Critical care medicine
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Critical care medicine · Oct 2020
Utilization of the Signature Method to Identify the Early Onset of Sepsis From Multivariate Physiological Time Series in Critical Care Monitoring.
Patients in an ICU are particularly vulnerable to sepsis. It is therefore important to detect its onset as early as possible. This study focuses on the development and validation of a new signature-based regression model, augmented with a particular choice of the handcrafted features, to identify a patient's risk of sepsis based on physiologic data streams. The model makes a positive or negative prediction of sepsis for every time interval since admission to the ICU. ⋯ The algorithm yielded a utility function score which was the first placed entry in the official phase of the challenge.
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Critical care medicine · Oct 2020
Multicenter Study Observational StudyCentral Venous-to-Arterial PCO2 Difference and Central Venous Oxygen Saturation in the Detection of Extubation Failure in Critically Ill Patients.
To evaluate the ability of central venous-to-arterial carbon dioxide pressure difference, central venous oxygen saturation, and the combination of these two parameters to detect extubation failure in critically ill patients. ⋯ We found that Δ - ΔPCO2 and central venous oxygen saturation, during spontaneous breathing trials, were independent predictors of weaning outcomes. Combination analysis of both parameters enhanced their diagnostic performance and provided excellent predictability in extubation failure detection in critically ill patients.
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Critical care medicine · Oct 2020
Multicenter Study Observational StudyVariation in Fluid and Vasopressor Use in Shock With and Without Physiologic Assessment: A Multicenter Observational Study.
To characterize the association between the use of physiologic assessment (central venous pressure, pulmonary artery occlusion pressure, stroke volume variation, pulse pressure variation, passive leg raise test, and critical care ultrasound) with fluid and vasopressor administration 24 hours after shock onset and with in-hospital mortality. ⋯ The use of physiologic assessment in the 24 hours after shock onset is associated with increased use of vasopressor but not with fluid administration.
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Critical care medicine · Oct 2020
Multicenter Study Observational StudyLong-Term Mortality Among ICU Patients With Stroke Compared With Other Critically Ill Patients.
Assessment of all-cause mortality of intracerebral hemorrhage and ischemic stroke patients admitted to the ICU and comparison to the mortality of other critically ill ICU patients classified into six other diagnostic subgroups and the general Dutch population. ⋯ Stroke patients who need intensive care treatment have a high short-term mortality risk, but this alters favorably with increasing duration of survival time after ICU admission in patients with both ischemic stroke and intracerebral hemorrhage, especially compared with other populations of critically ill patients such as sepsis or severe community-acquired pneumonia patients.