Journal of critical care
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Journal of critical care · Feb 2023
Observational StudyLung ultrasound to predict gas-exchange response to prone positioning in COVID-19 patients: A prospective study in pilot and confirmation cohorts.
To examine whether lung ultrasound prior to prone positioning can predict the resulting gas-exchange response. ⋯ Anterior LUSI, in addition to other clinical parameters, may be used to aid COVID-19 respiratory strategy and a clinician's decision to prone.
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Journal of critical care · Feb 2023
Observational StudyAssociation between metformin and survival outcomes in in-hospital cardiac arrest patients with diabetes.
Metformin has shown cardioprotective and neuroprotective effects in cardiac arrest and ischemia-reperfusion injury animal models. Therefore, this study aimed to determine the association between diabetes medication and survival outcomes in in-hospital cardiac arrest (IHCA) patients with type 2 DM (T2DM). ⋯ In IHCA patients with T2DM, administration of metformin within 24 h before IHCA was independently associated with survival to discharge.
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Journal of critical care · Feb 2023
Observational StudyHealth-related quality of life, one-year costs and economic evaluation in extracorporeal membrane oxygenation in critically ill adults.
This study reports on survival and health related quality of life (HRQOL) after extracorporeal membrane oxygenation (ECMO) treatment and the associated costs in the first year. ⋯ At one year after hospital admission requiring ECMO the health-related quality of life is favorable with substantial costs but considering the survival might be acceptable. However, our results are limited by loss of follow up. So it may be possible that only the best-recovered patients returned their questionnaires. This potential bias might lead to higher costs and worse HRQOL in a real-life scenario.
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Journal of critical care · Feb 2023
The impact of language barriers & interpreters on critical care patient outcomes.
In a multicultural society, the impact of language proficiency and interpreter use on critical care patient outcomes is unknown. ⋯ Being identified as having a requirement for an interpreter was associated with improved outcomes for adults admitted to public hospital ICUs in Victoria. Interpreter services should be more readily available in the hospital setting. It is recommended that patients, family members and clinicians actively use interpreter services when English is not the preferred language of an ICU patient.
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Journal of critical care · Feb 2023
The impact of temporary mechanical circulatory support strategies on thrombocytopenia.
One common but not well-understood phenomenon of temporary mechanical circulatory support (MCS) use is thrombocytopenia. This clinical issue increases the risk of bleeding and the need for platelet transfusion. Additionally, heparin-induced thrombocytopenia must be considered as part of the differential diagnosis, which complicates patient management. ⋯ A statistically significant mean percent drop occurred in MCS types - VA ECMO(-69.6%, p < 0.001), VV ECMO(-40.9%, p < 0.001), Impella 5.5(-20.9%, p = 0.01) and IABP(-28.3%, p = 0.01), except Centrimag BIVAD(-6.5%, p = 0.61). Platelet recovery to or above baseline occurred in VA ECMO(+107.0%, p = 0.42), Impella 5.5(+117.2%, p = 0.28), IABP(+108.3%, p = 0.37), VV-ECMO(163.3%, p = 0.01*) and Centrimag BIVAD(+100.1%, p = 0.99). These results show that the degree of thrombocytopenia depends on MCS device type and is reversible.