Journal of critical care
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Journal of critical care · Aug 2024
Determining steady-state trough range in vancomycin drug dosing using machine learning.
Vancomycin is a renally eliminated, nephrotoxic, glycopeptide antibiotic with a narrow therapeutic window, widely used in intensive care units (ICU). We aimed to predict the risk of inappropriate vancomycin trough levels and appropriate dosing for each ICU patient. ⋯ We developed models to assess the risk of sub- and supra-therapeutic vancomycin trough levels to improve the accuracy of drug dosing in critically ill patients.
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Journal of critical care · Aug 2024
The impact of aggressive and conservative propensity for initiation of neuromuscular blockade in mechanically ventilated patients with hypoxemic respiratory failure.
Neuromuscular blockade (NMB) in ventilated patients may cause benefit or harm. We applied "incremental interventions" to determine the impact of altering NMB initiation aggressiveness. ⋯ Aggressive or conservative initiation of NMB may worsen mortality. In healthier populations, marginally conservative NMB initiation strategies may lead to increased ventilator free days with minimal impact on mortality.
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Journal of critical care · Aug 2024
LetterResponse Letter to a Letter for the editor: "A modified Delphi process to identify, rank and prioritize quality indicators for continuous renal replacement therapy (CRRT) care in critically ill patients" and "Quality of care and safety measures of acute renal replacement therapy".
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Journal of critical care · Aug 2024
Automatic ARDS surveillance with chest X-ray recognition using convolutional neural networks.
This study aims to design, validate and assess the accuracy a deep learning model capable of differentiation Chest X-Rays between pneumonia, acute respiratory distress syndrome (ARDS) and normal lungs. ⋯ A CNN-based deep learning model showed clinically significant performance, providing potential for faster ARDS identification. Future research should prospectively evaluate these tools in a clinical setting.
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Journal of critical care · Aug 2024
Pharyngeal Electrical Stimulation prior to extubation - Reduction of extubation failure rate in acute stroke patients?
The aim of our study was to assess if PES before extubation can minimize the extubation failure risk in orally intubated, mechanically ventilated stroke patients at high risk of severe dysphagia. ⋯ In orally intubated and mechanically ventilated stroke patients at high risk of severe dysphagia, PES may improve swallowing function, reduce extubation failure risk and decrease time from extubation to discharge. Further research is required.