Journal of critical care
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Journal of critical care · Aug 2019
Review Meta AnalysisUtility of pleural effusion drainage in the ICU: An updated systematic review and META-analysis.
The effects on the respiratory or hemodynamic function of drainage of pleural effusion on critically ill patients are not completely understood. First outcome was to evaluate the PiO2/FiO2 (P/F) ratio before and after pleural drainage. ⋯ Pleural effusion drainage improves oxygenation of critically ill patients. It is a safe procedure. Further studies are needed to assess the hemodynamic effects of pleural drainage.
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Journal of critical care · Aug 2019
Randomized Controlled Trial Multicenter StudyImmune function testing in sepsis patients receiving sodium selenite.
We examined in a longitudinal study the role of sodium selenite in sepsis patients in strengthening the immune performance in whole blood samples using immune functional assays. ⋯ Selenium has long been an adjuvant therapy in treating sepsis. Recently, it was proven to not have beneficial effects on the mortality outcome. Using data from our center in this sub-cohort study, we identified no relative improvement in cytokine release of stimulated blood immune cells ex vivo from patients with selenium therapy over a three-week period. This offers a potential explanation for the lack of beneficial effects of selenium in sepsis patients.
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Journal of critical care · Aug 2019
Observational StudyThe incidence, characteristics, outcomes and associations of small short-term point-of-care creatinine increases in critically ill patients.
We assessed the incidence, characteristics, outcomes and associations of small, short-term point-of-care creatinine increases in critically ill patients. ⋯ Small, short-term point-of-care creatinine increase episodes are common. They are associated with illness severity, occur early, precede AKI by 10 h and are sensitive rather than specific markers of AKI.
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Journal of critical care · Aug 2019
Observational StudyThe effect of emergency department crowding on lung-protective ventilation utilization for critically ill patients.
To measure effects of ED crowding on lung-protective ventilation (LPV) utilization in critically ill ED patients. ⋯ ED patients remain on suboptimal tidal volume settings with infrequent ventilator adjustments during the ED stay. Hospitals should focus on both systemic factors and bedside physician and/or respiratory therapist interventions to increase LPV utilization in times of ED boarding and crowding for all patients.