-
Effects of mechanical ventilation on the interstitial extracellular matrix in healthy lungs and lungs affected by acute respiratory distress syndrome: a narrative review Crit. Care (IF 15.1) Pub Date : 2024-05-15 Lou’i Al-Husinat, Saif Azzam, Sarah Al Sharie, Ahmed H. Al Sharie, Denise Battaglini, Chiara Robba, John J. Marini, Lauren T. Thornton, Fernanda F. Cruz, Pedro L. Silva, Patricia R. M. Rocco
Mechanical ventilation, a lifesaving intervention in critical care, can lead to damage in the extracellular matrix (ECM), triggering inflammation and ventilator-induced lung injury (VILI), particularly in conditions such as acute respiratory distress syndrome (ARDS). This review discusses the detailed structure of the ECM in healthy and ARDS-affected lungs under mechanical ventilation, aiming to bridge
-
Causes and attributable fraction of death from ARDS in inflammatory phenotypes of sepsis Crit. Care (IF 15.1) Pub Date : 2024-05-14 Bruno Evrard, Pratik Sinha, Kevin Delucchi, Carolyn M. Hendrickson, Kirsten N. Kangelaris, Kathleen D. Liu, Andrew Willmore, Nelson Wu, Lucile Neyton, Emma Schmiege, Antonio Gomez, V. Eric Kerchberger, Ann Zalucky, Michael A. Matthay, Lorraine B. Ware, Carolyn S. Calfee
Hypoinflammatory and hyperinflammatory phenotypes have been identified in both Acute Respiratory Distress Syndrome (ARDS) and sepsis. Attributable mortality of ARDS in each phenotype of sepsis is yet to be determined. We aimed to estimate the population attributable fraction of death from ARDS (PAFARDS) in hypoinflammatory and hyperinflammatory sepsis, and to determine the primary cause of death within
-
Predicting outcome after aneurysmal subarachnoid hemorrhage by exploitation of signal complexity: a prospective two-center cohort study Crit. Care (IF 15.1) Pub Date : 2024-05-14 Stefan Yu Bögli, Ihsane Olakorede, Michael Veldeman, Erta Beqiri, Miriam Weiss, Gerrit Alexander Schubert, Jan Folkard Willms, Emanuela Keller, Peter Smielewski
Signal complexity (i.e. entropy) describes the level of order within a system. Low physiological signal complexity predicts unfavorable outcome in a variety of diseases and is assumed to reflect increased rigidity of the cardio/cerebrovascular system leading to (or reflecting) autoregulation failure. Aneurysmal subarachnoid hemorrhage (aSAH) is followed by a cascade of complex systemic and cerebral
-
Efficacy of expanded periurethral cleansing in reducing catheter-associated urinary tract infection in comatose patients: a randomized controlled clinical trial Crit. Care (IF 15.1) Pub Date : 2024-05-13 Xingsong Qin, He Zhao, Wei Qin, Xinglei Qin, Songying Shen, Hongyu Wang
The effect of the periurethral cleansing range on catheter-associated urinary tract infection (CAUTI) occurrence remains unknown. The purpose of this study was to evaluate the efficacy of expanded periurethral cleansing for reducing CAUTI in comatose patients. In this randomized controlled trial, eligible patients in our hospital were enrolled and allocated randomly to the experimental group (expanded
-
qSOFA combined with suPAR for early risk detection and guidance of antibiotic treatment in emergency department: a bit sweet and a bit sour randomized controlled trial Crit. Care (IF 15.1) Pub Date : 2024-05-13 Bharat Paliwal, Nikhil Kothari, Trishita Saha, Pradeep Bhatia
With great interest, we read the article by Adami et al. [1] on qSOFA (quick sepsis related organ failure assessment score) combined with suPAR (soluble urokinase plasminogen activator receptor) for early risk detection and guidance of antibiotic treatment in emergency department. Early identification and initiation of antibiotics in sepsis is crucial but at times we fail to identify it leading to
-
Organ donation after extracorporeal cardiopulmonary resuscitation: a nationwide retrospective cohort study Crit. Care (IF 15.1) Pub Date : 2024-05-13 Tetsuya Yumoto, Kohei Tsukahara, Takafumi Obara, Takashi Hongo, Tsuyoshi Nojima, Hiromichi Naito, Atsunori Nakao
Limited data are available on organ donation practices and recipient outcomes, particularly when comparing donors who experienced cardiac arrest and received extracorporeal cardiopulmonary resuscitation (ECPR) followed by veno-arterial extracorporeal membrane oxygenation (ECMO) decannulation, versus those who experienced cardiac arrest without receiving ECPR. This study aims to explore organ donation
-
Potential implications of long-acting GLP-1 receptor agonists for critically ill Crit. Care (IF 15.1) Pub Date : 2024-05-13 Luping Wang, Hao Yang, Xiaoxiao Xia, Bo Wang, Qin Wu
Dear editor, The increasing prevalence of obesity and type 2 diabetes has led to a surge in the use of long-acting glucagon-like peptide-1 receptor agonists (GLP-1 RAs). While these medications are approved for the treatment of type 2 diabetes and obesity, their use has important implications for intensivists, as critically ill patients admitted to the intensive care unit (ICU) may have been receiving
-
Incidence, risk factors and outcomes of nosocomial infection in adult patients supported by extracorporeal membrane oxygenation: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-05-10 Ali Ait Hssain, Amir Vahedian-Azimi, Abdulsalam Saif Ibrahim, Ibrahim Fawzy Hassan, Elie Azoulay, Michael Darmon
