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Journals Critical Care : the Official J...

Critical Care : the Official Journal of the Critical Care Forum

https://read.qxmd.com/read/38493142/trauma-systems-in-high-socioeconomic-index-countries-in-2050
#1
REVIEW
Tobias Gauss, Mariska de Jongh, Marc Maegele, Elaine Cole, Pierre Bouzat
Considerable political, structural, environmental and epidemiological change will affect high socioeconomic index (SDI) countries over the next 25 years. These changes will impact healthcare provision and consequently trauma systems. This review attempts to anticipate the potential impact on trauma systems and how they could adapt to meet the changing priorities. The first section describes possible epidemiological trajectories. A second section exposes existing governance and funding challenges, how these can be met, and the need to incorporate data and information science into a learning and adaptive trauma system...
March 16, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38491486/the-elusive-relationship-between-cardiac-filling-and-fluid-responsiveness
#2
LETTER
Jon-Emile S Kenny, Ross Prager, Korbin Haycock
No abstract text is available yet for this article.
March 15, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38491468/scrutinizing-mechanical-circulatory-support-in-cardiogenic-shock-have-we-jumped-the-gun
#3
LETTER
Enzo Lüsebrink, Hugo Lanz, Holger Thiele
Despite increasing therapeutic options and disposable resources, cardiogenic shock (CS) remains a formidable condition with high mortality. Today, veno-arterial extracorporeal membrane oxygenation and microaxial flow devices (Impella, Abiomed, Danvers, USA) are established forms of mechanical circulatory support (MCS) in CS, with increasing application over the years. Despite this trend, incorporation into current ESC (Class IIa, evidence C) and AHA/ACC (Class IIa, evidence B-NR) guidelines is based nearly exclusively on observational results...
March 15, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38491457/effects-of-prone-positioning-on-lung-mechanical-power-components-in-patients-with-acute-respiratory-distress-syndrome-a-physiologic-study
#4
JOURNAL ARTICLE
Christoph Boesing, Joerg Krebs, Alice Marguerite Conrad, Matthias Otto, Grietje Beck, Manfred Thiel, Patricia R M Rocco, Thomas Luecke, Laura Schaefer
BACKGROUND: Prone positioning (PP) homogenizes ventilation distribution and may limit ventilator-induced lung injury (VILI) in patients with moderate to severe acute respiratory distress syndrome (ARDS). The static and dynamic components of ventilation that may cause VILI have been aggregated in mechanical power, considered a unifying driver of VILI. PP may affect mechanical power components differently due to changes in respiratory mechanics; however, the effects of PP on lung mechanical power components are unclear...
March 15, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38491444/trends-in-pre-hospital-volume-resuscitation-of-blunt-trauma-patients-a-15-year-analysis-of-the-british-tarn-and-german-traumaregister-dgu%C3%A2-national-registries
#5
JOURNAL ARTICLE
M F Bath, J Schloer, J Strobel, W Rea, R Lefering, M Maegele, H De'Ath, Z B Perkins
INTRODUCTION: Fluid resuscitation has long been a cornerstone of pre-hospital trauma care, yet its optimal approach remains undetermined. Although a liberal approach to fluid resuscitation has been linked with increased complications, the potential survival benefits of a restrictive approach in blunt trauma patients have not been definitively established. Consequently, equipoise persists regarding the optimal fluid resuscitation strategy in this population. METHODS: We analysed data from the two largest European trauma registries, the UK Trauma Audit and Research Network (TARN) and the German TraumaRegister DGU® (TR-DGU), between 2004 and 2018...
March 15, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38486304/impact-of-covid-19-on-posttraumatic-stress-disorder-in-icu-survivors-a-prospective-observational-comparative-cohort-study
#6
JOURNAL ARTICLE
Pierre Kalfon, Wissam El-Hage, Marie-Agnès Geantot, Constance Favier, Laetitia Bodet-Contentin, Khaldoun Kuteifan, Pierre-Yves Olivier, Didier Thévenin, Julien Pottecher, Jullien Crozon-Clauzel, Bénédicte Mauchien, Arnaud Galbois, Roland de Varax, Sabine Valera, Philippe Estagnasie, Audrey Berric, Martine Nyunga, Nathalie Revel, Georges Simon, Benjamin Kowalski, Achille Sossou, Thomas Signouret, Marc Leone, Charles Delalé, Aurélien Seemann, Sigismond Lasocki, Jean-Pierre Quenot, Antoine Monsel, Olivier Michel, Mathieu Page, René-Gilles Patrigeon, Walid Nicola, Arnaud W Thille, Guillaume Hekimian, Pascal Auquier, Karine Baumstarck
BACKGROUND: Posttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors...
