journal
https://read.qxmd.com/read/38528556/predictors-and-outcomes-of-withholding-and-withdrawal-of-life-sustaining-treatments-in-intensive-care-units-in-singapore-a-multicentre-observational-study
#1
JOURNAL ARTICLE
Clare Fong, Wern Lunn Kueh, Sennen Jin Wen Lew, Benjamin Choon Heng Ho, Yu-Lin Wong, Yie Hui Lau, Yew Woon Chia, Hui Ling Tan, Ying Hao Christopher Seet, Wen Ting Siow, Graeme MacLaren, Rohit Agrawal, Tian Jin Lim, Shir Lynn Lim, Toon Wei Lim, Vui Kian Ho, Chai Rick Soh, Duu Wen Sewa, Chian Min Loo, Faheem Ahmed Khan, Chee Keat Tan, Roshni Sadashiv Gokhale, Chuin Siau, Noelle Louise Siew Hua Lim, Chik-Foo Yim, Jonathen Venkatachalam, Kumaresh Venkatesan, Naville Chi Hock Chia, Mei Fong Liew, Guihong Li, Li Li, Su Mon Myat, Zena Zena, Shuling Zhuo, Ling Ling Yueh, Caroline Shu Fang Tan, Jing Ma, Siew Lian Yeo, Yiong Huak Chan, Jason Phua
BACKGROUND: Clinical practice guidelines on limitation of life-sustaining treatments (LST) in the intensive care unit (ICU), in the form of withholding or withdrawal of LST, state that there is no ethical difference between the two. Such statements are not uniformly accepted worldwide, and there are few studies on LST limitation in Asia. This study aimed to evaluate the predictors and outcomes of withholding and withdrawal of LST in Singapore, focusing on the similarities and differences between the two approaches...
March 26, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38459599/risk-factors-for-arterial-catheter-failure-and-complications-during-critical-care-hospitalisation-a-secondary-analysis-of-a-multisite-randomised-trial
#2
JOURNAL ARTICLE
Jessica A Schults, Emily R Young, Nicole Marsh, Emily Larsen, Amanda Corley, Robert S Ware, Marghie Murgo, Evan Alexandrou, Matthew McGrail, John Gowardman, Karina R Charles, Adrian Regli, Hideto Yasuda, Claire M Rickard
OBJECTIVES: Arterial catheters (ACs) are critical for haemodynamic monitoring and blood sampling but are prone to complications. We investigated the incidence and risk factors of AC failure. METHODS: Secondary analysis of a multi-centre randomised controlled trial (ACTRN 12610000505000). Analysis included a subset of adult intensive care unit patients with an AC. The primary outcome was all-cause device failure. Secondary outcomes were catheter associated bloodstream infection (CABSI), suspected CABSI, occlusion, thrombosis, accidental removal, pain, and line fracture...
March 8, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38424645/from-bedside-to-recovery-exercise-therapy-for-prevention-of-post-intensive-care-syndrome
#3
REVIEW
Keibun Liu, Oystein Tronstad, Dylan Flaws, Luke Churchill, Alice Y M Jones, Kensuke Nakamura, John F Fraser
BACKGROUND: As advancements in critical care medicine continue to improve Intensive Care Unit (ICU) survival rates, clinical and research attention is urgently shifting toward improving the quality of survival. Post-Intensive Care Syndrome (PICS) is a complex constellation of physical, cognitive, and mental dysfunctions that severely impact patients' lives after hospital discharge. This review provides a comprehensive and multi-dimensional summary of the current evidence and practice of exercise therapy (ET) during and after an ICU admission to prevent and manage the various domains of PICS...
