87,552 results match your criteria critically ill

Electrolyte monitoring during regional citrate anticoagulation in continuous renal replacement therapy.

J Clin Monit Comput 2021 May 15. Epub 2021 May 15.

Department of Intensive Care Medicine, Gelre Hospitals, Apeldoorn, The Netherlands.

Patients with acute kidney injury who need continuous renal replacement therapy with locoregional citrate anticoagulation are at risk of citrate accumulation with disruption of the calcium balance. We aimed to evaluate the safety of detecting citrate accumulation and adjusting electrolyte disbalances during continuous venovenous hemodialysis (CVVHD) in critically ill patients with acute kidney injury using a blood sample frequency every 6 h. A prospective single center study in critically ill intensive care unit patients who suffered from acute kidney injury with the need of renal replacement therapy. Read More

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Differential effects of the blood pressure state on pulse rate variability and heart rate variability in critically ill patients.

NPJ Digit Med 2021 May 14;4(1):82. Epub 2021 May 14.

Research Centre for Biomedical Engineering, City, University of London, London, United Kingdom.

Heart rate variability (HRV) utilizes the electrocardiogram (ECG) and has been widely studied as a non-invasive indicator of cardiac autonomic activity. Pulse rate variability (PRV) utilizes photoplethysmography (PPG) and recently has been used as a surrogate for HRV. Several studies have found that PRV is not entirely valid as an estimation of HRV and that several physiological factors, including the pulse transit time (PTT) and blood pressure (BP) changes, may affect PRV differently than HRV. Read More

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Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report.

Transl Psychiatry 2021 May 14;11(1):288. Epub 2021 May 14.

Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.

Decentering is a ubiquitous therapeutic concept featuring in multiple schools of psychological intervention and science. It describes an ability to notice to day-to-day psychological stressors (negative thoughts, feelings, and memories) from an objective self-perspective and without perseverating on the themes they represent. Thus, decentering dampens the impact and distress associated with psychological stressors that can otherwise increase mental ill health in vulnerable individuals. Read More

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Indirect calorimetry in critical illness: a new standard of care?

Curr Opin Crit Care 2021 May 14. Epub 2021 May 14.

Department of Clinical Nutrition Department of Intensive Care Medicine Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium Department of Anesthesiology and Surgery, Duke University School of Medicine, Durham, North Carolina, USA.

Purpose Of Review: Review recent literature on the role of indirect calorimetry in critical care nutrition management.

Recent Findings: Critical illness demands objective, targeted nutritional therapy to prevent adverse effects of underfeeding/over feeding. Thus, all recent societal guidelines recommend indirect calorimetry use to determine energy needs. Read More

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Retrieval-constrained valuation: Toward prediction of open-ended decisions.

Proc Natl Acad Sci U S A 2021 May;118(20)

Haas School of Business, University of California, Berkeley, CA 94720;

Real-world decisions are often open ended, with goals, choice options, or evaluation criteria conceived by decision-makers themselves. Critically, the quality of decisions may heavily rely on the generation of options, as failure to generate promising options limits, or even eliminates, the opportunity for choosing them. This core aspect of problem structuring, however, is largely absent from classical models of decision-making, thereby restricting their predictive scope. Read More

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Impact of prone position in non-intubated spontaneously breathing patients admitted to the ICU for severe acute respiratory failure due to COVID-19.

J Crit Care 2021 May 1;64:199-204. Epub 2021 May 1.

Service de Médecine intensive et réanimation, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, France; INSERM UMR 1018, Clinical Epidemiology Team, CESP, Université de Paris Saclay, Villejuif, France. Electronic address:

Purpose: Studies performed in spontaneously breathing patients with mild to moderate respiratory failure suggested that prone position (PP) in COVID-19 could be beneficial.

Materials And Methods: Consecutive critically ill patients with COVID-19 were enrolled in four ICUs. PP sessions lasted at least 3 h each and were performed twice daily. Read More

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Adjunctive homeopathic treatment of hospitalized COVID-19 patients (COVIHOM): A retrospective case series.

Complement Ther Clin Pract 2021 May 11;44:101415. Epub 2021 May 11.

WissHom: Scientific Society for Homeopathy, Koethen, Germany.

Background: and purpose. COVID-19 is a novel viral disease causing worldwide pandemia. The aim of this study was to describe the effect of adjunctive individualized homeopathic treatment delivered to hospitalized patients with confirmed symptomatic SARS-CoV-2 infection. Read More

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A Communication Guide for Pediatric Extracorporeal Membrane Oxygenation.

