Journal of critical care
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Journal of critical care · Dec 2024
Meta AnalysisDoes extracorporeal cardiopulmonary resuscitation improve survival with favorable neurological outcome in out-of-hospital cardiac arrest? A systematic review and meta-analysis.
Extracorporeal cardiopulmonary resuscitation (E-CPR) may improve survival with favorable neurological outcome in patients with refractory out-of-hospital cardiac arrest (OHCA). Unfortunately, recent results from randomized controlled trials were inconclusive. We performed a meta-analysis to investigate the impact of E-CPR on neurological outcome compared to conventional cardiopulmonary resuscitation (C-CPR). ⋯ In this meta-analysis, E-CPR had a positive effect on survival with favorable neurological outcome and, to a smaller extent, on overall mortality in patients with refractory OHCA.
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Journal of critical care · Dec 2024
Randomized Controlled TrialContinuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial.
This study evaluated the clinical utility of continuous glucose monitoring system (CGMS) in critically ill patients. ⋯ Compared with conventional POCM, CGMS did not decrease the 28-day mortality in critically ill participants with diabetes or stress-induced hyperglycemia. But CGMS may improve the glycemic control and may be increasingly used in critically ill patients.
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Journal of critical care · Dec 2024
Randomized Controlled TrialHeliox ventilation in elderly, hypertensive ICU patients improves microcirculation: A randomized controlled study.
Conventional mechanical ventilation has adverse impacts on the hemodynamics of elderly, hypertensive ICU patients. Limited studies have addressed ways to ameliorate these negative effects. This study aimed to determine whether heliox ventilation could improve the hemodynamics, especially microcirculation, of elderly, hypertensive patients undergoing mechanical ventilation. ⋯ Heliox ventilation improves blood pressure and microcirculation in elderly hypertensive patients and may resolve the limitations of traditional nitrogen‑oxygen ventilation.
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Journal of critical care · Dec 2024
Preload responsiveness-guided fluid removal in mechanically ventilated patients with fluid overload: A comprehensive clinical-physiological study.
This study investigated fluid removal strategies for critically ill patients with fluid overload on mechanical ventilation. Traditionally, a negative fluid balance (FB) is aimed for. However, this approach can have drawbacks. ⋯ Additionally, FR group avoided metabolic problems like secondary alkalosis and potential hypokalemia seen in the negative FB group. FR-guided fluid-removal in fluid overloaded mechanically ventilated patients was a feasible, safe, and maybe superior strategy in facilitating weaning and disconnection from mechanical ventilation than negative FB-driven fluid removal. FR is a safe endpoint for optimizing cardiac function and preventing adverse consequences during fluid removal.