An Epidemiological Survey of Fluid Resuscitation Practices for Adult Burns Patients in the United Kingdom.

Fluid management is a critical component in the treatment of patients suffering with major burns. Clinicians must carefully balance judicious resuscitation with the risks of over- or under-resuscitation. We aimed to identify factors associated with survival in burns patients and determine the importance of resuscitation practices.

Advocating for the recognition of underlying immunosuppression in critical illness.

Unlabelled: Immunosuppression, characterised by impaired immune function, significantly influences infection risk and ICU admissions in critically ill patients. This manuscript highlights the need for grading criteria to assess pre-existing immunosuppression, considering factors like underlying diseases, immunosuppressive therapies, and clinical outcomes variability. We propose a grading system categorising immunosuppression as mild, moderate, or severe.

Platelet transfusion practice in the intensive care unit: the Nine-I international platelet transfusion survey.

Background: Platelet transfusions are frequent in the Intensive Care Unit (ICU), either as prophylaxis against bleeding complications or as treatment for bleeding. The European Society of Intensive Care Medicine guidelines for ICU patients generally recommend not using prophylactic platelet transfusions unless the platelet count falls below 10 × 10 cells/L in non-bleeding patients and make no recommendation for platelet transfusion threshold in non-massively bleeding patients with thrombocytopenia. Therefore, the decision to transfuse platelets is often left to clinical assessment by the treating physician.

Advances in the critical care management for patients with hematological malignancies.

Hematological malignancies (HMs) are increasingly associated with life-threatening complications requiring intensive care unit (ICU) management. Recent advancements in therapies, diagnostics, and critical care protocols have improved outcomes for these patients, yet significant challenges persist. This manuscript explores the evolving landscape of critical care in hematology, emphasizing the unique complications, management strategies, and future directions in the field.

Short- and long-term outcomes in oliguric and non-oliguric acute kidney injury in intensive care: a retrospective, post hoc, bicentric study.

Background: Patients admitted to intensive care units (ICUs) frequently develop acute kidney injury (AKI). There is limited research comparing outcomes between oliguric and non-oliguric AKI in this population. This study aimed to investigate the short- and long-term outcomes in oliguric and non-oliguric AKI in intensive care patients; the specific outcomes assessed were mortality and major adverse kidney events.

Understanding Bayesian analysis of clinical trials: an overview for clinicians.

Bayesian analysis is being used with increasing frequency in critical care research and brings advantages and disadvantages compared to traditional Frequentist techniques. This study overviews this methodology and explains the terminology encountered when appraising this literature. Setting different priors can impact the interpretation of new results, and we describe an approach to understanding this.

How experienced ICU specialists make decisions on prophylactic platelet transfusions-A qualitative study.

Background: Platelet transfusions are frequently used in the Intensive Care Unit (ICU) as prophylaxis against bleeding complications. Several guidelines exist on when to administer platelet transfusions in the ICU, but studies indicate that these guidelines are not necessarily followed. The aim of this qualitative study was to understand how experienced ICU physicians make decisions on prescribing prophylactic platelet transfusions and to gain insight into their general concerns and views on blood product transfusions.

Understanding and mitigating medication errors associated with patient harm in adult intensive care units: a scoping review.

Purpose: Medication interventions are fundamental to the care of the critically ill patient in the intensive care unit (ICU), relying on effective and appropriate delivery of the medication use process. Medication errors affect a high proportion of patients in the ICU. This scoping review maps the literature pertaining to medication errors and preventable adverse drug events in the adult ICU.

Longitudinal trend in post-discharge estimated glomerular filtration rate in intensive care survivors.

Background: Acute kidney injury (AKI) within the intensive care unit (ICU) is common but evidence is limited on longer-term renal outcomes. We aimed to model the trend of kidney function in ICU survivors using estimated glomerular filtration rate (eGFR), comparing those with and without AKI, and investigate potential risk factors associated with eGFR decline.

Methods: This observational cohort study included all patients aged 16 or older admitted to two general adult ICUs in Scotland between 1st July 2015 and 30th June 2018 who survived to 30 days following hospital discharge.

Patient and family member experience of hospital readmission following critical illness.

Background: Hospital readmission following critical illness is common. There is limited data which examines the patient and family perspective of hospital readmission. Understanding the impact of readmissions from a patient perspective can potentially help design meaningful clinical pathways to support improvements in care.

Rate of non-metastatic solid tumor progression following critical illness: a prospective cohort study of UK Biobank participants.

Objective: To determine whether admission to critical care is associated with subsequent disease progression in patients with non-metastatic solid tumors.

Methods: This observational cohort study of UK Biobank participants identified those diagnosed with solid tumors and survived hospitalization. Two cohorts were identified based on critical care admission and new metastatic disease as reported at UK Biobank follow-up visits, or primary or secondary care records were compared.

European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.

The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented.

Long term mortality in burn injury survivors: A matched cohort study.

Background: Survivors of burn injuries may be at risk of early death. This study describes the mortality of burn survivors in comparison with two matched cohorts.

Methods: This retrospective cohort study compared adults admitted with a burn injury from 2009 to 2019 with two matched cohorts; one from the general population and one with a diagnosis of acute pancreatitis.

The incidence of cancer following hospitalisation for a burn injury in Scotland 2009-2019: A retrospective cohort study.

Background: Studies suggest increased occurrence of cancer in persons who have experienced a burn injury with hospital admission.

Objective: To determine the incidence of cancer among those hospitalised for burn injuries in Scotland compared with a similar group without a history of burn injury hospitalisation.

Method: A retrospective cohort design was used to compare cancer (ICD10 C00-97, excluding C44) incidence in two groups: 6805 burn injury patients discharged from Scottish hospitals between 2009 and 2019, and 25,946 subjects from the general population who were matched to burn patients by sex, year of birth, and degree of social deprivation.

Long term opioid use after burn injury: a retrospective cohort study.

Background: Patients who have survive a burn injury might be at risk of opioid dependence after discharge. This study examined the use of opioids in patients who suffer burn injury and explored factors associated with persistent opioid use after hospital discharge.

Methods: This retrospective cohort study compared adults admitted with a burn injury from 2009 to 2019 with two matched comparison cohorts from the general population and adults with a diagnosis of acute pancreatitis.

Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort.

Introduction: Platelet transfusions are frequently used in intensive care unit (ICU) patients, but contemporary epidemiological data are sparse. We aim to present contemporary international data on the use of platelet transfusions in adult ICU patients with thrombocytopenia.

Methods: This is a protocol and statistical analysis plan for a post hoc sub-study of 504 thrombocytopenic patients from the 'Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)'.