Heart & lung : the journal of critical care
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Review Meta Analysis
Bicarbonate use and mortality outcome among critically ill patients with metabolic acidosis: A meta analysis.
The use of sodium bicarbonate in the treatment of metabolic acidosis in critically ill subjects has long been a subject of debate. Despite empiric use in the setting of severe acidemia in critically ill patients, there is little data looking into the role of sodium bicarbonate in the treatment of severe metabolic acidosis in the intensive care unit (ICU) setting. ⋯ There is no significant difference in mortality in the use of bicarbonate among critically ill patients with high anion gap metabolic acidosis predominantly driven by lactic acidosis.
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Review Meta Analysis Comparative Study
Comparison of early and midterm outcomes after transsubclavian/axillary versus transfemoral, transapical, or transaortic transcatheter aortic valve implantation.
Outcomes after transsubclavian/transaxillary (TSc/TAx)-transcatheter aortic valve implantation (TAVI) have been unclear. ⋯ Early all-cause mortality was lower after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, early pacemaker implantation was more frequent after TSc/TAx-TAVI than TAp-TAVI or TAo-TAVI, and midterm all-cause mortality was higher after TSc/TAx-TAVI than TF-TAVI.
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Although the order of vasopressor initiation in patients with septic shock is established, limited information is available on the order of vasopressor discontinuation. ⋯ Our results suggest that the risk of hypotension is higher in patients with septic shock in whom vasopressin is withdrawn before norepinephrine.
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Extracorporeal membrane oxygenation (ECMO), a rescue treatment for patients with severe pulmonary and/or cardiac dysfunction, is increasingly being used worldwide. A better understanding of long-term health-related quality of life (HRQOL) is needed. ⋯ Early identification and management of physical and mental health problems may improve HRQOL outcomes.
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This study was aimed at a serial evaluation of the prognostic values of initial shockable rhythm, bystander cardiopulmonary resuscitation (CPR) and gender for neurological outcome and survival in adults treated with targeted temperature management (TTM) following cardiac arrest (CA). PubMed, Embase and the Cochrane Library were searched for eligible studies. Pooled odds ratio (OR) with 95% confidence intervals (CIs) was calculated to evaluate prognostic values using RevMan 5.3. ⋯ In adult patients treated with TTM, initial shockable rhythm, bystander CPR and male sex were associated with a higher likelihood of favorable neurological outcome. Initial shockable rhythm and bystander CPR were associated with a higher likelihood of survival. These factors could help in identifying patients who are eligible for TTM.