Chaofu Yue, Huaiwu He, Longxiang Su, Jun Wang, Siyi Yuan, Yun Long, Zhanqi Zhao
BACKGROUND: This aim of study was to introduce a diaphragm-based EIT-belt placement method based on diaphragm position by ultrasound, and to evaluate the difference between diaphragm-based EIT-belt placement and conventional EIT-belt placement. METHOD: The diaphragm position (L0 ) determined by ultrasound was taken as zero reference level. The direction of headward is defined as positive, and toward feet is negative. For EIT data collection, the electrode belt was placed at 7 different levels, respectively (denoted as L-2 cm , L0 , L2cm , L4cm , L6cm , L8cm , L10cm ) at supine position in healthy volunteers...
September 25, 2023: Journal of Intensive Care
Yonghao Xu, Yu Zhang, Jie Zhang, Weibo Liang, Ya Wang, Zitao Zeng, Zhenting Liang, Zhaoyi Ling, Yubiao Chen, Xiumei Deng, Yongbo Huang, Xiaoqing Liu, Haibo Zhang, Yimin Li
BACKGROUND: Mechanical ventilation may cause pulmonary hypertension in patients with acute lung injury (ALI), but the underlying mechanism remains elucidated. METHODS: ALI was induced in rabbits by a two-hit injury, i.e., hydrochloric acid aspiration followed by mechanical ventilation for 1 h. Rabbits were then ventilated with driving pressure of 10, 15, 20, or 25 cmH2 O for 7 h. Clinicopathological parameters were measured at baseline and different timepoints of ventilation...
September 25, 2023: Journal of Intensive Care
Karn Suttapanit, Supawit Wongkrasunt, Sorravit Savatmongkorngul, Praphaphorn Supatanakij
BACKGROUND: Diaphragm dysfunction is common in critically ill patients and associated with poorer outcomes. The function of the diaphragm can be evaluated at the bedside by measuring diaphragmatic excursion using ultrasonography. In this study, we investigated the ability of right-sided diaphragmatic excursion (RDE) to predict the need for invasive mechanical ventilation (IMV). METHODS: Critically ill patients aged 18 years and older who presented to our emergency department between May 20, 2021 and May 19, 2022 and underwent measurement of RDE within 10 min of arrival were enrolled in this prospective study...
September 19, 2023: Journal of Intensive Care
Reimi Inoue, Yusuke Nagamine, Masahide Ohtsuka, Takahisa Goto
BACKGROUND: Diaphragmatic dysfunction often occurs after adult cardiovascular surgery. The prognostic effect of diaphragmatic dysfunction on ventilatory management in patients after cardiovascular surgery is unknown. This study aimed to investigate the association between diaphragmatic dysfunction and prognosis of ventilatory management in adult postoperative cardiovascular surgery patients. METHODS: This study was a single-center retrospective cohort study conducted at a tertiary care university hospital...
September 12, 2023: Journal of Intensive Care
Jonas Gmeiner, Bernhardt Bulach, Enzo Lüsebrink, Leonhard Binzenhöfer, Danny Kupka, Thomas Stocker, Kornelia Löw, Ludwig Weckbach, Wolf-Stephan Rudi, Tobias Petzold, Stefan Kääb, Jörg Hausleiter, Christian Hagl, Steffen Massberg, Martin Orban, Clemens Scherer
BACKGROUND: The efficacy and safety of saline versus balanced crystalloid solutions in ICU-patients remains complicated by exceptionally heterogenous study population in past comparative studies. This study sought to compare saline and balanced crystalloids for fluid resuscitation in patients with cardiogenic shock with or without out-of-hospital cardiac arrest (OHCA). METHODS: We retrospectively analyzed 1032 propensity score matched patients with cardiogenic shock from the Munich University Hospital from 2010 to 2022...
September 6, 2023: Journal of Intensive Care
Elias H Pratt, Samantha Morrison, Cynthia L Green, Craig R Rackley
The respiratory ECMO survival prediction (RESP) score is used to predict survival for patients managed with extracorporeal membrane oxygenation (ECMO), but its performance in patients with Coronavirus Disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) is unclear. We evaluated the ability of the RESP score to predict survival for patients with both non-COVID 19 ARDS and COVID-19 ARDS managed with ECMO at our institution. Receiver operating characteristic area under the curve (AUC) analysis found the RESP score reasonably predicted survival in patients with non-COVID-19 ARDS (AUC 0...
September 1, 2023: Journal of Intensive Care
Ellaha Kakar, Thomas Ottens, Susanne Stads, Sanne Wesselius, Diederik A M P J Gommers, Johannes Jeekel, Mathieu van der Jagt
BACKGROUND: Previous studies show positive effect of music on reducing anxiety, pain, and medication requirement. Anxiety has become a more pertinent issue in the intensive care unit (ICU) since wakefulness is preferred according to recent guidelines. Nevertheless, evidence on the effect of music in ICU patients is scarce. Therefore, we studied the effect of music intervention on anxiety in ICU patients. METHODS: A multicenter randomized clinical trial was conducted between August 2020 and December 2021 in ICU's at an academic medical centre and two regional hospitals...
