Journal of critical care
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Journal of critical care · Oct 2023
Randomized Controlled TrialDelirium in ventilated patients receiving fentanyl and morphine for Analgosedation: Findings from the ANALGESIC trial.
The differential effect of fentanyl vs. morphine analgosedation on the development of hospital inpatient delirium in patients receiving mechanical ventilation is unknown. We aimed to compare the incidence of coding for delirium and antipsychotic medication use in patients treated with fentanyl vs. morphine in the ANALGESIC trial. ⋯ Fentanyl is associated with a higher incidence of hospital inpatient delirium when used for analgosedation compared with morphine, and the dose of opioid is linearly related to the need for antipsychotic medication administration. The role of analgosedation in promoting delirium requires further investigation.
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Journal of critical care · Oct 2023
Comment Letter Randomized Controlled TrialAuthors response: "ICU- and ventilator-free days with isoflurane or propofol as a primary sedative - A post-hoc analysis of a randomized controlled trial".
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Journal of critical care · Aug 2023
Randomized Controlled Trial Multicenter StudySafety, tolerability, pharmacokinetics, and efficacy of kukoamine B in patients with sepsis: A randomized phase IIa trial.
To evaluate the safety, tolerability, pharmacokinetics, and efficacy of kukoamine B (KB), an alkaloid compound with high affinity for both lipopolysaccharide (LPS) and oligodeoxynucle-otides containing CpG motifs (CpG DNA), in patients with sepsis-induced organ failure. ⋯ In patients with sepsis-induced organ failure, KB was safe and well tolerated. Further investigation is warranted.
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Journal of critical care · Jun 2023
Randomized Controlled TrialClostridioides difficile infection in mechanically ventilated critically ill patients: A nested cohort study.
Clostridioides difficile infection (CDI) is a serious complication of critical illness. The objective of the study was to determine its incidence, prevalence, timing, severity, predictors, and outcomes. ⋯ Of 2650 patients, 86 were diagnosed with CDI during 90,833 hospital-days (0.95/1000 hospital-days); CDI prevalence was 3.2%. CDI incidence varied in timing; 0.3% patients had CDI pre-ICU, 2.2% in the ICU; an 0.8% developed CDI post-ICU. Relapse or recurrence of CDI was documented in 9.3% patients. Infections were mild/moderate in severity. Complications included septic shock (26.7%), organ failure (16.3%), and toxic megacolon requiring colectomy (1.2%). No risk factors for CDI were identified. CDI was not associated with hospital mortality. The duration of hospital stay was longer for those who had CDI compared those who did not, CONCLUSION: CDI was uncommon, severity was mild to moderate and not associated with mortality however CDI was associated with a longer hospital stay.