Publications by authors named "Duska F"

Background: Exposure of critically ill patients to antibiotics lead to intestinal dysbiosis, which often manifests as antibiotic-associated diarrhoea. Faecal microbiota transplantation restores gut microbiota and may lead to faster resolution of diarrhoea.

Methods: Into this prospective, multi-centre, randomized controlled trial we will enrol 36 critically ill patients with antibiotic-associated diarrhoea.

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Background: Dexamethasone 6 mg in patients with severe COVID-19 has been shown to decrease mortality and morbidity. The effects of higher doses of corticosteroid, that would further increase anti-inflammatory effects, are uncertain. The objective of our study was to assess the effect of 20 mg dexamethasone vs.

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Objectives: To evaluate the base excess response during acute in vivo carbon dioxide changes.

Design: Secondary analysis of individual participant data from experimental studies.

Setting: Three experimental studies investigating the effect of acute in vivo respiratory derangements on acid-base variables.

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Background: Faecal microbiota transplantation (FMT) is a developing therapy for disorders related to gut dysbiosis. Despite its growing application, standardised protocols for FMT filtrate preparation and quality assessment remain undeveloped. The viability of bacteria in the filtrate is crucial for FMT's efficacy and for validating protocol execution.

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Purpose: During the initial phase of the pandemic, healthcare professionals faced difficulties due to the limited availability of comprehensive learning resources on managing patients affected with coronavirus disease 2019 (COVID-19). The COVID-19 Skills Preparation Course (C19_SPACE) was tailored to meet the overwhelming demand for specialized training. The primary objective of this study was to assess the efficacy and impact of this program on enhancing clinical knowledge and to identify factors affecting this improvement.

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Introduction: Patients who have sustained extensive burns frequently exhibit substantial damage to skeletal muscle and associated complications. The rehabilitation of these patients can be challenging due to the nature of the injury and the subsequent complications. Nevertheless, there is a possibility that functional proprioceptive stimulation (illusory movements) may facilitate effective rehabilitation in patients with limited physiotherapy options.

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Article Synopsis
  • Excessive heart rates in septic shock patients can negatively impact their health, prompting a study on the use of the ultra-short-acting beta-blocker landiolol to control heart rate without raising the need for vasopressors.
  • Conducted across 20 sites in Europe from 2018 to 2022, the study compared landiolol combined with standard treatment to standard treatment alone in adults with septic shock and high heart rates, focusing on maintaining a target heart rate (80-94 bpm) without increasing vasopressor requirements.
  • Results showed that a higher percentage of patients receiving landiolol achieved the target heart rate compared to those receiving standard treatment (39.8% vs. 23.5%), but there were no
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Remdesivir therapy has been declared as efficient in the early stages of Covid-19. Of the 339 patients (males 55.8%, age 71(59;77) years) with a detectable viral load, 140 were treated with remdesivir (of those 103 in the ICU and 57 immunosuppressed) and retrospectively compared with 199 patients (of those 82 in the ICU and 28 immunosuppressed) who were denied therapy due to advanced Covid-19.

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Background: Advanced Life Support (ALS) during cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) is frequently administered by two-member crews. However, ALS CPR is mostly designed for larger crews, and the feasibility and efficacy of implementing ALS guidelines for only two rescuers remain unclear.

Objective: This scoping review aims to examine the existing evidence and identify knowledge gaps in the efficiency of pre-hospital ALS CPR performed by two-member teams.

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Purpose: The echocardiography parameters may predict the maintenance of sinus rhythm after cardioversion of a supraventricular arrhythmia (SVA).

Materials And Methods: Patients in septic shock with onset of an SVA, normal to moderately reduced LV systolic function (EF_LV˃̳35%) and on a continuous noradrenaline of <1.0 μg/kg.

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Background & Aim: Dysfunction of skeletal muscle satellite cells might impair muscle regeneration and prolong ICU-acquired weakness, a condition associated with disability and delayed death. This study aimed to elucidate the distinct metabolic effects of critical illness and β-OH-butyrate on satellite cells isolated from these patients.

Methods: Satellite cells were extracted from vastus lateralis muscle biopsies of patients with ICU-acquired weakness (n = 10) and control group of healthy volunteers or patients undergoing elective hip replacement surgery (n = 10).

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Article Synopsis
  • Faecal microbiota transplantation (FMT), a treatment for Clostridioides difficile infection, faces challenges with donor availability and stool preparation, leading to interest in using frozen stool samples.
  • A study evaluated the viability of bacteria in stool samples stored at -80°C for up to 12 months, finding no significant loss in bacterial viability over time.
  • The research supports the use of biobanked frozen stool for FMT, suggesting that a mix of samples from multiple donors could enhance the reliability of the treatment.
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Objectives: We published a meta-analysis in March 2020 to assess the impact of rehabilitation in the ICU on clinical outcomes. Since then, 15 new randomized controlled trials (RCTs) have been published; we updated the meta-analysis to show how the recent studies have tipped the scale.

Design: Systematic review and meta-analysis.

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It is commonly assumed that changes in plasma strong ion difference (SID) result in equal changes in whole blood base excess (BE). However, at varying pH, albumin ionic-binding and transerythrocyte shifts alter the SID of plasma without affecting that of whole blood (SID), i.e.

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Aims: A recently published trial has shown no differences in outcomes between patients with new-onset supraventricular arrhythmia (SVA) in septic shock treated with either propafenone or amiodarone. However, these outcome data have not been evaluated in relation to the presence or absence of a dilated left atrium (LA).

Methods And Results: Patients with SVA and a left ventricular ejection fraction ≥ 35% were randomized to receive intravenous propafenone (70 mg bolus followed by 400-840 mg/24 h) or amiodarone (300 mg bolus followed by 600-1800 mg/24 h).

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Background: Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.

Methods: This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020.

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Background: Critically ill patients suffer from acute muscle wasting, which is associated with significant physical functional impairment. We describe data from nested muscle biopsy studies from two trials of functional electrical stimulation (FES) that did not shown improvements in physical function.

Methods: Primary cohort: single-centre randomized controlled trial.

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Article Synopsis
  • Acute supraventricular arrhythmias can worsen hemodynamic stability in patients with septic shock, and a study compared the effects of intravenous propafenone and amiodarone on arrhythmias in this population.
  • In a trial with 209 patients, those receiving propafenone had a quicker return to sinus rhythm (3.7 hours) compared to those on amiodarone (7.3 hours), although the overall 24-hour sinus rhythm rates were similar.
  • Propafenone led to fewer cases of arrhythmia recurrence than amiodarone, especially in patients without a dilated left atrium, indicating it may be a more effective option for short-term management.
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Article Synopsis
  • Amiodarone, but not propafenone, causes significant mitochondrial dysfunction in human cardiomyocytes, leading to reduced ATP production and altered cellular metabolism.
  • * Prolonged exposure to amiodarone downregulates fatty acid oxidation and increases anaerobic glycolysis, while propafenone shows no adverse effects on cellular bioenergetics.
  • * The study indicates that the detrimental impacts of amiodarone on mitochondria are consistent across both human and mouse cardiomyocytes, highlighting potential risks in using this drug at therapeutic doses.
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Objective: To investigate whether observable differences exist between patterns of withdrawal of life-sustaining measures (WLSM) for patients eligible for donation after circulatory death (DCD) in whom donation was attempted compared with those patients in whom no donation attempts were made.

Setting: Adult intensive care units from 20 centres in Canada, the Czech Republic and the Netherlands.

Design: Secondary analysis of quantitative data collected as part of a large, prospective, cohort study (the Death Prediction and Physiology after Removal of Therapy study).

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