Seitaro Fujishima
Acute respiratory failure (ARF) is defined by acute and progressive hypoxemia caused by various cardiorespiratory or systemic diseases in previously healthy patients. Among ARF, acute respiratory distress syndrome (ARDS) is a serious condition with bilateral lung infiltration, which develops secondary to a variety of underlying conditions, diseases, or injuries. This review summarizes the current standard of care for ARF and ARDS based on current major guidelines in this field. When administering fluid in patients with ARF, particularly ARDS, restrictive strategies need to be considered in patients without shock or multiple organ dysfunction...
March 10, 2023: Journal of Intensive Care
Taro Watanabe, Koichi Ohsugi, Yuri Suminaga, Masayuki Somei, Kazuki Kikuyama, Maiko Mori, Hiroko Maruo, Nao Kono, Toru Kotani
BACKGROUND: The telemedicine intensive care unit (Tele-ICU) is defined as a system in which intensive care professionals remotely provide care to critically ill patients and support the on-site staff in the intensive care unit (ICU) using secured audio-video and electronic links. Although the Tele-ICU is expected to resolve the shortage of intensivists and reduce the regional disparities in intensive care resources, the efficacy has not yet been evaluated in Japan because of a lack of clinically available system...
March 7, 2023: Journal of Intensive Care
Takeshi Wada, Kazuma Yamakawa, Daijiro Kabata, Toshikazu Abe, Seitaro Fujishima, Shigeki Kushimoto, Toshihiko Mayumi, Hiroshi Ogura, Daizoh Saitoh, Atsushi Shiraishi, Yasuhiro Otomo, Satoshi Gando
BACKGROUND: The development of disseminated intravascular coagulation (DIC) in patients with sepsis has been repeatedly confirmed as a factor associated with poor prognosis. Anticoagulant therapy has been expected to improve sepsis patient outcomes, whereas no randomized controlled trials have demonstrated the survival benefit of anticoagulant therapies in non-specific overall sepsis. Patient selection based on the component of "high disease severity" in addition to "sepsis with DIC" has recently proved important in identifying appropriate targets for anticoagulant therapy...
March 5, 2023: Journal of Intensive Care
Jon-Émile S Kenny, Stanley O Gibbs, Delaney Johnston, Zhen Yang, Lisa M Hofer, Mai Elfarnawany, Joseph K Eibl, Amanda Johnson, Anthony J Buecker, Vivian C Lau, Benjamin O Kemp
BACKGROUND: Little data exist on the time spent by emergency department (ED) personnel providing intravenous (IV) fluid to 'responsive' versus 'unresponsive' patients. METHODS: A prospective, convenience sample of adult ED patients was studied; patients were enrolled if preload expansion was indicated for any reason. Using a novel, wireless, wearable ultrasound, carotid artery Doppler was obtained before and throughout a preload challenge (PC) prior to each bag of ordered IV fluid...
February 15, 2023: Journal of Intensive Care
Shinya Miura, Nobuaki Michihata, Yohei Hashimoto, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Children with community-acquired septic shock can rapidly deteriorate and die in acute-care hospitals. This study aimed to describe the mortality, timing, and risk factors in children with community-acquired septic shock. METHODS: This is a retrospective cohort study using a national inpatient database in Japan. The study population included children (age < 20 years) who were admitted to acute-care hospitals with a diagnosis of sepsis from July 2010 to March 2020, who were treated with antibiotics, and who were supported with vasoactive drugs within three days of hospitalization...
February 13, 2023: Journal of Intensive Care
Francesco Alessandri, Matteo Di Nardo, Kollengode Ramanathan, Daniel Brodie, Graeme MacLaren
A growing body of evidence supports the use of extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) refractory to maximal medical therapy. ARDS may develop in a proportion of patients hospitalized for coronavirus disease 2019 (COVID-19) and ECMO may be used to manage patients refractory to maximal medical therapy to mitigate the risk of ventilator-induced lung injury and provide lung rest while awaiting recovery. The mortality of COVID-19-related ARDS was variously reassessed during the pandemic...
