Francesca Guzzo, Gaetano Lombardi, Margherita Tozzi, Maria R Calvi, Maria L Azzolini, Ada C Alba, Simona Tamà, Matteo M D'Amico, Alessandro Belletti, Claudia Frassanito, Diego Palumbo, Andrea Doronzio, Alfredo Ravizza, Giovanni Landoni, Antonio Dell'acqua, Luigi Beretta, Alberto Zangrillo
BACKGROUND: COVID-19 acute respiratory distress syndrome (ARDS) is often managed with mechanical ventilation (MV), requiring sedation and paralysis, with associated risk of complications. There is limited evidence on the use of high flow nasal cannula (HFNC). We hypothesized that management of COVID-19 ARDS without MV is feasible. METHODS: Included were all adult patients diagnosed with COVID-19 ARDS, with PaO<inf>2</inf>/FiO<inf>2</inf> ratio <100 at admission, and whose management was initially performed without MV...
September 21, 2023: Minerva Anestesiologica
Haixin Huang, Jian Chen, Hongxing Dang, Chengjun Liu, Junming Huo, Yue-Qiang Fu
UNLABELLED: The therapeutic efficacy of intravenous immuneglobulin (IVIG) on children with septic shock remains uncertain. Therefore, we endeavored to investigate the impact of administering intravenous immunoglobulin (IVIG) in the pediatric intensive care unit (PICU) on patient with septic shock. We retrospectively analyzed the data of children admitted to the PICU due to septic shock from January 2017 to December 2021 in a tertiary pediatric hospital. The main outcome was in-hospital mortality...
September 21, 2023: European Journal of Pediatrics
Elisabetta Greco, Elisabetta Segre, Monica Melchio, Giulia Labarile, Davide Lison, Fulvio Morello, Enrico Lupia
No abstract text is available yet for this article.
September 21, 2023: Panminerva Medica
Giulia Naïm, Isabelle Malissin, Bruno Mégarbane
Critical illness-associated cerebral microbleeds of poorly understood pathophysiology have been observed on magnetic resonance imaging (MRI) in severely hypoxemic patients similarly to high-altitude cerebral edema patients. The prevalence and circumstances of occurrence of such cerebral microbleeds in the severely poisoned patients is unknown. We retrospectively reviewed all cerebral MRIs performed in the poisoned patients with atypical neurological presentation or outcome admitted to our intensive care unit in 2014-2021...
September 21, 2023: Basic & Clinical Pharmacology & Toxicology
Christina M Osborne, Charles Langelier, Jack Kamm, Kayla Williamson, Lilliam Ambroggio, Ron W Reeder, Christopher Locandro, J Kirk Harris, Brandie D Wagner, Aline B Maddux, Saharai Caldera, Amy Lyden, Victoria Soesanto, Eric A F Simões, Matthew K Leroue, Todd C Carpenter, Mark W Hall, Athena F Zuppa, Joseph A Carcillo, Kathleen L Meert, Murray M Pollack, Patrick S McQuillen, Daniel A Notterman, Joseph DeRisi, Peter M Mourani
OBJECTIVES: Viral lower respiratory tract infection (vLRTI) contributes to substantial morbidity and mortality in children. Diagnosis is typically confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal specimens in hospitalized patients; however, it is unknown whether nasopharyngeal detection accurately reflects presence of virus in the lower respiratory tract (LRT). This study evaluates agreement between viral detection from nasopharyngeal specimens by RT-PCR compared with metagenomic next-generation RNA sequencing (RNA-Seq) from tracheal aspirates (TAs)...
September 21, 2023: Pediatric Critical Care Medicine
Hai-Jun Wang, Wei Chen, Hong-Zhi Wang, He-Ling Zhao, Dong-Hao Wang, Yun Long, Xue-Zhong Xing
Objective This consensus aims to provide evidence-based recommendations on common questions in the diagnosis and treatment of acute respiratory failure (ARF) for critically ill cancer patients. Methods We developed six clinical questions using the PICO (population, intervention, comparison, and outcome) principle in diagnosis and treatment for critical ill cancer patients with acute respiratory failure (ARF). Based on literature searching and meta-analyses, recommendations were devised. The GRADE (grading of recommendation assessment, development and evaluation) method was applied to each question to reach consensus in the expert panel...
September 21, 2023: Chinese Medical Sciences Journal
Li Xiao, Kang Yu, Jiao-Jiao Yang, Wen-Tao Liu, Lei Liu, Hui-Hui Miao, Tian-Zuo Li
BACKGROUND: Electrical impedance tomography (EIT) has been shown to be useful in guiding individual positive end-expiratory pressure titration for patients with mechanical ventilation. However, the appropriate positive end-expiratory pressure (PEEP) level and whether the individualized PEEP needs to be adjusted during long-term surgery (>6 h) were unknown. Meanwhile, the effect of individualized PEEP on the distribution of pulmonary ventilation in patients who receive abdominal thermoperfusion chemotherapy is unknown...
