Journal of critical care
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Journal of critical care · Jun 2018
ReviewThe critically ill patient with tuberculosis in intensive care: Clinical presentations, management and infection control.
Tuberculosis (TB) is one of the top ten causes of death worldwide. In 2016, there were 490,000 cases of multi-drug resistant TB globally. Over 2 billion people have asymptomatic latent Mycobacterium tuberculosis infection. ⋯ The mortality of patients requiring intensive care is high. The majority of early TB deaths result from acute cardiorespiratory failure or septic shock. Important clinical presentations, management and infection control issues regarding TB in intensive care settings are reviewed.
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Journal of critical care · Jun 2018
Estimating attributable fraction of mortality from sepsis to inform clinical trials.
Nearly all sepsis trials report no statistically significant difference in mortality. The attributable fraction of deaths due to sepsis (AFsepsis) may be an important, yet overlooked consideration. We derived AFsepsis and explored the effect of incorporating AFsepsis into sample size calculations. ⋯ Estimating trial specific AFsepsis to inform sample size calculations could be an additional step in sepsis trial design.
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Journal of critical care · Jun 2018
Multicenter Study Observational StudyCurrent practices and safety of medication use during rapid sequence intubation.
Characterize medication practices during and immediately after rapid sequence intubation (RSI) by provider/location and evaluate adverse drug events. ⋯ Medication practices during RSI vary amongst provider and medications are often used inappropriately. There is opportunity for optimization of medication use during RSI.
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Journal of critical care · Jun 2018
ReviewThyrotoxicosis induced cardiomyopathy requiring support with extracorporeal membrane oxygenation.
Thyrotoxicosis-induced cardiomyopathy (TCM) is a rare, potentially life-threatening complication requiring extracorporeal membrane oxygenation (ECMO) for temporary mechanical support while a euthyroid state is being achieved. ⋯ The definitive therapy of TCM is returning the patient to a euthyroid state. For those patients who develop circulatory collapse, however, temporary mechanical support should be strongly considered to allow time for a euthyroid state to be achieved.
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Journal of critical care · Jun 2018
Multicenter Study Observational StudyEarly glycemia and mortality in critically ill septic patients: Interaction with insulin-treated diabetes.
To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). ⋯ Septic patients with a pre-existing diagnosis of ITDM show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 h than those without ITDM. These findings provide a rationale for an ITDM-specific approach to the management of dysglycemia.