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Adapting NeuroVanguard to real-world challenges Crit. Care (IF 15.1) Pub Date : 2024-04-23 Andres Giglio, Monserrat Pino, Andres Ferre, Andres Reccius
Dear Editor, We read with great interest the review by Rodriguez et al. on the "NeuroVanguard" strategy for neuromonitoring in severe adult brain injury patients [1]. The authors present a compelling case for combining noninvasive and invasive monitoring tools to enhance treatment customization and improve care quality. However, we believe that certain aspects of this approach warrant further consideration
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Respiratory drive heterogeneity associated with systemic inflammation and vascular permeability in acute respiratory distress syndrome Crit. Care (IF 15.1) Pub Date : 2024-04-23 Elias Baedorf-Kassis, Michael Murn, Amy L. Dzierba, Alexis L. Serra, Ivan Garcia, Emily Minus, Clarissa Padilla, Todd Sarge, Valerie M. Goodspeed, Michael A. Matthay, Michelle N. Gong, Deborah Cook, Stephen H. Loring, Daniel Talmor, Jeremy R. Beitler
In acute respiratory distress syndrome (ARDS), respiratory drive often differs among patients with similar clinical characteristics. Readily observable factors like acid–base state, oxygenation, mechanics, and sedation depth do not fully explain drive heterogeneity. This study evaluated the relationship of systemic inflammation and vascular permeability markers with respiratory drive and clinical outcomes
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Transforming research to improve therapies for trauma in the twenty-first century: an alternative perspective Crit. Care (IF 15.1) Pub Date : 2024-04-23 Geoffrey P. Dobson, Jodie L. Morris, Hayley L. Letson
We read with interest the perspective of Juffermans and colleagues on transforming research to improve therapies for trauma care in the twenty-first century [1]. We would like to offer a different perspective. We think a more interesting approach is to ask how historians of science 50 or 100 years from now might view our progress in the early twenty-first century? Instead of looking into the future
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Case study observational research: inflammatory cytokines in the bronchial epithelial lining fluid of COVID-19 patients with acute hypoxemic respiratory failure Crit. Care (IF 15.1) Pub Date : 2024-04-23 Kazuki Sudo, Mao Kinoshita, Ken Kawaguchi, Kohsuke Kushimoto, Ryogo Yoshii, Keita Inoue, Masaki Yamasaki, Tasuku Matsuyama, Kunihiko Kooguchi, Yasuo Takashima, Masami Tanaka, Kazumichi Matsumoto, Kei Tashiro, Tohru Inaba, Bon Ohta, Teiji Sawa
In this study, the concentrations of inflammatory cytokines were measured in the bronchial epithelial lining fluid (ELF) and plasma in patients with acute hypoxemic respiratory failure (AHRF) secondary to severe coronavirus disease 2019 (COVID-19). We comprehensively analyzed the concentrations of 25 cytokines in the ELF and plasma of 27 COVID-19 AHRF patients. ELF was collected using the bronchial
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Lower airway microbiota compositions differ between influenza, COVID-19 and bacteria-related acute respiratory distress syndromes Crit. Care (IF 15.1) Pub Date : 2024-04-22 Sébastien Imbert, Mathilde Revers, Raphaël Enaud, Arthur Orieux, Adrian Camino, Alexandre Massri, Laurent Villeneuve, Cédric Carrié, Laurent Petit, Alexandre Boyer, Patrick Berger, Didier Gruson, Laurence Delhaes, Renaud Prével
Acute respiratory distress syndrome (ARDS) is responsible for 400,000 deaths annually worldwide. Few improvements have been made despite five decades of research, partially because ARDS is a highly heterogeneous syndrome including various types of aetiologies. Lower airway microbiota is involved in chronic inflammatory diseases and recent data suggest that it could also play a role in ARDS. Nevertheless
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Rapidly improving ARDS differs clinically and biologically from persistent ARDS Crit. Care (IF 15.1) Pub Date : 2024-04-22 Patricia L. Valda Toro, Andrew Willmore, Nelson E. Wu, Kevin L. Delucchi, Alejandra Jauregui, Pratik Sinha, Kathleen D. Liu, Carolyn M. Hendrickson, Aartik Sarma, Lucile P. A. Neyton, Aleksandra Leligdowicz, Charles R. Langelier, Hanjing Zhuo, Chayse Jones, Kirsten N. Kangelaris, Antonio D. Gomez, Michael A. Matthay, Carolyn S. Calfee
Rapidly improving acute respiratory distress syndrome (RIARDS) is an increasingly appreciated subgroup of ARDS in which hypoxemia improves within 24 h after initiation of mechanical ventilation. Detailed clinical and biological features of RIARDS have not been clearly defined, and it is unknown whether RIARDS is associated with the hypoinflammatory or hyperinflammatory phenotype of ARDS. The purpose
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Ventilator-associated pneumonia related to extended-spectrum beta-lactamase producing Enterobacterales during severe acute respiratory syndrome coronavirus 2 infection: risk factors and prognosis Crit. Care (IF 15.1) Pub Date : 2024-04-20 Keyvan Razazi, Charles-Edouard Luyt, Guillaume Voiriot, Anahita Rouzé, Marc Garnier, Alexis Ferré, Laurent Camous, Nicholas Heming, Nathanaël Lapidus, Anais Charles-Nelson, Armand Mekontso-Dessap
