Articles: critical-illness.
-
J Coll Physicians Surg Pak · Aug 2024
Prediction of Mortality Using the Sequential Organ Failure Assessment Score in Critically Ill COVID-19 Patients.
To determine the accuracy and reliability of the sequential organ failure assessment (SOFA) score in predicting the risk of mortality in ICU-admitted COVID-19 patients. ⋯ COVID-19, Mortality prediction, SOFA score.
-
After acute burn injury, patients experience a hypermetabolic state often complicated by a stress-induced hyperglycemia. Recent research points towards glycemic variability as a contributing factor in adverse outcomes in critically ill patients. In burn patients, greater glycemic variability has been associated with increased rates of mortality and sepsis. ⋯ Mean glucose (OR 1.024; 95% CI 1.004-1.045) and J-index (OR 1.044; 95% CI 1.003-1.087) were associated with occurrence of infectious complications. Regarding target mean glucose threshold, a daily mean glucose above 150 mg/dL showed the strongest association with infectious complications (OR 3.634; 95% CI 1.008-13.101). Mean glucose, standard of deviation, and J-index were all independently associated with proven infection.
-
Journal of critical care · Aug 2024
Interfacility transfer of the critically ill: Transfer status does not influence survival.
To estimate differences in case-mix adjusted hospital mortality between adult ICU patients who are transferred during their ICU-stay and those who are not. ⋯ The transfer of critically ill patients between ICUs in Nova Scotia did not impact case-mix adjusted hospital mortality.
-
Journal of critical care · Aug 2024
Development and validation of potential phenotypes of serum electrolyte disturbances in critically ill patients and a Web-based application.
Electrolyte disturbances are highly heterogeneous and severely affect the prognosis of critically ill patients. Our study was to determine whether data-driven phenotypes of seven electrolytes have prognostic relevance in critically ill patients. ⋯ Three different clinical phenotypes were identified that correlated with electrolyte distribution and clinical outcomes. Further validation and characterization of these phenotypes is warranted.
-
The current S3 guideline, "Positioning Therapy and Mobilization of Critically Ill Patients in Intensive Care Units", introduces methodological changes and substantive updates compared to the previous version. Additionally, new evidence-based insights with specified PICO questions have been integrated, aiming for a more precise application of recommendations in clinical practice and thus enhancing the care of critically ill patients. A notable aspect is the more nuanced approach to early mobilization, which is recommended to commence within the first 72 hours of ICU admission. ⋯ It is recommended as a therapeutic option for invasively ventilated patients with ARDS and impaired arterial oxygenation (PaO2/FiO2 <150mmHg), with a recommended minimum duration of 12 hours, ideally 16 hours. Special recommendations apply, for example, to COVID-19 patients with acute hypoxemic respiratory failure, where awake proning should be considered. Additionally, new chapters have been introduced focusing on assistive devices and neuromuscular electrical stimulation.