Journal of critical care
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Journal of critical care · Apr 2024
Review Meta AnalysisEfficacy and safety of corticosteroids for the treatment of community-acquired pneumonia: A systematic review and meta-analysis of randomized controlled trials.
The role of corticosteroids in the treatment of community-acquired pneumonia (CAP) remains uncertain. We conducted an updated meta-analysis to investigate the effectiveness and potential effect modifiers of adjunctive corticosteroids in patients with CAP. ⋯ Corticosteroids reduce the risk of all-cause mortality, especially in younger patients receiving hydrocortisone, and probably decrease the need for MV, the incidence of shock, and the length of hospital and ICU stay in patients with CAP. Our findings indicate that patients with CAP, especially severe CAP, will benefit from adjunctive corticosteroid therapy.
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Trust is an essential element in the relationship between patients and intensive care unit (ICU) clinicians. Without a foundation of trust, communication is difficult, conflict is more likely, and even clinical outcomes can be affected. ⋯ Illness occurs suddenly, emotions can be charged, the environment is impersonal, and there is rarely a prior relationship between patients and their caregivers. Therefore, intensivists must have some understanding of the factors that impact patient and family trust, as well as the actions they can take to improve it.
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Journal of critical care · Feb 2024
ReviewManagement of swallowing disorders in ICU patients - A multinational expert opinion.
Dysphagia is common in intensive care unit (ICU) patients, yet it remains underrecognized and often unmanaged despite being associated with life-threatening complications, prolonged ICU stays and hospitalization. ⋯ Given the lack of robust scientific evidence, two clinical management algorithms are proposed for use by multidisciplinary teams to improve early systematic detection and effective management of dysphagia in ICU patients. Additionally, emerging therapeutic options such as neurostimulation have the potential to improve the quality of ICU dysphagia care.
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Journal of critical care · Feb 2024
Review Meta AnalysisLower versus higher oxygen targets after resuscitation from out-of-hospital cardiac arrest: A systematic review and meta-analysis of randomized controlled trials.
To update the existing evidence and gain further insight into effects of lower versus higher oxygen targets on the outcomes in patients resuscitated from out-of-hospital cardiac arrest (OHCA). ⋯ Current evidence suggests that targeting a lower or higher oxygen therapy in patients after resuscitation from OHCA results in similar short-term survival and other clinical outcomes.