February 29, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38409081/unit-to-unit-transfer-due-to-shortage-of-intensive-care-beds-in-sweden-2015-2019-was-associated-with-a-lower-risk-of-death-but-a-longer-intensive-care-stay-compared-to-no-transfer-a-registry-study
#4
JOURNAL ARTICLE
Christian Rylander, Jesper Sternley, Max Petzold, Jonatan Oras
BACKGROUND: Intensive care unit-to-unit transfer due to temporary shortage of beds is increasing in Sweden. Transportation induces practical hazards, and the change of health care provider may prolong the length of stay in intensive care. We previously showed that the risk of death at 90 days did not differ between patients transferred due to a shortage of beds and non-transferred patients with a similar burden of illness in a tertiary intensive care unit. The aim of this study was to widen the analysis to a nation-wide cohort of critically ill patients transferred to another intensive care unit in Sweden due to shortage of intensive care beds...
February 27, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38409068/exploring-the-therapeutic-role-of-early-heparin-administration-in-ards-management-a-mimic-iv-database-analysis
#5
JOURNAL ARTICLE
Ling-Xi Xiao, De Liang Zhu, Juan Chen, Jing Lv, Mei-Jun Liu, Xue Dai, Dao-Xin Wang, Wang Deng
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a severe respiratory condition characterized by a high mortality rate, the management of which relies on supportive care and a profound understanding of its pathophysiology. Heparin, with its anticoagulant and potential anti-inflammatory properties, offers a new therapeutic opportunity for the treatment of ARDS. METHODS: In this retrospective cohort study, we examined the MIMIC-IV database for ARDS patients who received prophylactic heparin within the first 72 h of ICU admission...
February 26, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38378667/development-and-validation-of-a-nomogram-to-predict-the-risk-of-sepsis-associated-encephalopathy-for-septic-patients-in-picu-a-multicenter-retrospective-cohort-study
#6
JOURNAL ARTICLE
Guan Wang, Xinzhu Jiang, Yanan Fu, Yan Gao, Qin Jiang, Enyu Guo, Haoyang Huang, Xinjie Liu
BACKGROUND: Patients with sepsis-associated encephalopathy (SAE) have higher mortality rates and longer ICU stays. Predictors of SAE are yet to be identified. We aimed to establish an effective and simple-to-use nomogram for the individual prediction of SAE in patients with sepsis admitted to pediatric intensive care unit (PICU) in order to prevent early onset of SAE. METHODS: In this retrospective multicenter study, we screened 790 patients with sepsis admitted to the PICU of three hospitals in Shandong, China...
February 20, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38360681/external-validation-of-the-hacor-score-and-rox-index-for-predicting-treatment-failure-in-patients-with-coronavirus-disease-2019-pneumonia-managed-on-high-flow-nasal-cannula-therapy-a-multicenter-retrospective-observational-study-in-japan
#7
JOURNAL ARTICLE
Hiromu Okano, Ryohei Yamamoto, Yudai Iwasaki, Daisuke Irimada, Daisuke Konno, Taku Tanaka, Takatoshi Oishi, Hiroki Nawa, Akihiko Yano, Hiroaki Taniguchi, Masayuki Otawara, Ayaka Matsuoka, Masanori Yamauchi
BACKGROUND: The HACOR score for predicting treatment failure includes vital signs and acid-base balance factors, whereas the ROX index only considers the respiratory rate, oxygen saturation, and fraction of inspired oxygen (FiO2 ). We aimed to externally validate the HACOR score and ROX index for predicting treatment failure in patients with coronavirus disease 2019 (COVID-19) on high-flow nasal cannula (HFNC) therapy in Japan. METHODS: This retrospective, observational, multicenter study included patients, aged ≥ 18 years, diagnosed with COVID-19 and treated with HFNC therapy between January 16, 2020, and March 31, 2022...
