Journal of critical care
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Journal of critical care · Oct 2022
Impact of cardiac surgery and neurosurgery patients on variation in severity-adjusted resource use in intensive care units.
The resource use of cardiac surgery and neurosurgery patients likely differ from other ICU patients. We evaluated the relevance of these patient groups on overall ICU resource use. ⋯ Cardiac and neurosurgery have major effects on the cost structure of multidisciplinary ICUs. Extending SRUR analysis to patient subpopulations facilitates comparison of resource use between ICUs and may help to optimize resource allocation.
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Journal of critical care · Oct 2022
Association of blood pressure variability with short- and long-term cognitive outcomes in patients with critical illness.
Blood pressure variability (BPV), a modifiable risk factor, can compromise cerebral perfusion in critically ill patients. We studied the association between BPV in the intensive care unit (ICU) and short- and long-term cognitive outcomes. ⋯ BPV was associated with increased likelihood of delirium in the ICU. Delirium, but not BPV, was associated with long-term cognitive decline.
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Journal of critical care · Oct 2022
Characterising acute kidney injury: The complementary roles of biomarkers of renal stress and renal function.
Although epidemiological studies have enhanced our understanding of acute kidney injury, defining the biologic processes corresponding to the clinical phenotype remains challenging. We have examined biomarkers associated with renal stress plus markers of glomerular function to assess whether this approach may aid prediction of AKI or other relevant endpoints. ⋯ The combination of cell-cycle arrest biomarkers, TIMP-2 and IGFBP7, with serum creatinine but not cystatin C or PENK improved risk stratification for the development of stage 2 or 3 AKI over [TIMP-2]·[IGFBP7] alone.
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Journal of critical care · Oct 2022
The incidence of propofol infusion syndrome in critically-ill patients.
PRIS is a potentially fatal syndrome characterized by various clinical symptoms and abnormalities. Experts suggest that propofol treatment duration ≥48 h or dose ≥83 μg/kg/min is associated with developing PRIS. We hypothesized PRIS might be underdiagnosed due to the overlap of PRIS clinical manifestations with critical illnesses. ⋯ PRIS can often be overlooked and underdiagnosed. It is important to monitor for early signs of PRIS in patients who are on prolonged propofol infusion. Prompt recognition and interventions can minimize the dangers resulting from PRIS.
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Journal of critical care · Oct 2022
Small, short-term, point-of-care creatinine changes as predictors of acute kidney injury in critically ill patients.
To assess short-term creatinine changes as predictors of acute kidney injury (AKI) when used alone and in combination with AKI risk factors. ⋯ In combination with key risk factors, frequent point-of-care creatinine assessment on arterial blood gases to detect small, short-term creatinine changes provides a robust, novel, low-cost, and rapid method for predicting AKI in critically ill patients.