Critical Care
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ICU Delirium Linked to Post-Discharge Change in Cancer Treatment and Higher Mortality Among Cancer Patients
In this single-center, retrospective cohort study, intensive care unit (ICU) delirium was associated with a higher rate of cancer treatment modification, only partly due to worsening performance status, after discharge and higher one-year mortality.
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Does Alkaline Phosphatase Reduce Sepsis-Associated Acute Kidney Injury?
This Phase III, international, multicenter, double-blind, randomized controlled trial did not show a reduction in 28-day all-cause mortality with ilofotase alfa (recombinant human alkaline phosphatase). However, the study showed evidence to suggest that ilofotase alfa reduced major adverse kidney events at 90 days, mainly driven by lowering the incidence of renal replacement therapy through day 90 in these patients.
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Ventilation and Oxygenation Considerations During and After Cardiopulmonary Resuscitation
With a multitude of recommendations spanning from monitoring during cardiopulmonary resuscitation (CPR) to post-arrest targeted temperature management, the specific focus of this article is to review considerations related to ventilation and oxygenation during and after CPR.
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Percutaneous Coronary Intervention vs. Placebo for Stable Angina Patients
In this randomized trial of patients with stable angina and objective evidence of ischemia, percutaneous coronary intervention resulted in a significant reduction in angina compared to a placebo procedure.
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Small-Volume Blood Collection May Reduce Transfusion Needs in the ICU
The STRATUS randomized clinical trial was a stepped-wedge cluster randomized trial in 25 adult medical-surgical intensive care units (ICUs) in Canada that studied standard-volume to small-volume vacuum tubes for blood collection in the ICU. In the primary analysis, there was no significant difference in red blood cell transfusion between groups. However, in a pre-specified secondary analysis, red blood cell transfusion decreased after the transition from standard-volume tubes to small-volume tubes.
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Buprenorphine May Be an Effective Alternative to Full Opioids for Pain in the ICU
In a small, single-center, retrospective, propensity-matched cohort study examining enteral oxycodone vs. sublingual buprenorphine in a critically ill population, pain control was equivalent, indicating that sublingual buprenorphine may be an effective and appropriate alternative.
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Using Targeted Trials to Investigate Early vs. Late Intubation Strategies
Authors used a machine learning framework to show that delaying intubation in critically ill patients when compared to early intubation does not result in a greater 30-day mortality.
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Significant Disparities Exist in Accessing Extracorporeal Membrane Oxygenation
After extensive sensitivity analyses to account for severity of illness and confounding, a comparison of patient characteristics of those receiving extracorporeal membrane oxygenation (ECMO) to those treated with mechanical ventilation alone revealed that female patients, those with Medicaid, and those living in the lowest-income neighborhoods were less likely to be treated with ECMO.
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Prevention of Ventilator-Associated Pneumonia with Inhaled Amikacin
A short course of inhaled amikacin at therapeutic doses prevented the occurrence of ventilator-associated pneumonia without changes to duration of mechanical ventilation, length of stay, or mortality.
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Bougie or Stylet Upfront for Endotracheal Intubation
In this secondary analysis of the BOUGIE trial, patient and operator characteristics may affect successful intubation with either technique despite no difference in outcomes in the primary analysis.