Intensive care medicine
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Intensive care medicine · Dec 2018
Randomized Controlled Trial Multicenter StudyTargeting low-normal or high-normal mean arterial pressure after cardiac arrest and resuscitation: a randomised pilot trial.
We aimed to determine the feasibility of targeting low-normal or high-normal mean arterial pressure (MAP) after out-of-hospital cardiac arrest (OHCA) and its effect on markers of neurological injury. ⋯ Targeting a specific range of MAP was feasible during post-resuscitation intensive care. However, the blood pressure level did not affect the NSE concentration at 48 h after cardiac arrest, nor any secondary outcomes.
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Intensive care medicine · Dec 2018
Multicenter Study Observational StudyAssociation of social deprivation with 1-year outcome of ICU survivors: results from the FROG-ICU study.
Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible for poor long-term outcomes would be beneficial in designing targeted interventions for at-risk populations. ⋯ A lower socioeconomic status was associated with lower self-reported physical component scores in the nondeprived patients. Psychiatric symptoms are frequently reported after an ICU stay, and subsequent interventions should target those fields.
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Intensive care medicine · Dec 2018
Multicenter Study Observational StudyTiming of onset of persistent critical illness: a multi-centre retrospective cohort study.
Persistent critical illness has been described as a subtype of chronic critical illness, characterized as a transition after ICU admission where primary diagnosis and illness acuity are no better at predicting outcome than pre-hospital characteristics. Herein we describe the occurrence and outcomes associated with persistent critical illness in a large Canadian health region. ⋯ Persistent critical illness occurred in one in six patients admitted to Alberta ICUs and portended greater risk of death, prolonged ICU and hospital stay, and disproportionate use of health resources compared to patients without persistent critical illness.
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Intensive care medicine · Dec 2018
Multicenter StudyUnrecognised myocardial infarction and its relationship to outcome in critically ill patients with cardiovascular disease.
To establish the incidence of myocardial infarction (MI) in ICU patients with co-existing cardiovascular disease (CVD), and explore its association with long-term survival. ⋯ Undiagnosed MI occurs in around a quarter of critically ill patients with co-existing CVD and is associated with lower long-term survival.
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Intensive care medicine · Dec 2018
Randomized Controlled Trial Multicenter Study Comparative StudyErythromycin versus metoclopramide for post-pyloric spiral nasoenteric tube placement: a randomized non-inferiority trial.
To determine whether erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of self-propelled spiral nasoenteric tubes (NETs) in critically ill patients. ⋯ Erythromycin is non-inferior to metoclopramide in facilitating post-pyloric placement of spiral NETs in critically ill patients. The success rates of post-D1, post-D2, post-D3, and proximal jejunum placement were not significantly different.