Critical care : the official journal of the Critical Care Forum
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Observational Study
Hallucinations and disturbed behaviour in the critically ill: incidence, patient characteristics, associations, trajectory, and outcomes.
To use natural language processing (NLP) to study the incidence, characteristics, trajectory, associations, and outcomes of hallucinations and disturbed behaviour in intensive care unit (ICU) patients. ⋯ Hallucinations affect one in 12 ICU patients and are strongly associated with disturbed behaviour, and the use of antipsychotic medications. Hallucinations may represent another phenotype of critical illness associated neurocognitive dysfunction and require a dedicated research program.
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Multicenter Study Observational Study
Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study.
Ulinastatin (UTI), recognized for its anti-inflammatory properties, holds promise for patients undergoing cardiac surgery. This study aimed to investigate the relationship between intraoperative UTI administration and the incidence of delirium following cardiac surgery. ⋯ UTI administration may mitigate glycocalyx degradation, potentially lowering the risk of POD in cardiac surgery patients, offering valuable insights for future interventions to prevent POD and enhance patient outcomes. Trial registration number ClinicalTrials.gov (No. NCT06268249). Retrospectively registered 4 February 2024.
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The role that sleep patterns play in sepsis risk remains poorly understood. ⋯ Findings from this cohort study suggest that a healthy sleep pattern may reduce the risk of developing sepsis, particularly among younger individuals.
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In severely injured trauma patients, hypofibrinoginaemia is associated with increased mortality. There is no evidence-based consensus for what constitutes optimal fibrinogen therapy, treatment dose or timing of administration. The aim of this systematic review was to evaluate the effects of early fibrinogen replacement, either cryoprecipitate or fibrinogen concentrate (FgC) on mortality, transfusion requirements and deep venous thrombosis (DVT). ⋯ There is no association between early fibrinogen replacement and mortality, DVT or transfusion requirements. We found no superiority between FgC or cryoprecipitate. This systematic review highlights the urgent need for further RCTs to assess the efficacy of early fibrinogen replacement, preferred strategy (goal-directed vs empiric) as well as optimal therapeutic product for both patient outcome and cost effectiveness.