Journal of critical care
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Journal of critical care · Feb 2025
Multicenter StudyPrognosis of major bleeding based on residual variables and machine learning for critical patients with upper gastrointestinal bleeding: A multicenter study.
Upper gastrointestinal bleeding (UGIB) is a significant cause of morbidity and mortality worldwide. This study investigates the use of residual variables and machine learning (ML) models for predicting major bleeding in patients with severe UGIB after their first intensive care unit (ICU) admission. ⋯ ML models using residuals improved the accuracy and interpretability in predicting major bleeding during ICU admission in patients with UGIB. These interpretable features may facilitate the early identification and management of high-risk patients, thereby improving hemodynamic stability and outcomes.
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Journal of critical care · Feb 2025
Sex dependent effects of cardiovascular agents on hemoglobin oxygen affinity - An ex-vivo experiment.
Hemoglobin‑oxygen (Hb-O2) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O2 affinity. ⋯ All investigated agents decreased Hb-O2 affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.
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Journal of critical care · Feb 2025
Malnutrition in survivors of critical illness and long-term survival outcomes: A cohort study.
This study aimed to determine the prevalence of malnutrition and associated risk factors among intensive care unit (ICU) survivors and to investigate whether malnutrition after ICU admission is associated with long-term survival outcomes. ⋯ Malnutrition within 1 year of ICU admission was reported in 8.1 % of survivors. Notably, malnutrition after ICU admission was associated with an increased risk of mortality between 1 and 5 years after ICU admission among ICU survivors.
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Journal of critical care · Feb 2025
Ultrasound assessment of muscle mass in critically ill patients: A correlation with nutritional support and clinical outcomes.
Critically ill patients are at high risk of Intensive Care Unit (ICU) Acquired weakness, which negatively impacts clinical outcomes. Traditional muscle mass and nutritional status assessments are often impractical in the ICU. Ultrasound offers a promising, non-invasive alternative. This study evaluates the relationship between ultrasound-based muscle assessments, patients' nutritional support, and clinical outcomes in the ICU. ⋯ Our study demonstrates that critically ill patients experience significant muscle mass loss within the first 72 h of ICU. QMLT reduction significantly impacts 28-day mortality, with an 8.8 % increase in the odds of death per 0.1 cm reduction.
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Journal of critical care · Feb 2025
Antibiotic allergy de-labeling in the intensive care unit: The prospective ADE-ICU study.
Critically ill patients in the intensive care unit (ICU) are frequently prescribed antibiotics, with many reporting an antibiotic allergy label, predominantly to penicillin. Mislabeling contributes to suboptimal antibiotic use, increasing multidrug-resistant organisms and Clostridium difficile infections, and increased hospital length of stay. This prospective study implemented an antibiotic allergy assessment and testing program in the ICU, independently of clinical immunology/allergy services. ⋯ This study shows the feasibility of ICU led antibiotic allergy assessment and testing, highlighting a potential model for implementation in settings lacking immunology/allergy services.