Articles: critical-illness.
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Emerg Med Australas · Feb 2024
End-of-life care: A retrospective cohort study of older people who died within 48 hours of presentation to the emergency department.
To describe the characteristics of, and care provided to, older people who died within 48 h of ED presentation. ⋯ Identification of patients at end-of-life (EoL) is not always straightforward; consider recent reduction in independence and recent ED visits/hospital admissions. System-based strategies that span pre-hospital, ED and in-patient care are recommended to facilitate EoL pathway implementation and care continuity.
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Minerva anestesiologica · Jul 2023
The power of mechanical ventilation may predict mortality in critically ill patients.
Mechanical power (MP) is the amount of energy transferred from the ventilator to the patient within a unit of time. It has been emphasized in ventilation-induced lung injury (VILI) and mortality. However, its measurement and use in clinical practice are challenging. "Electronic recording systems (ERS)" using mechanical ventilation parameters provided by the ventilator can be helpful to measure and record the MP. The MP (J/minutes) formula is 0.098 x tidal volume x respiratory rate x (Ppeak - ½ ∆P), in which ∆P is the driving pressure and Ppeak is the peak pressure. We aimed to define the association between MP values and ICU mortality, mechanical ventilation days, and intensive care unit length of stay (ICU-LOS). The secondary outcome was to determine the most potent or essential component of power in the equation that has a role in mortality. ⋯ The first 24 h MP maybe a predictive value for the ICU patients' prognosis. This implies that MP may be used as a decision-making system to define the clinical approach and as a scoring system to predict patient prognosis.
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Review Meta Analysis
Prolonged capillary refill time and short-term mortality of critically ill patients: A meta-analysis.
Prolonged capillary refill time (CRT) is an indicator of poor peripheral perfusion. The aim of the systematic review and meta-analysis was to evaluate the association of prolonged CRT and mortality of critically ill patients. ⋯ Prolonged CRT at admission may be a predictor of increased short-term mortality of critically ill patients.
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Multicenter Study
Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review.
It is unclear how often survival benefits observed in single-center randomized controlled trials (sRCTs) involving critically ill patients are confirmed by subsequent multicenter randomized controlled trials (mRCTs). We aimed to perform a systemic literature review of sRCTs with a statistically significant mortality reduction and to evaluate whether subsequent mRCTs confirmed such reduction. ⋯ Mortality reduction shown by sRCTs is typically not replicated by mRCTs. The findings of sRCTs should be considered hypothesis-generating and should not contribute to guidelines.
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Critical care medicine · Apr 2024
Randomized Controlled Trial Multicenter StudyA Comparison of High and Usual Protein Dosing in Critically Ill Patients With Obesity: A Post Hoc Analysis of an International, Pragmatic, Single-Blinded, Randomized, Clinical Trial.
Across guidelines, protein dosing for critically ill patients with obesity varies considerably. The objective of this analysis was to evaluate whether this population would benefit from higher doses of protein. ⋯ In critically ill patients with obesity, higher protein doses did not improve clinical outcomes, including those with higher nutritional and frailty risk.