Journal of critical care
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Journal of critical care · Oct 2018
Quantitative peripheral muscle ultrasound in sepsis: Muscle area superior to thickness.
The objective of this study is to describe the relationship between two quantitative muscle ultrasound measures, the rectus femoris cross-sectional area (RF-CSA) and quadriceps muscle thickness, with volitional measures of strength and function in critically ill patients with sepsis. ⋯ Muscle atrophy as detected by the rate of change in RF-CSA moderately correlated with strength one week after sepsis admission.
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Journal of critical care · Oct 2018
Early mobility in frail and non-frail older adults admitted to the cardiovascular intensive care unit.
Little is known about the effects of early mobilization in older adults in the Cardiovascular Intensive Care Unit (CICU). ⋯ EM is feasible in older adults admitted to the CICU. Functional status improved in both frail and non-frail older adults during CICU admission. Prospective studies are needed to determine whether frail older adults may benefit from EM.
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Journal of critical care · Oct 2018
Emergence of antimicrobial resistance to piperacillin/tazobactam or meropenem in the ICU: Intermittent versus continuous infusion. A retrospective cohort study.
Prolonged infusion of beta-lactam antibiotics is broadly recognized as a strategy to optimize antibiotic therapy by achieving a higher percentage of time that concentrations remain above the minimal inhibitory concentration (% fT>MIC), i.e. the pharmacokinetic/pharmacodynamic (PK/PD) index. However, %fT>MIC may not be the PK/PD index of choice for inhibition of resistance emergence and it is therefore unsure what impact prolonged infusion of beta-lactam antibiotics may have on the emergence of resistance. ⋯ In this retrospective cohort study, the emergence of antimicrobial resistance to piperacillin/tazobactam or meropenem was not related to the mode of infusion.
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Critical illnesses are a major cause of morbidity and mortality in The Gambia, yet national data on critical care capacity is lacking. ⋯ The Gambia has a very low ICU bed capacity and lacks the human resources and equipment necessary to diagnose and treat the large number of critically ill patients admitted to public hospitals in the country.
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Journal of critical care · Oct 2018
Editorial CommentSearching for better outcomes in septic shock trials.