Articles: critical-illness.
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Intensive care medicine · Oct 2021
Critically ill cancer patient's resuscitation: a Belgian/French societies' consensus conference.
To respond to the legitimate questions raised by the application of invasive methods of monitoring and life-support techniques in cancer patients admitted in the ICU, the European Lung Cancer Working Party and the Groupe de Recherche Respiratoire en Réanimation Onco-Hématologique, set up a consensus conference. The methodology involved a systematic literature review, experts' opinion and a final consensus conference about nine predefined questions1. Which triage criteria, in terms of complications and considering the underlying neoplastic disease and possible therapeutic limitations, should be used to guide admission of cancer patient to intensive care units?2. ⋯ What specific considerations should be taken into account in the intensive care unit?8. Based on which criteria, in terms of benefit and complications and taking into account the neoplastic disease, patients hospitalized in an intensive care unit (or equivalent) should receive cellular elements derived from the blood (red blood cells, white blood cells and platelets)?9. Which training is required for critical care doctors in charge of cancer patients?
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Journal of critical care · Oct 2021
Comparison of fixed dose versus train-of-four titration of cisatracurium in acute respiratory distress syndrome.
To compare the ventilatory and clinical outcomes associated with a fixed-dose cisatracurium infusion versus a titrated infusion strategy in patients with Acute Respiratory Distress Syndrome (ARDS). ⋯ Fixed-dose cisatracurium was associated with similar ventilatory and clinical outcomes compared to titrated strategy, yet it was associated with a 3-fold increase in dose administered.
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J Clin Monit Comput · Oct 2021
Observational StudyPeripheral arterial tonometry as a method of measuring reactive hyperaemia correlates with organ dysfunction and prognosis in the critically ill patient: a prospective observational study.
Predictions of mortality may help in the selection of patients who benefit from intensive care. Endothelial dysfunction is partially responsible for many of the organic dysfunctions in critical illness. Reactive hyperaemia is a vascular response of the endothelium that can be measured by peripheral arterial tonometry (RH-PAT). ⋯ RH-PAT is correlated with disease severity and seems to be an independent marker of early mortality, cardiovascular and renal dysfunctions. RH-PAT variation predicts late mortality. There appears to be an RH-PAT impairment in the acute phase of severe diseases that may be reversible and associated with better outcomes.
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Int. J. Clin. Pract. · Oct 2021
Performance of the CURB-65, ISARIC-4C, and COVID-GRAM scores in terms of severity for COVID-19 patients.
In the COVID-19 pandemic, difficulties have been experienced in the provision of healthcare services because of excessive patient admissions to hospitals and emergency departments. It has become important to use clear and objective criteria for the early diagnosis of patients with high-risk classification and clinical worsening risk. ⋯ Among the scoring systems assessed, CURB-65 score had better performance in predicting in-hospital mortality and ICU requirement in COVID-19 patients. ISARIC-4C has been found successful in identifying low-risk patients and the use of the ISARIC-4C score with CURB-65 increases the accuracy of risk assessment.