Journal of critical care最新文献

{"title":"Systematic review and meta-analysis of the treatment of hypernatremia in adult hospitalized patients: impact on mortality, morbidity, and treatment-related side effects","authors":"Nuanprae Kitisin ,&nbsp;Nattaya Raykateeraroj ,&nbsp;Yukiko Hikasa ,&nbsp;Larissa Bianchini ,&nbsp;Nuttapol Pattamin ,&nbsp;Anis Chaba ,&nbsp;Akinori Maeda ,&nbsp;Sofia Spano ,&nbsp;Glenn Eastwood ,&nbsp;Kyle White ,&nbsp;Rinaldo Bellomo","doi":"10.1016/j.jcrc.2024.155012","DOIUrl":"10.1016/j.jcrc.2024.155012","url":null,"abstract":"<div><h3>Background</h3><div>Hypernatremia is relatively common in acutely ill patients and associated with mortality. Guidelines recommend a slow rate of correction (≤ 0.5 mmol/L per hour). However, a faster correction rate may be safe and improve outcomes.</div></div><div><h3>Objectives</h3><div>To evaluate the impact of sodium correction rates on mortality and hospital length of stay and to assess types of hypernatremia treatment and treatment side effects.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis according to PRISMA guidelines, searching Ovid MEDLINE, Embase, and CENTRAL databases from inception to August 2024. Studies reporting sodium correction rates and clinical outcomes in hospitalized adults were included. A random-effects meta-analysis assessed mortality and hospital length of stay, with subgroup analyses exploring correction timing and severity. Treatment method and side effects were analyzed qualitatively.</div></div><div><h3>Results</h3><div>We reviewed 4445 articles and included 12 studies. Faster correction rates (&gt; 0.5 mmol/L/h) overall showed no significant change in mortality and a high level of heterogeneity (OR 0.68, 95 % CI: 0.38–1.24, I² = 95 %). However, subgroup analyses found significantly lower mortality with faster correction of hypernatremia at the time of hospital admission (OR 0.48, 95 % CI: 0.35–0.68, I² = 2 %), with fast correction within the first 24 h of diagnosis (OR 0.48, 95 % CI: 0.31–0.73, I² = 65 %), and for severe hypernatremia (OR 0.55, 95 % CI: 0.33–0.92, I² = 79 %). There was no significant different in hospital length of stay by correction rate. No major neurological complications were reported when the correction rate was &lt; 1 mmol/L/h.</div></div><div><h3>Conclusion</h3><div>Faster sodium correction appears safe and may benefit patients with severe admission-related hypernatremia, particularly within the first 24 h. Further studies are needed to refine correction protocols.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"87 ","pages":"Article 155012"},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143092707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications","authors":"Kamel A. Gharaibeh ,&nbsp;Mohammad O. Abdelhafez ,&nbsp;Kolman E.B. Guedze ,&nbsp;Hussain Siddiqi ,&nbsp;Abdurrahman M. Hamadah ,&nbsp;Avelino C. Verceles","doi":"10.1016/j.jcrc.2024.155011","DOIUrl":"10.1016/j.jcrc.2024.155011","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluated the impact of choosing the right versus left internal jugular vein (IJV) for initial central venous catheter (CVC) placement on hemodialysis catheter-related outcomes in critically ill patients.</div></div><div><h3>Materials and methods</h3><div>Medical records from the University of Maryland Medical Center were reviewed for adult critical care patients who received an IJV CVC between January 1, 2019, and December 31, 2022, and later required an additional temporary hemodialysis catheter.</div></div><div><h3>Results</h3><div>The study included 214 patients, with 100 (46.7 %) receiving the primary CVC in the right IJV and 114 (53.3 %) in the left IJV. The right IJV group had higher hemodialysis catheter re-insertion rates (40 % vs. 2.6 % in the left IJV group, <em>P</em> &lt; 0.001) related to using a different site other than the right IJV for the initial hemodialysis catheter (85 % for the right IJV group vs. 1.75 % for the left IJV group). Hemodialysis catheters were exchanged over a guidewire in 23 % of the right IJV group vs. 0.9 % in the left IJV group (<em>P</em> &lt; 0.001). Additionally, 38 % of patients in the right IJV group required three venous access interventions, with 14 % needing four or more, versus only 2.6 % requiring three interventions in the left IJV group.</div></div><div><h3>Conclusions</h3><div>Initiating CVC placement in the right IJV in critically ill patients is associated with a higher risk of hemodialysis catheter re-catheterization related to the use of veins other than the right IJV for hemodialysis catheter placement and an increased need for venous access interventions compared to placement in the left IJV.