Patients infected with the severe acute respiratory syndrome coronavirus 2 (SARS-COV 2) and requiring mechanical ventilation suffer from a high incidence of ventilator associated pneumonia (VAP), mainly related to Enterobacterales. Data regarding extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E) VAP are scarce. We aimed to investigate risk factors and outcomes of ESBL-E related VAP
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ACE inhibitors and angiotensin receptor blockers differentially alter the response to angiotensin II treatment in vasodilatory shock Crit. Care (IF 15.1) Pub Date : 2024-04-18 Daniel E. Leisman, Damian R. Handisides, Laurence W. Busse, Mark C. Chappell, Lakhmir S. Chawla, Michael R. Filbin, Marcia B. Goldberg, Kealy R. Ham, Ashish K. Khanna, Marlies Ostermann, Michael T. McCurdy, Christopher D. Adams, Tony N. Hodges, Rinaldo Bellomo
Angiotensin-converting enzyme inhibitor (ACEi) and angiotensin receptor blockers (ARB) medications are widely prescribed. We sought to assess how pre-admission use of these medications might impact the response to angiotensin-II treatment during vasodilatory shock. In a post-hoc subgroup analysis of the randomized, placebo-controlled, Angiotensin Therapy for High Output Shock (ATHOS-3) trial, we compared
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Time-dependent effect of prone position in ARDS: considerations for future research Crit. Care (IF 15.1) Pub Date : 2024-04-18 Yuxian Wang, Ming Zhong
To the Editor We have read the article by Yuan et al. [1] with great interest, where they indicated that prone position significantly reduced ventilation/perfusion (V/Q) mismatch in patients with early ARDS, while it increased V/Q mismatch in persistent ARDS patients. However, there are several factors that might influence the reported findings: Firstly, it is important to consider that the effect
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Policy framework for the utilization of generative AI Crit. Care (IF 15.1) Pub Date : 2024-04-18 Kunming Cheng, Haiyang Wu
The ascent of generative artificial intelligence (AI) technologies has engendered a pivotal juncture in policy formulation, necessitating a comprehensive framework to govern their deployment [1,2,3]. Here, we summarized several the use of guidelines for generative AI from different institutions. In May 2023, the International Committee of Medical Journal Editors (ICMJE) issued updated recommendations
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Significance of critical closing pressures (starling resistors) in arterial circulation Crit. Care (IF 15.1) Pub Date : 2024-04-18 Michael R. Pinsky, M. Ignacio Monge García, Arnaldo Dubin
Arterial pressure is the input pressure driving tissue blood flow. However, under most conditions organ blood flow is independent of arterial pressure. Tissue blood flow is proportional to local metabolic demand and can vary widely without any change in arterial pressure. Furthermore, changes in arterial pressure within physiologic limits do not alter tissue blood flow. The reason for these apparent
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Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: be aware of the temporal selection bias Crit. Care (IF 15.1) Pub Date : 2024-04-18 Romain Jouffroy, Anne-Cécile Vie, Benoît Vivien
To the editor We read with great interest the recent meta‑analysis and trial sequential analysis published in the Journal by Low et al. [1] reporting the benefit of extracorporeal cardiopulmonary resuscitation (ECPR) for both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) outcomes improvement. However, we believe that few issues deserve the results’ interpretation and manuscript’
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Effect of intra-arrest transport, extracorporeal cardiopulmonary resuscitation and immediate invasive assessment in refractory out-of-hospital cardiac arrest: a long-term follow-up of the Prague OHCA trial Crit. Care (IF 15.1) Pub Date : 2024-04-16 Daniel Rob, Klaudia Farkasovska, Marketa Kreckova, Ondrej Smid, Petra Kavalkova, Jaromir Macoun, Michal Huptych, Petra Havrankova, Juraj Gallo, Jan Pudil, Milan Dusik, Stepan Havranek, Ales Linhart, Jan Belohlavek
Randomized data evaluating the impact of the extracorporeal cardiopulmonary resuscitation (ECPR) approach on long-term clinical outcomes in patients with refractory out-of-hospital cardiac arrest (OHCA) are lacking. The objective of this follow-up study was to assess the long-term clinical outcomes of the ECPR-based versus CCPR approach. The Prague OHCA trial was a single-center, randomized, open-label
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Contribution of electrical impedance tomography to personalize positive end-expiratory pressure under ECCO2R Crit. Care (IF 15.1) Pub Date : 2024-04-16 Benjamin Pequignot, Alain Combes, Mickael Lescroart, Bruno Levy, Matthieu Koszutski
Extracorporeal Carbon Dioxide Removal (ECCO2R) is used in acute respiratory distress syndrome (ARDS) patients to facilitate lung-protective ventilatory strategies. Electrical Impedance Tomography (EIT) allows individual, non-invasive, real-time, bedside, radiation-free imaging of the lungs, providing global and regional dynamic lung analyses. To provide new insights for future ECCO2R research in ARDS
