Journal of critical care
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Journal of critical care · Feb 2021
Meta AnalysisAre thromboelastometric and thromboelastographic parameters associated with mortality in septic patients? A systematic review and meta-analysis.
Thromboelastometry/elastography (ROTEM/TEG) showed promising results for diagnosis of sepsis-induced coagulopathy, but their association with the outcome is unclear. Our aim was to assess any difference in ROTEM/TEG measurements between septic survivors and non-survivors. ⋯ Hypocoagulability and lower MCF in EXTEM may be associated with higher mortality in sepsis.
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Journal of critical care · Feb 2021
Randomized Controlled TrialSevere or critical hypotension during post cardiac arrest care is associated with factors available on admission - a post hoc analysis of the TTH48 trial.
We explored whether severe or critical hypotension can be predicted, based on patient and resuscitation characteristics in out-of-hospital cardiac arrest (OHCA) patients. We also explored the association of hypotension with mortality and neurological outcome. ⋯ Diabetes, non-shockable rhythm, longer delay to ROSC and lower admission MAP were predictors of severe or critical hypotension. Severe or critical hypotension was associated with poor outcome.
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To document the equipment, resource and bed capacity of Intensive Care Units (ICUs) in the Republic of Ghana. ⋯ Ghana has a significant shortage of critical care beds that are inequitably distributed across the country and a shortfall of intensivists to staff ICUs. A holistic approach that focuses on the key bottlenecks to quality improvement would be required to improve the capacity and quality of critical care delivery.
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Journal of critical care · Feb 2021
Randomized Controlled TrialEsophageal balloon calibration during Sigh: A physiologic, randomized, cross-over study.
Optimal esophageal balloon filling volume (Vbest) depends on the intrathoracic pressure. During Sigh breath delivered by the ventilator machine, esophageal balloon is surrounded by elevated intrathoracic pressure that might require higher filling volume for accurate measure of tidal changes in esophageal pressure (Pes). The primary aim of our investigation was to evaluate and compare Vbest during volume controlled and pressure support breaths vs. Sigh breath. ⋯ During Sigh breath, applying a calibrated approach for Pes assessment, a higher Vbest was required compared to VCV and PSV tidal breath.
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Journal of critical care · Feb 2021
Meta AnalysisImpact of early ICU admission on outcome of critically ill and critically ill cancer patients: A systematic review and meta-analysis.
Prognostic impact of early ICU admission remains controversial. The aim of this review was to investigate the impact of early ICU admission in the general ICU population and in critically ill cancer patients and to report level of evidences of this later. ⋯ Theses results suggest that early ICU admission is associated with decreased mortality in the general ICU population and in CICP. These results were however obtained from high risk of bias studies and a high heterogeneity was noted. Systematic review registration: PROSPERO 2018 CRD42018094828.