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
Reducing plastic waste in intensive care from longer use of intravenous administration and invasive monitoring sets: A before-and-after study.
Intensive care unit (ICU) treatment carries a large environmental burden. Extending routine replacement of plastic line sets that belong to intravenous administration or invasive monitoring might lower waste from single-use plastics in ICUs. We extended the routine replacement interval of line sets from 4 to 7 days and assessed plastic waste reduction. ⋯ This study demonstrates the benefits of 7-day replacement intervals for intravenous administration and invasive monitoring sets. We established this in terms of waste reduction, patient safety and costs.
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Journal of critical care · Dec 2024
ReviewMachine learning for predicting mortality in adult critically ill patients with Sepsis: A systematic review.
Various Machine Learning (ML) models have been used to predict sepsis-associated mortality. We conducted a systematic review to evaluate the methodologies employed in studies to predict mortality among patients with sepsis. ⋯ ML models demonstrate a modest improvement in predicting sepsis-associated mortality. The certainty of these findings remains low due to the high risk of bias and significant heterogeneity. Studies should include comprehensive methodological details on calibration and hyperparameter selection, adopt a standardized definition of sepsis, and conduct multicenter prospective designs along with external validations.
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Journal of critical care · Dec 2024
Association of early changes in arterial carbon dioxide with acute brain injury in adult patients with extracorporeal membrane oxygenation: A ten-year retrospective study in a German tertiary care hospital.
To assess the association between fluctuations of arterial carbon dioxide early after start of extracorporeal membrane oxygenation (ECMO) with intracranial hemorrhage (ICH) or ischemic stroke (IS). ⋯ Irrespective of the indication for ECMO, we did not find a significant association between the relative change in PaCO2 early after ECMO initiation and acute brain injury. Aside from early PaCO2 decline at cannulation, future studies should address fluctuations of PaCO2 throughout the course of ECMO support and their effect on acute brain injury.