Articles: intensive-care-units.
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Am. J. Respir. Crit. Care Med. · Dec 2024
Association Between Baseline Driving Pressure and Mortality in Very Old Patients with ARDS.
Rationale: Because of the effects of aging on the respiratory system, it is conceivable that the association between driving pressure and mortality depends on age. Objectives: We endeavored to evaluate whether the association between driving pressure and mortality of patients with acute respiratory distress syndrome (ARDS) varies across the adult lifespan, hypothesizing that it is stronger in older, including very old (⩾80 yr), patients. Methods: We performed a secondary analysis of individual patient-level data from seven ARDS Network and PETAL Network randomized controlled trials ("ARDSNet cohort"). ⋯ In both cohorts, a driving pressure threshold of 11 cm H2O was associated with mortality in very old patients. Conclusions: Data from randomized controlled trials with strict inclusion criteria suggest that the effect of driving pressure on the mortality of patients with ARDS may depend on age. These results may advocate for a personalized age-dependent mechanical ventilation approach.
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Curr Opin Crit Care · Dec 2024
ReviewProtective mechanical ventilation in critically ill patients after surgery.
This review aims to provide an updated overview of lung protective strategies in critically ill patients after surgery, focusing on the utility of postoperative open-lung ventilation during the transition from the operating room to the intensive care unit. ⋯ Mechanical ventilation in surgical patients should adhere to lung protective strategies (i.e., individualizing positive end expiratory pressure and prioritize alveolar recruitment) during the transition from the operating room to the intensive care unit.
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Journal of critical care · Dec 2024
Randomized Controlled TrialContinuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial.
This study evaluated the clinical utility of continuous glucose monitoring system (CGMS) in critically ill patients. ⋯ Compared with conventional POCM, CGMS did not decrease the 28-day mortality in critically ill participants with diabetes or stress-induced hyperglycemia. But CGMS may improve the glycemic control and may be increasingly used in critically ill patients.
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Critical care medicine · Dec 2024
Inability to Sit-to-Stand in Medical ICUs Survivors: When and Why We Should Care.
To investigate the prevalence and association with mortality of inability to perform sit-to-stand independently in critically ill survivors 3 months following medical ICU (MICU) discharge. ⋯ Inability to sit-to-stand affects about 36% of MICU survivors even at 3 months post-ICU discharge, highlighting rehabilitation challenges. Revisiting sit-to-stand ability post-ICU discharge is warranted. Additionally, using sit-to-stand as a screening tool for interventions to improve return of its function and mortality is suggested.
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Pediatr Crit Care Me · Dec 2024
Observational StudyPhysical, Cognitive, Emotional, and Social Health Outcomes of Children in the First 6 Months After Childhood Critical Illness: A Prospective Single-Center Study.
To describe physical, cognitive, emotional, and social health outcomes of children and their trajectory in the first 6 months after PICU discharge. ⋯ In our cohort of PICU patients, we found three unique trajectory groups. Children in the severe group were older, more likely to have preexisting conditions and at increased risk for PTSS. Early identification and intervention may improve recovery in patients with severe PICU trajectories.