An increasing number of patients requires extracorporeal membrane oxygenation (ECMO) for life support. This supportive modality is associated with nosocomial infections (NIs). This systematic review and meta-analysis aim to assess the incidence and risk factors of NIs in adult. We searched PubMed, Scopus, Web of Science, and ProQuest databases up to 2022. The primary endpoint was incidence of NI. Secondary
-
Effect of immediate initiation of invasive ventilation on mortality in acute hypoxemic respiratory failure: a target trial emulation Crit. Care (IF 15.1) Pub Date : 2024-05-10 Ricard Mellado-Artigas, Xavier Borrat, Bruno L. Ferreyro, Christopher Yarnell, Sicheng Hao, Kerollos N. Wanis, Enric Barbeta, Antoni Torres, Carlos Ferrando, Laurent Brochard
Invasive ventilation is a fundamental treatment in intensive care but its precise timing is difficult to determine. This study aims at assessing the effect of initiating invasive ventilation versus waiting, in patients with hypoxemic respiratory failure without immediate reason for intubation on one-year mortality. Emulation of a target trial to estimate the benefit of immediately initiating invasive
-
Machine learning derived serum creatinine trajectories in acute kidney injury in critically ill patients with sepsis Crit. Care (IF 15.1) Pub Date : 2024-05-10 Kullaya Takkavatakarn, Wonsuk Oh, Lili Chan, Ira Hofer, Khaled Shawwa, Monica Kraft, Neomi Shah, Roopa Kohli-Seth, Girish N. Nadkarni, Ankit Sakhuja
Current classification for acute kidney injury (AKI) in critically ill patients with sepsis relies only on its severity-measured by maximum creatinine which overlooks inherent complexities and longitudinal evaluation of this heterogenous syndrome. The role of classification of AKI based on early creatinine trajectories is unclear. This retrospective study identified patients with Sepsis-3 who developed
-
Extent of microbial over-identification of endotracheal aspirate versus bronchoalveolar lavage in the diagnosis of ventilator-associated pneumonia Crit. Care (IF 15.1) Pub Date : 2024-05-09 Alessandra Bisanti, Valentina Giammatteo, Giuseppe Bello, Domenico Luca Grieco, Gennaro De Pascale, Massimo Antonelli
Respiratory tract secretion sampling is widely used in intensive care units (ICUs) for the microbiological diagnosis of ventilator-associated pneumonia (VAP). However, a consensus on the optimal method for microbiological confirmation of clinically suspected VAP is still lacking [1,2,3]. Therefore, sampling methods are commonly selected depending on operator expertise, costs, and personal preference
-
Past, present, and future of sustainable intensive care: narrative review and a large hospital system experience Crit. Care (IF 15.1) Pub Date : 2024-05-09 Faisal N. Masud, Farzan Sasangohar, Iqbal Ratnani, Sahar Fatima, Marco Antonio Hernandez, Teal Riley, Jason Fischer, Atiya Dhala, Megan E. Gooch, Konya Keeling-Johnson, Jukrin Moon, Jean-Louis Vincent
Healthcare systems are large contributors to global emissions, and intensive care units (ICUs) are a complex and resource-intensive component of these systems. Recent global movements in sustainability initiatives, led mostly by Europe and Oceania, have tried to mitigate ICUs’ notable environmental impact with varying success. However, there exists a significant gap in the U.S. knowledge and published
-
The neurovanguard concept and real-world embracement Crit. Care (IF 15.1) Pub Date : 2024-05-08 Fabio Silvio Taccone, Edith Elianna Rodriguez, Mario Zaccarelli, Elda Diletta Sterchele
Dear Editor, We were delighted to receive the correspondence from Giglio et al. [1] regarding our recent viewpoint proposing the "NeuroVanguard" strategy for neuromonitoring in severe adult brain injury patients [2]. The authors aptly addressed potential challenges associated with implementing such an approach in real-world settings, particularly in low- and middle-income countries. These challenges
-
Effects of non-invasive respiratory support in post-operative patients: a systematic review and network meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-05-08 Tommaso Pettenuzzo, Annalisa Boscolo, Elisa Pistollato, Chiara Pretto, Tommaso Antonio Giacon, Sara Frasson, Francesco Maria Carbotti, Francesca Medici, Giovanni Pettenon, Giuliana Carofiglio, Marco Nardelli, Nicolas Cucci, Clara Letizia Tuccio, Veronica Gagliardi, Chiara Schiavolin, Caterina Simoni, Sabrina Congedi, Francesco Monteleone, Francesco Zarantonello, Nicolò Sella, Alessandro De Cassai,
Re-intubation secondary to post-extubation respiratory failure in post-operative patients is associated with increased patient morbidity and mortality. Non-invasive respiratory support (NRS) alternative to conventional oxygen therapy (COT), i.e., high-flow nasal oxygen, continuous positive airway pressure, and non-invasive ventilation (NIV), has been proposed to prevent or treat post-extubation respiratory
-
Inflammatory subphenotypes previously identified in ARDS are associated with mortality at intensive care unit discharge: a secondary analysis of a prospective observational study Crit. Care (IF 15.1) Pub Date : 2024-05-07 Marleen A. Slim, Rombout B. E. van Amstel, Lieuwe D. J. Bos, Olaf L. Cremer, W. Joost Wiersinga, Tom van der Poll, Lonneke A. van Vught