August 17, 2023: Journal of Intensive Care
Beomsu Shin, Jin Young Lee, Yunjoo Im, Hongseok Yoo, Junseon Park, Joo Sang Lee, Ki-Young Lee, Kyeongman Jeon
BACKGROUND: Despite the understanding of sepsis-induced extracellular vesicles (EVs), such as exosomes, and their role in intercellular communication during sepsis, little is known about EV contents such as microRNA (miRNA), which modulate important cellular processes contributing to sepsis in body fluids. This study aimed to analyze the differential expression of exosomal miRNAs in plasma samples collected from sepsis patients and healthy controls, and to identify potential miRNA regulatory pathways contributing to sepsis pathogenesis...
August 3, 2023: Journal of Intensive Care
Mineji Hayakawa, Takashi Tagami, Daisuke Kudo, Kota Ono, Makoto Aoki, Akira Endo, Tetsuya Yumoto, Yosuke Matsumura, Shiho Irino, Kazuhiko Sekine, Noritaka Ushio, Takayuki Ogura, Sho Nachi, Yuhei Irie, Katsura Hayakawa, Yusuke Ito, Yuko Okishio, Tomohiro Muronoi, Yoshinori Kosaki, Kaori Ito, Keita Nakatsutsumi, Yutaka Kondo, Taichiro Ueda, Hiroshi Fukuma, Yuichi Saisaka, Naoki Tominaga, Takeo Kurita, Fumihiko Nakayama, Tomotaka Shibata, Shigeki Kushimoto
BACKGROUND: The efficacies of fresh frozen plasma and coagulation factor transfusion have been widely evaluated in trauma-induced coagulopathy management during the acute post-injury phase. However, the efficacy of red blood cell transfusion has not been adequately investigated in patients with severe trauma, and the optimal hemoglobin target level during the acute post-injury and resuscitation phases remains unclear. Therefore, this study aimed to examine whether a restrictive transfusion strategy was clinically non-inferior to a liberal transfusion strategy during the acute post-injury phase...
July 24, 2023: Journal of Intensive Care
Takero Terayama, Hiromu Okano, Sadatoshi Kawakami, Kenichi Kano, Masaaki Sakuraya, Yoshitaka Aoki
No abstract text is available yet for this article.
July 17, 2023: Journal of Intensive Care
Shodai Yoshihro, Shunsuke Taito, Tomoaki Yatabe
BACKGROUND: Recent systematic reviews and meta-analyses have suggested that low-dose steroids are effective in the treatment of acute respiratory distress syndrome (ARDS). Recent guidelines recommend the use of low-dose steroids instead of high-dose steroids. These systematic reviews were conducted based on the concept that the effect of steroids is constant regardless of their type. We discuss whether the type of steroid used influences the outcomes in patients with ARDS. MAIN BODY: From a pharmacological standpoint, methylprednisolone has little activity as a mineralocorticoid and may cause pulmonary hypertension...
July 10, 2023: Journal of Intensive Care
Jin Kirigaya, Noriaki Iwahashi, Kengo Terasaka, Ichiro Takeuchi
BACKGROUND: Cardiogenic shock (CS) is a common cause of morbidity and mortality in cardiac intensive care units (CICUs), even in the contemporary era. MAIN TEXT: Although mechanical circulatory supports have recently become widely available and used in transforming the management of CS, their routine use to improve outcomes has not been established. Transportation to a high-volume center, early reperfusion, tailored mechanical circulatory supports, regionalized systems of care with multidisciplinary CS teams, a dedicated CICU, and a systemic approach, including preventing noncardiogenic complications, are the key components of CS treatment strategies...
July 6, 2023: Journal of Intensive Care
Francesco Bellanti, Sławomir Kasperczyk, Aleksandra Kasperczyk, Michał Dobrakowski, Gabriella Pacilli, Giuseppina Vurchio, Alessandro Maddalena, Stefano Quiete, Aurelio Lo Buglio, Cristiano Capurso, Gaetano Serviddio, Gianluigi Vendemiale
BACKGROUND: Mechanisms underpinning ARDS induced by COVID-19 are mostly immune-mediated, but need to be completely clarified. This study aimed to investigate redox balance in COVID-19 patients with ARDS, trying to recognize possible differences from typical ARDS related to the pathophysiology of severe disease. METHODS: Patients affected by ARDS and positive for the SARS-CoV-2 virus (N = 40, COVID-19) were compared to ARDS patients negative to the molecular test (N = 42, No COVID-19)...