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Impact of attaining aggressive vs. conservative PK/PD target on the clinical efficacy of beta-lactams for the treatment of Gram-negative infections in the critically ill patients: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-04-16 Milo Gatti, Pier Giorgio Cojutti, Federico Pea
To perform a systematic review with meta-analysis with the dual intent of assessing the impact of attaining aggressive vs. conservative beta-lactams PK/PD target on the clinical efficacy for treating Gram-negative infections in critical patients, and of identifying predictive factors of failure in attaining aggressive PK/PD targets. Two authors independently searched PubMed-MEDLINE and Scopus database
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Smoking on the risk of acute respiratory distress syndrome: a systematic review and meta-analysis Crit. Care (IF 15.1) Pub Date : 2024-04-14 Lujia Zhang, Jiahuan Xu, Yue Li, Fanqi Meng, Wei Wang
The relationship between smoking and the risk of acute respiratory distress syndrome (ARDS) has been recognized, but the conclusions have been inconsistent. This systematic review and meta-analysis investigated the association between smoking and ARDS risk in adults. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for eligible studies published from January 1, 2000
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Correction to: Interventions to promote cost-effectiveness in adult intensive care units: consensus statement and considerations for best practice from a multidisciplinary and multinational eDelphi study Crit. Care (IF 15.1) Pub Date : 2024-04-12 Amit Kansal, Jos M. Latour, Kay Choong See, Sumeet Rai, Maurizio Cecconi, Carl Britto, Andrew Conway Morris, Raymond Dominic Savio, Vinay M. Nadkarni, B. K. Rao, Rajesh Mishra
Correction to: Crit Care (2023) 27:487 https://doi.org/10.1186/s13054-023-04766-2 Following publication of the original article [1], the authors identified an error in the author name of Maurizio Cecconi. The incorrect author name is: Maurizo Cecconi The correct author name is: Maurizio Cecconi The Funding section currently reads: Funding The study was not funded. The Funding section should read: Funding
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Neo-epitope detection identifies extracellular matrix turnover in systemic inflammation and sepsis: an exploratory study Crit. Care (IF 15.1) Pub Date : 2024-04-12 YiWen Fan, Jill Moser, Matijs van Meurs, Dorien Kiers, Jannie Marie Bülow Sand, Diana Julie Leeming, Peter Pickkers, Janette K. Burgess, Matthijs Kox, Janesh Pillay
Sepsis is associated with high morbidity and mortality, primarily due to systemic inflammation-induced tissue damage, resulting organ failure, and impaired recovery. Regulated extracellular matrix (ECM) turnover is crucial for maintaining tissue homeostasis in health and in response to disease-related changes in the tissue microenvironment. Conversely, uncontrolled turnover can contribute to tissue
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Job description and perception of clinical research personnel working in a network of French intensive care units Crit. Care (IF 15.1) Pub Date : 2024-04-11 Mireille Adda, Claire Dupuis, Gérald Gouby, Claude Dubray, Jean Reignier, Bertrand Souweine, Christian Dualé
There is a lack of information about the organisation and management of clinical research personnel in Europe and of their professional activity in intensive care. We therefore conducted a cross-sectional survey among personnel currently working in a French intensive care research network that involves 41 centres nationwide. The aim of the survey was to describe the personnel’s personal and institutional
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Outcome prediction of cardiac arrest with automatically computed gray-white matter ratio on computed tomography images Crit. Care (IF 15.1) Pub Date : 2024-04-09 Hsinhan Tsai, Chien-Yu Chi, Liang-Wei Wang, Yu-Jen Su, Ya-Fang Chen, Min-Shan Tsai, Chih-Hung Wang, Cheyu Hsu, Chien-Hua Huang, Weichung Wang
This study aimed to develop an automated method to measure the gray-white matter ratio (GWR) from brain computed tomography (CT) scans of patients with out-of-hospital cardiac arrest (OHCA) and assess its significance in predicting early-stage neurological outcomes. Patients with OHCA who underwent brain CT imaging within 12 h of return of spontaneous circulation were enrolled in this retrospective
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Correction: Non-ventilator-associated ICU-acquired pneumonia (NV-ICU-AP) in patients with acute exacerbation of COPD: From the French OUTCOMEREA cohort Crit. Care (IF 15.1) Pub Date : 2024-04-09 Louis‑Marie Galerneau, Sebastien Bailly, Nicolas Terzi, Stephane Ruckly, Maite Garrouste‑Orgeas, Johanna Oziel, Vivien Hong Tuan Ha, Marc Gainnier, Shidasp Siami, Claire Dupuis, Jean‑Marie Forel, Anais Dartevel, Julien Dessajan, Christophe Adrie, Dany Goldgran‑Toledano, Virginie Laurent, Laurent Argaud, Jean Reignier, Jean‑Louis Pepin, Michael Darmon, Jean‑Francois Timsit
