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Mashup Score: 4
ding all patients who were admitted to the ICU from January 2013 to December 2021 and stayed at least 24 hours. SETTING: The study was conducted in an academic hospital (University Hospital Basel, Switzerland). PATIENTS: A total of 20,927 admissions were included, of which 3748 received albumin at least once during their ICU stay. To analyze volume expansion, 2006 admissions met the inclusion criteria, namely at least two hemoglobin measurements within 12 hours, one albumin delivery, and experienced no bleeding, dialysis, or transfusions during this period. INTERVENTIONS: None. MEASUREMENTS: We examined the hemoglobin levels before and after albumin administration and compared them with a matched control group to assess the amount and duration of volume expansion. MAIN RESULTS: From 2013 to 2021 the proportion of critically ill patients treated with albumin rose from 5.0% to 32.5%. An overproportioned increase in albumin use could be seen in surgical patients (4.7–47.2%) and in those r
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Mashup Score: 150Application of Cardiovascular Physiology to the Critically... : Critical Care Medicine - 1 day(s) ago
ects of therapeutic interventions. We will build on this foundation by using a cardiovascular simulator to illustrate the application of these principles in the care of patients with severe sepsis, cardiogenic shock, and acute mechanical circulatory support. DATA SOURCES: Publications relevant to the discussion of the time-varying elastance model, cardiogenic shock, and sepsis were retrieved from MEDLINE. Supporting evidence was also retrieved from MEDLINE when indicated. STUDY SELECTION, DATA EXTRACTION, AND SYNTHESIS: Data from relevant publications were reviewed and applied as indicated. CONCLUSIONS: The ventricular pressure–volume relationship and time-varying elastance model provide a foundation for understanding cardiovascular physiology and pathophysiology. We have built on this foundation by using a cardiovascular simulator to illustrate the application of these important principles and have demonstrated how complex pathophysiologic abnormalities alter clinical parameters used
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Mashup Score: 83Executive Summary: Guidelines on Use of Corticosteroids in... : Critical Care Medicine - 2 day(s) ago
An abstract is unavailable.
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Mashup Score: 0Fixed- Versus Variable-Dose Prothrombin Complex Concentrate ... : Critical Care Medicine - 3 day(s) ago
tabases from January 2000 to August 2023 for clinical studies comparing fixed- vs. variable-dose 4-PCC for emergent VKA reversal with at least one reported clinical outcome. STUDY SELECTION: Abstracts and full texts were assessed independently and in duplicate by two reviewers. DATA EXTRACTION: Data were extracted independently and in duplicate by two reviewers using predefined extraction forms. DATA SYNTHESIS: The analysis comprised three randomized trials and 16 cohort studies comprising a total of 323 participants in randomized trials (161 in fixed dosage and 162 in variable dosage) and 1912 patients in cohort studies (858 in fixed-dose and 1054 in variable dose). Extracranial bleeding was the predominant indication, while intracranial hemorrhage varied. Overall, a fixed-dose regimen may be associated with a lower dose of 4-PCC and results in a reduction in 4-PCC administration time compared with a variable-dose regimen. A fixed-dose regimen also likely results in increased clinical
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Mashup Score: 9
site B was in the Northeast. Patients: Patients 18 years old or older admitted to a study ICU between March 1, 2017, and February 28, 2020. Interventions: None. Measurements and Main Results: We applied target trial emulation to compare admission during an intensivist’s first week (as a proxy for 2 wk of maximal continuity) vs. admission during their second week (as a proxy for 1 wk of maximal continuity). Outcomes included hospital mortality, ICU length of stay, and, for mechanically ventilated patients, duration of ventilation. Exploratory outcomes included imaging, echocardiogram, and consultation orders. We used inverse probability weighting to adjust for baseline differences and random-effects meta-analysis to calculate overall effect estimates. Among 2571 patients, 1254 were admitted during an intensivist’s first week and 1317 were admitted during a second week. At sites A and B, hospital mortality rates were 25.8% and 24.2%, median ICU length of stay were 4 and 2 days, and media
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Mashup Score: 4Recovery Trajectories in Children Requiring 3 or More Days... : Critical Care Medicine - 4 day(s) ago