Intensive care unit (ICU)-survivors have an increased risk of mortality after discharge compared to the general population. On ICU admission subphenotypes based on the plasma biomarker levels of interleukin-8, protein C and bicarbonate have been identified in patients admitted with acute respiratory distress syndrome (ARDS) that are prognostic of outcome and predictive of treatment response. We hypothesized
-
Critical care outcomes in decompensated cirrhosis: a United States national inpatient sample cross-sectional study Crit. Care (IF 15.1) Pub Date : 2024-05-07 Spencer R. Goble, Abdellatif S. Ismail, Jose D. Debes, Thomas M. Leventhal
Prior assessments of critical care outcomes in patients with cirrhosis have shown conflicting results. We aimed to provide nationwide generalizable results of critical care outcomes in patients with decompensated cirrhosis. This is a retrospective study using the National Inpatient Sample from 2016 to 2019. Adults with cirrhosis who required respiratory intubation, central venous catheter placement
-
Generative artificial intelligence is infiltrating peer review process Crit. Care (IF 15.1) Pub Date : 2024-05-07 Kunming Cheng, Zaijie Sun, Xiaojun Liu, Haiyang Wu, Cheng Li
The advancement of scientific research has been rapid in recent years, leading to a surge in the number of manuscript submissions and posing formidable challenges to peer review processes. In addressing these challenges, some generative artificial intelligence (AI) tools have emerged as potentially effective solutions [1, 2]. For instance, Saad et al. [3] explored the efficiency and efficacy of one
-
Sepsis mortality among patients with haematological malignancy admitted to intensive care 2000–2022: a binational cohort study Crit. Care (IF 15.1) Pub Date : 2024-05-06 Aleece MacPhail, Claire Dendle, Monica Slavin, Robert Weinkove, Michael Bailey, David Pilcher, Zoe McQuilten
Sepsis occurs in 12–27% of patients with haematological malignancy within a year of diagnosis. Sepsis mortality has improved in non-cancer patients in the last two decades, but longitudinal trends in patients with haematological malignancy are not well characterised. We aimed to compare outcomes, including temporal changes, in patients with and without a haematological malignancy admitted to ICU with
-
Bias caused by sample selection for lower respiratory tract microbiome research Crit. Care (IF 15.1) Pub Date : 2024-05-02 Mingqiang Wang, Xiaojie Li
Dear Editor, We read the article by Imbert et al. [1] published on Critical Care with great interest. The authors described the characteristics of the lower respiratory tract microbiota (specifically bacteria and fungi) in patients with ARDS caused by COVID-19, influenza A, and bacterial pneumonia. Here, we offer two suggestions for the authors to consider. Firstly, we have doubts about whether endotracheal
-
Effects of extracorporeal CO2 removal on gas exchange and ventilator settings: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-04-30 Alexandra-Maria Stommel, Harald Herkner, Calvin Lukas Kienbacher, Brigitte Wildner, Alexander Hermann, Thomas Staudinger
A systematic review and meta-analysis to evaluate the impact of extracorporeal carbon dioxide removal (ECCO2R) on gas exchange and respiratory settings in critically ill adults with respiratory failure. We conducted a comprehensive database search, including observational studies and randomized controlled trials (RCTs) from January 2000 to March 2022, targeting adult ICU patients undergoing ECCO2R
-
The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial Crit. Care (IF 15.1) Pub Date : 2024-04-30 Eliisa Nissilä, Marja Hynninen, Ville Jalkanen, Anne Kuitunen, Minna Bäcklund, Outi Inkinen, Johanna Hästbacka
Screening for hazardous alcohol use and performing brief interventions (BIs) are recommended to reduce alcohol-related negative health consequences. We aimed to compare the effectiveness (defined as an at least 10% absolute difference) of BI with usual care in reducing alcohol intake in intensive care unit survivors with history of hazardous alcohol use. We used Alcohol Use Disorder Identification
-
Assessing the safety of physical rehabilitation in critically ill patients: a Delphi study Crit. Care (IF 15.1) Pub Date : 2024-04-30 Huw R. Woodbridge, Christopher J. McCarthy, Mandy Jones, Matthew Willis, David B. Antcliffe, Caroline M. Alexander, Anthony C. Gordon
Physical rehabilitation of critically ill patients is implemented to improve physical outcomes from an intensive care stay. However, before rehabilitation is implemented, a risk assessment is essential, based on robust safety data. To develop this information, a uniform definition of relevant adverse events is required. The assessment of cardiovascular stability is particularly relevant before physical
-
Intermittent intravenous paracetamol versus continuous morphine in infants undergoing cardiothoracic surgery: a multi-center randomized controlled trial Crit. Care (IF 15.1) Pub Date : 2024-04-30 Gerdien Zeilmaker-Roest, Christine de Vries-Rink, Joost van Rosmalen, Monique van Dijk, Saskia N. de Wildt, Catherijne A. J. Knibbe, Erik Koomen, Nicolaas J. G. Jansen, Martin C. J. Kneyber, Sofie Maebe, Greet Van den Berghe, Renata Haghedooren, Dirk Vlasselaers, Ad J. J. C. Bogers, Dick Tibboel, Enno D. Wildschut
