Articles: critical-illness.
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Zampieri FG, Machado FR, Biondi RS, et al. Effect of slower vs faster intravenous fluid bolus rates on mortality in critically ill patients: the BaSICS randomized clinical trial. JAMA. 2021;326:830-8. 34547081.
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Intensive care medicine · Feb 2022
Association of patient-to-intensivist ratio with hospital mortality in Australia and New Zealand.
The impact of intensivist workload on intensive care unit (ICU) outcomes is incompletely described and assessed across healthcare systems and countries. We sought to examine the association of patient-to-intensivist ratio (PIR) with hospital mortality in Australia/New Zealand (ANZ) ICUs. ⋯ We found no association of PIR with hospital mortality across ANZ ICUs. The low cohort predicted mortality may limit external validity.
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Journal of critical care · Feb 2022
Observational StudyCircadian variation in new-onset atrial fibrillation in patients in ICUs.
New-onset atrial fibrillation (NOAF) is common in patients treated on an intensive care unit (ICU). Onset of certain arrhythmias exhibit circadian variation. Whether NOAF follows a circadian rhythm in patients in ICU is unknown. ⋯ We identified 2017 patients who developed NOAF during their ICU stay. NOAF onset exhibited a bimodal distribution with peaks at 8 am and 8 pm, consistent with the onset of paroxysmal AF in patients in the community. Future studies in ICUs should record time of AF onset, as understanding high risk periods may inform timing of preventative interventions.
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Mayo Clinic proceedings · Feb 2022
Relationship Between Etiology of Cirrhosis and Survival Among Patients Hospitalized in Intensive Care Units.
To determine short-term outcomes of patients with alcohol-associated cirrhosis (ALC) admitted to the intensive care unit (ICU) compared with other etiologies of liver disease. In addition, we investigate whether quick sequential organ failure assessment accurately predicts presence of sepsis and in-hospital mortality in critically ill patients with various etiologies of cirrhosis. ⋯ Critically ill patients with ALC have decreased survival after ICU discharge compared with patients with other etiologies of cirrhosis, independent of alcohol abstinence.
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J Clin Monit Comput · Feb 2022
Safety aspects of the PiCCO thermodilution-cardiac output catheter during magnetic resonance imaging at 3 Tesla.
Thermodilution cardiac output monitoring, using a thermistor-tipped intravascular catheter, is used in critically ill patients to guide hemodynamic therapy. Often, these patients also need magnetic resonance imaging (MRI) for diagnostic or prognostic reasons. As thermodilution catheters contain metal, they are considered MRI-unsafe and advised to be removed prior to investigation. ⋯ No magnetically induced catheter displacements were observed. Under the tested circumstances, no heating or dislocation of the PiCCO™ catheter was observed in a tissue mimicking phantom during 3T-MRI. Leaving the catheter in the critically ill patient during MRI investigation might pose a lower risk of complications than catheter removal and replacement.