Critical care : the official journal of the Critical Care Forum
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Perioperative airway management and oxygenation maintenance during central airway obstruction (CAO) treatment pose great challenges. While veno-venous extracorporeal membrane oxygenation (V-V ECMO) shows promise as a bridge therapy, optimal implementation and management strategies remain lacking. We present our experience with V-V ECMO in CAO management from a high-volume center. ⋯ The application of V-V ECMO with minimal anticoagulation demonstrates safety and efficacy as a bridging support in the therapeutic approach to CAO.
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Multicenter Study Comparative Study
Comparison of methods to normalize urine output in critically ill patients: a multicenter cohort study.
Oliguria diagnosis includes the normalization of urine output (UO) by body weight. However, the rational and the method to apply to normalize UO to body weight are unclear. We aimed to explore the impact of the method applied to normalize UO on oliguria incidence and association with outcomes. ⋯ UO normalization by IBW lead to a stable incidence of oliguria across categories of weight and improved the association between oliguria and outcomes. IBW should be preferred to normalize UO in critically ill patients.
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Guidelines for diabetic ketoacidosis (DKA) management are limited, resulting in varied practices. This study assessed Intensive Care Unit (ICU) admission criteria, fluid resuscitation, insulin therapy, and metabolic management in adult patients with DKA. ⋯ The management of patients with DKA remains heterogeneous worldwide. Future randomized trials are needed, especially regarding fluid resuscitation and insulin therapy. Trial registrationNot applicable.
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Patients with sepsis-induced AKI can be classified into two distinct sub-phenotypes (AKI-SP1, AKI-SP2) that differ in clinical outcomes and response to treatment. The biologic mechanisms underlying these sub-phenotypes remains unknown. Our objective was to understand the underlying biology that differentiates AKI sub-phenotypes and associations with kidney outcomes. ⋯ Our findings suggest AKI-SP1 is characterized by a reparative, regenerative phenotype and AKI-SP2 is characterized as an immune and inflammatory phenotype associated with blood bacteremia. We identified shared biology between AKI sub-phenotypes and eventual risk of RRT highlighting potential therapeutic targets. Urine proteomics may be used to non-invasively classify SP2 participants.