To determine whether intermittent intravenous (IV) paracetamol as primary analgesic would significantly reduce morphine consumption in children aged 0–3 years after cardiac surgery with cardiopulmonary bypass. Multi-center, randomized, double-blinded, controlled trial in four level-3 Pediatric Intensive Care Units (PICU) in the Netherlands and Belgium. Inclusion period; March 2016–July 2020. Children
-
Clinical validation of a capnodynamic method for measuring end-expiratory lung volume in critically ill patients Crit. Care (IF 15.1) Pub Date : 2024-04-30 J. A. Sanchez Giralt, G. Tusman, M. Wallin, M. Hallback, A. Perez Lucendo, M. Sanchez Galindo, B. Abad Santamaria, E. Paz Calzada, P. Garcia Garcia, D. Rodriguez Huerta, A. Canabal Berlanga, Fernando Suarez-Sipmann
End-expiratory lung volume (EELV) is reduced in mechanically ventilated patients, especially in pathologic conditions. The resulting heterogeneous distribution of ventilation increases the risk for ventilation induced lung injury. Clinical measurement of EELV however, remains difficult. Validation of a novel continuous capnodynamic method based on expired carbon dioxide (CO2) kinetics for measuring
-
Stress & strain in mechanically nonuniform alveoli using clinical input variables: a simple conceptual model Crit. Care (IF 15.1) Pub Date : 2024-04-29 John J. Marini, Patricia R. M. Rocco, Lauren T. Thornton, Philip S. Crooke
Clinicians currently monitor pressure and volume at the airway opening, assuming that these observations relate closely to stresses and strains at the micro level. Indeed, this assumption forms the basis of current approaches to lung protective ventilation. Nonetheless, although the airway pressure applied under static conditions may be the same everywhere in healthy lungs, the stresses within a mechanically
-
Fluid responsiveness and venous congestion: unraveling the nuances of fluid status Crit. Care (IF 15.1) Pub Date : 2024-04-26 Adrien Joseph, Matthieu Petit, Philippe Vignon, Antoine Vieillard-Baron
The concept of fluid tolerance, which refers to the capacity of patients to undergo fluid expansion without experiencing harmful effects of volume overload with organ dysfunction, is gaining recognition in both intensive care literature [1] and clinical practice, driven by the mounting evidence of the detrimental impacts of fluid overload [2]. It physiologically makes sense that systemic venous return
-
Beta-blockade in V-V ECMO Crit. Care (IF 15.1) Pub Date : 2024-04-25 Aravind K. Bommiasamy, Bishoy Zakhary, Ran Ran
To the Editor, We read with great interest Staudacher et al.’s illustrative cases of beta-blocker therapy on V-V ECMO [1]. The authors’ excellent work reminds us not to focus on the easily measured arterial oxygen saturation (\({S}_{a}{O}_{2}\)) but rather on the much more physiologically important variable of delivered oxygen (\({DO}_{2}\)). Herein, we demonstrate physiologically and mathematically
-
Quantitative analysis of apparent diffusion coefficients to predict neurological prognosis in cardiac arrest survivors: an observational derivation and internal–external validation study Crit. Care (IF 15.1) Pub Date : 2024-04-25 Jung A Yoon, Changshin Kang, Jung Soo Park, Yeonho You, Jin Hong Min, Yong Nam In, Wonjoon Jeong, Hong Jun Ahn, Hye Seon Jeong, Yong Hwan Kim, Byung Kook Lee, Dongha Kim
This study aimed to validate apparent diffusion coefficient (ADC) values and thresholds to predict poor neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors by quantitatively analysing the ADC values via brain magnetic resonance imaging (MRI). This observational study used prospectively collected data from two tertiary academic hospitals. The derivation cohort comprised 70% of the
-
Adapting NeuroVanguard to real-world challenges Crit. Care (IF 15.1) Pub Date : 2024-04-23 Andres Giglio, Monserrat Pino, Andres Ferre, Andres Reccius
Dear Editor, We read with great interest the review by Rodriguez et al. on the "NeuroVanguard" strategy for neuromonitoring in severe adult brain injury patients [1]. The authors present a compelling case for combining noninvasive and invasive monitoring tools to enhance treatment customization and improve care quality. However, we believe that certain aspects of this approach warrant further consideration
-
Respiratory drive heterogeneity associated with systemic inflammation and vascular permeability in acute respiratory distress syndrome Crit. Care (IF 15.1) Pub Date : 2024-04-23 Elias Baedorf-Kassis, Michael Murn, Amy L. Dzierba, Alexis L. Serra, Ivan Garcia, Emily Minus, Clarissa Padilla, Todd Sarge, Valerie M. Goodspeed, Michael A. Matthay, Michelle N. Gong, Deborah Cook, Stephen H. Loring, Daniel Talmor, Jeremy R. Beitler
In acute respiratory distress syndrome (ARDS), respiratory drive often differs among patients with similar clinical characteristics. Readily observable factors like acid–base state, oxygenation, mechanics, and sedation depth do not fully explain drive heterogeneity. This study evaluated the relationship of systemic inflammation and vascular permeability markers with respiratory drive and clinical outcomes
-
Transforming research to improve therapies for trauma in the twenty-first century: an alternative perspective Crit. Care (IF 15.1) Pub Date : 2024-04-23 Geoffrey P. Dobson, Jodie L. Morris, Hayley L. Letson
