Journal of critical care
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Journal of critical care · Feb 2023
Multicenter Study Observational StudyDetermining respiratory rate using measured expiratory time constant: A prospective observational study.
Potential negative implications associated with high respiratory rate (RR) are intrinsic positive end-expiratory pressure (PEEPi) generation, cardiovascular depression and possibly ventilator induced lung injury. Despite these negative consequences, optimal RR remains largely unknown. We hypothesized that without consideration of dynamics of lung emptying (i.e., the expiratory time constant [RCEXP]) clinician settings of RR may exceed the frequency needed for optimal lung emptying. ⋯ Use of RRP based on measured RCEXP revealed that the clinician-set RR exceeded that predicted by RCEXP in the majority of patients. Measuring RCEXP appears to be a useful variable for adjusting the RR during mandatory mechanical ventilation.
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Journal of critical care · Dec 2022
Multicenter StudyCardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients.
To evaluate cardiac function in mechanically ventilated patients with COVID-19. ⋯ Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
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Journal of critical care · Oct 2022
Multicenter StudyIn-hospital mortality of critically Ill patients with interactions of acute kidney injury and acute respiratory failure in the resource-limited settings: Results from SEA-AKI study.
Our goal was to describe clinical outcomes and explore the physiological interactions between acute kidney injury (AKI) and acute respiratory failure (ARF) in critically ill patients. ⋯ Critically ill patients with ARF and AKI are at higher risk of in-hospital death. Different patterns of AKI and ARF interaction result in unique clinical outcomes as well as risk factors.