Articles: critical-illness.
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Randomized Controlled Trial
Ultrasound guided transcutaneous phrenic nerve stimulation in critically ill patients: a new method to evaluate diaphragmatic function.
Diaphragm dysfunction is common in intensive care unit and associated with weaning failure and mortality. The diagnosis gold standard is the transdiaphragmatic or tracheal pressure induced by magnetic phrenic nerve stimulation. However, the equipment is not commonly available and requires specific technical skills. This study aimed to evaluate ultrasound-guided transcutaneous phrenic nerve stimulation for daily bedside assessment of diaphragm function by targeted electrical phrenic nerve stimulation. ⋯ The SONOTEPS method is a simple and accurate tool for bedside assessment of diaphragm function with ultrasound-guided transcutaneous phrenic nerve stimulation in sedated patients with no or minimal spontaneous respiratory activity.
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Acta Anaesthesiol Scand · Mar 2025
ReviewFluid accumulation in adult ICU patients - A protocol for a scoping review.
Fluid accumulation in critically ill patients is associated with adverse outcomes. However, there is a substantial variability in the terminology and definitions used to describe fluid accumulation. We aim to provide an overview of evidence describing fluid accumulation in critically ill adult patients admitted to the intensive care unit (ICU), including how it is defined, patient characteristics associated with fluid accumulation, ICU population, and outcomes assessed. ⋯ This scoping review will provide an overview of definitions used for fluid accumulation, and describe ICU patient populations, patient characteristics, and outcomes assessed in ICU research.
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Critical care medicine · Feb 2025
Health Care Disparities and Critical Illnesses-Related Mortality in the United States.
To examine the association between social vulnerability index (SVI) and social deprivation index (SDI) with critical illness-related mortality in the United States and to guide future research and interventions aimed at reducing disparities in outcomes in patients with critical illness. ⋯ Critical illness mortality is significantly associated with indicators of socioeconomic disadvantage. The SDI appears to be a more effective tool than the SVI for guiding resource allocation. Targeted interventions to address social determinants of health, including poverty, education, and unemployment, are essential to reduce disparities and improve outcomes in patients with critical illness. Public health strategies should focus on addressing these social determinants and enhancing support for vulnerable populations and areas.
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Critical care medicine · Feb 2025
Ableism After Critical Illness: A Qualitative Translation of Key Concepts to the Post-ICU Context.
Ableism-discrimination and social prejudice against people with disabilities-defines people by their disability and assumes that disabled people require fixing. We sought to characterize ableism after critical illness and to describe its relationship with care delivery. ⋯ Ableism presents multifaceted barriers to participation after critical illness, undermining resilience and wellbeing. We hypothesize that anti-ableist interventions could reduce disability-related barriers to resilience to optimize recovery after critical illness.
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Eur J Trauma Emerg Surg · Feb 2025
Observational StudyEarly detection of muscle wasting assessed by ultrasound and analysis of growth factor and systemic inflammation mediators in critically ill trauma patients: an observational study.
The present study aims to describe initial changes in muscle thickness and composition, muscle growth signaling mediators, and systemic inflammation in critically ill patients after major trauma. ⋯ These findings reveal substantial thickness and muscle composition alterations within 48 h post-admission, worsening over five days. Despite standard rehabilitation care, changes in IGF-1 and IFN-y levels suggest early declines in muscle growth stimulus and increased inflammation.