Critical care medicine
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Critical care medicine · Nov 2016
Review Meta AnalysisNeuromuscular Blocking Agents and Neuromuscular Dysfunction Acquired in Critical Illness: A Systematic Review and Meta-Analysis.
The relationship between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness remains unclear. We examined the association between neuromuscular blocking agents and ICU-acquired weakness, critical illness polyneuropathy, and critical illness myopathy. ⋯ This meta-analysis suggests a modest association between neuromuscular blocking agents and neuromuscular dysfunction acquired in critical illness; limitations include studies with a high risk of bias and a disproportionate contribution from studies examining patients for critical illness polyneuropathy/critical illness myopathy and those with severe sepsis/septic shock.
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Critical care medicine · Nov 2016
Multicenter StudyImpact of Weight Extremes on Clinical Outcomes in Pediatric Acute Respiratory Distress Syndrome.
To determine whether weight extremes impact clinical outcomes in pediatric acute respiratory distress syndrome. ⋯ These data support the obesity paradox in pediatric acute respiratory distress syndrome. Obese children with indirect lung injury pediatric acute respiratory distress syndrome have a lower risk of mortality. Importantly, among survivors, the overweight with indirect lung injury requires longer duration of mechanical ventilation. Our data require prospective validation to further elucidate the pathobiology of this phenomenon.
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Critical care medicine · Nov 2016
Multicenter StudyPatient Recollection of ICU Procedural Pain and Post ICU Burden: The Memory Study.
To assess patients' recollections of in-ICU procedural pain and its impact on post-ICU burden. ⋯ Many patients remembered ICU, with far fewer able to rate procedure-associated pain. For those able to do so, recalled pain intensity and pain distress scores were significantly greater than reported in ICU. One in seven patients was having current pain, recalling even higher ICU procedural pain scores and greater traumatic stress when compared with patients without current pain. Studies are needed to assess the impact of ICU procedural pain on post-ICU pain recall, pain status over time, and the relationship between postdischarge pain status and post-ICU burden.