February 15, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38287432/association-between-regional-critical-care-capacity-and-the-incidence-of-invasive-mechanical-ventilation-for-coronavirus-disease-2019-a-population-based-cohort-study
#8
JOURNAL ARTICLE
Hiroyuki Ohbe, Satoru Hashimoto, Takayuki Ogura, Mitsuaki Nishikimi, Daisuke Kudo, Nobuaki Shime, Shigeki Kushimoto
BACKGROUND: Coronavirus disease 2019 (COVID-19) has exposed critical care supply shortages worldwide. This study aimed to investigate the association between regional critical care capacity and the incidence of invasive mechanical ventilation following novel COVID-19 during the pandemic in Japan, a country with a limited intensive care unit (ICU) bed capacity of a median of 5.1 ICU beds per 100,000 individuals. METHODS: This population-based cohort study used data from the CRoss Icu Searchable Information System database and publicly available databases provided by the Japanese government and Japanese Society of Intensive Care Medicine...
January 30, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38273416/chest-ct-findings-in-severe-acute-respiratory-distress-syndrome-requiring-v-v-ecmo-j-carve-registry
#9
JOURNAL ARTICLE
Mitsuaki Nishikimi, Shinichiro Ohshimo, Wataru Fukumoto, Jun Hamaguchi, Kazuki Matsumura, Kenji Fujizuka, Yoshihiro Hagiwara, Ryuichi Nakayama, Naofumi Bunya, Junichi Maruyama, Toshikazu Abe, Tatsuhiko Anzai, Yoshitaka Ogata, Hiromichi Naito, Yu Amemiya, Tokuji Ikeda, Masayuki Yagi, Yutaro Furukawa, Hayato Taniguchi, Tsukasa Yagi, Ken Katsuta, Daisuke Konno, Ginga Suzuki, Yuki Kawasaki, Noriyuki Hattori, Tomoyuki Nakamura, Natsuki Kondo, Hitoshi Kikuchi, Shinichi Kai, Saaya Ichiyama, Kazuo Awai, Kunihiko Takahashi, Nobuaki Shime
BACKGROUND: Chest computed tomography findings are helpful for understanding the pathophysiology of severe acute respiratory distress syndrome (ARDS). However, there is no large, multicenter, chest computed tomography registry for patients requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO). The aim of this study was to describe chest computed tomography findings at V-V ECMO initiation and to evaluate the association between the findings and outcomes in severe ARDS. METHODS: This multicenter, retrospective cohort study enrolled patients with severe ARDS on V-V ECMO, who were admitted to the intensive care units of 24 hospitals in Japan between January 1, 2012, and December 31, 2022...
January 26, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38254228/efficacy-of-permissive-underfeeding-for-critically-ill-patients-an-updated-systematic-review-and-trial-sequential-meta-analysis
#10
JOURNAL ARTICLE
Han-Yang Yue, Wei Peng, Jun Zeng, Yang Zhang, Yu Wang, Hua Jiang
BACKGROUND: Our previous study in 2011 concluded that permissive underfeeding may improve outcomes in patients receiving parenteral nutrition therapy. This conclusion was tentative, given the small sample size. We conducted the present systematic review and trial sequential meta-analysis to update the status of permissive underfeeding in patients who were admitted to the intensive care unit (ICU). METHODS: Seven databases were searched: PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database, and Cochrane Library...
January 23, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38225647/limitation-of-life-sustaining-measures-in-neurocritical-care-sex-timing-and-advance-directive
#11
JOURNAL ARTICLE
Stefan Yu Bögli, Federica Stretti, Didar Utebay, Ladina Hitz, Caroline Hertler, Giovanna Brandi
BACKGROUND: The limitation of life sustaining treatments (LLST) causes ethical dilemmas even in patients faced with poor prognosis, which applies to many patients admitted to a Neurocritical Care Unit (NCCU). The effects of social and cultural aspects on LLST in an NCCU population remain poorly studied. METHODS: All NCCU patients between 01.2018 and 08.2021 were included. Medical records were reviewed for: demographics, diagnosis, severity of disease, and outcome...
