Intensive care medicine
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Intensive care medicine · Apr 2024
Multicenter Study Observational StudyLong-term survival and functional outcomes of critically ill patients with hematologic malignancies: a Canadian multicenter prospective study.
Patients with hematologic malignancy (HM) commonly develop critical illness. Their long-term survival and functional outcomes have not been well described. ⋯ 49% of all HM patients were alive at 7 days post-ICU discharge, and 21% at 12 months. Survival varied based upon hematologic diagnosis and frailty status. Survivors had important functional disability and impairment in emotional, physical, and general well-being.
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Intensive care medicine · Mar 2024
Randomized Controlled Trial Multicenter StudyRenal replacement therapy initiation strategies in comatose patients with severe acute kidney injury: a secondary analysis of a multicenter randomized controlled trial.
The effect of renal replacement therapy (RRT) in comatose patients with acute kidney injury (AKI) remains unclear. We compared two RRT initiation strategies on the probability of awakening in comatose patients with severe AKI. ⋯ In comatose patients with severe AKI, a more-delayed RRT initiation strategy resulted in a lower chance of transitioning from coma to awakening.
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Intensive care medicine · Mar 2024
Multicenter Study Observational StudyReactivation of Epstein-Barr virus among intensive care patients: a prospective observational study.
Herpesvirus reactivation has been documented among patients in the intensive care unit (ICU) and is associated with increased morbidity and mortality, particularly for cytomegalovirus (CMV). Epstein-Barr virus (EBV) has been poorly studied despite >95% of the population being seropositive. Our preliminary study suggested an association between EBV reactivation and increased morbidity and mortality. This study aimed to investigate this association among patients admitted to the ICU. ⋯ While EBV reactivation was not associated with increased 90-day mortality, it was associated with significantly increased morbidity.
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Intensive care medicine · Feb 2024
Randomized Controlled Trial Multicenter StudyEffect of aggressive vs conservative screening and confirmatory test on time to extubation among patients at low or intermediate risk: a randomized clinical trial.
This study aimed to determine the best strategy to achieve fast and safe extubation. ⋯ Among patients at low or intermediate risk for extubation failure with planned HFNC, combining aggressive screening with preventive PEEP and a conservative SBT reduced the time to extubation without increasing the reintubation rate.
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Intensive care medicine · Feb 2024
Multicenter StudyAcute kidney disease beyond day 7 after major surgery: a secondary analysis of the EPIS-AKI trial.
Acute kidney disease (AKD) is a significant health care burden worldwide. However, little is known about this complication after major surgery. ⋯ One in ten major surgery patients developed AKD beyond 7 days after surgery, in most cases without an episode of early postoperative-AKI. However, early postoperative-AKI severity and duration were associated with an increased rate of AKD and early postoperative-AKI was strongly associated with AKD independent of all other potential risk factors.