Articles: critical-care.
-
Multicenter Study
Prevalence and risk factors of significant persistent pain symptoms after critical care illness: a prospective multicentric study.
Prevalence, risk factors and medical management of persistent pain symptoms after critical care illness have not been thoroughly investigated. ⋯ Persistent pain symptoms were frequent in critical illness survivors and specialized management remained infrequent. Innovative approaches must be developed in the ICU to minimize the consequences of pain.
-
J. Korean Med. Sci. · May 2023
Multicenter StudyThe Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea.
Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. ⋯ In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.
-
Critical care medicine · May 2023
Multicenter StudyImpact of the Magnitude and Timing of Fluid Overload on Outcomes in Critically Ill Children: A Report From the Multicenter International Assessment of Worldwide Acute Kidney Injury, Renal Angina, and Epidemiology (AWARE) Study.
With the recognition that fluid overload (FO) has a detrimental impact on critically ill children, the critical care nephrology community has focused on identifying clinically meaningful targets for intervention. The current study aims to evaluate the epidemiology and outcomes associated with FO in an international multicenter cohort of critically ill children. The current study also aims to evaluate the association of FO at predetermined clinically relevant thresholds and time points (FO ≥ 5% and FO ≥ 10% at the end of ICU days 1 and 2) with outcomes. ⋯ This study found that mild-to-moderate FO as early as at the end of ICU Day1 is associated with adverse outcomes. The current study fills an important void in the literature by identifying critical combinations of FO timing and quantity associated with adverse outcomes (FO ≥ 5%Day1, FO ≥10%Day1, FO ≥ 5%Day2, and FO ≥ 10%Day2). Those novel findings will help guide the development of interventional strategies and trials targeting the treatment and prevention of clinically relevant FO.
-
Intensive care medicine · May 2023
Multicenter StudyAssociation between prehospital end-tidal carbon dioxide levels and mortality in patients with suspected severe traumatic brain injury.
Severe traumatic brain injury is a leading cause of mortality and morbidity, and these patients are frequently intubated in the prehospital setting. Cerebral perfusion and intracranial pressure are influenced by the arterial partial pressure of CO2 and derangements might induce further brain damage. We investigated which lower and upper limits of prehospital end-tidal CO2 levels are associated with increased mortality in patients with severe traumatic brain injury. ⋯ A safe zone of 35-45 mmHg for end-tidal CO2 guidance seems reasonable during prehospital care. Particularly, end-tidal partial pressures of less than 35 mmHg were associated with a significantly increased mortality.
-
Multicenter Study
The influencing factors of choosing future medical specialties among students in Saudi Arabia: A nationwide multicenter survey.
Choosing a future medical speciality is considered one of the most critical challenges for undergraduate students worldwide. The present study assessed the influences and factors related to medical students career choices in Saudi Arabia. The study was designed in a cross-sectional manner to collect data from all undergraduate medical students and interns in the Kingdom of Saudi Arabia for 5 months, starting from September 2021 and ending in January 2022. ⋯ A student's lower grade point average, the lower average monthly income of their family, lack of working relative in the healthcare field and absence of advice about future specialities are all significant predictors for stopping specialities endeavor. Our study concluded that students career choices depend on different factors, including gender based preferences and that their specialized preferences did not change considerably prior to or after graduation. Further studies are required to analyze the factors influencing student and intern speciality preferences in their early clinical and career years.