March 14, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38486295/albumin-for-sepsis-related-peripheral-tissue-hypoperfusion
#7
LETTER
Mingqiang Wang, Lin Zhong
No abstract text is available yet for this article.
March 14, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38486268/flow-starvation-during-square-flow-assisted-ventilation-detected-by-supervised-deep-learning-techniques
#8
MULTICENTER STUDY
Candelaria de Haro, Verónica Santos-Pulpón, Irene Telías, Alba Xifra-Porxas, Carles Subirà, Montserrat Batlle, Rafael Fernández, Gastón Murias, Guillermo M Albaiceta, Sol Fernández-Gonzalo, Marta Godoy-González, Gemma Gomà, Sara Nogales, Oriol Roca, Tai Pham, Josefina López-Aguilar, Rudys Magrans, Laurent Brochard, Lluís Blanch, Leonardo Sarlabous
BACKGROUND: Flow starvation is a type of patient-ventilator asynchrony that occurs when gas delivery does not fully meet the patients' ventilatory demand due to an insufficient airflow and/or a high inspiratory effort, and it is usually identified by visual inspection of airway pressure waveform. Clinical diagnosis is cumbersome and prone to underdiagnosis, being an opportunity for artificial intelligence. Our objective is to develop a supervised artificial intelligence algorithm for identifying airway pressure deformation during square-flow assisted ventilation and patient-triggered breaths...
March 14, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38486247/real-time-machine-learning-model-to-predict-short-term-mortality-in-critically-ill-patients-development-and-international-validation
#9
JOURNAL ARTICLE
Leerang Lim, Ukdong Gim, Kyungjae Cho, Dongjoon Yoo, Ho Geol Ryu, Hyung-Chul Lee
BACKGROUND: A real-time model for predicting short-term mortality in critically ill patients is needed to identify patients at imminent risk. However, the performance of the model needs to be validated in various clinical settings and ethnicities before its clinical application. In this study, we aim to develop an ensemble machine learning model using routinely measured clinical variables at a single academic institution in South Korea. METHODS: We developed an ensemble model using deep learning and light gradient boosting machine models...
March 14, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38486211/prognostic-value-of-near-infrared-spectroscopy-regional-oxygen-saturation-and-cerebrovascular-reactivity-index-in-acute-traumatic-neural-injury-a-canadian-high-resolution-traumatic-brain-injury-cahr-tbi-cohort-study
#10
JOURNAL ARTICLE
Alwyn Gomez, Logan Froese, Donald Griesdale, Eric P Thelin, Rahul Raj, Levi van Iperenburg, Jeanette Tas, Marcel Aries, Kevin Y Stein, Clare Gallagher, Francis Bernard, Andreas H Kramer, Frederick A Zeiler
BACKGROUND: Near-infrared spectroscopy regional cerebral oxygen saturation (rSO2 ) has gained interest as a raw parameter and as a basis for measuring cerebrovascular reactivity (CVR) due to its noninvasive nature and high spatial resolution. However, the prognostic utility of these parameters has not yet been determined. This study aimed to identify threshold values of rSO2 and rSO2 -based CVR at which outcomes worsened following traumatic brain injury (TBI). METHODS: A retrospective multi-institutional cohort study was performed...
March 14, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38475823/mean-arterial-pressure-during-cardiopulmonary-bypass-a-modifiable-risk-factor-for-acute-kidney-injury-in-cardiac-surgery-patients
#11
LETTER
Nikolaus Schreiber, Simon Orlob, Stephanie Fida, Christoph Klivinyi, Alexander H Kirsch, Michael Kolland, Michael Schörghuber
No abstract text is available yet for this article.
