Journal of critical care
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Journal of critical care · Apr 2019
Review Meta Analysis Comparative StudyCrystalloids vs. colloids for fluid resuscitation in the Intensive Care Unit: A systematic review and meta-analysis.
Guidelines recommend crystalloids for fluid resuscitation in sepsis/shock and switching to albumin in cases where crystalloids are insufficient. We evaluated hemodynamic response to crystalloids/colloids in critically ill adults. ⋯ Crystalloids were less efficient than colloids at stabilizing resuscitation endpoints; guidance on when to switch is urgently required.
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Journal of critical care · Apr 2019
Severity of illness assessment with application of the APACHE IV predicted mortality and outcome trends analysis in an academic cardiac intensive care unit.
To assess trends in life support interventions and performance of the automated Acute Physiology and Chronic Health Evaluation (APACHE) IV model at mortality prediction compared with Oxford Acute Severity of Illness Score (OASIS) in a contemporary cardiac intensive care unit (CICU). ⋯ Contemporary CICU patients are increasingly ill, observed in upward trends in comorbid conditions and life support interventions. APACHE IV predicted death and OASIS showed good discrimination in predicting death in this population. APACHE IV and OASIS may be useful for benchmarking and quality improvement initiatives in the CICU, the former having better discrimination.
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Journal of critical care · Apr 2019
Review Meta AnalysisRenal resistive index as predictor of acute kidney injury after major surgery: A systematic review and meta-analysis.
To determine the efficacy of Doppler renal resistive index in the prediction of acute kidney injury after major surgery. ⋯ Renal resistive index represents a useful marker with fair performance in the prediction of postoperative acute kidney injury. Future cohorts should establish the optimal timing of measurement and evaluate the most appropriate cut-off value that should be used in the clinical setting.
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Journal of critical care · Apr 2019
Multicenter Study Comparative StudyComparison of outcomes and costs between adult diabetic ketoacidosis patients admitted to the ICU and step-down unit.
There is wide variation in the utilization of Intensive Care Unit (ICU) beds for treatment and monitoring of adult patients with Diabetic Ketoacidosis (DKA). We sought to compare the outcomes and hospital costs of adult DKA patients admitted to ICUs as compared to those admitted to step-down units. ⋯ Adult DKA patients admitted to a step-down unit had comparable in-hospital mortality and lower hospital costs as compared to those admitted to the ICU.
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Journal of critical care · Apr 2019
ReviewInterventions for the management and prevention of sarcopenia in the critically ill: A systematic review.
In the critically ill, sarcopenia is associated with a variety of adverse outcomes however there is no consensus regarding its management. This study aimed to systematically review the evidence for interventions for the management and prevention of sarcopenia in critically ill patients. ⋯ NMES and exercise-based interventions may preserve muscle mass and function in patients with critical illness. There is a lack of consistency seen in the effects of these interventions. Further, large, high quality RCTs are required.