Articles: hospitals.
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Delirium is an organic mental syndrome significantly associated with long-term cognitive decline, increased hospital stays and higher mortality. This systematic review of randomised controlled trials (RCTs) with meta-analysis assesses the association of remimazolam with postoperative cognitive function and delirium compared with non-benzodiazepine hypnotics. ⋯ PROSPERO CRD42024532751.
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Pediatr Crit Care Me · Dec 2024
The Pediatric Influence of Cooling Duration on Efficacy in Cardiac Arrest Patients (P-ICECAP): Statistical Methods Planned in the Bayesian, Adaptive, Duration Finding Trial.
To determine the optimal cooling duration for children after out-of-hospital cardiac arrest (OHCA) using an adaptive Bayesian trial design. ⋯ The P-ICECAP trial aims to identify the shortest cooling duration that provides the maximum treatment effect for pediatric OHCA patients. The adaptive design allows for flexibility and efficiency in handling various clinical scenarios, potentially transforming pediatric cardiac arrest care by optimizing hypothermia treatment protocols.
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Pol. Arch. Med. Wewn. · Dec 2024
ReviewDiagnosis of sepsis: which clinical and laboratory biomarkers are useful?
The quest for a definitive diagnostic tool for sepsis has spanned decades, yet it remains elusive. The diagnostic workup of sepsis is inherently complex, involving dozens of biochemical, hematologic, and immunologic parameters, alongside complex microbiological diagnostics. Over the past decade, the integration of omics technologies has further complicated this diagnostic landscape. ⋯ This work provides an overview of selected diagnostic biomarkers that are deemed readily applicable in routine clinical practice, extending applicability beyond highly specialized university hospitals. Verifying the reliability and clinical utility of diagnostic parameters generally takes several years, and often is more challenging in patients with sepsis, as compared with other cohorts, because of the complexity of this condition. Nevertheless, the integration of new technologies, the expanded use of bedside diagnostics, and advancements in omics technologies are propelling us toward the realization of personalized medicine and theranostics.
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The integration of enhanced recovery after surgery (ERAS) protocols into the peri-operative management of video-assisted thoracic surgery (VATS) has facilitated rapid patient recovery, enabling discharge within 48 h. However, postoperative pulmonary complications (PPCs) postdischarge pose significant concerns for patient welfare. Despite the established utility of lung ultrasound (LUS) in diagnosing the causes of dyspnoea, the effectiveness of quantitative LUS in predicting PPCs after VATS remains uncertain. ⋯ LUSS on POD 1 emerged as an independent risk factor for PPCs in fast-track VATS patients and reliably predicted the occurrence of PPCs within 30 days of hospital discharge.
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Survivors of acute respiratory failure (ARF) have complex healthcare needs postdischarge, frequently resulting in unmet needs. This prospective multicenter study explores the association between COVID-19 status and unmet healthcare needs in survivors of ARF following hospital discharge. We analyzed patient characteristics and unmet healthcare needs by COVID-19 status using a multivariable regression model with propensity weights. ⋯ The median (IQR) percentage of unmet healthcare needs was 26% (17%-36%), with follow-up appointments accounting for most unmet needs. Unmet medication needs were found to be very low at 6%. Despite the challenges in healthcare delivery during the COVID-19 pandemic, our data suggest COVID status had no observable effect on unmet healthcare needs for ARF survivors, after controlling for patient baseline and clinical status.