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JOURNAL ARTICLE
John Nathan Freeman, Callie Giroux, Timothy King, Christina Marbrey, Matthew Maready, Simeen Pasha, Justin Davis
OBJECTIVES: Our objectives were to characterize variations from standardized, evidence-based guidelines in the management of pediatric patients with diabetic ketoacidosis (DKA) based on initial presentation to a tertiary pediatric emergency department (PED) versus a community emergency department (OSH) and compare clinical outcomes. METHODS: We conducted a retrospective study on children 18 years and younger with DKA who presented to an OSH or PED over a 3-year period...
April 2, 2024: Pediatric Emergency Care
#22
JOURNAL ARTICLE
Miguel Ortiz-Barrios, Antonella Petrillo, Sebastián Arias-Fonseca, Sally McClean, Fabio de Felice, Chris Nugent, Sheyla-Ariany Uribe-López
BACKGROUND: Shortages of mechanical ventilation have become a constant problem in Emergency Departments (EDs), thereby affecting the timely deployment of medical interventions that counteract the severe health complications experienced during respiratory disease seasons. It is then necessary to count on agile and robust methodological approaches predicting the expected demand loads to EDs while supporting the timely allocation of ventilators. In this paper, we propose an integration of Artificial Intelligence (AI) and Discrete-event Simulation (DES) to design effective interventions ensuring the high availability of ventilators for patients needing these devices...
April 2, 2024: International Journal of Emergency Medicine
#23
JOURNAL ARTICLE
Chuanlin Zhang, Xueqin Wang, Jie Mi, Zeju Zhang, Xinyi Luo, Ruiying Gan, Shaoyu Mu
OBJECTIVE: Intensive care unit (ICU)-acquired weakness often occurs in patients with invasive mechanical ventilation (IMV). Early active mobility may reduce ICU-acquired weakness, improve functional status, and reduce disability. The aim of this study was to investigate whether high-intensity early mobility improves post-ICU discharge functional status of IMV patients. METHODS: 132 adult patients in the ICU who were undergoing IMV were randomly assigned into two groups with a ratio of 1 : 1, with one group received high-intensity early mobility (intervention group, IG), while the other group received conventional treatment (control group, CG)...
2024: Critical Care Research and Practice
#24
JOURNAL ARTICLE
Shaurya Taran, Bastien Perrot, Federico Angriman, Raphael Cinotti
OBJECTIVES: To evaluate the association between the pre-extubation sum of eye and motor components of the Glasgow Coma Score (GCS-EM) and odds of extubation failure in patients with acute brain injury being liberated from mechanical ventilation. DESIGN: Secondary analysis of a prospective, multicenter observational study (ClinicalTrials.gov identifier NCT03400904). SETTING: Sixty-three hospital sites worldwide, with patient recruitment from January 2018 to November 2020...
April 1, 2024: Critical Care Medicine
#25
JOURNAL ARTICLE
Suzana Margareth Lobo, Gaétan Plantefève, Girish Nair, Adilson Joaquim Cavalcante, Nara Franzin de Moraes, Estevao Nunes, Otis Barnum, Claudio Marcel Berdun Stadnik, Maria Patelli Lima, Muriel Lins, Ludhmila Abrahao Hajjar, Christopher Lipinski, Shaheen Islam, Fabiano Ramos, Tiago Simon, Jean-Benoît Martinot, Thomas Guimard, Arnaud Desclaux, Bertrand Lioger, Fernando Carvalho Neuenschwander, Bruno DeSouza Paolino, Alpesh Amin, Samuel Amil Acosta, Daniel Forde Dilling, Edgardo Cartagena, Brian Snyder, Edouard Devaud, Ana Karolina Barreto Berselli Marinho, Suzana Tanni, Patricia Medeiros Milhomem Beato, Stephan De Wit, Vani Selvan, Jeffrey Gray, Ricardo Fernandez, Valérie Pourcher, Lee Maddox, Richard Kay, Anait Azbekyan, Mounia Chabane, Cendrine Tourette, Luis Everton Esmeraldino, Pierre J Dilda, René Lafont, Jean Mariani, Serge Camelo, Sandrine Rabut, Samuel Agus, Stanislas Veillet, Waly Dioh, Rob van Maanen, Capucine Morelot-Panzini
BACKGROUND: SARS-CoV-2 binding to ACE2 is potentially associated with severe pneumonia due to COVID-19. The aim of the study was to test whether Mas-receptor activation by 20-hydroxyecdysone (BIO101) could restore the Renin-Angiotensin System equilibrium and limit the frequency of respiratory failure and mortality in adults hospitalized with severe COVID-19. METHODS: Double-blind, randomized, placebo-controlled phase 2/3 trial. Randomization: 1:1 oral BIO101 (350 mg BID) or placebo, up to 28 days or until an endpoint was reached...