Pediatr Crit Care Med 2021 May 17. Epub 2021 May 17.

Department of Cardiology, Division of Cardiovascular Critical Care, Boston Children's Hospital, Boston, MA. Department of Pediatrics, Harvard Medical School, Boston, MA. School of Medicine, University of Queensland, Brisbane, QLD, Australia. Department of Pediatrics, Boston Children's Hospital, Boston, MA. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA. Division of Critical Care Medicine, Children's National Hospital, Washington, DC.

Decision-making surrounding extracorporeal membrane oxygenation initiation and decannulation has become a key challenge in critical care. Nuanced communication skills and transparent discussions about prognosis are imperative during this lifesaving, yet high-risk and burdensome intervention. Serious illness conversation guides are proving beneficial for patients, families and staff to communicate uncertainty and facilitate shared decision-making toward goal-concordant care. Read More

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Characteristics, management, and prognosis of elderly patients with COVID-19 admitted in the ICU during the first wave: insights from the COVID-ICU study : Prognosis of COVID-19 elderly critically ill patients in the ICU.

Ann Intensive Care 2021 May 14;11(1):77. Epub 2021 May 14.

Sorbonne Université, INSERM, UMRS_1166-iCAN, Institute of Cardiometabolism and Nutrition, 75651, Paris Cedex 13, France.

Background: The COVID-19 pandemic is a heavy burden in terms of health care resources. Future decision-making policies require consistent data on the management and prognosis of the older patients (> 70 years old) with COVID-19 admitted in the intensive care unit (ICU).

Methods: Characteristics, management, and prognosis of critically ill old patients (> 70 years) were extracted from the international prospective COVID-ICU database. Read More

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Reconceptualizing How to Support Surrogates Making Medical Decisions for Critically Ill Patients.

JAMA 2021 May 14. Epub 2021 May 14.

Program on Ethics and Decision Making in Critical Illness, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

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The relationship between serum lactate dehydrogenase level and mortality in critically ill patients.

Biomark Med 2021 May 14. Epub 2021 May 14.

Department of Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

To assess the association between serum lactate dehydrogenase (LDH) levels and mortality in intensive care unit patients. A total of 1981 patients in the eICU Collaborative Research Database were divided into four groups according to quartiles of LDH levels. Logistic regressions were performed. Read More

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Improvements in Functional Status Among Survivors of Orthotopic Heart Transplantation Following High-risk Bridging Modalities.

Transplantation 2021 Jan 7. Epub 2021 Jan 7.

1 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA. 2 Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA. 3 Division of Cardiac Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

Background: The 2018 heart allocation change has resulted in greater frequency of high-risk bridging to orthotopic heart transplantation (OHT). Although survival has been studied in these patients, functional status outcomes are less established. This study evaluated changes in functional status of OHT survivors based on bridging strategy. Read More

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January 2021

Increased peripheral blood neutrophil activation phenotypes and NETosis in critically ill COVID-19 patients: a case series and review of the literature.

Clin Infect Dis 2021 May 14. Epub 2021 May 14.

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of California San Diego (UCSD), La Jolla, CA 92093, USA.

Background: Increased inflammation has been well defined in COVID-19, while definitive pathways driving severe forms of this disease remain uncertain. Neutrophils are known to contribute to immunopathology in infections, inflammatory diseases and acute respiratory distress syndrome (ARDS), a primary cause of morbidity and mortality in COVID-19. Changes in neutrophil function in COVID-19 may give insight into disease pathogenesis and identify therapeutic targets. Read More

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Artificial neural network model from a case series of COVID-19 patients: a prognostic analysis.

Acta Biomed 2021 May 12;92(2):e2021202. Epub 2021 May 12.

Department of Medicine, University of Udine, Udine, Italy; Department of Anesthesia and Intensive Care, ASUFC Santa Maria della Misericordia University Hospital of Udine, Udine, Italy.

Background And Aim:  There is a need to determine which clinical variables predict the severity of COVID-19. We analyzed a series of critically ill COVID-19 patients to see if any of our dataset's clinical variables were associated with patient outcomes.

Methods:  We retrospectively analyzed the data of COVID-19 patients admitted to the ICU of the Hospital in Pordenone from March 11, 2020, to April 17, 2020. Read More

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Recall of pain and discomfort during oral procedures experienced by intubated critically ill patients in the intensive care unit: A qualitative elicitation study.

Can J Pain 2020 Sep 24;4(3):19-28. Epub 2020 Sep 24.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.

