Journal of critical care
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Journal of critical care · Jun 2023
ReviewDiabetes insipidus related to sedation in the intensive care unit: A review of the literature.
To identify cases of diabetes insipidus (DI) related to sedation in the ICU to determine which medications pose the greatest risk and understand patterns of presentation. ⋯ Awareness of the potential for sedatives to cause DI may lead to greater identification with swifter medication discontinuation and subsequent resolution of DI.
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Journal of critical care · Jun 2023
Refractory septic shock and alternative wordings: A systematic review of literature.
We reviewed the different studies using the terms "refractory septic shock" and/or "catecholamine resistance" and/or "high dose norepinephrine" so as to highlight the heterogeneity of the definitions used by authors addressing such concepts. ⋯ Marked inconsistencies were identified in the usage of the terms for refractory septic shock. There is a pressing need to determine consensus definitions so as to establish a common language in the medical literature and to harmonize future studies.
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Journal of critical care · Jun 2023
Randomized Controlled TrialClostridioides difficile infection in mechanically ventilated critically ill patients: A nested cohort study.
Clostridioides difficile infection (CDI) is a serious complication of critical illness. The objective of the study was to determine its incidence, prevalence, timing, severity, predictors, and outcomes. ⋯ Of 2650 patients, 86 were diagnosed with CDI during 90,833 hospital-days (0.95/1000 hospital-days); CDI prevalence was 3.2%. CDI incidence varied in timing; 0.3% patients had CDI pre-ICU, 2.2% in the ICU; an 0.8% developed CDI post-ICU. Relapse or recurrence of CDI was documented in 9.3% patients. Infections were mild/moderate in severity. Complications included septic shock (26.7%), organ failure (16.3%), and toxic megacolon requiring colectomy (1.2%). No risk factors for CDI were identified. CDI was not associated with hospital mortality. The duration of hospital stay was longer for those who had CDI compared those who did not, CONCLUSION: CDI was uncommon, severity was mild to moderate and not associated with mortality however CDI was associated with a longer hospital stay.
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Journal of critical care · Jun 2023
Multicenter StudyDefinitions, rates and associated mortality of ICU-acquired pneumonia: A multicenter cohort study.
We aimed to analyze intensive care unit (ICU)-acquired pneumonia according to 7 definitions, estimating associated hospital mortality. ⋯ Rates of ICU-acquired pneumonia vary by definition and are associated with differential increased risk of death.
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Journal of critical care · Jun 2023
Lower mean phosphate independently predicts mortality in critically ill patients: Results from a prospective cohort study.
To evaluate lower mean phosphate as a prognostic tool in critically ill patients. ⋯ Hypophosphatemia is frequent in the ICU, and was associated with unfavorable outcomes. This study introduces the importance of longitudinal monitoring of phosphate levels, since lower mean phosphate is an independent predictor of mortality in critically ill patients.