Journal of critical care
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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
Conservative or liberal oxygen therapy for mechanically ventilated adults with acute brain pathologies: A post-hoc subgroup analysis.
To compare the effect of conservative vs. liberal oxygen therapy in mechanically ventilated adults in the intensive care unit (ICU) with non-hypoxic ischemic encephalopathy (HIE) acute brain pathologies. ⋯ In this post-hoc analysis, patients admitted to the ICU with non-HIE acute brain pathologies treated with conservative oxygen therapy did not have significantly lower mortality than those treated with liberal oxygen. A trial with adequate statistical power is needed to determine whether our day 180 mortality point estimate of treatment effect favoring liberal oxygen therapy indicates a true effect.
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Journal of critical care · Oct 2022
Impact of intraabdominal hypertension on kidney failure in critically ill patients: A post-hoc database analysis.
To assess whether intraabdominal hypertension (IAH) may influence kidney failure as well as mortality. ⋯ This study suggest that duration as well as higher grades of IAH are associated with kidney failure and may increase mortality.
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Journal of critical care · Oct 2022
Development of a machine learning model for the prediction of the short-term mortality in patients in the intensive care unit.
The aim of this study was to develop and evaluate a machine learning model that predicts short-term mortality in the intensive care unit using the trends of four easy-to-collect vital signs. ⋯ This simple yet powerful new mortality prediction model could be useful for early detection of probable mortality and appropriate medical intervention, especially in rapidly deteriorating patients.
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Journal of critical care · Oct 2022
The possible predictive value of muscle ultrasound in the diagnosis of ICUAW in long-term critically ill patients.
Intensive Care Unit acquired weakness (ICUAW) occurs commonly. Muscular ultrasonography allows visualization and classification of muscle characteristics. The aims of this study were to evaluate peripheral and respiratory muscles, their changes during long-term ICU stays, and the possible diagnostic predictive value of ICUAW as compared to the Medical Research Council strength score (MRC-SS). ⋯ Quadriceps and respiratory muscles were altered within the first week of mechanical ventilation. The loss of pennation angle offers high diagnostic accuracy for ICUAW, allowing for an earlier diagnosis before patients became able to perform volitional tests.