March 12, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38475798/long-term-outcome-in-new-onset-refractory-status-epilepticus-a-retrospective-study
#12
JOURNAL ARTICLE
Federica Stretti, Stefan Yu Bögli, Francesca Casagrande, Amanda Eisele, Marian Galovic, Emanuela Keller, Giovanna Brandi
BACKGROUND: New onset refractory status epilepticus (NORSE) is a neurologic emergency without an immediately identifiable cause. The complicated and long ICU stay of the patients can lead to perceiving a prolongation of therapies as futile. However, a recovery is possible even in severe cases. This retrospective study investigates ICU treatments, short- and long-term outcome and ethical decisions of a case series of patients with NORSE. METHODS: Overall, 283 adults were admitted with status epilepticus (SE) to the Neurocritical Care Unit of the University Hospital Zurich, Switzerland, between 01...
March 12, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38475786/transitions-of-blood-immune-endotypes-and-improved-outcome-by-anakinra-in-covid-19-pneumonia-an-analysis-of-the-save-more-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Evdoxia Kyriazopoulou, Yehudit Hasin-Brumshtein, Uros Midic, Garyfallia Poulakou, Haralampos Milionis, Simeon Metallidis, Myrto Astriti, Archontoula Fragkou, Aggeliki Rapti, Eleonora Taddei, Ioannis Kalomenidis, Georgios Chrysos, Andrea Angheben, Ilias Kainis, Zoi Alexiou, Francesco Castelli, Francesco Saverio Serino, Petros Bakakos, Emanuele Nicastri, Vasiliki Tzavara, Sofia Ioannou, Lorenzo Dagna, Katerina Dimakou, Glykeria Tzatzagou, Maria Chini, Matteo Bassetti, Vasileios Kotsis, Dionysios G Tsoukalas, Carlo Selmi, Alexandra Konstantinou, Michael Samarkos, Michael Doumas, Aikaterini Masgala, Konstantinos Pagkratis, Aikaterini Argyraki, Karolina Akinosoglou, Styliani Symbardi, Mihai G Netea, Periklis Panagopoulos, George N Dalekos, Oliver Liesenfeld, Timothy E Sweeney, Purvesh Khatri, Evangelos J Giamarellos-Bourboulis
BACKGROUND: Endotype classification may guide immunomodulatory management of patients with bacterial and viral sepsis. We aimed to identify immune endotypes and transitions associated with response to anakinra (human interleukin 1 receptor antagonist) in participants in the SAVE-MORE trial. METHODS: Adult patients hospitalized with radiological findings of PCR-confirmed severe pneumonia caused by SARS-CoV-2 and plasma-soluble urokinase plasminogen activator receptor levels of ≥ 6 ng/ml in the SAVE-MORE trial (NCT04680949) were characterized at baseline and days 4 and 7 of treatment using a previously defined 33-messenger RNA classifier to assign an immunological endotype in blood...
March 12, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38454487/accuracy-of-respiratory-muscle-assessments-to-predict-weaning-outcomes-a-systematic-review-and-comparative-meta-analysis
#14
JOURNAL ARTICLE
Diego Poddighe, Marine Van Hollebeke, Yasir Qaiser Choudhary, Débora Ribeiro Campos, Michele R Schaeffer, Jan Y Verbakel, Greet Hermans, Rik Gosselink, Daniel Langer
BACKGROUND: Several bedside assessments are used to evaluate respiratory muscle function and to predict weaning from mechanical ventilation in patients on the intensive care unit. It remains unclear which assessments perform best in predicting weaning success. The primary aim of this systematic review and meta-analysis was to summarize and compare the accuracy of the following assessments to predict weaning success: maximal inspiratory (PImax) and expiratory pressures, diaphragm thickening fraction and excursion (DTF and DE), end-expiratory (Tdiee ) and end-inspiratory (Tdiei ) diaphragm thickness, airway occlusion pressure (P0...
March 7, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38454447/pathophysiology-of-acute-lung-injury-in-patients-with-acute-brain-injury-the-triple-hit-hypothesis
#15
REVIEW
Mairi Ziaka, Aristomenis Exadaktylos
It has been convincingly demonstrated in recent years that isolated acute brain injury (ABI) may cause severe dysfunction of peripheral extracranial organs and systems. Of all potential target organs and systems, the lung appears to be the most vulnerable to damage after ABI. The pathophysiology of the bidirectional brain-lung interactions is multifactorial and involves inflammatory cascades, immune suppression, and dysfunction of the autonomic system. Indeed, the systemic effects of inflammatory mediators in patients with ABI create a systemic inflammatory environment ("first hit") that makes extracranial organs vulnerable to secondary procedures that enhance inflammation, such as mechanical ventilation (MV), surgery, and infections ("second hit")...
