Notes

Polydatin Brings about Differentiation along with Rays Sensitivity throughout Human Osteosarcoma Tissue and also Parallel Release through Lipid Metabolite Release.
3% vs. 52.4%, p<0.001). Being admitted in the control ICU was independently associated with hyperoxemia and excess oxygen use. Multivariable analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FiO
use and adverse clinical outcomes.

Following FiO
protocol was associated with lower hyperoxemia and less excess oxygen use. Although those results were not associated with better clinical outcomes, adopting FiO
protocol may be useful in a scenario of depleted oxygen resources, as was seen during the COVID-19 pandemic.
Following FiO2 protocol was associated with lower hyperoxemia and less excess oxygen use. Although those results were not associated with better clinical outcomes, adopting FiO2 protocol may be useful in a scenario of depleted oxygen resources, as was seen during the COVID-19 pandemic.
To assess children's functional outcomes one year after critical illness and identify which factors influenced these functional outcomes.

Ambispective cohort study.

Pediatric intensive care unit (PICU) in a tertiary academic center.

Children (1 month-17-year-old) and their caregivers.

None.

Demographic, clinical, and functional status.

Of 242 patients screened, 128 completed the year follow-up. These children had significant changes in functional status over time (p<0.001). The functional decline occurred in 62% of children at discharge and, after one year, was persistent in 33%. Age>12 months was a protective factor against poor functional outcomes in two regression models (p<0.05). A moderately abnormal functional status and a severely/very severely abnormal functional status at discharge increased the risks of poor functional outcomes by 4.14 (95% CI 1.02-16.72; p=0.04), and 4.76 (CI 95% 1.19-19.0; p=0.02). A functional decline at discharge increased by 6.86 (95%CI 2.16-21.79; p=0.001) the risks of children's long-term poor functional outcomes, regardless of the FSS scores.

This is the first study evaluating long-term functional outcomes after pediatric critical illnesses in Latin America. Our findings show baseline data and raise relevant questions for future multicentre studies in this field in Latin America, contributing to a better understanding of the effects of critical illnesses on long-term functional outcomes in children.
This is the first study evaluating long-term functional outcomes after pediatric critical illnesses in Latin America. CNQX Our findings show baseline data and raise relevant questions for future multicentre studies in this field in Latin America, contributing to a better understanding of the effects of critical illnesses on long-term functional outcomes in children.
Evaluation of glucometrics in the first week of ICU stay and its association with outcomes.

Prospective observational study.

Mixed ICU of teaching hospital.

Adults initiated on insulin infusion for 2 consecutive blood glucose (BG) readings ≥180mg/dL.

Glucometrics calculated from the BG of first week of admission hyperglycemia (BG>180mg/dL) and hypoglycemia (BG<70mg/dL) episodes; median, standard deviation (SD) and coefficient of variation (CV) of BG, glycemic lability index (GLI), time in target BG range (TIR). Factors influencing glucometrics and the association of glucometrics to patient outcomes analyzed.

A total of 5762 BG measurements in 100 patients of median age 55 years included. Glucometrics hyperglycemia 2253 (39%), hypoglycemia 28 (0.48%), median BG 169mg/dL (162-178.75), SD 31mg/dL (26-38.75), CV 18.6% (17.1-22.5), GLI 718.5 [(mg/dL)
/h]/week (540.5-1131.5) and TIR 57% (50-67). Diabetes and higher APACHE II score were associated with higher SD and CV, and lower TIR. On multivariate regression, diabetes (p=0.009) and APACHE II score (p=0.016) were independently associated with higher SD. Higher SD and CV were associated with less vasopressor-free days; lower TIR with more blood-stream infections (BSI). Patients with higher SD, CV and GLI had a higher 28-day mortality. On multivariate analysis, GLI alone was associated with a higher mortality (OR 2.99, p=0.04).

Glycemic lability in the first week in ICU patients receiving insulin infusion is associated with higher mortality. Lower TIR is associated with more blood stream infections.
Glycemic lability in the first week in ICU patients receiving insulin infusion is associated with higher mortality. Lower TIR is associated with more blood stream infections.
To comprehensively assess peer-reviewed studies using volatile (VA) or intravenous (i/v) anesthetics for sedation in intensive care units (ICUs), with the hypothesis that the type of sedation may have an impact on survival and other clinically relevant outcomes.

Systematic review and meta-analysis of randomized and non-randomized trials.

ICUs.

Critically ill and postoperative patients.

None.

Studies comparing VA versus i/v anesthetics used in the ICU settings were independently systematically searched. Finally, 15 studies (1520 patients of predominantly surgical profile needed VA sedation for less than 96h) were included. VA had no impact on all-cause mortality (very low quality of evidence, Odds Ratio=0.82 [0.60-1.12], p=0.20). However, VA were associated with a reduction in duration of mechanical ventilation (p=0.03) and increase in ventilator-free days (p<0.001). VA also reduced postoperative levels of cardiac troponin (24h), time to extubation (p<0.001) and awakening (p=0.04).

