Current opinion in critical care
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Curr Opin Crit Care · Dec 2022
ReviewCoronavirus disease 2019 aftermath: psychological trauma in ICU healthcare workers.
We aim to describe the extent of psychological trauma and moral distress in healthcare workers (HCW) working in the intensive care unit (ICU) during the coronavirus disease 2019 (COVID-19) pandemic. Specifically, we review reports on prevalence of mental health symptoms, highlight vulnerable populations and summarize modifiable risk factors associated with mental health symptoms in ICU HCW. ⋯ The COVID-19 pandemic has severely impacted ICU HCW worldwide. The psychological trauma, manifesting as posttraumatic stress disorder, burnout, anxiety, and depression, is substantial and concerning. Urgent action by lawmakers and healthcare administrators is required to protect ICU HCW and sustain a healthy workforce.
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Curr Opin Crit Care · Dec 2022
ReviewLung transplantation in patients with lung disease secondary to coronavirus disease 2019 infection.
In this article, we describe preoperative patient selection and outcomes of patients with lung disease secondary to infection from COVID-19 who receive lung transplantation. ⋯ Patients with respiratory failure secondary to COVID-19 infection that require a lung transplant generally have a complicated preoperative course and the operations are more complex, but the long-term outcomes are excellent.
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Curr Opin Crit Care · Dec 2022
ReviewFluid balance in pediatric critically ill patients (with and without kidney dysfunction).
The issues of fluid balance and fluid overload are currently considered crucial aspects of pediatric critically ill patients' care. ⋯ Current evidence on fluid balance in critically ill children is mainly based on retrospective and observational studies, and intense research should be recommended in this important field. In theory, active decongestion of patients with fluid overload could improve mortality and other clinical outcomes, but randomized trials or advanced pragmatic studies are needed to better understand the optimal timing, patient characteristics, and tools to achieve this.
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Curr Opin Crit Care · Dec 2022
ReviewSelection criteria and triage in extracorporeal membrane oxygenation during coronavirus disease 2019.
Coronavirus disease 2019 (COVID-19) pandemic changed the way we had to approach hospital- and intensive care unit (ICU)-related resource management, especially for demanding techniques required for advanced support, including extracorporeal membrane oxygenation (ECMO). ⋯ http://links.lww.com/COCC/A43.
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Curr Opin Crit Care · Dec 2022
ReviewPragmatic platform trials to improve the outcome of patients with acute kidney injury.
There is an important need for improved diagnostic strategies and treatment among patients with acute kidney injury (AKI). Classical randomized clinical trials have generated relevant results in AKI but are associated with shortcomings, such as high costs and sometimes lack of generalizability. In this minireview, we discuss the value and limits of pragmatic trials and platform trials for AKI research. ⋯ Pragmatic and platform trials can provide clinical answers in 'real-life' settings, facilitate a significant sample size enrollment at a limited cost, and provide results that can have a faster implementation in clinical practice.