2023: Frontiers in Medicine
Elizabeth Colglazier, Angelica J Ng, Claire Parker, David Woolsey, Raymond Holmes, Allison Dsouza, Jasmine Becerra, Leah Stevens, Hythem Nawaytou, Roberta L Keller, Jeffrey R Fineman
Inhaled iloprost (iILO) has shown efficacy in treating patients with hypoxic lung disease and pulmonary hypertension, inducing selective pulmonary vasodilation and improvement in oxygenation. However, its short elimination half-life of 20-30 min necessitates frequent intermittent dosing (6-9 times per day). Thus, the administration of iILO via continuous nebulization represents an appealing method of drug delivery in the hospital setting. The objectives are: (1) describe our continuous iILO delivery methodology and safety profile in mechanically ventilated pediatric pulmonary hypertension patients; and (2) characterize the initial response of iILO in these pediatric patients currently receiving iNO...
July 2023: Pulmonary Circulation
Sahar Kmal Hegazy, Samar Tharwat, Ahmed Hosny Hassan
BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic stimulates research works to find a solution to this crisis from starting 2020 year up to now. With ending of the 2021-year, various advances in pharmacotherapy against COVID-19 have emerged. Regarding antiviral therapy, casirivimab and imdevimab antibody combination is a type of new immunotherapy against COVID-19. Standard antiviral therapy against COVID-19 includes Remdesivir and Favipiravir. AIM: To evaluate the efficacy of antibodies cocktail (casirivimab and imdevimab) compared to standard antiviral therapy in reducing the need for invasive mechanical ventilation (IMV)...
September 16, 2023: World Journal of Clinical Cases
Jun-Jun Wang, Zhong Zhou, Li-Ying Zhang
BACKGROUND: At present, understanding of the most effective ventilation methods for treating chronic obstructive pulmonary disease (COPD) patients experiencing acute worsening symptoms and respiratory failure remains relatively limited. This report analyzed the efficiency and side effects of various ventilation techniques used for individuals experiencing an acute COPD exacerbation. AIM: To determine whether pressure-controlled ventilation (PCV) can lower peak airway pressures (PAPs) and reduce the incidence of barotrauma compared to volume-controlled ventilation (VCV), without compromising clinical outcomes and oxygenation parameters...
September 16, 2023: World Journal of Clinical Cases
Andrea Sikora, Hayoung Jeong, Mengyun Yu, Xianyan Chen, Brian Murray, Rishikesan Kamaleswaran
Unsupervised clustering of intensive care unit (ICU) medications may identify unique medication clusters (i.e., pharmacophenotypes) in critically ill adults. We performed an unsupervised analysis with Restricted Boltzmann Machine of 991 medications profiles of patients managed in the ICU to explore pharmacophenotypes that correlated with ICU complications (e.g., mechanical ventilation) and patient-centered outcomes (e.g., length of stay, mortality). Six unique pharmacophenotypes were observed, with unique medication profiles and clinically relevant differences in ICU complications and patient-centered outcomes...
September 20, 2023: Scientific Reports
Yong Xu, Yu Li, Da Zhai, Chen Yan, Jingyan Liang, Taiga Ichinomiya, Tetsuya Hara, Chiaki Inadomi, Tao-Sheng Li
BACKGROUND: Mechanical ventilation is a supportive therapy used to maintain respiratory function in several clinical and surgical cases but is always accompanied by lung injury risk due to improper treatment. We investigated how tidal volume and oxygen delivery would contribute independently or synergistically to ventilator-induced lung injury (VILI). METHODS: Under general anesthesia and tracheal intubation, healthy female C57BL/6 N mice (9 weeks old) were randomly ventilated for 2 h by standard (7 ml/kg) or high (14 ml/kg) tidal volume at positive end-expiratory pressure (PEEP) of 2 cmH2 O, with room air, 50% O2 (moderate hyperoxia), or 100% O2 (severe hyperoxia); respectively...
September 20, 2023: BMC Pulmonary Medicine
Alfonsina Ruiz-Spinelli, Jordi Rello
The optimal antimicrobial regimen for adults with respiratory failure due to Legionella pneumonia remains controversial. A systematic review was performed to assess the impact on outcomes comparing quinolones versus macrolides. A literature search was conducted in PubMed, Cochrane Library and Web of Science between 2012 and 2022. It yielded 124 potentially articles and ten observational studies met the inclusion criteria. A total of 4271 patients were included, 2879 (67 %) were male. A total of 1797 (42 %) subjects required intensive care unit (ICU) admission and 942 (52 %) mechanical ventilation...
