Journal of critical care
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Journal of critical care · Feb 2025
Meta AnalysisHospital readmission after surviving sepsis: A systematic review of readmission reasons and meta-analysis of readmission rates.
To review the evidence regarding hospital readmission diagnoses and analyse related readmission rates following a sepsis admission. ⋯ Infection and sepsis are frequent readmission diagnoses for sepsis survivors, with one in 21 adult survivors readmitted for sepsis at 30-days. PROSPERO registration: CRD42023455851.
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Journal of critical care · Feb 2025
Multicenter Study Comparative Study Observational StudyVasopressor utilization in septic shock patients receiving propofol versus midazolam.
The purpose of this study was to evaluate the effect of propofol versus midazolam on vasopressor requirements in patients with septic shock to better guide sedative selection. ⋯ In patients with septic shock, vasopressor requirement increases with propofol were non-inferior to midazolam within the first 12 h.
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Journal of critical care · Feb 2025
Sex dependent effects of cardiovascular agents on hemoglobin oxygen affinity - An ex-vivo experiment.
Hemoglobin‑oxygen (Hb-O2) affinity is an important determinant for oxygen delivery and oxygen extraction. Although cardiovascular agents such as noradrenaline, adrenaline, atropine, milrinone and levosimendan are widely used in intensive care units worldwide, nothing is known about their possible effects on Hb-O2 affinity. ⋯ All investigated agents decreased Hb-O2 affinity, with marked differences between males and females. Although the underlying mechanisms remain unclear, the extent of these effects may increase oxygen extraction at the tissue level as long as pulmonary oxygen uptake is maintained.
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Journal of critical care · Feb 2025
Advance directives in the intensive care unit: An eight-year vanguard cohort study.
To investigate the frequency, content, and clinical translation of advance directives in intensive care units (ICUs). ⋯ Advance directives are available in a minority of ICU patients and often contain subjective/contradictory wording. Physicians respected directives in 90 % of patients, with treatment adapted following their wishes. However, violation of directives may have serious consequences with unfavorable in-hospital outcomes and decreased long-term survival with treatment adaption following directives.
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Journal of critical care · Feb 2025
Optimizing fosfomycin dosing regimens in critically ill patients with and without continuous renal replacement therapy.
To define the optimal fosfomycin dosing regimens for drug-resistant gram-negative bacteria in critically ill patients and those receiving continuous renal replacement therapy (CRRT) via Monte Carlo simulations. ⋯ Dosing regimens for bacteria with high MICs as 64 mg/L in these patients were 18-24 g/day. Dose adjustments were required in those undergoing CRRT. Clinical validation is strongly needed.