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"87 ","pages":"Article 155011"},"PeriodicalIF":3.2,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can ChatGPT-4 perform as a competent physician based on the Chinese critical care examination?","authors":"Xueqi Wang,&nbsp;Jin Tang,&nbsp;Yajing Feng,&nbsp;Cijun Tang,&nbsp;Xuebin Wang","doi":"10.1016/j.jcrc.2024.155010","DOIUrl":"10.1016/j.jcrc.2024.155010","url":null,"abstract":"<div><h3>Background</h3><div>The use of ChatGPT in medical applications is of increasing interest. However, its efficacy in critical care medicine remains uncertain. This study aims to assess ChatGPT-4's performance in critical care examination, providing insights into its potential as a tool for clinical decision-making.</div></div><div><h3>Methods</h3><div>A dataset from the Chinese Health Professional Technical Qualification Examination for Critical Care Medicine, covering four components—fundamental knowledge, specialized knowledge, professional practical skills, and related medical knowledge—was utilized. ChatGPT-4 answered 600 questions, which were evaluated by critical care experts using a standardized rubric.</div></div><div><h3>Results</h3><div>ChatGPT-4 achieved a 73.5 % success rate, surpassing the 60 % passing threshold in four components, with the highest accuracy in fundamental knowledge (81.94 %). ChatGPT-4 performed significantly better on single-choice questions than on multiple-choice questions (76.72 % vs. 51.32 %, <em>p</em> &lt; 0.001), while no significant difference was observed between case-based and non-case-based questions.</div></div><div><h3>Conclusion</h3><div>ChatGPT demonstrated notable strengths in critical care examination, highlighting its potential for supporting clinical decision-making, information retrieval, and medical education. However, caution is required regarding its potential to generate inaccurate responses. Its application in critical care must therefore be carefully supervised by medical professionals to ensure both the accuracy of the information and patient safety.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155010"},"PeriodicalIF":3.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study”","authors":"Yudai Iwasaki,&nbsp;Takayuki Ogura","doi":"10.1016/j.jcrc.2024.155008","DOIUrl":"10.1016/j.jcrc.2024.155008","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155008"},"PeriodicalIF":3.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: “Platelet dysfunction in heatstroke-induced coagulopathy: A retrospective observational study”","authors":"Ryota Inokuchi ,&nbsp;Kent Doi","doi":"10.1016/j.jcrc.2024.155009","DOIUrl":"10.1016/j.jcrc.2024.155009","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155009"},"PeriodicalIF":3.2,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid management in adult patients undergoing venoarterial extracorporeal membrane oxygenation: A scoping review","authors":"Ali Jendoubi ,&nbsp;Quentin de Roux ,&nbsp;Solène Ribot ,&nbsp;Aurore Vanden Bulcke ,&nbsp;Camille Miard ,&nbsp;Bérénice Tiquet ,&nbsp;Bijan Ghaleh ,&nbsp;Renaud Tissier ,&nbsp;Matthias Kohlhauer ,&nbsp;Nicolas Mongardon","doi":"10.1016/j.jcrc.2024.155007","DOIUrl":"10.1016/j.jcrc.2024.155007","url":null,"abstract":"<div><h3>Background</h3><div>The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a cardiocirculatory support has tremendously increased in critically ill patients. Although fluid therapy is an essential component of the hemodynamic management of VA-ECMO patients, the optimal fluid resuscitation strategy remains controversial. We performed a scoping review to map out the existing knowledge on fluid management in terms of fluid type, dosing and the impact of fluid balance on VA-ECMO patient outcomes.</div></div><div><h3>Methods</h3><div>A literature search within PubMed and EMBASE was conducted from database inception to April 2024. We included all studies involving critically ill adult patients, supported by VA-ECMO regardless of clinical indication (cardiogenic shock or extracorporeal cardiopulmonary resuscitation) with or without Renal Replacement Therapy and describing fluid resuscitation strategies or focusing on fluid type or reporting the impact of fluid balance on clinical outcomes and mortality. Details of study population, ECMO indications, fluid types, resuscitation strategies, fluid balance and outcome measures were extracted.</div></div><div><h3>Results</h3><div>Sixteen studies met inclusion criteria, including 14 clinical studies and two experimental animal studies. We found a lack of studies comparing restrictive and liberal approaches. No study has compared the efficacy and safety of balanced and saline solutions. The place of albumin, as an alternative fluid, should be investigated. Despite their heterogeneity, studies found a negative impact of both early and cumulative fluid overload on survival and renal outcomes.