Crit Care Resusc
-
Knowledge of intensive care unit (ICU) acquired hypernatremia (ICU-AH) has been hampered by the absence of granular data and confounded by variable definitions and inclusion criteria. ⋯ In a large multicentric study of critically ill patients, ICU-acquired hypernatremia occurred in one in eight admissions after a median of four days in the ICU and was preceded by identifiable and modifiable risk factors. If severe, its correction was slow, and normalisation was delayed. After adjusting for other factors, all levels of hypernatremia were an independent risk factor for 30-d in-hospital mortality.
-
There is uncertainty about whether early infusion of intravenous amino acids confers clinical benefits in critically ill patients. In this study, we aimed to test the hypothesis that intravenous amino acids could improve 90-day mortality in critically ill patients with normal kidney function. ⋯ This study protocol was registered with the Chinese Clinical Trial Registry, and the identifier is ChiCTR2100053359 (https://www.chictr.org.cn/hvshowprojectEN.html?id=257327&v=1.7).
-
To describe the epidemiology and clinical features of pressure injury (PI) development in adult patients supported with extracorporeal membrane oxygenation (ECMO). ⋯ A significant proportion of patients develop PIs while receiving ECMO. Vigilance on the prevention of medical device related PI is required. Gender, renal replacement therapy, oral diet, and length of mechanical ventilation were independent predictors for PI development in this population.
-
The optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality. ⋯ In patients with septic shock, early adjunctive vasopressin initiation was independently associated with lower hospital mortality. Vasopressin starting at any time was also associated with reduced tachycardia, acidosis, and hyperlactatemia.