February 8, 2023: Journal of Intensive Care
Yuji Nishimoto, Hiroyuki Ohbe, Hiroki Matsui, Mikio Nakajima, Yusuke Sasabuchi, Yukihito Sato, Tetsuya Watanabe, Takahisa Yamada, Masatake Fukunami, Hideo Yasunaga
BACKGROUND: Current guidelines recommend systemic thrombolysis as the first-line reperfusion treatment for patients with high-risk pulmonary embolism (PE) who present with cardiogenic shock but do not require venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, little is known about the optimal reperfusion treatment in high-risk PE patients requiring VA-ECMO. We aimed to evaluate whether systemic thrombolysis improved high-risk PE patients' outcomes who received VA-ECMO...
February 6, 2023: Journal of Intensive Care
Ling Wang, Rui-Fang Li, Xiao-Lan Guan, Shuang-Shuang Liang, Ping Gong
BACKGROUND: sCD59, as a soluble form of CD59, is observed in multiple types of body fluids and correlated with the cell damage after ischemia/reperfusion injury. This study aims to observe the dynamic changes of serum sCD59 in patients after restoration of spontaneous circulation (ROSC) and explore the association of serum sCD59 with neurological prognosis and all-cause mortality in patients after ROSC. METHODS: A total of 68 patients after ROSC were prospectively recruited and divided into survivors (n = 23) and non-survivors (n = 45) groups on the basis of 28-day survival...
February 2, 2023: Journal of Intensive Care
Takehiko Oami, Taro Imaeda, Taka-Aki Nakada, Toshikazu Abe, Nozomi Takahashi, Yasuo Yamao, Satoshi Nakagawa, Hiroshi Ogura, Nobuaki Shime, Yutaka Umemura, Asako Matsushima, Kiyohide Fushimi
BACKGROUND: A substantial number of sepsis patients require specialized care, including multidisciplinary care, close monitoring, and artificial organ support in the intensive care unit (ICU). However, the efficacy of ICU management on clinical outcomes remains insufficiently researched. Therefore, we tested the hypothesis that ICU admission would increase the survival rate among sepsis patients. METHODS: We conducted a retrospective study using the nationwide medical claims database of sepsis patients in Japan from 2010 to 2017 with propensity score matching to adjust for baseline imbalances...
January 7, 2023: Journal of Intensive Care
Kuang-Yao Yang, Chung-Kan Peng, Chau-Chyun Sheu, Yu-Chao Lin, Ming-Cheng Chan, Sheng-Huei Wang, Chia-Min Chen, Chih-Yu Chen, Zhe-Rong Zheng, Jia-Yih Feng
BACKGROUND: Tigecycline has in vitro bacteriostatic activity against a broad spectrum of bacteria, including carbapenem-resistant Gram-negative bacteria (CR-GNB). However, the role of tigecycline in treatment of nosocomial pneumonia caused by CR-GNB remains controversial and clinical evidences are limited. We aimed to investigate the clinical benefits of tigecycline as part of the combination treatment of nosocomial CR-GNB pneumonia in intensive care unit (ICU). METHODS: This multi-centre cohort study retrospectively enrolled ICU-admitted patients with nosocomial pneumonia caused by CR-GNB...
January 3, 2023: Journal of Intensive Care
Ryota Nukiwa, Akinori Uchiyama, Aiko Tanaka, Tetsuhisa Kitamura, Ryota Sakaguchi, Yoshimitsu Shimomura, Suguru Ishigaki, Yusuke Enokidani, Tomonori Yamashita, Yukiko Koyama, Takeshi Yoshida, Natsuko Tokuhira, Naoya Iguchi, Yasushi Shintani, Shigeru Miyagawa, Yuji Fujino
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is an integral method of life support in critically ill patients with severe cardiopulmonary failure; however, such patients generally require prolonged mechanical ventilation and exhibit high mortality rates. Tracheostomy is commonly performed in patients on mechanical ventilation, and its early implementation has potential advantages for favorable patient outcomes. This study aimed to investigate the association between tracheostomy timing and patient outcomes, including mortality, in patients requiring ECMO...
