Journal of critical care
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Journal of critical care · Dec 2023
Population pharmacokinetics of dexamethasone in critically ill COVID-19 patients: Does inflammation play a role?
The aim of this study is to design a population pharmacokinetic study to gain a deeper understanding of the pharmacokinetics of dexamethasone in critically ill COVID-19 patients in order to identify relevant covariates that can be used to personalize dosing regimens. ⋯ Dexamethasone PK parameters in ICU COVID patients were substantially different from those from non-ICU non-COVID patients, and inflammation may play an important role in dexamethasone exposure. This finding suggests that fixed-dose dexamethasone over several days may not be appropriate for ICU COVID patients.
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Journal of critical care · Dec 2023
Randomized Controlled TrialICU- and ventilator-free days with isoflurane or propofol as a primary sedative - A post- hoc analysis of a randomized controlled trial.
To compare ICU-free (ICU-FD) and ventilator-free days (VFD) in the 30 days after randomization in patients that received isoflurane or propofol without receiving the other sedative. ⋯ Isoflurane via the ACD was not associated with more VFD but with more ICU-FD and less concomitant sedative use.
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Journal of critical care · Dec 2023
Randomized Controlled TrialGranulocyte-macrophage colony-stimulating factor (GM-CSF) in patients presenting sepsis-induced immunosuppression: The GRID randomized controlled trial.
Septic shock is associated in some patients with a profound immunosuppression. We hypothesized that GM-CSF would reduce the occurrence of ICU-acquired infections in immunosuppressed septic patients. ⋯ GM-CSF had no effect on the prevention of ICU-acquired infection in sepsis immunosuppression, but any conclusion is limited by the early termination of the study leading to low number of included patients.
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Journal of critical care · Dec 2023
The Metamorphosis, struggling to adapt to a new condition. The lived experience of patients with Thrombotic microangiopathies diagnosed in the ICU. A qualitative study.
Using qualitative interviews, our objective was to better understand the experience of patients with Thrombotic microangiopathies (TMA), from discovering their disease in the ICU to the psychological, emotional, and social specifics of living with this rare disorder. ⋯ Patients with TMA share common experiences with patients with other rare diseases, but also specific experiences related to their illness. Improved information at the onset and during the course of the illness, associated with enhanced care coordination plans would help TMA patients better cope with their illness and adhere to their care projects.