Journal of critical care
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Journal of critical care · Dec 2024
Contemporary assessment of short- and functional 90-days outcome in old intensive care patients suffering from COVID-19.
There are limited data about the outcome of old intensive care (ICU) patients suffering from Covid-19 in the post-vaccination era. This study distinguishes the pre- and post-acute illness living conditions of ICU survivors from non-survivors. ⋯ Living conditions influence the outcome of critically ill old patients suffering from Covid-19. Only a minority returned to their initial habitat after ICU survival. Trial registration numberNCT04321265.
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Journal of critical care · Dec 2024
Randomized Controlled Trial Multicenter StudyAntisense therapy to block the Kallikrein-kinin pathway in COVID-19: The ASKCOV randomized controlled trial.
To assess the effect of antisense therapy to block kallikrein-kinin pathway in COVID-19 patients. ⋯ NCT04549922.
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Journal of critical care · Dec 2024
ReviewCritical care management of hantavirus cardiopulmonary syndrome. A narrative review.
Hantaviruses, members of the Bunyaviridae family, can cause two patterns of disease in humans, hantavirus hemorrhagic fever with renal syndrome (HFRS) and cardiopulmonary syndrome (HCPS), being the latter hegemonic on the American continent. Andesvirus is one of the strains that can cause HCPS and is endemic in Chile. Its transmission occurs through direct or indirect contact with infected rodents' urine, saliva, or feces and inhalation of aerosol particles containing the virus. ⋯ The hemodynamic pattern of HCPS is not identical to that of cardiogenic or septic shock, being characterized by hypovolemia, systolic dysfunction, and pulmonary edema secondary to increased permeability. Given the lack of specific effective therapies to treat this viral infection, the focus of treatment lies in the timely provision of intensive care, specifically hemodynamic and respiratory support, which often requires veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This narrative review aims to provide insights into specific ICU management of HCPS based on the available evidence and gathered experience in Chile and South America including perspectives of pathophysiology, organ dysfunction kinetics, timely life support provision, safe patient transportation, and key challenges for the future.
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Journal of critical care · Dec 2024
Review Meta AnalysisFluid infusion prior to intubation or anesthesia: A meta-analysis of randomized controlled trials.
The results of current randomized controlled trials (RCTs) vary regarding the effectiveness of rehydration prior to anesthesia induction. Our objective was to determine the effectiveness of pre-induction rehydration in patients undergoing tracheal intubation or surgical procedures. ⋯ Pre-induction rehydration can reduce the occurrence of hypotensive events, but only in pre-surgical patients, and does not decrease the use of vasoactive medications.