January 16, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38217059/post-intensive-care-syndrome-follow-up-system-after-hospital-discharge-a-narrative-review
#12
REVIEW
Nobuto Nakanishi, Keibun Liu, Junji Hatakeyama, Akira Kawauchi, Minoru Yoshida, Hidenori Sumita, Kyohei Miyamoto, Kensuke Nakamura
BACKGROUND: Post-intensive care syndrome (PICS) is the long-lasting impairment of physical functions, cognitive functions, and mental health after intensive care. Although a long-term follow-up is essential for the successful management of PICS, few reviews have summarized evidence for the efficacy and management of the PICS follow-up system. MAIN TEXT: The PICS follow-up system includes a PICS follow-up clinic, home visitations, telephone or mail follow-ups, and telemedicine...
January 12, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38195590/development-of-quality-indicators-for-palliative-care-in-intensive-care-units-and-pilot-testing-them-via-electronic-medical-record-review
#13
JOURNAL ARTICLE
Yuta Tanaka, Kento Masukawa, Hideaki Sakuramoto, Akane Kato, Yuichiro Ishigami, Junko Tatsuno, Kaori Ito, Yoshiyuki Kizawa, Mitsunori Miyashita
BACKGROUND: Patients in intensive care units (ICUs) often require quality palliative care for relief from various types of suffering. To achieve quality palliative care, specific goals need to be identified, measured, and reported. The present study aimed to develop quality indicators (QIs) for palliative care in ICUs, based on a systematic review and modified Delphi method, and test their feasibility by reviewing electronic medical record (EMR) data. METHODS: The current study was performed in two phases: the development of QIs using the modified Delphi method, and pilot-testing the quality of palliative care in ICUs based on EMR review...
January 9, 2024: Journal of Intensive Care
https://read.qxmd.com/read/38115065/mechanical-circulatory-support-in-cardiogenic-shock
#14
REVIEW
Jun Nakata, Takeshi Yamamoto, Keita Saku, Yuki Ikeda, Takashi Unoki, Kuniya Asai
Cardiogenic shock is a complex and diverse pathological condition characterized by reduced myocardial contractility. The goal of treatment of cardiogenic shock is to improve abnormal hemodynamics and maintain adequate tissue perfusion in organs. If hypotension and insufficient tissue perfusion persist despite initial therapy, temporary mechanical circulatory support (t-MCS) should be initiated. This decade sees the beginning of a new era of cardiogenic shock management using t-MCS through the accumulated experience with use of intra-aortic balloon pump (IABP) and venoarterial extracorporeal membrane oxygenation (VA-ECMO), as well as new revolutionary devices or systems such as transvalvular axial flow pump (Impella) and a combination of VA-ECMO and Impella (ECPELLA) based on the knowledge of circulatory physiology...
December 19, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38111069/higher-levels-of-circulating-desphospho-uncarboxylated-matrix-gla-protein-over-time-are-associated-with-worse-survival-the-prospective-maastricht-intensive-care-covid-cohort
#15
JOURNAL ARTICLE
Mark M G Mulder, Joep Schellens, Jan-Willem E M Sels, Frank van Rosmalen, Anne-Marije Hulshof, Femke de Vries, Ruud Segers, Casper Mihl, Walther N K A van Mook, Aalt Bast, Henri M H Spronk, Yvonne M C Henskens, Iwan C C van der Horst, Hugo Ten Cate, Leon J Schurgers, Marjolein Drent, Bas C T van Bussel
BACKGROUND: Extra-hepatic vitamin K-status, measured by dephosphorylated uncarboxylated matrix Gla protein (dp-ucMGP), maintains vascular health, with high levels reflecting poor vitamin K status. The occurrence of extra-hepatic vitamin K deficiency throughout the disease of COVID-19 and possible associations with pulmonary embolism (PE), and mortality in intensive care unit (ICU) patients has not been studied. The aim of this study was to investigated the association between dp-ucMGP, at endotracheal intubation (ETI) and both ICU and six months mortality...
