Articles: critical-illness.
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Randomized Controlled Trial
Effect of an enteral amino acid blend on muscle and gut functionality in critically ill patients: a proof-of-concept randomized controlled trial.
A defining feature of prolonged critical illness is muscle wasting, leading to impaired recovery. Supplementation with a tailored blend of amino acids may bolster the innate gut defence, promote intestinal mucosa repair and limit muscle loss. ⋯ Amino acid supplementation increased plasma citrulline levels, reduced alanine aminotransferase and alkaline phosphatase levels, and improved twitch airway pressure and anterior quadriceps volume. Trial registration ClinicalTrials.gov, NCT02968836. Registered November 21, 2016.
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Weaning from mechanical ventilation (MV) is an essential issue in critically ill patients, and we used an explainable machine learning (ML) approach to establish an extubation prediction model. ⋯ We developed an extubation prediction model with high accuracy and visualised explanations aligned with clinical workflow, and the model may serve as an autonomous screen tool for timely weaning.
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Randomized Controlled Trial Pragmatic Clinical Trial
Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation.
Invasive mechanical ventilation in critically ill adults involves adjusting the fraction of inspired oxygen to maintain arterial oxygen saturation. The oxygen-saturation target that will optimize clinical outcomes in this patient population remains unknown. ⋯ Among critically ill adults receiving invasive mechanical ventilation, the number of ventilator-free days did not differ among groups in which a lower, intermediate, or higher Spo2 target was used. (Supported by the National Heart, Lung, and Blood Institute and others; PILOT ClinicalTrials.gov number, NCT03537937.).
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Editorial Comment
Early Mobilization of Critical Care Patients - Still More to Learn.