September 18, 2023: European Journal of Internal Medicine
Anca Balintescu, Susanne Rysz, Carl Hertz, Jonathan Grip, Maria Cronhjort, Anders Oldner, Christer Svensen, Johan Mårtensson
OBJECTIVE: Using glycated haemoglobin A1c (HbA1c) screening, we aimed to determine the prevalence of chronic dysglycaemia among patients with COVID-19 admitted to the intensive care unit (ICU). Additionally, we aimed to explore the association between chronic dysglycaemia and clinical outcomes related to ICU stay. DESIGN: Multicentre retrospective observational study. SETTING: ICUs in three hospitals in Stockholm, Sweden. PARTICIPANTS: COVID-19 patients admitted to the ICU between 5 March 2020 and 13 August 2020 with available HbA1c at admission...
September 19, 2023: BMJ Open
Xiaojuan Duan, Xin Song, Caidie Yang, Yunchi Li, Liang Wei, Yushun Gong, Yongqin Li
UNLABELLED: Respiration is one of the critical vital signs for human health status and accurate respiratory monitoring has important clinical significance. There is substantial evidence that alterations in key respiratory parameters can be used to determine a patient's health status, aid in the selection of appropriate treatments, predict potentially serious clinical events and control respiratory activity. Although various approaches have been developed for respiration monitoring, no definitive conclusions have been drawn about the accuracy of these approaches because each has different advantages and limitations...
September 20, 2023: Physiological Measurement
Jason H T Bates, David W Kaczka, Michaela Kollisch-Singule, Gary F Nieman, Donald P Gaver Iii
No abstract text is available yet for this article.
September 20, 2023: American Journal of Respiratory and Critical Care Medicine
Guilherme Jorge Costa, José Roberto da Silva Junior, Caio Cesar Arruda da Silva, Tiago Pessoa Ferreira de Lima, Mariana Menezes Costa, Marcos Henrique Oliveira Sousa, Gabriela Carla Dos Santos Costa, José Iran Costa Júnior, Mozart Júlio Tabosa Sales
OBJECTIVE: To determine the clinical profile of COVID-19 inpatients who were vaccinated prior to hospitalization and to compare the risk factors for death and the 28-day survival rate of between those inpatients vaccinated with one, two, or three doses and unvaccinated COVID-19 inpatients. METHODS: This was a retrospective observational cohort study involving COVID-19 patients admitted to a referral hospital in the city of Recife, Brazil, between July of 2020 and June of 2022...
2023: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Marcella M Musumeci, Bruno Valle Pinheiro, Luciana Dias Chiavegato, Danielle Silva Almeida Phillip, Flavia R Machado, Fabrício Freires, Osvaldo Shigueomi Beppu, Jaquelina Sonoe Ota Arakaki, Roberta Pulcheri Ramos
OBJECTIVE: To identify factors associated with prolonged weaning and mortality in critically ill COVID-19 patients admitted to ICUs and under invasive mechanical ventilation. METHODS: Between March of 2020 and July of 2021, we retrospectively recorded clinical and ventilatory characteristics of critically ill COVID-19 patients from the day of intubation to the outcome. We classified the patients regarding the weaning period in accordance with established criteria...
2023: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Tomasz Jarymowicz, Artur Baranowski, Justyna Pietrzyk, Izabela Pągowska-Klimek
INTRODUCTION: Although manifestation of SARS-CoV-2 infection in children is gene-rally mild or asymptomatic, anaesthetic implications of the infection in children are still a matter of concern. Single reports suggest that patients with SARS-CoV-2 infection are at higher risk of anaesthetic complications. MATERIAL AND METHODS: We performed a retrospective, case control study analysing the risk of general anaesthesia in SARS-CoV-2 infected children admitted to a tertiary paediatric university hospital for the purpose of urgent procedures requiring anaesthesia  between April 1st and September 30 th , 2021...
2023: Anaesthesiology Intensive Therapy
Justyna Sysiak-Sławecka, Oksana Wichowska, Paweł Piwowarczyk, Michał Borys
INTRODUCTION: Bacterial superinfections are common in severely ill COVID-19 patients and could be associated with a significant increase in morbidity and mortality. MATERIAL AND METHODS: We assessed 29 critically ill patients treated in a university hospital's intensive care unit (ICU). Each patient required mechanical ventilation due to COVID-19-induced acute respiratory distress syndrome (ARDS). Fifteen patients who required venovenous extracorporeal membrane oxygenation (VV-ECMO) support (ECMO group) were compared to a control group (CON group) of 14 individuals without ECMO...
2023: Anaesthesiology Intensive Therapy
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