Articles: critical-illness.
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Introduction: In this study, we assessed whether changes in oxygen consumption (VO 2 ) and other metabolic parameters could be used as an early warning system for detecting clinical deterioration in mechanically ventilated patients. Methods: This was a prospective cohort study of adult patients requiring mechanical ventilation between February 2016 and March 2019. We looked for changes in VO 2 , carbon dioxide production (VCO 2 ), respiratory quotient (RQ), and end-tidal carbon dioxide (EtCO 2 ), occurring prior to clinical deterioration. ⋯ RQ increased significantly within the 4 hours prior to an increase in lactate as compared with no increase in lactate, but there were no detectable changes prior to other clinical deteriorations. Conclusions RQ has the potential to be an early marker of tissue hypoperfusion or mitochondrial dysfunction. However, future studies are necessary to evaluate the use of RQ as a bedside monitor in critical care settings.
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Journal of critical care · Oct 2023
Observational StudyApplication of urinary biomarkers for diagnosing acute kidney injury in critically ill patients without baseline renal function data.
Estimating the baseline renal function of patients without prior creatinine measurement is crucial for diagnosing acute kidney injury (AKI). This study aimed to incorporate AKI biomarkers into a new AKI diagnosis rule when no premorbid baseline is available. ⋯ The novel diagnostic rule incorporating serum creatinine and urinary NGAL at ICU admission showed superiority to the MDRD approach in AKI diagnosis without baseline renal function data.
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Journal of critical care · Oct 2023
Visceral obesity measured using computed tomography scans: No significant association with mortality in critically ill patients.
The association between obesity and outcome in critical illness is unclear. Since the amount of visceral adipose tissue(VAT) rather than BMI mediates the health effects of obesity we aimed to investigate the association between visceral obesity, BMI and 90-day mortality in critically ill patients. ⋯ No significant association of visceral obesity and BMI with 90-day mortality was observed in critically ill patients, although obesity and visceral obesity tended to be associated with improved 90-day mortality.
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Preventive medicine · Oct 2023
Application of blood purification based on a new type of nanofiber membrane in critically ill patients and comparative analysis of its nursing methods.
Blood purification technology is one of the main treatment methods to prolong the life of severe patients. The traditional blood purification membrane materials have the disadvantages of non-selective adsorption, single pore size and low permeability, and need to develop new and efficient blood purification membrane materials. To explore the application of a new type of nanofiber membrane in blood purification of critically ill patients and compare and analyze its nursing methods. ⋯ The physiological and biochemical indexes of both groups tend to be normal, but the experimental group is more obvious. The patients in the experimental group were more satisfied with the nursing services provided in the process. The new blood purification method of nanofiber membrane can overcome the shortcomings of traditional purification and remove toxic small and medium-sized molecules to the maximum extent.
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Journal of critical care · Oct 2023
Comment Letter Randomized Controlled TrialAuthor's response: Prolonged sedation with sevoflurane in comparison to intravenous sedation in critically ill patients - A randomized controlled trial.