Journal of critical care
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Journal of critical care · Oct 2024
Observational StudyHigh PEEP/low FiO2 ventilation is associated with lower mortality in COVID-19.
The positive end-expiratory pressure (PEEP) strategy in patients with coronavirus 2019 (COVID-19) acute respiratory distress syndrome (ARDS) remains debated. Most studies originate from the initial waves of the pandemic. Here we aimed to assess the impact of high PEEP/low FiO2 ventilation on outcomes during the second wave in the Netherlands. ⋯ High PEEP ventilation was associated with improved ICU survival in patients with COVID-ARDS.
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Journal of critical care · Oct 2024
The ratio of parasternal intercostal muscle-thickening fraction-to-diaphragm thickening fraction for predicting weaning failure.
Diaphragm dysfunction is associated with weaning outcomes in mechanical ventilation patients, in the case of diaphragm dysfunction, the accessory respiratory muscles would be recruited. The main purpose of this study is to explore the performance of parasternal intercostal muscle thickening fraction in relation to diaphragmatic thickening fraction ratio (TFic1/TFdi2) for predicting weaning outcomes, and compare its accuracy with D-RSBI in predicting weaning failure. ⋯ The TFic/TFdi ratio predicted weaning failure with high accuracy and outperformed the D-RSBI.
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Journal of critical care · Oct 2024
Prevalence and prognostic relevance of invasive fungal disease during veno-arterial ECMO: A retrospective single-center study.
To assess the prevalence and relevance of invasive fungal disease (IFD) during veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO). ⋯ IFD are detected in about one in 20 patients on V-A ECMO, indicating mortality >90%. However, IFD do not contribute to prognosis in this population.
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Journal of critical care · Oct 2024
Impact of AKI on metabolic compensation for respiratory acidosis in ICU patients with AECOPD.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can result in severe respiratory acidosis. Metabolic compensation is primarily achieved by renal retention of bicarbonate. The extent to which acute kidney injury (AKI) impairs the kidney's capacity to compensate for respiratory acidosis remains unclear. ⋯ AKI leads to poor outcomes and compromises metabolic compensation of respiratory acidosis in ICU patients with AECOPD. While buffering agents may aid compensation for severe AKI, their use should be approached with caution.