Correction:Crit Care (2023) 27:359 https://doi.org/10.1186/s13054-023-04631-2 Following publication of the original article [1], the authors identified an error in Table 1. The results were inverted between for variable No decrease in consciousness Day 1–Day 2. The correct table is given hereafter. Table 1 Baseline characteristics and mortality rate for patients with non-ventilator-associated ICU-acquired
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Plasma glial fibrillary acidic protein and tau: predictors of neurological outcome after cardiac arrest Crit. Care (IF 15.1) Pub Date : 2024-04-09 Isabelle Arctaedius, Helena Levin, Bergthóra Thorgeirsdóttir, Marion Moseby-Knappe, Tobias Cronberg, Martin Annborn, Niklas Nielsen, Henrik Zetterberg, Kaj Blennow, Nicholas J. Ashton, Attila Frigyesi, Hans Friberg, Anna Lybeck, Niklas Mattsson-Carlgren
The purpose was to evaluate glial fibrillary acidic protein (GFAP) and total-tau in plasma as predictors of poor neurological outcome after out-of-hospital (OHCA) and in-hospital cardiac arrest (IHCA), including comparisons with neurofilament light (NFL) and neuron-specific enolase (NSE). Retrospective multicentre observational study of patients admitted to an intensive care unit (ICU) in three hospitals
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Characteristics, predictors and outcomes of new-onset QT prolongation in sepsis: a multicenter retrospective study Crit. Care (IF 15.1) Pub Date : 2024-04-09 Weizhuo Liu, Rongjiao Shao, Shen Zhang, Lei Jin, Rongchen Liu, Peidong Chen, Jintao Hu, Haocheng Ma, Bangwei Wu, Weiguo Liang, Xinping Luo, Jian Li, Weiming Chen, Nanqing Xiong, Bin He
Sepsis-induced myocardial injury is a serious complication of sepsis. QT prolongation is a proarrhythmic state which reflects myocardial injury in a group of heterogeneous disorders. However, the study on the clinical value of QT prolongation in sepsis is limited. We aimed to investigate the clinical characteristics and predictors of new-onset QT prolongation in sepsis and its impact on the outcome
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Anti-inflammatory therapies are associated with delayed onset of anemia and reduction in transfusion requirements in critically ill patients: results from two studies Crit. Care (IF 15.1) Pub Date : 2024-04-09 Madelief Bolscher, Stephanie C. E. Koster, Matty Koopmans, Jelle L. G. Haitsma Mulier, Lennie P. G. Derde, Nicole P. Juffermans
Anemia is a hallmark of critical illness, which is largely inflammatory driven. We hypothesized that the use of anti-inflammatory agents limits the development of anemia and reduces the need for red blood cell (RBC) transfusions in patients with a hyper-inflammatory condition due to COVID-19. An observational cohort (n = 772) and a validation cohort (a subset of REMAP-CAP, n = 119) of critically ill
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Use of artificial intelligence in critical care: opportunities and obstacles Crit. Care (IF 15.1) Pub Date : 2024-04-08 Michael R. Pinsky, Armando Bedoya, Azra Bihorac, Leo Celi, Matthew Churpek, Nicoleta J. Economou-Zavlanos, Paul Elbers, Suchi Saria, Vincent Liu, Patrick G. Lyons, Benjamin Shickel, Patrick Toral, David Tscholl, Gilles Clermont
Perhaps nowhere else in the healthcare system than in the intensive care unit environment are the challenges to create useful models with direct time-critical clinical applications more relevant and the obstacles to achieving those goals more massive. Machine learning-based artificial intelligence (AI) techniques to define states and predict future events are commonplace activities of modern life.
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Effects of robotic-assisted early mobilization versus conventional mobilization in intensive care unit patients: prospective interventional cohort study with retrospective control group analysis Crit. Care (IF 15.1) Pub Date : 2024-04-06 Lucas Huebner, Angelika Warmbein, Christina Scharf, Ines Schroeder, Kirsi Manz, Ivanka Rathgeber, Marcus Gutmann, Johanna Biebl, Amrei Mehler-Klamt, Jana Huber, Inge Eberl, Eduard Kraft, Uli Fischer, Michael Zoller
Approximately one in three survivors of critical illness suffers from intensive-care-unit-acquired weakness, which increases mortality and impairs quality of life. By counteracting immobilization, a known risk factor, active mobilization may mitigate its negative effects on patients. In this single-center trial, the effect of robotic-assisted early mobilization in the intensive care unit (ICU) on patients’
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Volatile versus propofol sedation after cardiac valve surgery: a single-center prospective randomized controlled trial Crit. Care (IF 15.1) Pub Date : 2024-04-05 Armin Niklas Flinspach, Florian Jürgen Raimann, Philipp Kaiser, Michaela Pfaff, Kai Zacharowski, Vanessa Neef, Elisabeth Hannah Adam
Optimal intensive care of patients undergoing valve surgery is a complex balancing act between sedation for monitoring and timely postoperative awakening. It remains unclear, if these requirements can be fulfilled by volatile sedations in intensive care medicine in an efficient manner. Therefore, this study aimed to assess the time to extubation and secondary the workload required. We conducted a prospective