March 7, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38444031/toxicities-intensive-care-management-and-outcome-of-chimeric-antigen-receptor-t-cells-in-adults-an-update
#16
REVIEW
Mathieu Bellal, Jolan Malherbe, Gandhi Damaj, Damien Du Cheyron
BACKGROUND: Chimeric antigen receptor T cells are a promising new immunotherapy for haematological malignancies. Six CAR-T cells products are currently available for adult patients with refractory or relapsed high-grade B cell malignancies, but they are associated with severe life-threatening toxicities and side effects that may require admission to ICU. OBJECTIVE: The aim of this short pragmatic review is to synthesize for intensivists the knowledge on CAR-T cell therapy with emphasis on CAR-T cell-induced toxicities and ICU management of complications according to international recommendations, outcomes and future issues...
March 5, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38438848/the-acute-mesenteric-ischaemia-amesi-study-a-matter-of-incidence
#17
LETTER
Lorenzo Garzelli, Mathieu Nacher
No abstract text is available yet for this article.
March 4, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38429791/impact-of-hyperoxia-on-the-gut-during-critical-illnesses
#18
REVIEW
Ninan Dai, Juan Gu, Yanhong Luo, Yuanfa Tao, Yuehting Chou, Ying He, Han Qin, Tao Chen, Xiaoyun Fu, Miao Chen, Zhouxiong Xing
Molecular oxygen is typically delivered to patients via oxygen inhalation or extracorporeal membrane oxygenation (ECMO), potentially resulting in systemic hyperoxia from liberal oxygen inhalation or localized hyperoxia in the lower body from peripheral venoarterial (VA) ECMO. Consequently, this exposes the gastrointestinal tract to excessive oxygen levels. Hyperoxia can trigger organ damage due to the overproduction of reactive oxygen species and is associated with increased mortality. The gut and gut microbiome play pivotal roles in critical illnesses and even small variations in oxygen levels can have a dramatic influence on the physiology and ecology of gut microbes...
March 1, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38424569/imatinib-treatment-improves-hyperglycaemic-dysregulation-in-severe-covid-19-a-secondary-analysis-of-blood-biomarkers-in-a-randomised-controlled-trial
#19
JOURNAL ARTICLE
Erik Duijvelaar, Xiaoke Pan, Harm Jan Bogaard, Etto C Eringa, Jurjan Aman
SARS-CoV-2 can induce insulin resistance, which is, among others, mediated by adipose tissue dysfunction and reduced angiotensin-converting enzyme 2 (ACE2) enzymatic activity. In SARS-CoV-2-infected mice, the tyrosine kinase inhibitor imatinib attenuates inflammation and improves insulin sensitivity. Here, we report the effects of imatinib on incident hyperglycaemia, circulating levels of glucoregulatory proteins, longitudinal insulin sensitivity and ACE-2 enzymatic activity in 385 hospitalized COVID-19 patients who participated in a randomized, double-blind, placebo-controlled clinical trial...
February 29, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38419119/prevention-of-post-operative-delirium-using-an-overnight-infusion-of-dexmedetomidine-in-patients-undergoing-cardiac-surgery-a-pragmatic-randomized-double-blind-placebo-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Olivier Huet, Thomas Gargadennec, Jean-Ferréol Oilleau, Bertrand Rozec, Nicolas Nesseler, Adrien Bouglé, Thomas Kerforne, Sigismond Lasocki, Vedat Eljezi, Géraldine Dessertaine, Julien Amour, Xavier Chapalain
BACKGROUND: After cardiac surgery, post-operative delirium (PoD) is acknowledged to have a significant negative impact on patient outcome. To date, there is no valuable and specific treatment for PoD. Critically ill patients often suffer from poor sleep condition. There is an association between delirium and sleep quality after cardiac surgery. This study aimed to establish whether promoting sleep using an overnight infusion of dexmedetomidine reduces the incidence of delirium after cardiac surgery...
February 29, 2024: Critical Care: the Official Journal of the Critical Care Forum
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