Articles: critical-illness.
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Acta Anaesthesiol Scand · Oct 2021
Multicenter StudyGlycemic lability index and mortality in critically ill patients - a multicenter cohort study.
Emerging evidence indicates a relationship between glycemic variability during intensive care unit (ICU) admission and death. We assessed whether mean glucose, hypoglycemia occurrence, or premorbid glycemic control modified this relationship. ⋯ In adult patients admitted to an ICU in Sweden and Australia, a high GLI was associated with increased hospital mortality irrespective of the level of mean glycemia, hypoglycemia occurrence, or premorbid glycemic control. These findings support the assessment of interventions to reduce glycemic variability during critical illness.
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Journal of critical care · Oct 2021
Randomized Controlled Trial Multicenter StudyFrequency and risk factors of post-intensive care syndrome components in a multicenter randomized controlled trial of German sepsis survivors.
Post-intensive care syndrome (PICS) is a combination of cognitive, psychiatric and physical impairments in survivors of critical illness and intensive care. There is little data on long-term co-occurrence of associated impairments. ⋯ Almost all study participants showed impairments associated with PICS in at least one domain. The proposed classification models for PICS appear to be too broad to identify specific risk factors beyond its individual components.
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Journal of critical care · Oct 2021
ReviewCOVID-19-related echocardiographic patterns of cardiovascular dysfunction in critically ill patients: A systematic review of the current literature.
Coronavirus disease 2019 (COVID-19) infection may trigger a multi-systemic disease involving different organs. There has been growing interest regarding the harmful effects of COVID-19 on the cardiovascular system. This systematic review aims to systematically analyze papers reporting echocardiographic findings in hospitalized COVID-19 subjects. ⋯ Data regarding the use of echocardiography on hospitalized, predominantly ICU, COVID-19 patients were retrieved from studies with heterogeneous designs, variable sample sizes, and severity scores. Normal echocardiographic findings were reported in about 50% of subjects, with LVEF usually not affected. Overall, RV dysfunction seems more likely associated with increased mortality.
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Observational Study
Admission Blood Glucose in the Emergency Department is Associated with Increased In-Hospital Mortality in Nontraumatic Critically Ill Patients.
Abnormal admission blood glucose was reported as a useful predictor of outcome in critically ill patients. ⋯ Abnormal admission blood glucose is associated with a high in-hospital mortality. Admission blood glucose is an inexpensive and rapidly available laboratory parameter that may predict mortality and help to identify critically ill patients at risk in a general nontraumatic critically ill ED patient cohort. The breakpoint for in-hospital mortality may be an admission blood glucose ≤ 100 and ≥ 272 mg/dL.
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Int. J. Clin. Pract. · Oct 2021
Performance of the CURB-65, ISARIC-4C, and COVID-GRAM scores in terms of severity for COVID-19 patients.
In the COVID-19 pandemic, difficulties have been experienced in the provision of healthcare services because of excessive patient admissions to hospitals and emergency departments. It has become important to use clear and objective criteria for the early diagnosis of patients with high-risk classification and clinical worsening risk. ⋯ Among the scoring systems assessed, CURB-65 score had better performance in predicting in-hospital mortality and ICU requirement in COVID-19 patients. ISARIC-4C has been found successful in identifying low-risk patients and the use of the ISARIC-4C score with CURB-65 increases the accuracy of risk assessment.