December 30, 2022: Journal of Intensive Care
Laura Amado-Rodríguez, Raquel Rodríguez-Garcia, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, John G Laffey, Guillermo M Albaiceta
BACKGROUND: Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. METHODS: Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model...
December 25, 2022: Journal of Intensive Care
Lisa Smit, Eveline J A Wiegers, Zoran Trogrlic, Wim J R Rietdijk, Diederik Gommers, Erwin Ista, Mathieu van der Jagt
BACKGROUND: The prognostic implication of delirium subtypes in critically ill medical and surgical patients is scarcely investigated. The objective was to determine how delirium subtypes are associated with hospital mortality and other clinical outcomes. METHODS: We performed a secondary analysis on data from a prospective multicenter study aimed at implementation of delirium-oriented measures, conducted between 2012 and 2015 in The Netherlands. We included adults (≥ 18 years) admitted to the medical or surgical intensive care unit (ICU)...
December 20, 2022: Journal of Intensive Care
Romain Jouffroy, Benoît Vivien
No abstract text is available yet for this article.
December 8, 2022: Journal of Intensive Care
Romain Jouffroy, Papa Gueye
No abstract text is available yet for this article.
December 5, 2022: Journal of Intensive Care
Hiroyuki Ohbe, Yusuke Sasabuchi, Hiroki Matsui, Hideo Yasunaga
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has disrupted critical care services worldwide. Examining how critical care systems responded to the COVID-19 pandemic on a national level will be useful in setting future critical care plans. The present study aimed to describe the utilization of critical care services before and during the COVID-19 pandemic using a nationwide Japanese inpatient administrative database. METHODS: All patients admitted to an intensive care unit (ICU) or a high-dependency care unit (HDU) from February 9, 2019, to February 8, 2021, in the Japanese Diagnosis Procedure Combination inpatient database were included...
December 2, 2022: Journal of Intensive Care
(no author information available yet)
Given the available clinical evidence through the literature search when the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 was being created, we suggested administering vitamin C to such patients. Recently, several randomized control trials have been published, some of which suggested the harmful effect of vitamin C in terms of mortality or persistent organ dysfunction. Therefore, we performed updated systematic reviews and meta-analyses. Accordingly, we revised our recommendation as "We suggest against administering vitamin C to septic patients (GRADE 2D: certainty of evidence = "very low")...
November 29, 2022: Journal of Intensive Care
Nozomi Takahashi, Taro Imaeda, Taka-Aki Nakada, Takehiko Oami, Toshikazu Abe, Yasuo Yamao, Satoshi Nakagawa, Hiroshi Ogura, Nobuaki Shime, Asako Matsushima, Kiyohide Fushimi
BACKGROUND: The appropriate duration of antibiotic treatment in patients with bacterial sepsis remains unclear. The purpose of this study was to evaluate the association of a shorter course of antibiotics on 28-day mortality in comparison with a longer course using a national database in Japan. METHODS: We conducted a post hoc analysis from the retrospective observational study of patients with sepsis using a Japanese claims database from 2010 to 2017. The patient dataset was divided into short-course (≤ 7 days) and long-course (≥ 8 days) groups according to the duration of initial antibiotic administration...
October 29, 2022: Journal of Intensive Care
Jacek Kolcz, Elzbieta Karnas, Zbigniew Madeja, Ewa K Zuba-Surma
BACKGROUND: Fontan surgery with cardiopulmonary bypass (CPB) causes tremendous systemic stress and inflammatory responses, affecting postoperative organ function, morbidity, and mortality. Although this reaction triggers partially protective anti-inflammatory responses, it is harmful in patients with single ventricle congenital heart defects. Despite decades of research, an effective anti-inflammatory and stress defense strategy is lacking. This study investigated the influence of inhaled nitric oxide (NO) during CPB on early clinical results, including the duration of postoperative respiratory support as a primary outcome and a panel of laboratory analytes...
October 13, 2022: Journal of Intensive Care
Koji Endo, Kayoko Mizuno, Tomotsugu Seki, Woo Jin Joo, Chikashi Takeda, Masato Takeuchi, Koji Kawakami
No abstract text is available yet for this article.
October 12, 2022: Journal of Intensive Care
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