Quaternary children’s hospital PICU. PATIENTS: Children without a preexisting tracheostomy who received greater than or equal to 3 days of invasive ventilation, survived hospitalization, and completed greater than or equal to 1 postdischarge data collection. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated 144 children measuring HRQL using proxy-report Pediatric Quality of Life Inventory and functional status using the Functional Status Scale (FSS) reflecting preillness baseline, PICU and hospital discharge, and 1, 3, 6, and 12 months after hospital discharge. They had a median age of 5.3 years (interquartile range, 1.1–13.0 yr), 58 (40%) were female, 45 (31%) had a complex chronic condition, and 110 (76%) had normal preillness FSS scores. Respiratory failure etiologies included lung disease (n = 49; 34%), neurologic failure (n = 23; 16%), and septic shock (n = 22; 15%). At 1-month postdischarge, 68 of 122 (56%) reported worsened HRQL and 35 (29%) had a new functional i
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Mashup Score: 5
d higher mortality, independent of other factors. Design: This is a multicenter retrospective observational study. Setting: The sample was recruited from a single healthcare system in New York. The recruitment period spanned from March 1, 2020, to April 30, 2020. Patients: The sample includes patients who were intubated for COVID-19 acute respiratory distress syndrome (ARDS). Interventions: None. Measurements and Main Results: The primary outcome was 28-day in-hospital mortality. Multivariable logistic regression was used to derive the odds of mortality among patients managed exclusively with NCV throughout their ventilation period compared with the remainder of the sample while adjusting for other factors. A secondary analysis was also done, in which the mortality of a subset of the sample exclusively ventilated with NCV was compared with that of a propensity score-matched subset of the control group. Exclusive use of NCV was associated with a higher 28-day in-hospital mortality while
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Mashup Score: 8A Nationwide, Prospective Study of Tracheal Intubation in... : Critical Care Medicine - 5 day(s) ago
as well as the changes of the intubation procedure observed in the COVID-19 pandemic. DESIGN: Prospective, observational, and cohort study. SETTING: Forty-three Spanish ICU. PATIENTS: A total of 1837 critically ill adult patients undergoing tracheal intubation. The enrollment period was six months (selected by each center from April 16, 2019, to October 31, 2020). INTERVENTIONS: None. MEASUREMENT AND MAIN RESULTS: At least one major adverse peri-intubation event occurred in 40.4 % of the patients (973 major adverse events were registered) the most frequent being hemodynamic instability (26.5%) and severe hypoxemia (20.3%). The multivariate analysis identified seven variables independently associated with a major adverse event whereas the use of neuromuscular blocking agents (NMBAs) was associated with reduced odds of major adverse events. Intubation on the first attempt was achieved in 70.8% of the patients. The use of videolaryngoscopy at the first attempt was the only protective fact
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Mashup Score: 2
ional study. SETTING: Three hospitals in the pediatric Resuscitation Quality (pediRES-Q) collaborative from 2015 to 2022. PATIENTS: Children younger than 18 years, gestational age 37 weeks old or older with in-hospital cardiac arrest (IHCA) receiving cardiopulmonary resuscitation greater than or equal to 1 minute and intra-arrest crSo2 monitoring. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Primary outcome was ROSC greater than or equal to 20 minutes without extracorporeal membrane oxygenation. Secondary outcomes included SHD and favorable neurologic outcome (FNO) (Pediatric Cerebral Performance Category 1–2 or no change from prearrest). Among 3212 IHCA events (index and nonindex), 123 met inclusion criteria in 93 patients. Median age was 0.3 years (0.1–1.4 yr) and 31% (38/123) of the cardiopulmonary resuscitation events occurred in patients with cyanotic heart disease. Median cardiopulmonary resuscitation duration was 8 minutes (3–28 min) and ROSC was achieved in 65% (80/123).
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Mashup Score: 12Critical Care Explorations Editor-In-Chief - 8 day(s) ago
APPLICATION DEADLINE IS FRIDAY, MAY 31, 2024 Primary purpose: Responsible for directing the clinical, professional, and editorial content of SCCM’s fully open-access journal Critical Care Explorations (CCE) to rapidly evaluate and disseminate new data and analyses that stimulate further innovation and i
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#PharmICU Abdelhamid et al: Impact of albumin admin on serum Hgb concentration. 📅20,927 admissions 🏥Swiss ICU 💉infusion practices based on pt population Link: https://t.co/T8fv9LtKft #CritCareMed @SCCM Fig: Hgb changes after albumin ~12 hrs https://t.co/gNgdai7UQ6