Journal of critical care
-
Journal of critical care · Feb 2025
Multicenter Study Observational StudyClinical phenotyping of septic shock with latent profile analysis: A retrospective multicenter study.
Septic shock (SS) is a highly fatal and heterogeneous syndrome. Identifying distinct clinical phenotypes provides valuable insights into the underlying pathophysiological mechanisms and may help to propose precise clinical management strategies. ⋯ The individualized identification of phenotypes is well suited to clinical practice. The three SS phenotypes differed significantly in pathophysiological and clinical outcomes, which are crucial for informing management decisions and prognosis.
-
Journal of critical care · Feb 2025
Multicenter Study Observational StudyClinical impact of hypermagnesemia in acute kidney injury patients undergoing continuous kidney replacement therapy: A propensity score analysis utilizing real-world data.
While hypomagnesemia is known to be a risk factor for acute kidney injury (AKI), the impact of hypermagnesemia on prognosis in AKI patients undergoing continuous kidney replacement therapy (CKRT) remains unclear. This study investigates the relationship between hypermagnesemia and clinical outcomes in this patient population. ⋯ Our study suggests that hypermagnesemia in AKI patients undergoing CKRT is not associated with improved renal recovery but is linked to worse clinical outcomes, including all-cause mortality and arrhythmia. Close monitoring of serum magnesium levels is recommended in this population for optimizing clinical outcomes.
-
Journal of critical care · Feb 2025
Fever following extracorporeal membrane oxygenation decannulation: Infection, thrombosis or just physiology?
Fever is frequent after extracorporeal membrane oxygenation (ECMO) decannulation. We aimed to evaluate the incidence of post-decannulation fever and describe its causes. ⋯ Post-decannulation fever was common, and was mainly due to infections or thrombosis. Fever should therefore not be considered as a benign inflammatory reaction until proven otherwise.
-
Journal of critical care · Feb 2025
Multicenter StudyPrognosis of major bleeding based on residual variables and machine learning for critical patients with upper gastrointestinal bleeding: A multicenter study.
Upper gastrointestinal bleeding (UGIB) is a significant cause of morbidity and mortality worldwide. This study investigates the use of residual variables and machine learning (ML) models for predicting major bleeding in patients with severe UGIB after their first intensive care unit (ICU) admission. ⋯ ML models using residuals improved the accuracy and interpretability in predicting major bleeding during ICU admission in patients with UGIB. These interpretable features may facilitate the early identification and management of high-risk patients, thereby improving hemodynamic stability and outcomes.
-
Journal of critical care · Feb 2025
Feasibility of estimating tidal volume from electrocardiograph-derived respiration signal and respiration waveform.
Estimating tidal volume (VT) from electrocardiography (ECG) can be quite useful during deep sedation or spinal anesthesia since it eliminates the need for additional monitoring of ventilation. This study aims to validate and compare VT estimation methodologies based on ECG-derived respiration (EDR) using real-world clinical data. ⋯ Although EDR-based VT estimation is promising, current methodologies are limited by noisy ICU ECG signals, but controlled environment data showed significant short-term correlations with measured respiration waveforms. Future studies should develop reliable EDR extraction procedures and improve predictive models to broaden clinical applications.