Journal of critical care
-
Journal of critical care · Jun 2021
Multicenter StudyAssessment of fluid resuscitation on time to hemodynamic stability in obese patients with septic shock.
Assess time to hemodynamic stability (HDS) in obese patients with septic shock who received <30 vs. ≥30 ml/kg of initial fluid resuscitation based on actual body weight (ABW). ⋯ Obese patients given ≥30 ml/kg based on ABW had a shorter time to HDS and a lower risk of in-hospital death. Exploratory results suggest improved outcomes resuscitating by ABW vs. IBW; ABW showed no strong benefit over AdjBW. Further prospective studies are needed to confirm the optimal fluid dosing in obese patients.
-
Journal of critical care · Apr 2021
Randomized Controlled Trial Multicenter StudyEffect of non-sedation on physical function in survivors of critical illness - A substudy of the NONSEDA randomized trial.
Critical illness impairs physical function. The NONSEDA trial was a multicenter randomized trial, assessing non-sedation versus sedation during mechanical ventilation. The aim of this sub-study was to assess the effect of non-sedation on physical function. ⋯ Non-sedation did not lead to improved quality of life regarding physical function or better function in activities of everyday living. Non-sedated patients had a better physical recovery at ICU discharge.
-
Journal of critical care · Apr 2021
Multicenter StudyIncreasing serum ammonia level is a risk factor for the prognosis of critically ill patients: A multicenter retrospective cohort study.
To assess the association between serum ammonia level upon admission during the initial intensive care unit (ICU) stay and mortality. ⋯ Elevated serum ammonia level in critically ill patients upon admission was an early risk factor for higher ICU and in-hospital mortality.
-
Journal of critical care · Apr 2021
Multicenter Study Observational StudyClinically relevant potential drug-drug interactions in intensive care patients: A large retrospective observational multicenter study.
Potential drug-drug interactions (pDDIs) may harm patients admitted to the Intensive Care Unit (ICU). Due to the patient's critical condition and continuous monitoring on the ICU, not all pDDIs are clinically relevant. Clinical decision support systems (CDSSs) warning for irrelevant pDDIs could result in alert fatigue and overlooking important signals. Therefore, our aim was to describe the frequency of clinically relevant pDDIs (crpDDIs) to enable tailoring of CDSSs to the ICU setting. ⋯ Considering clinical relevance of pDDIs in the ICU setting is important, as only half of the detected pDDIs were crpDDIs. Therefore, tailoring CDSSs to the ICU may reduce alert fatigue and improve medication safety in ICU patients.
-
Journal of critical care · Apr 2021
Multicenter StudyHepatic dysfunction impairs prognosis in critically ill patients with hematological malignancies: A post-hoc analysis of a prospective multicenter multinational dataset.
Hyperbilirubinemia is frequent in patients with hematological malignancies admitted to the intensive care unit (ICU). Literature about hepatic dysfunction (HD) in this context is scarce. ⋯ HD is common, underestimated, infrequently investigated, and is associated with impaired outcome in critically ill hematology patients. HD should be considered upon ICU admission and managed as other organ dysfunctions.