</div></div><div><h3>Conclusions</h3><div>The available literature on the fluid management in VA-ECMO setting is scarce. More high-quality evidence is needed regarding optimal fluid dosing, type and resuscitation endpoints in order to standardize practice and improve outcomes.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155007"},"PeriodicalIF":3.2,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic effects of slower versus faster intravenous fluid bolus rates in critically ill patients: An observational study","authors":"Daniere Yurie Vieira Tomotani ,&nbsp;Flávio Geraldo Rezende Freitas ,&nbsp;Alexandre Biasi Cavalcante ,&nbsp;Ary Serpa Neto ,&nbsp;Rodrigo Cruvinel Figueiredo ,&nbsp;Rodrigo Santos Biondi ,&nbsp;João Manoel Silva-Jr ,&nbsp;Bruno Adler Maccagnan Pinheiro Besen ,&nbsp;Jorge Luiz da Rocha Paranhos ,&nbsp;Fernando José da Silva Ramos ,&nbsp;Fernanda Chohfi Atallah ,&nbsp;Thiago Miranda Lopes de Almeida ,&nbsp;Maria Aparecida de Souza ,&nbsp;Fernando Godinho Zampieri ,&nbsp;Flávia Ribeiro Machado ,&nbsp;BRICNet","doi":"10.1016/j.jcrc.2024.154985","DOIUrl":"10.1016/j.jcrc.2024.154985","url":null,"abstract":"<div><h3>Purpose</h3><div>We compared the immediate and sustained effects of 500 mL of crystalloid administered at slow (333 mL/h) versus fast rates (999 mL/h) on mean arterial pressure (MAP) in critically ill patients.</div></div><div><h3>Materials and methods</h3><div>Hemodynamic variables were collected immediately before and every 30 min up to 60 min after the end of the infusion. The primary outcome was the adjusted difference in MAP.</div></div><div><h3>Results</h3><div>We included 146 patients (slow rate: 71, fast rate: 75). One hour after the end of the infusion, there was no difference in the overall mean marginal effect on MAP between the groups [1.9 mmHg (95 % CI: −1.5 to 5.3 mmHg), <em>p</em> = 0.27] or on the perfusion parameters. Similarly, no difference was found in the immediate effect after 90 min [overall marginal effect: 1.1 mmHg (95 % CI: −2.3 to 4.6 mmHg); <em>p</em> = 0.52]. In patients with cardiac output (CO) monitoring, there was an increase in CO in the fast rate group (overall mean marginal effect: 1.78 L/min (95 % CI: 0.08 to 3.48 L/min); <em>p</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>In critically ill patients, crystalloid infusion at both fast and slow rates did not lead to immediate or sustained differences in MAP. However, fast infusion may result in a greater increase in CO.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 154985"},"PeriodicalIF":3.2,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective Cohort study on the effect of the LOw-molecular weighT heparin (LMWH) nadroparin dose on anti-XA levels in a mixed medical-surgical ICU population: CLOT-Xa","authors":"Lisanne van Berkel ,&nbsp;Marnix Kuindersma ,&nbsp;Ingrid D. van Iperen ,&nbsp;Henk J. Adriaansen ,&nbsp;Janine J.J. Hulstein ,&nbsp;Peter E. Spronk","doi":"10.1016/j.jcrc.2024.154991","DOIUrl":"10.1016/j.jcrc.2024.154991","url":null,"abstract":"<div><h3>Purpose</h3><div>Low-molecular-weight heparins (LMWHs) are widely used for prevention and treatment of venous thromboembolism (VTE) in critically ill patients. The objective of this study was to assess the dose-response relationship between nadroparin dose and anti-Xa activity in ICU patients.</div></div><div><h3>Materials and methods</h3><div>Critically ill adult patients who were admitted to the ICU, and received at least three subcutaneous injections of nadroparin were included. The dose-effect relationship between nadroparin dose and anti-Xa level was analysed through a mixed-effects logistic regression model.</div></div><div><h3>Results</h3><div>In total, 327 ICU patients were included. Median anti-Xa levels ranged from &lt;0.1 IU/mL after nadroparin 0–37 IU/kg/day to 0.6 IU/mL after nadroparin &gt;85 IU/kg/day (<em>p</em> &lt; 0.01). Among all 1520 anti-Xa measurements, 859 (57 %) measurements were in the desired anti-Xa range. The best adequacy of anti-Xa levels was observed in nadroparin doses of 38–85 IU/kg (73 %). No differences in the odds of bleeding events or VTE between different anti-Xa levels were found.</div></div><div><h3>Conclusions</h3><div>We found a clear dose-response relationship between nadroparin dose and anti-Xa levels. Increasing nadroparin doses led to more adequate anti-Xa levels without a change in the occurrence of VTE or major bleeding events, suggesting that LMWH therapy can be successfully and safely personalized using anti-Xa guided dosing.