Articles: intensive-care-units.
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Observational Study
Could lactate clearance be a marker of mortality in pediatric intensive care unit?
Hyperlactatemia is a common finding in critically ill patients and has significant prognostic implications. However, a single lactate measurement has not been correlated to mortality consistently. In this study, we aimed to correlate the clinical efficacy of lactate clearance for the prediction of mortality in pediatric intensive care unit patients. ⋯ The present study revealed that lactate clearance is a simple and rapid risk-stratification tool holding to be a potential biomarker of managing the treatment efficacy of children in the pediatric intensive care unit.
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Journal of critical care · Dec 2022
Review Meta AnalysisHigher versus lower oxygenation strategies in the general intensive care unit population: A systematic review, meta-analysis and meta-regression of randomized controlled trials.
Oxygen therapy is vital in adult intensive care unit (ICU) patients, but it is indistinct whether higher or lower oxygen targets are favorable. Our aim was to update the findings of randomized controlled trials (RTCs) comparing higher and lower oxygen strategies. ⋯ No difference was found for 90-day mortality, support free days and ICU and hospital LOS. However, a lower incidence of SAEs was found for lower oxygenation. These findings may have clinical implications for practice guidelines, yet it remains of paramount importance to continue conducting clinical trials, comparing groups with a clinically relevant contrast and focusing on the impact of important side effects.
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Curr Opin Crit Care · Dec 2022
ReviewFundamental drivers of nurses' experiences of ICU surging during the coronavirus disease 2019 (COVID-19) pandemic.
Nurses working in intensive care units have been heavily impacted by the coronavirus disease 2019 (COVID-19) pandemic. This review summarizes the current state of the evidence regarding intensive care nurses experience of the pandemic. ⋯ Many of the adverse impacts of the pandemic are interdependent; for example, reducing nurses' workload is likely to have benefits for mental health indicators.Adverse mental health outcomes are likely to have an impact on future recruitment and retention for intensive care nursing.More studies are needed to understand the longer term impact of the pandemic on intensive care nurses.
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Minerva anestesiologica · Dec 2022
ReviewArtificial intelligence in intensive care: moving towards clinical decision support systems.
The high complexity of care in the Intensive Care Unit environment has led, in the last decades, to a big effort in term of the improvement of patient's monitoring devices, increase of diagnostic and therapeutic opportunities, and development of electronic health records. Such advancements have enabled an increasing availability of large amounts of data that were supposed to provide more insight and understanding regarding pathophysiological processes and patient's prognosis providing useful tools able to support physicians in the clinical decision-making process. ⋯ The present review aimed to provide an overview of the status of ML-based algorithms in intensive care, to explore the concept of digital transformation, and to highlight possible next steps necessary to move towards a routine use of ML-based clinical decision support systems at the bedside. Finally, we described our attempt to apply the pillars of digital transformation in the field of microcirculation monitoring with the creation of the Microcirculation Network Research Group (MNRG).
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The coronavirus disease 2019 (COVID-19) pandemic has posed great challenges to intensive care units (ICUs) across the globe. The objective of this review is to provide an overview on how ICU surging was managed during COVID-19 pandemic, with a special focus on papers published in the last 18 months. ⋯ Although healthcare systems learned how to face some of the challenges with subsequent waves, the pandemic had persistent effects on healthcare systems.