of neurocognitive assessments after cardiac arrest, are urgently needed.
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The present review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium. ⋯ Developing delirium after cardiac arrest is associated with increased morbidity and mortality. The importance of addressing modifiable risk factors, recognizing symptoms early, and initiating coordinated treatment strategies can help to improve outcomes within this high risk population.
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Curr Opin Crit Care · Jun 2019
ReviewPhysician factors in utilizing haemodynamic data in patient care.
To focus on the missing link between accuracy and precision of monitoring devices and effective implementation of therapeutic strategies. ⋯ The clinical success of haemodynamic monitoring goes far beyond accuracy and precision of monitoring devices. Understanding of the factors influencing the effective implementation of therapeutic strategies plays an important role in the meaningful introduction of haemodynamic monitoring.
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Curr Opin Crit Care · Jun 2019
ReviewWhat should I use next if clinical evaluation and echocardiographic haemodynamic assessment is not enough?
To provide an integrated clinical approach to the critically ill patients in shock. ⋯ Bedside haemodynamic assessment in critically ill patients should be considered an integrated approach supporting the decision-making process and should be based on clinical examination and critical care echocardiography.