In this meta-analysis, volatile sedation vs propofol caused the increase in ventilator-free days, the reduction in the duration of mechanical ventilation, time to extubation and the troponin release in medical or surgical ICU patients, while in surgical ICU patients the time to awakening was shortened.
In this meta-analysis, volatile sedation vs propofol caused the increase in ventilator-free days, the reduction in the duration of mechanical ventilation, time to extubation and the troponin release in medical or surgical ICU patients, while in surgical ICU patients the time to awakening was shortened.
Abnormal endotoxin activity in critically ill patients has been described in the absence of Gram-negative bacterial (GNB) infection. As disease severity seems to be crucial in the detection of this phenomenon, we decided to assess and compare endotoxin exposure in those patients representing the critical situation septic shock and cardiogenic shock.

Prospective, observational non intervention study.

Critical Care Department of a University tertiary hospital.

Cardiogenic shock (CS) and septic shock (SS) patients.

None.

Follow-up was performed for the first three days. Inflammatory biomarkers (C-reactive protein, procalcitonin and interleuquin-6) and IgM antiendotoxin-core antibodies titter (IgM EndoCAb) were daily analyzed. Sixty-two patients were included; twenty-five patients with SS and thirty-seven with CS. Microbial etiology was established in 23 SS patients (92%) and GNB were present in 13 cases (52%). Although infection was suspected and even treated in 30 CS patients (81%), any episode could be finally confirmed. EndoCAb consumption was more intense in SS patients, although twenty-two CS patients (59.5%) had IgM anti-endotoxin value below 10th percentile range for healthy people. No statistically significant difference in endotoxin exposure was detected between Gram-positive and Gram-negative infections in the SS group. Endotoxin exposure ability to distinguish between SS and CS was moderate (AUC 0.7892, 95% IC 0.6564-0.9218).

In the severely ill patient some mechanisms take place allowing endotoxin incursion and therefore blurring the limits of diseases pathophysiology. Our work representatively shows how exposure to endotoxin was not fully capable of distinguishing between CS and SS.
In the severely ill patient some mechanisms take place allowing endotoxin incursion and therefore blurring the limits of diseases pathophysiology. Our work representatively shows how exposure to endotoxin was not fully capable of distinguishing between CS and SS.
To evaluate the impact of the novel P/FP
index to classify ARDS severity on mortality of patients with ARDS.

A retrospective cohort study.

Twelve-bed medical and surgical intensive care unit from January 2018 to December 2020.

A total of 217 ARDS patients managed with invasive mechanical ventilation >48h.

None.

ARDS severity on day 1 and day 3 was measured based on PaO
/FiO
ratio and P/FP
index [PaO
/(FiO
×PEEP)]. Primary outcome was the hospital mortality.

Hospital mortality rate was 59.9%. Relative to PaO
/FiO
ratio, 31.8% of patients on day 1 and 77.0% on day 3 were reclassified into a different category of ARDS severity by P/FP
index. The level of PEEP was lower by P/FP
index-based ARDS severity classification than by using PaO
/FiO
ratio. The performance for predicting mortality of P/FP
index was superior to PaO
/FiO
ratio in term of AROC (day 1 0.72 vs. 0.62; day 3 0.87 vs. 0.68) and CORR (day 1 0.370 vs. 0.213; day 3 0.634 vs. 0.301). P/FP
index improved prediction of risk of death compared to PaO
/FiO
ratio as showed by the qNRI (day 1 72.0%, p<0.0001; day 3 132.4%, p<0.0001) and IDI (day 1 0.09, p<0.0001; day 3 0.31, p<0.0001).

Assessment of ARDS severity based on P/FP
index seems better than PaO
/FiO
ratio for predicting mortality. The value of P/FP
index for clinical decision-making requires confirmation by randomized controlled trials.
Assessment of ARDS severity based on P/FPE index seems better than PaO2/FiO2 ratio for predicting mortality. The value of P/FPE index for clinical decision-making requires confirmation by randomized controlled trials.
Sepsis is an infection-caused syndrome, that leads to life-threatening organ damage. We aim to develop machine learning models with large-scale data to predict sepsis patients' mortality.

we extracted sepsis patients from two databases, Medical Information Mart for Intensive Care IV (MIMIC-IV) as a train set and Philips eICU Collaborative Research Database as a test set.

ICUs in multicenter hospitals in the USA during 2012-2019.

A total of 21,680 sepsis-3 patients are included in the study, in which, 3771 patients were dead and 17,909 survived during hospitalization, respectively.

No interventions.

Basic information, examination items during hospitalization and some medication and treatment information are incorporated into analyzed. Seven different models were built with a Support vector machine, Decision Tree Classifier, Random Forest, Gradients Boosting, Multiple Layer Perception, Xgboost, light Gradients Boosting to predict dead or live during hospitalization.

Algorithms with an AUC value in the test set of the top three light GBM, GBM, Xgboost. Considering the performance of the training set and the test set, the light GBM model performs best, and then the parameters of the model were adjusted, after that the AUC value was 0.99 in the train set, 0.96 in the test set, respectively.

Models built with light GBM algorithm from real-world sepsis patients from electronic health records accurately predict whether sepsis patients are dead and can be incorporated into clinical decision tools to enhance the prognosis of the patient and prevent adverse outcomes.
Models built with light GBM algorithm from real-world sepsis patients from electronic health records accurately predict whether sepsis patients are dead and can be incorporated into clinical decision tools to enhance the prognosis of the patient and prevent adverse outcomes.
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