Critical care : the official journal of the Critical Care Forum
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Observational Study
Hallucinations and disturbed behaviour in the critically ill: incidence, patient characteristics, associations, trajectory, and outcomes.
To use natural language processing (NLP) to study the incidence, characteristics, trajectory, associations, and outcomes of hallucinations and disturbed behaviour in intensive care unit (ICU) patients. ⋯ Hallucinations affect one in 12 ICU patients and are strongly associated with disturbed behaviour, and the use of antipsychotic medications. Hallucinations may represent another phenotype of critical illness associated neurocognitive dysfunction and require a dedicated research program.
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Multicenter Study Observational Study
Ulinastatin treatment mitigates glycocalyx degradation and associated with lower postoperative delirium risk in patients undergoing cardiac surgery: a multicentre observational study.
Ulinastatin (UTI), recognized for its anti-inflammatory properties, holds promise for patients undergoing cardiac surgery. This study aimed to investigate the relationship between intraoperative UTI administration and the incidence of delirium following cardiac surgery. ⋯ UTI administration may mitigate glycocalyx degradation, potentially lowering the risk of POD in cardiac surgery patients, offering valuable insights for future interventions to prevent POD and enhance patient outcomes. Trial registration number ClinicalTrials.gov (No. NCT06268249). Retrospectively registered 4 February 2024.
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The role that sleep patterns play in sepsis risk remains poorly understood. ⋯ Findings from this cohort study suggest that a healthy sleep pattern may reduce the risk of developing sepsis, particularly among younger individuals.
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Randomized Controlled Trial
Early phosphate changes as potential indicator of unreadiness for artificial feeding: a secondary analysis of the EPaNIC RCT.
As compared to withholding parenteral nutrition (PN) until one week after intensive care unit (ICU) admission, Early PN prolonged ICU dependency in the EPaNIC randomized controlled trial (RCT). The Refeeding RCT showed improved outcome by temporary macronutrient restriction in ICU patients developing refeeding hypophosphatemia, defined as a phosphate decrease of > 0.16 mmol/L to levels < 0.65 mmol/L. We hypothesized that early phosphate changes may identify critically ill patients who are harmed by Early PN, and that dynamic phosphate changes are more discriminative than an absolute threshold for hypophosphatemia. ⋯ Development of RHP may identify patients who are particularly harmed by early PN. Future studies should prospectively validate the potential of including RHP in a ready-to-feed indicator.