Journal of critical care
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Journal of critical care · Dec 2020
Multicenter Study Observational StudyDEXmedetomidine compared to PROpofol in NEurocritical Care [DEXPRONE]: A multicenter retrospective evaluation of clinical utility and safety.
Although guidelines recommend dexmedetomidine (DEX) or propofol (PRO) as preferred sedatives in critically ill adults, comparisons in neurocritical care (NCC) are limited. We aimed to evaluate the clinical utility and safety of DEX compared with PRO in NCC setting. ⋯ DEX and PRO were used for distinct indications in our cohort. Adverse effect profiles and clinical outcome, in the cohorts are largely similar.
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Journal of critical care · Dec 2020
Multicenter StudyTiming of resumption of beta-blockers after discontinuation of vasopressors is not associated with post-operative atrial fibrillation in critically ill patients recovering from non-cardiac surgery: A retrospective cohort analysis.
Post-operative atrial fibrillation is a complication with high morbidity. In patients on prior-to-admission beta-blockers, early post-operative beta-blockade reduces atrial fibrillation risk; however, this benefit is not studied in hemodynamically unstable patients requiring vasopressors. ⋯ In patients requiring postoperative vasopressors, early beta-blockade did not protect against postoperative atrial fibrillation.
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Journal of critical care · Dec 2020
Multicenter Study Clinical TrialTherapy limitation in octogenarians in German intensive care units is associated with a longer length of stay and increased 30 days mortality: A prospective multicenter study.
The approach to limit therapy in very old intensive care unit patients (VIPs) significantly differs between regions. The focus of this multicenter analysis is to illuminate, whether the Clinical Frailty Scale (CFS) is a suitable tool for risk stratification in VIPs admitted to intensive care units (ICUs) in Germany. Furthermore, this investigation elucidates the impact of therapeutic limitation on the length of stay and mortality in this setting. ⋯ In German ICUs, any limitation of life-sustaining therapy in VIPs is associated with a significantly increased ICU length of stay and mortality. CFS reliably predicts the outcome.
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Journal of critical care · Oct 2020
Multicenter StudyClinical course after identification of new-onset atrial fibrillation in critically ill patients: The AFTER-ICU study.
Epidemiological information is lacking after identification of new-onset atrial fibrillation (AF) in critically ill patients. This study aimed to describe the clinical course after the identification of new-onset AF. ⋯ Although the proportion of patients with AF continued to decrease with various treatments, these patients had high risk of death. Further research to assess the management of new-onset AF in critically ill patients is warranted.
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Journal of critical care · Oct 2020
Multicenter Study Observational StudyInformed consent procedures in patients with an acute inability to provide informed consent: Policy and practice in the CENTER-TBI study.
Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. ⋯ Alternatives to patient consent are essential for TBI research. While there seems to be concordance amongst national legislations, there is regional variability in institutional practices with respect to the use of different informed consent procedures. Variation could be caused by several reasons, including inconsistencies in clear legislation or knowledge of such legislation amongst researchers.