February 2024: EClinicalMedicine
#26
REVIEW
Rozeta Sokou, Alexia Eleftheria Palioura, Paschalia Kopanou Taliaka, Aikaterini Konstantinidi, Andreas G Tsantes, Daniele Piovani, Konstantina A Tsante, Eleni A Gounari, Zoi Iliodromiti, Theodora Boutsikou, Argirios E Tsantes, Stefanos Bonovas, Nicoletta Iacovidou
(1) Background: In recent years, a global epidemiological shift in candidemia has been observed, marked by the emergence of resistant non-albicans Candida species. Candida auris , in particular, has become a significant global concern, causing infections in both pediatric and adult populations within healthcare settings. Despite its widespread impact, there is a limited understanding of the clinical course and transmission dynamics of neonatal systemic Candida auris infections, hindering effective prevention and management...
March 10, 2024: Journal of Clinical Medicine
#27
JOURNAL ARTICLE
Tamara Jahmani, Michael R Miller, Orlando da Silva, Soume Bhattacharya
UNLABELLED: Minimally invasive surfactant therapy (MIST) has emerged as a preferred method of surfactant delivery. Pioneers of this technique have described the use of direct laryngoscopy (DL) for MIST. With the increasing application of video laryngoscopy (VL) for neonatal airway management, it is speculated that MIST techniques can be adapted for use with VL. OBJECTIVE: To compare procedural success, operator ease of use, and complication of MIST using VL vs. MIST using DL...
March 9, 2024: Biomedicines
#28
REVIEW
Ricardo Arriagada, María Consuelo Bachmann, Constanza San Martin, Michela Rauseo, Denise Battaglini
Respiratory physiotherapy, including the management of invasive mechanical ventilation (MV) and noninvasive mechanical ventilation (NIV), is a key supportive intervention for critically ill patients. MV has potential for inducing ventilator-induced lung injury (VILI) as well as long-term complications related to prolonged bed rest, such as post-intensive care syndrome and intensive care unit acquired weakness. Physical and respiratory therapy, developed by the critical care team, in a timely manner, has been shown to prevent these complications...
March 26, 2024: Medicina intensiva
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JOURNAL ARTICLE
Yuemei Feng, Qiao Sun, Chun Guan, Sumei Wang, Peng Wang, Dan Hu
OBJECTIVE: To investigate the effect of early pulmonary rehabilitation (PR) training on the improvement of respiratory function in patients with acute respiratory distress syndrome (ARDS) after weaning of invasive mechanical ventilation in the intensive care unit (ICU). METHODS: The retrospective cohort research method was used. The clinical information of adult patients with ARDS receiving invasive mechanical ventilation admitted to the ICU of Qingdao Municipal Hospital from January 2019 to March 2023 was collected...
March 2024: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
#30
JOURNAL ARTICLE
Decai Ren, Lili Zhou, Chengqing Zheng, Shanmin Xie, Ranjie Yu
OBJECTIVE: To investigate the clinical effect of helium-oxygen mechanical ventilation on inflammation of the diseased lung segment and diaphragm function in patients with acute respiratory distress syndrome (ARDS) caused by pneumonia who suffered difficulty weaning from mechanical ventilation. METHODS: A prospective controlled study was conducted. A total of 40 patients with ARDS caused by pneumonia and requiring tracheal intubation with difficulty weaning from mechanical ventilation, admitted to the department of critical care medicine in Pingtan Branch of Fujian Medical University Union Hospital from October 2020 to December 2021 were enrolled...
