Journal of critical care
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Journal of critical care · Oct 2022
Review Meta AnalysisVitamin C-based regimens for sepsis and septic shock: Systematic review and meta-analysis of randomized clinical trials.
to critically appraise and synthesize the evidence on the effects of vitamin C-based regimens for patients with sepsis or septic shock. ⋯ CRD42021251786.
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Fluid resuscitation is a core component of emergency and critical care medicine. While the focus of clinicians has largely been on detecting patients who would respond to fluid therapy, relatively little work has been done on assessing patients' tolerance to this therapy. In this article we seek to review the concept of fluid tolerance, propose a working definition, and introduce relevant clinical signals by which physicians can assess fluid tolerance, hopefully becoming a starting point for further research.
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Journal of critical care · Oct 2022
ReviewPitfalls and pearls with drug dosing in the critically ill obese patient: 10 statements to guide ICU practitioners.
Obesity is highly prevalent in ICU patients presenting a number of challenges, one of which is drug dosing. There are limited high-quality data describing drug dosing in obesity, which can lead to dosing strategies that are suboptimal. ⋯ A generalized framework for decision making specific for obese patients is available that describes a step-by-step approach for constructing dosing regimens. This manuscript will build on that framework by providing pitfalls and pearls for clinicians to consider when making dosing decisions in critically ill patients with severe obesity.
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Journal of critical care · Oct 2022
Multicenter StudyCharacteristics and outcomes of autologous hematopoietic stem cell transplant recipients admitted to intensive care units: A multicenter study.
Studies of critically ill hematopoietic stem cell transplantation (HSCT) recipients have mainly been single-center and focused on allogenic HSCT recipients. We aimed to describe a cohort of autologous HSCT with an unplanned intensive care unit (ICU) admission. ⋯ In this large cohort of critically ill autologous HSCT recipients, mechanical ventilation was the only organ support-therapy associated with increased mortality in autologous HSCT recipients.
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Journal of critical care · Oct 2022
Observational StudyPropofol versus midazolam sedation in patients with cardiogenic shock - an observational propensity-matched study.
Benzodiazepines are recommended as first line sedative agent in ventilated cardiogenic shock patients, although data regarding the optimal sedation strategy are sparse. The aim of this study was to investigate the hemodynamic effects of propofol versus midazolam sedation in our cardiogenic shock registry. ⋯ In this observational cohort study, sedation with propofol in comparison to midazolam was linked to a reduced dose of catecholamines, decreased mortality and bleeding rates for patients with cardiogenic shock. Based on this study and in contrast to current recommendations, propofol should be given consideration for sedation in cardiogenic shock patients.