We read with interest the perspective of Juffermans and colleagues on transforming research to improve therapies for trauma care in the twenty-first century [1]. We would like to offer a different perspective. We think a more interesting approach is to ask how historians of science 50 or 100 years from now might view our progress in the early twenty-first century? Instead of looking into the future
-
Case study observational research: inflammatory cytokines in the bronchial epithelial lining fluid of COVID-19 patients with acute hypoxemic respiratory failure Crit. Care (IF 15.1) Pub Date : 2024-04-23 Kazuki Sudo, Mao Kinoshita, Ken Kawaguchi, Kohsuke Kushimoto, Ryogo Yoshii, Keita Inoue, Masaki Yamasaki, Tasuku Matsuyama, Kunihiko Kooguchi, Yasuo Takashima, Masami Tanaka, Kazumichi Matsumoto, Kei Tashiro, Tohru Inaba, Bon Ohta, Teiji Sawa
In this study, the concentrations of inflammatory cytokines were measured in the bronchial epithelial lining fluid (ELF) and plasma in patients with acute hypoxemic respiratory failure (AHRF) secondary to severe coronavirus disease 2019 (COVID-19). We comprehensively analyzed the concentrations of 25 cytokines in the ELF and plasma of 27 COVID-19 AHRF patients. ELF was collected using the bronchial
-
Lower airway microbiota compositions differ between influenza, COVID-19 and bacteria-related acute respiratory distress syndromes Crit. Care (IF 15.1) Pub Date : 2024-04-22 Sébastien Imbert, Mathilde Revers, Raphaël Enaud, Arthur Orieux, Adrian Camino, Alexandre Massri, Laurent Villeneuve, Cédric Carrié, Laurent Petit, Alexandre Boyer, Patrick Berger, Didier Gruson, Laurence Delhaes, Renaud Prével
Acute respiratory distress syndrome (ARDS) is responsible for 400,000 deaths annually worldwide. Few improvements have been made despite five decades of research, partially because ARDS is a highly heterogeneous syndrome including various types of aetiologies. Lower airway microbiota is involved in chronic inflammatory diseases and recent data suggest that it could also play a role in ARDS. Nevertheless
-
Rapidly improving ARDS differs clinically and biologically from persistent ARDS Crit. Care (IF 15.1) Pub Date : 2024-04-22 Patricia L. Valda Toro, Andrew Willmore, Nelson E. Wu, Kevin L. Delucchi, Alejandra Jauregui, Pratik Sinha, Kathleen D. Liu, Carolyn M. Hendrickson, Aartik Sarma, Lucile P. A. Neyton, Aleksandra Leligdowicz, Charles R. Langelier, Hanjing Zhuo, Chayse Jones, Kirsten N. Kangelaris, Antonio D. Gomez, Michael A. Matthay, Carolyn S. Calfee
Rapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS. The purpose
-
Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis Crit. Care (IF 15.1) Pub Date : 2024-04-20 Keyvan Razazi, Charles-Edouard Luyt, Guillaume Voiriot, Anahita Rouzé, Marc Garnier, Alexis Ferré, Laurent Camous, Nicholas Heming, Nathanaël Lapidus, Anais Charles-Nelson, Armand Mekontso-Dessap
Patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) and requiring mechanical ventilation suffer from a high incidence of ventilator associated pneumonia (VAP), mainly related to Enterobacterales. Data regarding extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E) VAP are scarce. We aimed to investigate risk factors and outcomes of ESBL-E related VAP
-
ACE inhibitors and angiotensin receptor blockers differentially alter the response to angiotensin II treatment in vasodilatory shock Crit. Care (IF 15.1) Pub Date : 2024-04-18 Daniel E. Leisman, Damian R. Handisides, Laurence W. Busse, Mark C. Chappell, Lakhmir S. Chawla, Michael R. Filbin, Marcia B. Goldberg, Kealy R. Ham, Ashish K. Khanna, Marlies Ostermann, Michael T. McCurdy, Christopher D. Adams, Tony N. Hodges, Rinaldo Bellomo
Angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blockers (ARB) medications are widely prescribed. We sought to assess how pre-admission use of these medications might impact the response to angiotensin-II treatment during vasodilatory shock. In a post-hoc subgroup analysis of the randomized, placebo-controlled, Angiotensin Therapy for High Output Shock (ATHOS-3) trial, we compared
-
Time-dependent effect of prone position in ARDS: considerations for future research Crit. Care (IF 15.1) Pub Date : 2024-04-18 Yuxian Wang, Ming Zhong
To the Editor We have read the article by Yuan et al. [1] with great interest, where they indicated that prone position significantly reduced ventilation/perfusion (V/Q) mismatch in patients with early ARDS, while it increased V/Q mismatch in persistent ARDS patients. However, there are several factors that might influence the reported findings: Firstly, it is important to consider that the effect
-
Policy framework for the utilization of generative AI Crit. Care (IF 15.1) Pub Date : 2024-04-18 Kunming Cheng, Haiyang Wu
The ascent of generative artificial intelligence (AI) technologies has engendered a pivotal juncture in policy formulation, necessitating a comprehensive framework to govern their deployment [1,2,3]. Here, we summarized several the use of guidelines for generative AI from different institutions. In May 2023, the International Committee of Medical Journal Editors (ICMJE) issued updated recommendations
-