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Correction: Selected articles from the annual update in Intensive Care and Emergency Medicine 2021 Crit. Care (IF 15.1) Pub Date : 2024-04-05
Correction: Crit Care 25, 310 (2021). https://doi.org/10.1186/s13054-021-03670-x, Crit Care 25, 318 (2021). https://doi.org/10.1186/s13054-021-03671-w, Crit Care 25, 317 (2021). https://doi.org/10.1186/s13054-021-03672-9, Crit Care 25, 309 (2021). https://doi.org/10.1186/s13054-021-03673-8, Crit Care 25, 316 (2021). https://doi.org/10.1186/s13054-021-03674-7, Crit Care 25, 315 (2021). https://doi.org/10
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GFAP point-of-care measurement for prehospital diagnosis of intracranial hemorrhage in acute coma Crit. Care (IF 15.1) Pub Date : 2024-04-05 Sabina Zylyftari, Sebastian Luger, Kristaps Blums, Stephan Barthelmes, Sebastian Humm, Hannsjörg Baum, Stephan Meckel, Jörg Braun, Gregor Lichy, Andreas Heilgeist, Love-Preet Kalra, Christian Foerch
Prehospital triage and treatment of patients with acute coma is challenging for rescue services, as the underlying pathological conditions are highly heterogenous. Recently, glial fibrillary acidic protein (GFAP) has been identified as a biomarker of intracranial hemorrhage. The aim of this prospective study was to test whether prehospital GFAP measurements on a point-of-care device have the potential
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Vitamin D metabolism in critically ill patients with acute kidney injury: a prospective observational study Crit. Care (IF 15.1) Pub Date : 2024-04-02 Lynda K. Cameron, Lesedi Ledwaba-Chapman, Kieran Voong, Geeta Hampson, Lui G. Forni, Nina Seylanova, Dominic J. Harrington, Rosario Lim, Aneta Bociek, Wang Yanzhong, Marlies Ostermann
Vitamin D deficiency in critically ill patients is associated with poor outcomes, and vitamin D supplementation is recommended for patients with chronic kidney disease. Whether acute kidney injury (AKI) is associated with altered Vitamin D metabolism is unknown. We aimed to compare the longitudinal profiles of serum 25(OH)D and 1,25(OH)2D concentrations in critically ill patients with and without moderate
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Dyssynchronous diaphragm contractions impair diaphragm function in mechanically ventilated patients Crit. Care (IF 15.1) Pub Date : 2024-04-02 Benjamin Coiffard, Jose Dianti, Irene Telias, Laurent J. Brochard, Arthur S. Slutsky, Jennifer Beck, Christer Sinderby, Niall D. Ferguson, Ewan C. Goligher
Pre-clinical studies suggest that dyssynchronous diaphragm contractions during mechanical ventilation may cause acute diaphragm dysfunction. We aimed to describe the variability in diaphragm contractile loading conditions during mechanical ventilation and to establish whether dyssynchronous diaphragm contractions are associated with the development of impaired diaphragm dysfunction. In patients receiving
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Facial appearance associates with longitudinal multi-organ failure: an ICU cohort study Crit. Care (IF 15.1) Pub Date : 2024-04-02 Eline G. M. Cox, Bas C. T. van Bussel, Nerea Campillo Llamazares, Jan-Willem E. M. Sels, Marisa Onrust, Iwan C. C. van der Horst, Jacqueline Koeze
Facial appearance, whether consciously or subconsciously assessed, may affect clinical assessment and treatment strategies in the Intensive Care Unit (ICU). Nevertheless, the association between objective clinical measurement of facial appearance and multi-organ failure is currently unknown. The objective of this study was to examine whether facial appearance at admission is associated with longitudinal
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The management of heart failure cardiogenic shock: an international RAND appropriateness panel Crit. Care (IF 15.1) Pub Date : 2024-04-02 Stefan Williams, Antonis Kalakoutas, Segun Olusanya, Benedict Schrage, Guido Tavazzi, Anthony P. Carnicelli, Santiago Montero, Christophe Vandenbriele, Adriana Luk, Hoong Sern Lim, Sai Bhagra, Sascha C. Ott, Marta Farrero, Marc D. Samsky, Jamie L. W. Kennedy, Sounok Sen, Richa Agrawal, Penelope Rampersad, Amanda Coniglio, Federico Pappalardo, Christopher Barnett, Alastair G. Proudfoot
Observational data suggest that the subset of patients with heart failure related CS (HF-CS) now predominate critical care admissions for CS. There are no dedicated HF-CS randomised control trials completed to date which reliably inform clinical practice or clinical guidelines. We sought to identify aspects of HF-CS care where both consensus and uncertainty may exist to guide clinical practice and
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“NeuroVanguard”: a contemporary strategy in neuromonitoring for severe adult brain injury patients Crit. Care (IF 15.1) Pub Date : 2024-04-01 Edith Elianna Rodriguez, Mario Zaccarelli, Elda Diletta Sterchele, Fabio Silvio Taccone
Severe acute brain injuries, stemming from trauma, ischemia or hemorrhage, remain a significant global healthcare concern due to their association with high morbidity and mortality rates. Accurate assessment of secondary brain injuries severity is pivotal for tailor adequate therapies in such patients. Together with neurological examination and brain imaging, monitoring of systemic secondary brain
