Critical care medicine
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Critical care medicine · May 2022
Neighborhood Socioeconomic Disadvantage and Disability After Critical Illness.
Factors common to socioeconomically disadvantaged neighborhoods, such as low availability of transportation, may limit access to restorative care services for critical illness survivors. Our primary objective was to evaluate whether neighborhood socioeconomic disadvantage was associated with an increased disability burden after critical illness. Our secondary objective was to determine if the effect differed for those discharged to the community compared with those discharged to a facility. ⋯ Neighborhood socioeconomic disadvantage is associated with a higher disability burden in the 12 months after a critical illness. Future studies should evaluate barriers to functional recovery for ICU survivors living in disadvantaged neighborhoods.
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Critical care medicine · May 2022
Randomized Controlled Trial Multicenter StudyEvaluating Vitamin C in Septic Shock: A Randomized Controlled Trial of Vitamin C Monotherapy.
To determine whether IV vitamin C therapy reduces 28-day mortality in patients with septic shock. ⋯ Vitamin C monotherapy failed to significantly reduce mortality in septic shock patients as hypothesized. Our findings do not support its routine clinical use for this purpose.
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Critical care medicine · May 2022
Randomized Controlled Trial Multicenter StudyEarly Neuromuscular Blockade in Moderate-to-Severe Pediatric Acute Respiratory Distress Syndrome.
The use of neuromuscular blocking agents (NMBAs) in pediatric acute respiratory distress syndrome (PARDS) is common but unsupported by efficacy data. We sought to compare the outcomes between patients with moderate-to-severe PARDS receiving continuous NMBA during the first 48 hours of endotracheal intubation (early NMBA) and those without. ⋯ Early NMBA use was associated with a longer duration of MV. This propensity score analysis underscores the need for a randomized controlled trial in pediatrics.
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Critical care medicine · May 2022
Multicenter StudyA Multicenter Cohort Study of Falls Among Patients Admitted to the ICU.
To determine the incidence of falls, risk factors, and adverse outcomes, among patients admitted to the ICU. ⋯ We observed that among ICU patients, falls occur frequently, vary substantially between ICUs, and are associated with modifiable risk factors, longer ICU and hospital stays, and lower risk of death. Our study suggests that fall prevention strategies should be considered for critically ill patients admitted to ICU.
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Critical care medicine · May 2022
Preexisting Clinical Frailty Is Associated With Worse Clinical Outcomes in Patients With Sepsis.
Frailty is a multidimensional syndrome or state of increased vulnerability to poor resolution of homoeostasis following a stressor event. Frailty is common in patients with sepsis. Sepsis and frailty are both associated with older age and chronic medical conditions. However, there is limited evidence about the direct association between frailty and sepsis. The aim of this study is to determine the association between preexisting clinical frailty and clinical outcomes in patients with sepsis. ⋯ In patients with sepsis, preexisting clinical frailty is associated with worse clinical outcomes than that in nonfrail patients, including inhospital mortality and discharge to home.