Significance of critical closing pressures (starling resistors) in arterial circulation Crit. Care (IF 15.1) Pub Date : 2024-04-18 Michael R. Pinsky, M. Ignacio Monge García, Arnaldo Dubin
Arterial pressure is the input pressure driving tissue blood flow. However, under most conditions organ blood flow is independent of arterial pressure. Tissue blood flow is proportional to local metabolic demand and can vary widely without any change in arterial pressure. Furthermore, changes in arterial pressure within physiologic limits do not alter tissue blood flow. The reason for these apparent
-
Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: be aware of the temporal selection bias Crit. Care (IF 15.1) Pub Date : 2024-04-18 Romain Jouffroy, Anne-Cécile Vie, Benoît Vivien
To the editor We read with great interest the recent meta‑analysis and trial sequential analysis published in the Journal by Low et al. [1] reporting the benefit of extracorporeal cardiopulmonary resuscitation (ECPR) for both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) outcomes improvement. However, we believe that few issues deserve the results’ interpretation and manuscript’
-
Effect of intra-arrest transport, extracorporeal cardiopulmonary resuscitation and immediate invasive assessment in refractory out-of-hospital cardiac arrest: a long-term follow-up of the Prague OHCA trial Crit. Care (IF 15.1) Pub Date : 2024-04-16 Daniel Rob, Klaudia Farkasovska, Marketa Kreckova, Ondrej Smid, Petra Kavalkova, Jaromir Macoun, Michal Huptych, Petra Havrankova, Juraj Gallo, Jan Pudil, Milan Dusik, Stepan Havranek, Ales Linhart, Jan Belohlavek
Randomized data evaluating the impact of the extracorporeal cardiopulmonary resuscitation (ECPR) approach on long-term clinical outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA) are lacking. The objective of this follow-up study was to assess the long-term clinical outcomes of the ECPR-based versus CCPR approach. The Prague OHCA trial was a single-center, randomized, open-label
-
Contribution of electrical impedance tomography to personalize positive end-expiratory pressure under ECCO2R Crit. Care (IF 15.1) Pub Date : 2024-04-16 Benjamin Pequignot, Alain Combes, Mickael Lescroart, Bruno Levy, Matthieu Koszutski
Extracorporeal Carbon Dioxide Removal (ECCO2R) is used in acute respiratory distress syndrome (ARDS) patients to facilitate lung-protective ventilatory strategies. Electrical Impedance Tomography (EIT) allows individual, non-invasive, real-time, bedside, radiation-free imaging of the lungs, providing global and regional dynamic lung analyses. To provide new insights for future ECCO2R research in ARDS
-
Impact of attaining aggressive vs. conservative PK/PD target on the clinical efficacy of beta-lactams for the treatment of Gram-negative infections in the critically ill patients: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-04-16 Milo Gatti, Pier Giorgio Cojutti, Federico Pea
To perform a systematic review with meta-analysis with the dual intent of assessing the impact of attaining aggressive vs. conservative beta-lactams PK/PD target on the clinical efficacy for treating Gram-negative infections in critical patients, and of identifying predictive factors of failure in attaining aggressive PK/PD targets. Two authors independently searched PubMed-MEDLINE and Scopus database
-
Smoking on the risk of acute respiratory distress syndrome: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-04-14 Lujia Zhang, Jiahuan Xu, Yue Li, Fanqi Meng, Wei Wang
The relationship between smoking and the risk of acute respiratory distress syndrome (ARDS) has been recognized, but the conclusions have been inconsistent. This systematic review and meta-analysis investigated the association between smoking and ARDS risk in adults. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for eligible studies published from January 1, 2000
-
Correction to: Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study Crit. Care (IF 15.1) Pub Date : 2024-04-12 Amit Kansal, Jos M. Latour, Kay Choong See, Sumeet Rai, Maurizio Cecconi, Carl Britto, Andrew Conway Morris, Raymond Dominic Savio, Vinay M. Nadkarni, B. K. Rao, Rajesh Mishra
Correction to: Crit Care (2023) 27:487 https://doi.org/10.1186/s13054-023-04766-2 Following publication of the original article [1], the authors identified an error in the author name of Maurizio Cecconi. The incorrect author name is: Maurizo Cecconi The correct author name is: Maurizio Cecconi The Funding section currently reads: Funding The study was not funded. The Funding section should read: Funding
-
Neo-epitope detection identifies extracellular matrix turnover in systemic inflammation and sepsis: an exploratory study Crit. Care (IF 15.1) Pub Date : 2024-04-12 YiWen Fan, Jill Moser, Matijs van Meurs, Dorien Kiers, Jannie Marie Bülow Sand, Diana Julie Leeming, Peter Pickkers, Janette K. Burgess, Matthijs Kox, Janesh Pillay
Sepsis is associated with high morbidity and mortality, primarily due to systemic inflammation-induced tissue damage, resulting organ failure, and impaired recovery. Regulated extracellular matrix (ECM) turnover is crucial for maintaining tissue homeostasis in health and in response to disease-related changes in the tissue microenvironment. Conversely, uncontrolled turnover can contribute to tissue