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Response to commentary “The importance of assessing left ventricular longitudinal function in presence of increased afterload” Crit. Care (IF 15.1) Pub Date : 2024-03-29 Hugues de Courson, Alexandre Loiseau, Grégoire Chadefaux, Matthieu Biais
Dear Editor, We very much appreciate Dr. Santonocito's thoughtful comments on our research, titled Myocardial dysfunction assessed by speckle-tracking in good-grade subarachnoid hemorrhage patients (WFNS 1–2): a prospective observational study [1]. The authors raise two valuable points: Threshold for defining left ventricular damage We agree that the chosen threshold may have been too high for our
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Quality of life-related and non-quality of life-related issues in ICU survivors and non-ICU-treated controls: a multi-group exploratory factor analysis Crit. Care (IF 15.1) Pub Date : 2024-03-29 Johan Malmgren, Stefan Lundin, Ann-Charlotte Waldenström, Christian Rylander, Elias Johannesson
Quality of life (QoL) is a key outcome measure in healthcare. However, the heterogeneity in its definitions presents challenges in the objective evaluation of improvement. Universal questionnaires, tailored for a broad demographic group, inadequately represent the unique experiences of intensive care unit (ICU) survivors, including a lack of ability to discriminate issues related to QoL from issues
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Hydrocortisone rapidly and significantly reduces the IL-6 level in blood and lungs of patients with COVID-19-related ARDS Crit. Care (IF 15.1) Pub Date : 2024-03-28 Antoine Guillon, Youenn Jouan, Arthur Kassa-Sombo, Christophe Paget, Pierre-François Dequin
Dear Editor, Increased levels of inflammatory mediators, particularly IL-6, have been observed in conditions like sepsis, acute respiratory distress syndrome (ARDS), and more recently, COVID-19, leading to the exploration of anti-inflammatory treatments. To date, clinical practice guidelines include strong recommendations in favor of a limited number of immunomodulatory for severe COVID-19: corticosteroids
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Unraveling the role of HIF-1α in sepsis: from pathophysiology to potential therapeutics—a narrative review Crit. Care (IF 15.1) Pub Date : 2024-03-27 Hang Ruan, Qin Zhang, You-ping Zhang, Shu-sheng Li, Xiao Ran
Sepsis is characterized by organ dysfunction resulting from a dysregulated inflammatory response triggered by infection, involving multifactorial and intricate molecular mechanisms. Hypoxia-inducible factor-1α (HIF-1α), a notable transcription factor, assumes a pivotal role in the onset and progression of sepsis. This review aims to furnish a comprehensive overview of HIF-1α's mechanism of action in
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Association between intensive care unit nursing grade and mortality in patients with cardiogenic shock and its cost-effectiveness Crit. Care (IF 15.1) Pub Date : 2024-03-25 Ki Hong Choi, Danbee Kang, Jin Lee, Hyejeong Park, Taek Kyu Park, Joo Myung Lee, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Juhee Cho, Jeong Hoon Yang
Despite the high workload of cardiac intensive care unit (ICU), there is a paucity of evidence on the association between nurse workforce and mortality in patients with cardiogenic shock (CS). This study aimed to evaluate the prognostic impact of the ICU nursing grade on mortality and cost-effectiveness in CS. A nationwide analysis was performed using the K-NHIS database. Patients diagnosed with CS
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Physical activity is associated with a lower risk of contracting and dying in infection and sepsis: a Swedish population-based cohort study Crit. Care (IF 15.1) Pub Date : 2024-03-24 Karl Stattin, Mikael Eriksson, Robert Frithiof, Rafael Kawati, Michael Hultström, Miklos Lipcsey
Sepsis is a condition where the immune response to infection becomes dysregulated and life-threatening. It is not known whether lifestyle factors influence the risk of sepsis. The aim of the present study is to investigate the association between physical activity and the risk of acquiring and dying in infection or sepsis. The population-based Swedish Mammography Cohort and Cohort of Swedish Men sent
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Vascular leak in sepsis: physiological basis and potential therapeutic advances Crit. Care (IF 15.1) Pub Date : 2024-03-23 Ross R. McMullan, Daniel F. McAuley, Cecilia M. O’Kane, Jonathan A. Silversides
Sepsis is a life-threatening condition characterised by endothelial barrier dysfunction and impairment of normal microcirculatory function, resulting in a state of hypoperfusion and tissue oedema. No specific pharmacological therapies are currently used to attenuate microvascular injury. Given the prominent role of endothelial breakdown and microcirculatory dysfunction in sepsis, there is a need for
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Breath metabolomics for diagnosis of acute respiratory distress syndrome Crit. Care (IF 15.1) Pub Date : 2024-03-23 Shiqi Zhang, Laura A. Hagens, Nanon F. L. Heijnen, Marry R. Smit, Paul Brinkman, Dominic Fenn, Tom van der Poll, Marcus J. Schultz, Dennis C. J. J. Bergmans, Ronny M. Schnabel, Lieuwe D. J. Bos
