Journal of critical care
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Journal of critical care · Jun 2024
Multicenter Study Clinical TrialMulticentre implementation of a quality improvement initiative to reduce delirium in adult intensive care units: An interrupted time series analysis.
The ABCDEF bundle may improve delirium outcomes among intensive care unit (ICU) patients, however population-based studies are lacking. In this study we evaluated effects of a quality improvement initiative based on the ABCDEF bundle in adult ICUs in Alberta, Canada. ⋯ An ABCDEF delirium initiative was implemented on a population-basis within adult ICUs and was successful at reducing the prevalence of delirium.
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Journal of critical care · Jun 2024
Multicenter StudyPatient-important upper gastrointestinal bleeding in the ICU: A mixed-methods study of patient and family perspectives.
The objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial. ⋯ Survivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.
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Journal of critical care · Jun 2024
Multicenter StudyPlasma sodium during the recovery of renal function in critically ill adult patients: Multicenter prospective cohort study.
Sodium increases during acute kidney injury (AKI) recovery. Both hypernatremia and positive fluid balances are associated with increased mortality. We aimed to evaluate the association between daily fluid balance and daily plasma sodium during the recovery from AKI among critical patients. ⋯ The increase in plasma sodium is common during AKI recovery and can only partially be attributed to the water and electrolyte balances. The incidence of hypernatremia in this population of patients is higher than in the general critically ill patient population.
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Journal of critical care · Apr 2024
Multicenter StudyDevelopment and validation of a machine learning model to predict the use of renal replacement therapy in 14,374 patients with COVID-19.
To develop a model to predict the use of renal replacement therapy (RRT) in COVID-19 patients. ⋯ An early ML model using easily available clinical and laboratory data accurately predicted the use of RRT in critically ill patients with COVID-19. Our study demonstrates that using ML techniques is feasible to provide early prediction of use of RRT in COVID-19 patients.
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Journal of critical care · Feb 2024
Multicenter StudyMechanical ventilation practices in Asian intensive care units: A multicenter cross-sectional study.
This study investigated current practices of mechanical ventilation in Asian intensive care units, focusing on tidal volume, plateau pressure, and positive end-expiratory pressure (PEEP). ⋯ In Asia, low tidal volume ventilation and sufficient PEEP were underused in patients with ARDS. The majority of patients without ARDS were on intermediate tidal volumes. Country income, age, and severity of illness were associated with mortality.