Journal of critical care
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Journal of critical care · Jan 2025
Macronutrient intake is different across Europe: Results of a Belgian cohort of critically ill adults.
Medical nutrition therapy (MNT) is fundamental for ICU patients. This post-hoc subgroup analysis of the prospective observational EuroPN survey aimed to assess MNT in the participating Belgian ICUs. ⋯ Similar to overall, the Belgian subgroup received a daily average moderate caloric and low protein intake. The gradual intake increase aligned with ESPEN guidelines, though temporary overfeeding occurred in about one third of the patients.
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Journal of critical care · Jan 2025
Kidney recovery after iodinated contrast administration in patients with acute kidney injury receiving renal replacement therapy.
Acute kidney injury (AKI) is common in hospitalized patients. Administration of iodinated contrast may impede kidney recovery but avoiding contrast may delay diagnosis and therapeutic interventions. There is limited data on the impact of contrast exposure in patients with established AKI receiving renal replacement therapy (RRT). ⋯ The receipt of contrast in patients with AKI receiving RRT was associated with an increased risk of RRT dependence at hospital discharge. Contrast exposure in RRT-dependent patients may delay recovery from AKI. The benefits of contrast should be carefully weighed against this risk in patients with AKI receiving RRT.
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Journal of critical care · Jan 2025
Elevated glycocalyx shedding components as the early predictors of unfavorable outcomes in patients after cardiac arrest: A single-center observational study.
To assess the association of serum glycocalyx shedding components (Heparan sulfate, HS; Hyaluronic acid, HA; Syndecan-1, Sdc-1) with outcomes after CA. ⋯ Elevated serum HA at 24 h after CA is an independent risk factor for 30-day unfavorable neurological function or mortality and elevated serum Sdc-1 concentrations is an independent risk factor for 30-day mortality. Our results suggested the potential value of serum glycocalyx shedding components as predictors for the outcomes in post-CA patients.
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Journal of critical care · Jan 2025
Predicting a strongly positive fluid balance in critically ill patients with acute kidney injury: A multicentre, international study.
In critically ill patients with acute kidney injury (AKI), a fluid balance (FB) > 2 L at 72 h after AKI diagnosis is associated with adverse outcomes. Identification of patients at high-risk for such fluid accumulation may help prevent it. ⋯ We developed and validated the "AKI-FB risk score" to predict patients who developed a positive FB >2 L within 72 h of AKI diagnosis. This prediction score was robust and facilitated the identification of high-risk AKI patients who could be the tarted for preventive measures and be included in future clinical trials of FB management.
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Journal of critical care · Jan 2025
Cardiogenic shock in patients with active onco-hematological malignancies: A multicenter retrospective study.
Onco-hematological (OH) patients face significant cardiovascular risks due to malignancy and drug toxicity. Data are limited on the characteristics and outcomes of OH patients with cardiogenic shock (CS) in intensive care units (ICUs). ⋯ The prognosis for OH patients with CS in the ICU is poor, with epinephrine use associated with worse outcomes. Further research is needed to refine risk stratification and improve treatments for this population.