Acute respiratory distress syndrome (ARDS) poses challenges in early identification. Exhaled breath contains metabolites reflective of pulmonary inflammation. To evaluate the diagnostic accuracy of breath metabolites for ARDS in invasively ventilated intensive care unit (ICU) patients. This two-center observational study included critically ill patients receiving invasive ventilation. Gas chromatography
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The long-term intercorrelation between post-burn pain, anxiety, and depression: a post hoc analysis of the “RE-ENERGIZE” double-blind, randomized, multicenter placebo-controlled trial Crit. Care (IF 15.1) Pub Date : 2024-03-22 Adriana C. Panayi, Daren K. Heyland, Christian Stoppe, Marc G. Jeschke, Oliver Didzun, Dany Matar, Christian Tapking, Alen Palackic, Björn Bliesener, Leila Harhaus, Samuel Knoedler, Valentin Haug, Amir K. Bigdeli, Ulrich Kneser, Dennis P. Orgill, Gabriel Hundeshagen
Despite the growing prevalence of burn survivors, a gap persists in our understanding of the correlation between acute burn trauma and the long-term impact on psychosocial health. This study set out to investigate the prevalence of long-term pain and symptoms of anxiety and depression in survivors of extensive burns, comparing this to the general population, and identify injury and demographic-related
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Correction : Selected articles from the annual update in intensive care and emergency medicine 2020 Crit. Care (IF 15.1) Pub Date : 2024-03-21
Correction: Crit Care 24, 104 (2020). https://doi.org/10.1186/s13054-020-2776-z; Crit Care 24, 106 (2020). https://doi.org/10.1186/s13054-020-2777-y; Crit Care 24, 102 (2020). https://doi.org/10.1186/s13054-020-2778-x; Crit Care 24, 99 (2020). https://doi.org/10.1186/s13054-020-2779-9; Crit Care 24, 105 (2020). https://doi.org/10.1186/s13054-020-2780-3; Crit Care 24, 100 (2020). https://doi.org/10
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Intra-aortic balloon pump in patients undergoing VA-ECMO: an analysis of the Chinese Extracorporeal Life Support Registry Crit. Care (IF 15.1) Pub Date : 2024-03-21 Liangshan Wang, Xing Hao, Chenglong Li, Haixiu Xie, Feng Yang, Hong Wang, Zhongtao Du, Xiaotong Hou
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used to treat refractory cardiogenic shock (CS) or cardiac arrest (CA) over the past decades. Peripheral VA-ECMO increases left ventricular (LV) afterload, potentially impairing myocardial recovery and leading to poor outcomes. Intra-aortic balloon pump (IABP) has been suggested as an approach to unload LV in patients
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Sepsis-associated acute kidney injury: recent advances in enrichment strategies, sub-phenotyping and clinical trials Crit. Care (IF 15.1) Pub Date : 2024-03-21 Matthieu Legrand, Sean M. Bagshaw, Pavan K. Bhatraju, Azra Bihorac, Ellen Caniglia, Ashish K. Khanna, John A. Kellum, Jay Koyner, Michael O. Harhay, Fernando G. Zampieri, Alexander Zarbock, Kevin Chung, Kathleen Liu, Ravindra Mehta, Peter Pickkers, Abigail Ryan, Juliane Bernholz, Laura Dember, Martin Gallagher, Patrick Rossignol, Marlies Ostermann
Acute kidney injury (AKI) often complicates sepsis and is associated with high morbidity and mortality. In recent years, several important clinical trials have improved our understanding of sepsis-associated AKI (SA-AKI) and impacted clinical care. Advances in sub-phenotyping of sepsis and AKI and clinical trial design offer unprecedented opportunities to fill gaps in knowledge and generate better
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Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort Crit. Care (IF 15.1) Pub Date : 2024-03-21 Adrian Ceccato, Carles Forne, Lieuwe D. Bos, Marta Camprubí-Rimblas, Aina Areny-Balagueró, Elena Campaña-Duel, Sara Quero, Emili Diaz, Oriol Roca, David De Gonzalo-Calvo, Laia Fernández-Barat, Anna Motos, Ricard Ferrer, Jordi Riera, Jose A. Lorente, Oscar Peñuelas, Rosario Menendez, Rosario Amaya-Villar, José M. Añón, Ana Balan-Mariño, Carme Barberà, José Barberán, Aaron Blandino-Ortiz, Maria Victoria
Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients
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Feasibility of 3D-EIT in identifying lung perfusion defect and V/Q mismatch in a patient with VA-ECMO Crit. Care (IF 15.1) Pub Date : 2024-03-20 Yelin Gao, Ke Zhang, Maokun Li, Siyi Yuan, Qianlin Wang, Yi Chi, Yun Long, Zhanqi Zhao, Huaiwu He
Three-dimensional (3D) electrical impedance tomography (EIT) is a recently developed lung ventilation and perfusion imaging technique. Conventional two-dimensional (2D) EIT provides information on a single plane, which potentially omits important information concerning changes in global lung conditions. With the advantage of providing lung information on three planes, 3D-EIT may overcome these pitfalls
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Association between tranexamic acid administration and mortality based on the trauma phenotype: a retrospective analysis of a nationwide trauma registry in Japan Crit. Care (IF 15.1) Pub Date : 2024-03-19 Jotaro Tachino, Shigeto Seno, Hisatake Matsumoto, Tetsuhisa Kitamura, Atsushi Hirayama, Shunichiro Nakao, Yusuke Katayama, Hiroshi Ogura, Jun Oda