March 2024: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
#31
JOURNAL ARTICLE
Mohamad F El-Khatib, Salah M Zeinelddine, Thuraya H HajAli, Marwan Rizk, Matthias van der Staay, Robert L Chatburn
BACKGROUND: In recent years, mechanical power (MP) has emerged as an important concept that can significantly impact outcomes from mechanical ventilation. Several individual components of ventilatory support such as tidal volume (VT ), breathing frequency, and PEEP have been shown to contribute to the extent of MP delivered from a mechanical ventilator to patients in respiratory distress/failure. The aim of this study was to identify which common individual setting of mechanical ventilation is more efficient in maintaining safe and protective levels of MP using different modes of ventilation in simulated subjects with ARDS...
March 27, 2024: Respiratory Care
#32
JOURNAL ARTICLE
Klara R Klein, Trine J Abrahamsen, Anna R Kahkoska, G Caleb Alexander, Christopher G Chute, Melissa Haendel, Stephanie S Hong, Hemalkumar Mehta, Richard Moffitt, Til Stürmer, Kajsa Kvist, John B Buse
INTRODUCTION: People with type 2 diabetes are at heightened risk for severe outcomes related to COVID-19 infection, including hospitalization, intensive care unit admission, and mortality. This study was designed to examine the impact of premorbid use of glucagon-like peptide-1 receptor agonist (GLP-1RA) monotherapy, sodium-glucose cotransporter-2 inhibitor (SGLT-2i) monotherapy, and concomitant GLP1-RA/SGLT-2i therapy on the severity of outcomes in individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection...
March 27, 2024: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
#33
JOURNAL ARTICLE
Valentino Allocca, Luca Guidelli, Angela Galgano, Lucia Benedetti, Roberto Fabbroni, Andrea Bianco, Piero Paladini, Raffaele Scala
INTRODUCTION: Medical pleuroscopy (MP) is an invasive technique that provides access to the pleural space with a rigid or semi-rigid work instrument, allowing for visualization and the obtaining of bioptic pleural samples. Using pulmonologist-based analgosedation to perform pleuroscopy is still debated for safety reasons. The aim of this real-life study is to demonstrate the safety and diagnostic yield of MP performed under balanced analgosedation by a pulmonologist team with expertise in the management of critically ill patients in the respiratory intensive care unit (RICU) and interventional pulmonology unit as compared to video-assisted thoracic surgery (VATS) performed by a thoracic surgeon team under anesthesiologist-based analgosedation...
March 7, 2024: Diagnostics
#34
Adriana América Silva, Inês Zão, João A Louro, Eduarda Pereira, Elisabete Monteiro
Meningitis is a rare but possible complication of sinusitis. We present a case of a 21-year-old woman with a history of fever, headache and nasal obstruction who presented at the emergency department with psychomotor agitation. Orotracheal intubation and invasive mechanical ventilation were given to protect airway. Blood analysis showed leukocytosis and elevated C-reactive protein. Cerebral and maxillofacial computed tomography (CT) demonstrated pansinusitis with gas foci more prominent in the left frontal sinus with an area of bone rarefaction on the posterior wall with possible communication with the cranial cavity...
February 2024: Curēus
#35
JOURNAL ARTICLE
Luca F Roggeveen, Ali El Hassouni, Harm-Jan de Grooth, Armand R J Girbes, Mark Hoogendoorn, Paul W G Elbers
BACKGROUND: Reinforcement learning (RL) holds great promise for intensive care medicine given the abundant availability of data and frequent sequential decision-making. But despite the emergence of promising algorithms, RL driven bedside clinical decision support is still far from reality. Major challenges include trust and safety. To help address these issues, we introduce cross off-policy evaluation and policy restriction and show how detailed policy analysis may increase clinical interpretability...