-
Job description and perception of clinical research personnel working in a network of French intensive care units Crit. Care (IF 15.1) Pub Date : 2024-04-11 Mireille Adda, Claire Dupuis, Gérald Gouby, Claude Dubray, Jean Reignier, Bertrand Souweine, Christian Dualé
There is a lack of information about the organisation and management of clinical research personnel in Europe and of their professional activity in intensive care. We therefore conducted a cross-sectional survey among personnel currently working in a French intensive care research network that involves 41 centres nationwide. The aim of the survey was to describe the personnel’s personal and institutional
-
Outcome prediction of cardiac arrest with automatically computed gray-white matter ratio on computed tomography images Crit. Care (IF 15.1) Pub Date : 2024-04-09 Hsinhan Tsai, Chien-Yu Chi, Liang-Wei Wang, Yu-Jen Su, Ya-Fang Chen, Min-Shan Tsai, Chih-Hung Wang, Cheyu Hsu, Chien-Hua Huang, Weichung Wang
This study aimed to develop an automated method to measure the gray-white matter ratio (GWR) from brain computed tomography (CT) scans of patients with out-of-hospital cardiac arrest (OHCA) and assess its significance in predicting early-stage neurological outcomes. Patients with OHCA who underwent brain CT imaging within 12 h of return of spontaneous circulation were enrolled in this retrospective
-
Correction: Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD: From the French OUTCOMEREA cohort Crit. Care (IF 15.1) Pub Date : 2024-04-09 Louis‑Marie Galerneau, Sebastien Bailly, Nicolas Terzi, Stephane Ruckly, Maite Garrouste‑Orgeas, Johanna Oziel, Vivien Hong Tuan Ha, Marc Gainnier, Shidasp Siami, Claire Dupuis, Jean‑Marie Forel, Anais Dartevel, Julien Dessajan, Christophe Adrie, Dany Goldgran‑Toledano, Virginie Laurent, Laurent Argaud, Jean Reignier, Jean‑Louis Pepin, Michael Darmon, Jean‑Francois Timsit
Correction:Crit Care (2023) 27:359 https://doi.org/10.1186/s13054-023-04631-2 Following publication of the original article [1], the authors identified an error in Table 1. The results were inverted between for variable No decrease in consciousness Day 1–Day 2. The correct table is given hereafter. Table 1 Baseline characteristics and mortality rate for patients with non-ventilator-associated ICU-acquired
-
Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest Crit. Care (IF 15.1) Pub Date : 2024-04-09 Isabelle Arctaedius, Helena Levin, Bergthóra Thorgeirsdóttir, Marion Moseby-Knappe, Tobias Cronberg, Martin Annborn, Niklas Nielsen, Henrik Zetterberg, Kaj Blennow, Nicholas J. Ashton, Attila Frigyesi, Hans Friberg, Anna Lybeck, Niklas Mattsson-Carlgren
The purpose was to evaluate glial fibrillary acidic protein (GFAP) and total-tau in plasma as predictors of poor neurological outcome after out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA), including comparisons with neurofilament light (NFL) and neuron-specific enolase (NSE). Retrospective multicentre observational study of patients admitted to an intensive care unit (ICU) in three hospitals
-
Characteristics, predictors and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study Crit. Care (IF 15.1) Pub Date : 2024-04-09 Weizhuo Liu, Rongjiao Shao, Shen Zhang, Lei Jin, Rongchen Liu, Peidong Chen, Jintao Hu, Haocheng Ma, Bangwei Wu, Weiguo Liang, Xinping Luo, Jian Li, Weiming Chen, Nanqing Xiong, Bin He
Sepsis-induced myocardial injury is a serious complication of sepsis. QT prolongation is a proarrhythmic state which reflects myocardial injury in a group of heterogeneous disorders. However, the study on the clinical value of QT prolongation in sepsis is limited. We aimed to investigate the clinical characteristics and predictors of new-onset QT prolongation in sepsis and its impact on the outcome
-
Anti-inflammatory therapies are associated with delayed onset of anemia and reduction in transfusion requirements in critically ill patients: results from two studies Crit. Care (IF 15.1) Pub Date : 2024-04-09 Madelief Bolscher, Stephanie C. E. Koster, Matty Koopmans, Jelle L. G. Haitsma Mulier, Lennie P. G. Derde, Nicole P. Juffermans
Anemia is a hallmark of critical illness, which is largely inflammatory driven. We hypothesized that the use of anti-inflammatory agents limits the development of anemia and reduces the need for red blood cell (RBC) transfusions in patients with a hyper-inflammatory condition due to COVID-19. An observational cohort (n = 772) and a validation cohort (a subset of REMAP-CAP, n = 119) of critically ill
-
Use of artificial intelligence in critical care: opportunities and obstacles Crit. Care (IF 15.1) Pub Date : 2024-04-08 Michael R. Pinsky, Armando Bedoya, Azra Bihorac, Leo Celi, Matthew Churpek, Nicoleta J. Economou-Zavlanos, Paul Elbers, Suchi Saria, Vincent Liu, Patrick G. Lyons, Benjamin Shickel, Patrick Toral, David Tscholl, Gilles Clermont
Perhaps nowhere else in the healthcare system than in the intensive care unit environment are the challenges to create useful models with direct time-critical clinical applications more relevant and the obstacles to achieving those goals more massive. Machine learning-based artificial intelligence (AI) techniques to define states and predict future events are commonplace activities of modern life.
