Critical care : the official journal of the Critical Care Forum
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Machine learning algorithms have recently been developed to enable the automatic and real-time echocardiographic assessment of left ventricular ejection fraction (LVEF) and have not been evaluated in critically ill patients. ⋯ Machine learning-enabled real-time measurements of LVEF were strongly correlated with manual measurements obtained by experts. The accuracy of real-time LVEF measurements was excellent, and the precision was fair. The reproducibility of LVEF measurements was better with the machine learning system. The specificity to detect left ventricular dysfunction was excellent both for experts and for novices, whereas the sensitivity could be improved.
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The association of ageing with increased sepsis mortality is well established. Nonetheless, current investigations on the influence of age on host response aberrations are largely limited to plasma cytokine levels while neglecting other pathophysiological sepsis domains like endothelial cell activation and function, and coagulation activation. The primary objective of this study was to gain insight into the association of ageing with aberrations in key host response pathways and blood transcriptomes in sepsis. ⋯ This study provides novel evidence that older age is associated with relatively mitigated sepsis-induced endothelial cell activation and dysfunction, and a blood leukocyte transcriptome signature indicating impaired innate immune and cytokine signaling. These data suggest that age should be considered in patient selection in future sepsis trials targeting the immune system and/or the endothelial cell response.
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Multicenter Study
Impact of COVID-19 pandemic on antifungal consumption: a multicenter retrospective analysis.
In the context of COVID-19 pandemic, antifungal overuse may have occurred in our hospitals as it has been previously reported for antibacterials. ⋯ We observed an increased consumption of antifungals including voriconazole and caspofungin in our hospital during the COVID-19 pandemic and explained in part by an increased incidence of invasive fungal diseases in COVID-19 patients. These results are of utmost importance as it raises concern about the urgent need for appropriate antifungal stewardship activities to control antifungal consumption.