March 25, 2024: Intensive Care Medicine Experimental
#36
Christopher M Russo, Mitchell E Harrison, Nathaniel M Harry, John R Benjamin, Christian Popa
Intraoperative acute cardiac tamponade associated with iatrogenic intracardiac perforation from percutaneous interventional cardiac procedures is a rare but potentially catastrophic complication. We report a case of intraoperative acute hemopericardium caused by a left atrial (LA) perforation resulting in cardiac tamponade in a patient undergoing a baffling procedure for the correction of two anomalous pulmonary veins draining into her superior vena cava (SVC) that required continuous pericardiocentesis with autologous blood transfusion via the femoral vein and an emergency intraoperative transfer from the interventional cardiology cath lab to the cardiac operating room for an open sternotomy and primary repair...
February 2024: Curēus
#37
JOURNAL ARTICLE
Lucas Pereto Silva, Rebecca Benício Stocco, Marcos Roberto Curcio Pereira, Julia Naomi Koga, Isabela Pontarolo Gomes, João Eduardo Carvalho, Giovana Muniz Beni, Paulo Negreiros, Cristina P Baena, Gustavo Lenci Marques
INTRODUCTION: With the advent of the COVID-19 pandemic, numerous questions have arisen regarding the screening, diagnosis, treatment, and prognosis of infected patients. Among these, screening infected patients through body temperature measurement has proven ineffective. However, doubts persist regarding the role of fever as a prognostic factor in the disease. OBJECTIVE: To assess the prevalence of fever and its relevance as a marker of mortality in COVID-19. METHODOLOGY: This prospective and longitudinal cohort study was conducted between April 2020 and December 2021 and analyzed 1400 COVID-19 patients systematically admitted to the emergency department of a reference hospital during the period from April 2020 to December 2021, in the city of Curitiba, Brazil...
February 2024: Curēus
#38
REVIEW
Yitianhe Xu, Leyao Lv, Qian Wang, Qing Yao, Longfa Kou, Hailin Zhang
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are serious lung injuries caused by various factors, leading to increased permeability of the alveolar-capillary barrier, reduced stability of the alveoli, inflammatory response, and hypoxemia. Despite several decades of research since ARDS was first formally described in 1967, reliable clinical treatment options are still lacking. Currently, supportive therapy and mechanical ventilation are prioritized, and there is no medication that can be completely effective in clinical treatment...
March 21, 2024: Colloids and Surfaces. B, Biointerfaces
#39
REVIEW
Frances M Russell, Nicholas E Harrison, Oliver Hobson, Nicholas Montelauro, Cecelia J Vetter, Daniel Brenner, Sarah Kennedy, Benton R Hunter
BACKGROUND: Lung ultrasound (LUS) reduces time to diagnosis and treatment of acute decompensated heart failure (ADHF) in emergency department (ED) patients with undifferentiated dyspnea. We conducted a systematic review to evaluate the diagnostic accuracy and clinical impact of LUS for ADHF in the prehospital setting. METHODS: We performed a keyword search of multiple databases from inception through June 1, 2023. Included studies were those enrolling prehospital patients with undifferentiated dyspnea or suspected ADHF, and specifically diagnostic studies comparing prehospital LUS to a gold standard and intervention studies with a non-US comparator group...
March 18, 2024: American Journal of Emergency Medicine
#40
JOURNAL ARTICLE
Mesiya Aydin, Tuba Yilmaz Bulut, İlknur Aydin Avcİ
AIM: The aim of this study is to investigate the adaptation of caregivers of individuals on mechanical ventilation (MV) at home to their caregiver role. STUDY DESIGN: The phenomenological research method, one of the qualitative research methods, was employed in the study. MATERIALS AND METHODS: The sample consisted of 21 individuals who agreed to participate in the research. Necessary legal permissions were obtained to conduct the study. RESULTS: The data were analyzed according to the Roy adaptation model (RAM)...
January 2024: Indian Journal of Critical Care Medicine
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