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 154991"},"PeriodicalIF":3.2,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of cardiogenic shock among critically ill patients admitted to intensive care units in Australia and New Zealand from 2003 to 2022","authors":"Wisam Al-Bassam ,&nbsp;Samer Noaman ,&nbsp;Rahul Kumar ,&nbsp;Neil Glassford ,&nbsp;Daryl Jones ,&nbsp;Carys Jones ,&nbsp;William Chan ,&nbsp;David M. Kaye ,&nbsp;David Pilcher ,&nbsp;Rinaldo Bellomo ,&nbsp;Yehya shehabi ,&nbsp;Ary Serpa Neto","doi":"10.1016/j.jcrc.2024.155001","DOIUrl":"10.1016/j.jcrc.2024.155001","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients with Cardiogenic shock (CS) admitted to intensive care units (ICUs) have high mortality rates. We aimed to investigate the changes patient characteristics and outcomes over time among patients admitted to the ICU with CS.</div></div><div><h3>Methods</h3><div>Retrospective study utilizing a large bi-national ICU database from 2003 to 2022. Patient characteristics and outcomes based on the ICU admission diagnosis of CS were evaluated and changes in outcomes over time after adjusting for key baseline variables were assessed.</div></div><div><h3>Results</h3><div>During the study period, among CS patients, there were significant reductions in severity of illness (APACHE III from 80 to 72 and Australian and New Zealand Risk of Death Scores from 0.34 to 0.30, both <em>p</em> &lt; 0.001). There was also a significant increase in admissions from emergency departments (32 % to 41 %, p &lt; 0.001). Over time, unadjusted hospital mortality decreased from 57 % in 2003 to 41 % in 2022 (<em>P</em> &lt; 0.001). After adjustment for severity of illness, the odds ratios for hospital mortality also decreased to 0.49 (95 % CI, 0.38 to 0.64) compared with 2003 (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Over twenty years period, among patients with CS admitted to ICU, there has been a significant change in the epidemiological characteristics and a decrease in absolute and adjusted mortality rates.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155001"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial","authors":"Akinori Maeda ,&nbsp;Alastair Brown ,&nbsp;Sofia Spano ,&nbsp;Anis Chaba ,&nbsp;Atthaphong Phongphithakchai ,&nbsp;Yukiko Hikasa ,&nbsp;Nuttapol Pattamin ,&nbsp;Nuanprae Kitisin ,&nbsp;Jonathan Nübel ,&nbsp;Bethany Nielsen ,&nbsp;Jennifer Holmes ,&nbsp;Leah Peck ,&nbsp;Helen Young ,&nbsp;Glenn Eastwood ,&nbsp;Rinaldo Bellomo ,&nbsp;Ary Serpa Neto","doi":"10.1016/j.jcrc.2024.155002","DOIUrl":"10.1016/j.jcrc.2024.155002","url":null,"abstract":"<div><h3>Purpose</h3><div>Furosemide is the most commonly used diuretic in intensive care units (ICU). We aimed to evaluate the physiological effects of adjunctive acetazolamide with furosemide on diuresis and the prevention of potential furosemide-induced metabolic alkalosis.</div></div><div><h3>Materials and methods</h3><div>We performed a two-center, pilot, open-label, randomized trial. Where the treating physicians planned intravenous diuretic therapy, we randomized ICU patients to a bolus of furosemide (40 mg) plus acetazolamide (500 mg) (<em>n</em> = 15) or furosemide alone (40 mg) (n = 15). Urine output, additional furosemide use, acid-base parameters, and electrolytes were compared following a Bayesian framework.</div></div><div><h3>Results</h3><div>Adjunctive acetazolamide didn't increase urine output in the first six hours (mean difference: −112 ml, credible interval: [−742, 514]). However, compared with furosemide alone, it maintained a greater urine output response to furosemide over 24 h, with 100 % probability. Acetazolamide also acidified plasma (pH difference: −0.045, [−0.081, −0.008]) while alkalinizing urine (1.10, [0.04, 2.11]) at six hours, compared to furosemide alone with &gt;95 % probability. Finally, we didn't observe severe acidosis or electrolyte disturbances over 24 h.</div></div><div><h3>Conclusions</h3><div>Adjunctive acetazolamide may increase diuretic efficacy and counterbalance furosemide-induced metabolic alkalosis without safety concerns. Larger trials are warranted to verify these findings and assess their impacts on clinical outcomes.</div></div><div><h3>Registration number</h3><div>ACTRN12623000624684.</div></div><div><h3>Registration title</h3><div>A pilot trial of single versus dual diuretic therapy in the intensive care unit.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"86 ","pages":"Article 155002"},"PeriodicalIF":3.2,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}