Journal of critical care
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Journal of critical care · Oct 2022
A critical care outreach team under strain - Evaluation of the service provided to patients with haematological malignancy during the Covid-19 pandemic.
Critical Care Outreach Teams (CCOTs) have been associated with improved outcomes in patients with haematological malignancy (HM). This study aims to describe CCOT activation by patients with HM before and during the Covid-19 pandemic, assess amny association with worse outcomes, and examine the psychological impact on the CCOT. ⋯ Despite the increase in total hospital referrals, the number of patients with HM that were reviewed during the surge periods decreased, as did their ICU admission rate and mortality. The quality of care provided was not impaired, as reflected by the number of patients receiving bedside reviews and the shorter-than-pre-pandemic response time.
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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.
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Journal of critical care · Oct 2022
Clinicopathological features and short outcomes of oliguric acute tubular injury.
To explore the clinicopathological features and analyze the relevant risk factors and short-term renal outcomes of acute tubular injury (ATI) patients. ⋯ Oliguric ATI patients had severe clinicopathological conditions. The severity of tubular lesions seriously influenced renal function recovery, demonstrating the importance of renal biopsy in assessing the prognosis of patients with kidney disease.
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Journal of critical care · Oct 2022
Clinical characteristics, respiratory management, and determinants of oxygenation in COVID-19 ARDS: A prospective cohort study.
To identify determinants of oxygenation over time in patients with COVID-19 acute respiratory distress syndrome (ARDS); and to analyze their characteristics according to Berlin definition categories. ⋯ Hypoxemia in patients with COVID-19-related ARDS is associated with comorbidities, deadspace and activated coagulation markers, and disease severity-reflected by the PEEP level required.
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Journal of critical care · Oct 2022
Impact of colonization with multidrug-resistant bacteria on the risk of ventilator-associated pneumonia in septic shock.
The objective is to identify the risk markers of multi-drug resistant bacteria (MDRB) related ventilator-associated pneumonia (VAP) in septic shock patients with previous MDRB carriage. ⋯ Imported and acquired MDRB carriage harbor different risks of subsequent MDRB-related VAP in patients with septic shock.