December 18, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38093389/functional-intervention-following-cardiac-surgery-to-prevent-postoperative-delirium-in-older-patients-feel-well-study
#16
JOURNAL ARTICLE
Tuğce Dinç Dogan, Vera Guttenthaler, Alexa Zimmermann, Andrea Kunsorg, Merve Özlem Dinç, Niko Knuelle, Jens-Christian Schewe, Maria Wittmann
BACKGROUND: Postoperative delirium is a common complication in patients after cardiac surgery, especially in older patients, and can manifest as a disturbance of attention and consciousness. It can lead to increased postoperative morbidity, prolonged need for care, and mortality. The presented study investigates whether the occurrence of postoperative delirium after cardiac surgery can be prevented by a multisensory stimulation. It was conducted as a prospective, randomized, controlled, non-pharmacological intervention study in the years 2021 and 2022 at the University Hospital Bonn in Germany...
December 13, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38062528/light-and-dark-sides-of-evidence-based-and-supportive-icu-care-for-patients-undergoing-extracorporeal-membrane-oxygenation
#17
LETTER
Keibun Liu, Mohan Gurjar, Ricardo Kenji Nawa, Chi Ryang Chung, Kensuke Nakamura
No abstract text is available yet for this article.
December 7, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38049894/intensive-care-unit-mortality-and-cost-effectiveness-associated-with-intensivist-staffing-a-japanese-nationwide-observational-study
#18
JOURNAL ARTICLE
Saori Ikumi, Takuya Shiga, Takuya Ueda, Eichi Takaya, Yudai Iwasaki, Yu Kaiho, Kunio Tarasawa, Kiyohide Fushimi, Yukiko Ito, Kenji Fujimori, Masanori Yamauchi
BACKGROUND: Japan has four types of intensive care units (ICUs) that are divided into two categories according to the management fee charged per day: ICU management fees 1 and 2 (ICU1/2) (equivalent to high-intensity staffing) and 3 and 4 (ICU3/4) (equivalent to low-intensity staffing). Although ICU1/2 charges a higher rate than ICU3/4, no cost-effectiveness analysis has been performed for ICU1/2. This study evaluated the clinical outcomes and cost-effectiveness of ICU1/2 compared with those of ICU3/4...
December 4, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38031184/visualizing-the-dynamic-mechanical-power-and-time-burden-of-mechanical-ventilation-patients-an-analysis-of-the-mimic-iv-database
#19
JOURNAL ARTICLE
Han Chen, Zhi-Zhong Chen, Shu-Rong Gong, Rong-Guo Yu
BACKGROUND: Limiting driving pressure and mechanical power is associated with reduced mortality risk in both patients with and without acute respiratory distress syndrome. However, it is still poorly understood how the intensity of mechanical ventilation and its corresponding duration impact the risk of mortality. METHODS: Critically ill patients who received mechanical ventilation were identified from the Medical Information Mart for Intensive Care (MIMIC)-IV database...
November 29, 2023: Journal of Intensive Care
https://read.qxmd.com/read/38031107/prognostic-value-of-oxygen-saturation-index-trajectory-phenotypes-on-icu-mortality-in-mechanically-ventilated-patients-a-multi-database-retrospective-cohort-study
#20
JOURNAL ARTICLE
Xiawei Shi, Yangyang Shi, Liming Fan, Jia Yang, Hao Chen, Kaiwen Ni, Junchao Yang
BACKGROUND: Heterogeneity among critically ill patients undergoing invasive mechanical ventilation (IMV) treatment could result in high mortality rates. Currently, there are no well-established indicators to help identify patients with a poor prognosis in advance, which limits physicians' ability to provide personalized treatment. This study aimed to investigate the association of oxygen saturation index (OSI) trajectory phenotypes with intensive care unit (ICU) mortality and ventilation-free days (VFDs) from a dynamic and longitudinal perspective...
November 29, 2023: Journal of Intensive Care
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