-
Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: prospective interventional cohort study with retrospective control group analysis Crit. Care (IF 15.1) Pub Date : 2024-04-06 Lucas Huebner, Angelika Warmbein, Christina Scharf, Ines Schroeder, Kirsi Manz, Ivanka Rathgeber, Marcus Gutmann, Johanna Biebl, Amrei Mehler-Klamt, Jana Huber, Inge Eberl, Eduard Kraft, Uli Fischer, Michael Zoller
Approximately one in three survivors of critical illness suffers from intensive-care-unit-acquired weakness, which increases mortality and impairs quality of life. By counteracting immobilization, a known risk factor, active mobilization may mitigate its negative effects on patients. In this single-center trial, the effect of robotic-assisted early mobilization in the intensive care unit (ICU) on patients’
-
Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial Crit. Care (IF 15.1) Pub Date : 2024-04-05 Armin Niklas Flinspach, Florian Jürgen Raimann, Philipp Kaiser, Michaela Pfaff, Kai Zacharowski, Vanessa Neef, Elisabeth Hannah Adam
Optimal intensive care of patients undergoing valve surgery is a complex balancing act between sedation for monitoring and timely postoperative awakening. It remains unclear, if these requirements can be fulfilled by volatile sedations in intensive care medicine in an efficient manner. Therefore, this study aimed to assess the time to extubation and secondary the workload required. We conducted a prospective
-
Correction: Selected articles from the annual update in Intensive Care and Emergency Medicine 2021 Crit. Care (IF 15.1) Pub Date : 2024-04-05
Correction: Crit Care 25, 310 (2021). https://doi.org/10.1186/s13054-021-03670-x, Crit Care 25, 318 (2021). https://doi.org/10.1186/s13054-021-03671-w, Crit Care 25, 317 (2021). https://doi.org/10.1186/s13054-021-03672-9, Crit Care 25, 309 (2021). https://doi.org/10.1186/s13054-021-03673-8, Crit Care 25, 316 (2021). https://doi.org/10.1186/s13054-021-03674-7, Crit Care 25, 315 (2021). https://doi.org/10
-
GFAP point-of-care measurement for prehospital diagnosis of intracranial hemorrhage in acute coma Crit. Care (IF 15.1) Pub Date : 2024-04-05 Sabina Zylyftari, Sebastian Luger, Kristaps Blums, Stephan Barthelmes, Sebastian Humm, Hannsjörg Baum, Stephan Meckel, Jörg Braun, Gregor Lichy, Andreas Heilgeist, Love-Preet Kalra, Christian Foerch
Prehospital triage and treatment of patients with acute coma is challenging for rescue services, as the underlying pathological conditions are highly heterogenous. Recently, glial fibrillary acidic protein (GFAP) has been identified as a biomarker of intracranial hemorrhage. The aim of this prospective study was to test whether prehospital GFAP measurements on a point-of-care device have the potential
-
Vitamin D metabolism in critically ill patients with acute kidney injury: a prospective observational study Crit. Care (IF 15.1) Pub Date : 2024-04-02 Lynda K. Cameron, Lesedi Ledwaba-Chapman, Kieran Voong, Geeta Hampson, Lui G. Forni, Nina Seylanova, Dominic J. Harrington, Rosario Lim, Aneta Bociek, Wang Yanzhong, Marlies Ostermann
Vitamin D deficiency in critically ill patients is associated with poor outcomes, and vitamin D supplementation is recommended for patients with chronic kidney disease. Whether acute kidney injury (AKI) is associated with altered Vitamin D metabolism is unknown. We aimed to compare the longitudinal profiles of serum 25(OH)D and 1,25(OH)2D concentrations in critically ill patients with and without moderate
-
Dyssynchronous diaphragm contractions impair diaphragm function in mechanically ventilated patients Crit. Care (IF 15.1) Pub Date : 2024-04-02 Benjamin Coiffard, Jose Dianti, Irene Telias, Laurent J. Brochard, Arthur S. Slutsky, Jennifer Beck, Christer Sinderby, Niall D. Ferguson, Ewan C. Goligher
Pre-clinical studies suggest that dyssynchronous diaphragm contractions during mechanical ventilation may cause acute diaphragm dysfunction. We aimed to describe the variability in diaphragm contractile loading conditions during mechanical ventilation and to establish whether dyssynchronous diaphragm contractions are associated with the development of impaired diaphragm dysfunction. In patients receiving
-
Facial appearance associates with longitudinal multi-organ failure: an ICU cohort study Crit. Care (IF 15.1) Pub Date : 2024-04-02 Eline G. M. Cox, Bas C. T. van Bussel, Nerea Campillo Llamazares, Jan-Willem E. M. Sels, Marisa Onrust, Iwan C. C. van der Horst, Jacqueline Koeze
Facial appearance, whether consciously or subconsciously assessed, may affect clinical assessment and treatment strategies in the Intensive Care Unit (ICU). Nevertheless, the association between objective clinical measurement of facial appearance and multi-organ failure is currently unknown. The objective of this study was to examine whether facial appearance at admission is associated with longitudinal