July 5, 2023: Journal of Intensive Care
Jianbo Li, Lijie Wang, Huan Zhang, Tongjuan Zou, Yan Kang, Wei He, Yuan Xu, Wanhong Yin
BACKGROUND: A unified clinical definition of feeding intolerance (FI) is urged for better management of enteral nutrition (EN) in critically ill patients. We aimed to identify optimum clinical FI definitions based on reported evidence. METHODS: We searched clinical studies comparing FI with non-FI with a clear definition, summarized the evidence by random-effect meta-analyses, and rated the certainty of evidence by the Grading of Recommendations Assessment, Development and Evaluation frameworks...
July 5, 2023: Journal of Intensive Care
Sanchit Chawla, Ryota Sato, Abhijit Duggal, Mahmoud Alwakeel, Daisuke Hasegawa, Dina Alayan, Patrick Collier, Filippo Sanfilippo, Michael Lanspa, Siddharth Dugar
BACKGROUND: Tissue Doppler-derived left ventricular systolic velocity (mitral S') has shown excellent correlation to left ventricular ejection fraction (LVEF) in non-critically patients. However, their correlation in septic patients remains poorly understood and its impact on mortality is undetermined. We investigated the relationship between mitral S' and LVEF in a large cohort of critically-ill septic patients. METHODS: We conducted a retrospective cohort study between 01/2011 and 12/2020...
July 3, 2023: Journal of Intensive Care
Le Bai, Jingyi Huang, Dan Wang, Dongwei Zhu, Qi Zhao, Tingyuan Li, Xianmei Zhou, Yong Xu
BACKGROUND: The effects of body mass index (BMI) on mortality of sepsis remain unknown, since previous meta-analyses have reported conflicting results. Several observational studies published recently have provided new evidence. Thus, we performed this updated meta-analysis. METHODS: PubMed, Embase, Web of Science, and Cochran Library were searched for articles published before February 10, 2023. Observational studies that assessed the association of BMIs with mortality of sepsis patients aged > 18 years were selected...
July 3, 2023: Journal of Intensive Care
Akihiro Shirakabe, Masato Matsushita, Yusaku Shibata, Shota Shighihara, Suguru Nishigoori, Tomofumi Sawatani, Kazutaka Kiuchi, Kuniya Asai
BACKGROUND: Cardiogenic shock (CS) is caused by primary cardiac dysfunction and induced by various and heterogeneous diseases (e.g., acute impairment of cardiac performance, or acute or chronic impairment of cardiac performance). MAIN BODY: Although a low cardiac index is a common finding in patients with CS, the ventricular preload, pulmonary capillary wedge pressure, central venous pressure, and systemic vascular resistance might vary between patients. Organ dysfunction has traditionally been attributed to the hypoperfusion of the organ due to either progressive impairment of the cardiac output or intravascular volume depletion secondary to CS...
June 29, 2023: Journal of Intensive Care
Masashi Yokose, Shunsuke Takaki, Yusuke Saigusa, Takahiro Mihara, Yoshinobu Ishiwata, Shingo Kato, Keiichi Horie, Takahisa Goto
BACKGROUND: Post-pyloric enteral feeding reduces respiratory complications and shortens the duration of mechanical ventilation. Blind placement of post-pyloric enteral feeding tubes (EFT) in patients with critical illnesses is often the first-line method because endoscopy or fluoroscopy cannot be easily performed at bedside; however, difficult placements regularly occur. We reported an association between the stomach position caudal to spinal level L1-L2, evaluated by abdominal radiographs after placement, and difficult placement; however, this method could not indicate difficulty before EFT placement...
May 30, 2023: Journal of Intensive Care
Toshiaki Iba, Julie Helms, Jean Marie Connors, Jerrold H Levy
BACKGROUND: The International Society on Thrombosis and Haemostasis (ISTH) released overt disseminated intravascular coagulation (DIC) diagnostic criteria in 2001. Since then, DIC has been understood as the end-stage consumptive coagulopathy and not the therapeutic target. However, DIC is not merely a decompensated coagulation disorder, but also includes early stages with systemic activation in coagulation. Thus, the ISTH has recently released sepsis-induced coagulopathy (SIC) criteria that can diagnose compensated-phase of coagulopathy with readily available biomarkers...
May 23, 2023: Journal of Intensive Care
Stephanie L Hiser, Arooj Fatima, Mazin Ali, Dale M Needham
An increasing number of patients are surviving critical illness, but some experience new or worsening long-lasting impairments in physical, cognitive and/or mental health, commonly known as post-intensive care syndrome (PICS). The need to better understand and improve PICS has resulted in a growing body of literature exploring its various facets. This narrative review will focus on recent studies evaluating various aspects of PICS, including co-occurrence of specific impairments, subtypes/phenotypes, risk factors/mechanisms, and interventions...
May 23, 2023: Journal of Intensive Care
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