Journal of critical care
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Journal of critical care · Oct 2022
Multicenter StudyIn-hospital mortality of critically Ill patients with interactions of acute kidney injury and acute respiratory failure in the resource-limited settings: Results from SEA-AKI study.
Our goal was to describe clinical outcomes and explore the physiological interactions between acute kidney injury (AKI) and acute respiratory failure (ARF) in critically ill patients. ⋯ Critically ill patients with ARF and AKI are at higher risk of in-hospital death. Different patterns of AKI and ARF interaction result in unique clinical outcomes as well as risk factors.
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Journal of critical care · Aug 2022
Randomized Controlled Trial Multicenter Study Observational StudyStandard care versus individualized blood pressure targets among critically ill patients with shock: A multicenter feasibility and preliminary efficacy study.
Emerging evidence suggests that minimizing mean perfusion pressure (MPP) deficit during vasopressor therapy for shock can potentially reduce adverse kidney-related outcomes in ICU. We assessed feasibility and preliminary efficacy of individualizing MPP targets based on patients' own pre-illness basal-MPP among vasopressor-treated patients with shock. ⋯ ACTRN12617001459314.
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Journal of critical care · Jun 2022
Randomized Controlled Trial Multicenter StudySteps to recovery: Body weight-supported treadmill training for critically ill patients: A randomized controlled trial.
Early mobilization of critically ill patients improves functional recovery, but is often hampered by tubes, drains, monitoring devices and muscular weakness. A mobile treadmill with bodyweight support facilitates early mobilization and may shorten recovery time to independent ambulation as compared to usual care physiotherapy alone. ⋯ BWSTT seems a promising intervention to enhance recovery of ambulation and shorten hospital length of stay of ICU patients, justifying a sufficiently powered multicenter RCT.
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Journal of critical care · Jun 2022
Multicenter StudyAntiplatelet pretreatment and mortality in patients with severe sepsis: A secondary analysis from a multicenter, prospective survey of severe sepsis in Japan.
Antiplatelet agents may attenuate inflammatory and coagulation responses in patients with sepsis. This study aimed to examine the association between pre-sepsis antiplatelet therapy and survival outcomes in patients with sepsis. ⋯ In this study, pretreatment with antiplatelet medication before the onset of sepsis was associated with decreased in-hospital mortality rates.
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Journal of critical care · Jun 2022
Multicenter StudyDexamethasone as risk-factor for ICU-acquired respiratory tract infections in severe COVID-19.
Dexamethasone is the only drug that has consistently reduced mortality in patients with COVID-19, especially in patients needing oxygen or invasive mechanical ventilation. However, there is a growing concern about the relation of dexamethasone with the unprecedented rates of ICU-acquired respiratory tract infections (ICU-RTI) observed in patients with severe COVID-19. ⋯ Patients treated with dexamethasone for severe COVID-19 had a higher risk of developing ICU-acquired respiratory tract infections after adjusting for days of invasive mechanical ventilation and ICU length of stay, suggesting a cautious use of this treatment.