Journal of critical care
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Journal of critical care · Feb 2021
ReviewThe effects of arterial CO2 on the injured brain: Two faces of the same coin.
Serum levels of carbon dioxide (CO2) closely regulate cerebral blood flow (CBF) and actively participate in different aspects of brain physiology such as hemodynamics, oxygenation, and metabolism. Fluctuations in the partial pressure of arterial CO2 (PaCO2) modify the aforementioned variables, and at the same time influence physiologic parameters in organs such as the lungs, heart, kidneys, and the gastrointestinal tract. In general, during acute brain injury (ABI), maintaining normal PaCO2 is the target to be achieved. ⋯ On the other hand, inducing hypercapnia could be beneficial when certain specific situations require increasing CBF. The evidence supporting this claim is very weak. This review attempts providing an update on the physiology of CO2, its risks, benefits, and potential utility in the neurocritical care setting.
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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.
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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
Meta AnalysisTemperature control in critically ill patients with fever: A meta-analysis of randomized controlled trials.
Fever is frequently encountered in ICU. It is unclear if targeted temperature control is beneficial in critically ill patients with suspected or confirmed infection. We conducted a systemic review and meta-analysis to answer this question. ⋯ Antipyretic therapy effectively reduces temperature in non-neurocritical ill patients but does not reduce mortality or impact other outcomes.