: Intubated and mechanically ventilated patients in the intensive care unit (ICU) may experience pain during routine oral procedures such as oral suctioning and tooth brushing. Despite the importance of pain prevention and management, little is known about patients' experiences of procedural oral pain. : The aim of this study was to explore patients' recollections and recommendations for pain and discomfort during routine oral procedures. Read More

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September 2020

Clinical features in coronavirus disease 2019 (COVID-19) patients with early clearance and prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA.

Ann Transl Med 2021 Apr;9(8):665

Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Background: Since the outbreak of coronavirus disease 2019 (COVID-19), the pattern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding has not been well characterized.

Methods: In our study, 652 patients in Wuhan Designated Hospital were recruited, and their clinical and laboratory findings were extracted and analyzed.

Results: The median duration of SARS-CoV-2 RNA detection was 23 days [interquartile range (IQR), 18 days] from symptom onset. Read More

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Role of a successful spontaneous breathing trial in ventilator liberation in brain-injured patients.

Ann Transl Med 2021 Apr;9(7):548

Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Background: Spontaneous breathing trials (SBTs) have been shown to improve outcomes in critically ill patients. However, in patients with brain injury, indications for intubation and mechanical ventilation are different from those of non-neurological patients, and the role of an SBT in patients with brain injury is less established. The aim of the present study was to compare key respiratory variables acquired during a successful SBT between patients with successful ventilator liberation versus failed ventilator liberation. Read More

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Day-90 survival in critically-ill patients with COVID-19 and hydroxychloroquine: a propensity analysis.

Ann Transl Med 2021 Apr;9(7):524

Medical Intensive Care Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France.

Background: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population.

Methods: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Read More

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Disparities of SARS-CoV-2 Nucleoprotein-Specific IgG in Healthcare Workers in East London, UK.

Front Med (Lausanne) 2021 27;8:642723. Epub 2021 Apr 27.

Centre for Immunobiology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

SARS-CoV-2 antibody detection serves as an important diagnostic marker for past SARS-CoV-2 infection and is essential to determine the spread of COVID-19, monitor potential COVID-19 long-term effects, and to evaluate possible protection from reinfection. A study was conducted across three hospital sites in a large central London NHS Trust in the UK, to evaluate the prevalence and duration of SARS-CoV-2 IgG antibody positivity in healthcare workers. A matrix equivalence study consisting of 228 participants was undertaken to evaluate the Abbott Panbio™ COVID-19 IgG/IgM rapid test device. Read More

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Target Calorie Intake Achievements for Patients Treated in the Surgical Intensive Care Unit.

Clin Nutr Res 2021 Apr 19;10(2):107-114. Epub 2021 Apr 19.

Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul 06973, Korea.

Adequate nutritional support in critically ill patients is important, however, sometimes it has been neglected in perioperative period of patients at surgical intensive care units (SICU). The aim of this study was to investigate whether approaching target calorie intake of surgical patients influences on their clinical outcomes. A total of 279 patients who admitted at SICU in perioperative period from August 2014 to July 2016 at our hospital were analyzed. Read More

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Outcomes of critically ill end-stage kidney disease patients who underwent major surgery.

PeerJ 2021 3;9:e11324. Epub 2021 May 3.

Department of Medicine, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.

Purpose: End-stage kidney disease (ESKD) is a major worldwide health problem. Patients with ESKD are thought to have a significant risk for development of complications following an operation. However, the study of ESKD and its outcomes following major operations remains rare, particularly in critical illness. Read More

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The Use of Dornase Alfa in the Management of COVID-19-Associated Adult Respiratory Distress Syndrome.

Crit Care Res Pract 2021 23;2021:8881115. Epub 2021 Apr 23.

Palm Beach Gardens Medical Center, Palm Beach Gardens, FL, USA.

Objective: Currently, management of acute respiratory distress syndrome (ARDS) in COVID-19 infection with invasive mechanical ventilation results in poor prognosis and high mortality rates. Interventions to reduce ventilatory requirements or preclude their needs should be evaluated in order to improve survival rates in critically ill patients. Formation of neutrophil extracellular traps (NETs) during the innate immune response could be a contributing factor to the pulmonary pathology. Read More

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Nursing Scheduling Mode and Experience from the Medical Teams in Aiding Hubei Province During the COVID-19 Outbreak: A Systematic Scoping Review of 17 Studies.

Risk Manag Healthc Policy 2021 6;14:1805-1813. Epub 2021 May 6.

Department of Epidemiology, School of Public Health, China Medical University, Shenyang, 110122, Liaoning, People's Republic of China.

Introduction: Due to COVID-19 outbreak, since January 24, 2020, national medical teams from across the country and the armed forces have been dispatched to aid Hubei. The present review was designed to timely summarize the existing frontline information about nursing scheduling mode with special focus on the length of shifts with the aim to contribute to improve the nurses' job satisfaction and the quality of nursing services.

Methods: Articles from Jan 2020 to October 2020 were retrieved from China National Knowledge Infrastructure, Wanfang Data and Weipu Information, with the terms "COVID-19", "designated hospital", "Hubei-assisted", "makeshift hospital", "nursing", "nursing shift", "whole-system takeover" and variations of these, in the title and abstract fields and the Boolean combinations of these words as the retrieval strategy. Read More

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Successful elimination of bilirubin in critically ill patients with acute liver dysfunction using a cytokine adsorber and albumin dialysis: a pilot study.

Sci Rep 2021 May 13;11(1):10190. Epub 2021 May 13.

Department of Anesthesiology, LMU Hospital, Marchioninistrasse 15, 81377, Munich, Germany.

There are different methods of artificial liver support for patients with acute liver dysfunction (ALD). However, CytoSorb (CS) might be a new approved option for those patients. Question of interest is whether the elimination performance of CS was comparable to that of advanced organ support (ADVOS). Read More

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A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States.

Sci Rep 2021 May 13;11(1):10231. Epub 2021 May 13.

Division of Cardiovascular Disease, University of Alabama at Birmingham, 1670 University Boulevard, Volker Hall B140, Birmingham, AL, 35294-0019, USA.

Children and adolescents account for ~ 13% of total COVID-19 cases in the United States. However, little is known about the nature of the illness in children. The reopening of schools underlines the importance of understanding the epidemiology of pediatric COVID-19 infections. Read More

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Reducing antibiotic treatment duration for ventilator-associated pneumonia (REGARD-VAP): a trial protocol for a randomised clinical trial.

BMJ Open 2021 May 13;11(5):e050105. Epub 2021 May 13.

Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.

Introduction: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs). Using short-course antibiotics to treat VAP caused by Gram-negative non-fermenting bacteria has been reported to be associated with excess pneumonia recurrences. The "REducinG Antibiotic tReatment Duration for Ventilator-Associated Pneumonia" (REGARD-VAP) trial aims to provide evidence for using a set of reproducible clinical criteria to shorten antibiotic duration for individualised treatment duration of VAP. Read More

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Premorbid β1-selective (but not non-selective) β-blocker exposure reduces intensive care unit mortality among septic patients.

J Intensive Care 2021 May 13;9(1):40. Epub 2021 May 13.

Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.

Background: β-blockers may protect against catecholaminergic myocardial injury in critically ill patients. Long-term β-blocker users are known to have lower lactate concentrations and favorable sepsis outcomes. However, the effects of β1-selective and nonselective β-blockers on sepsis outcomes have not been compared. Read More

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OASIS +: leveraging machine learning to improve the prognostic accuracy of OASIS severity score for predicting in-hospital mortality.

BMC Med Inform Decis Mak 2021 May 13;21(1):156. Epub 2021 May 13.

Department of Translational Data Science and Informatics, Geisinger, Danville, PA, 17822, USA.

Background: Severity scores assess the acuity of critical illness by penalizing for the deviation of physiologic measurements from normal and aggregating these penalties (also called "weights" or "subscores") into a final score (or probability) for quantifying the severity of critical illness (or the likelihood of in-hospital mortality). Although these simple additive models are human readable and interpretable, their predictive performance needs to be further improved.

Methods: We present OASIS +, a variant of the Oxford Acute Severity of Illness Score (OASIS) in which an ensemble of 200 decision trees is used to predict in-hospital mortality based on the 10 same clinical variables in OASIS. Read More

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The Safety of Continuous Infusion Propofol in Mechanically Ventilated Adults With Coronavirus Disease 2019.

Ann Pharmacother 2021 May 14:10600280211017315. Epub 2021 May 14.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA.

Background: Propofol is commonly used to achieve ventilator synchrony in critically ill patients with coronavirus disease 2019 (COVID-19), yet its safety in this patient population is unknown.

Objective: To evaluate the safety, in particular the incidence of hypertriglyceridemia, of continuous infusion propofol in patients with COVID-19.

Methods: This was a retrospective study at 1 academic medical center and 1 affiliated teaching hospital in New York City. Read More

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