In trauma systems, criteria for individualised and optimised administration of tranexamic acid (TXA), an antifibrinolytic, are yet to be established. This study used nationwide cohort data from Japan to evaluate the association between TXA and in-hospital mortality among all patients with blunt trauma based on clinical phenotypes (trauma phenotypes). A retrospective analysis was conducted using data
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Monocyte state 1 (MS1) cells in critically ill patients with sepsis or non-infectious conditions: association with disease course and host response Crit. Care (IF 15.1) Pub Date : 2024-03-19 Giuseppe G. F. Leite, Justin de Brabander, Erik H. A. Michels, Joe M. Butler, Olaf L. Cremer, Brendon P. Scicluna, Timothy E. Sweeney, Miguel Reyes, Reinaldo Salomao, Hessel Peters-Sengers, Tom van der Poll
Sepsis is a life-threatening condition arising from an aberrant host response to infection. Recent single-cell RNA sequencing investigations identified an immature bone-marrow-derived CD14+ monocyte phenotype with immune suppressive properties termed “monocyte state 1” (MS1) in patients with sepsis. Our objective was to determine the association of MS1 cell profiles with disease presentation, outcomes
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Effect of a self-developed fixation device on preventing endotracheal intubation-related pressure injury: a randomised controlled trial Crit. Care (IF 15.1) Pub Date : 2024-03-19 Xiaodong Zhang, Qibing Zhang, Jiqin You, Rong Xu, Zhaojie Zhang, Yunlan Shi, Chunrong Han, Shiyan Zhao, Bangtao Yao, Yan Geng, Songqiao Liu
To evaluate the effects of our self-developed endotracheal tube fixation device in mechanically ventilated patients. In a dual-centre randomised controlled trial, patients who were expected to require mechanical ventilation for over 48 h were assigned to the observation group (using self-developed device) or the control group (using the traditional device). The primary endpoint was the incidence of
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43rd International Symposium on Intensive Care & Emergency Medicine Crit. Care (IF 15.1) Pub Date : 2024-03-19
J Saoraya, ACKB Amaral, F Angriman Sunnybrook Health Sciences Centre, Department of Critical Care Medicine, Toronto, Canada Critical Care 2024, 28(Suppl 1): P001 Introduction: Prolonged boarding of critically ill patients in the emergency department (ED) may be associated with worse clinical outcomes. However, whether this association would exist in settings that have implemented a critical care consultation
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A comparison of extracorporeal and conventional cardiopulmonary resuscitation for cardiac arrest Crit. Care (IF 15.1) Pub Date : 2024-03-18 Yang Zhao, Qian Wang, Bin Zang
To the Editor, We are highly interested in the recent article published in Critical Care by Low CJW et al., titled "Extracorporeal cardiopulmonary resuscitation versus conventional CPR in cardiac arrest: an updated meta-analysis and trial sequential analysis" [1]. In updating their previous systematic review and meta-analysis [2], the authors found that extracorporeal cardiopulmonary resuscitation
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The incidences of acute mesenteric ischaemia vary greatly depending on the population and diagnostic activity Crit. Care (IF 15.1) Pub Date : 2024-03-18 Annika Reintam Blaser, Kadri Tamme, Joel Starkopf, Alastair Forbes, Marko Murruste, Peep Talving, Stefan Acosta, Martin Björck
We much appreciate the interest of Drs Gazelli and Nacher regarding the AMESI study [1, 2], and for their effort to debate the difficulties in establishing a “true incidence” of acute mesenteric ischaemia (AMI) [3]. To address the question of true incidence, we first need to acknowledge the multifaceted nature of AMI. The main drivers of arterial occlusive AMI are cardiac arrhythmias (that increase
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Trauma systems in high socioeconomic index countries in 2050 Crit. Care (IF 15.1) Pub Date : 2024-03-16 Tobias Gauss, Mariska de Jongh, Marc Maegele, Elaine Cole, Pierre Bouzat
Considerable political, structural, environmental and epidemiological change will affect high socioeconomic index (SDI) countries over the next 25 years. These changes will impact healthcare provision and consequently trauma systems. This review attempts to anticipate the potential impact on trauma systems and how they could adapt to meet the changing priorities. The first section describes possible
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The elusive relationship between cardiac filling and fluid responsiveness Crit. Care (IF 15.1) Pub Date : 2024-03-15 Jon-Emile S. Kenny, Ross Prager, Korbin Haycock
Munoz et al. [1] have recently published an important pilot study in Critical Care. In 90 mechanically ventilated patients with circulatory failure who were admitted to the intensive care unit (ICU) for less than 24 h, four measures of ‘venous congestion’ (VC) were related to fluid responsiveness (FR) or unresponsiveness (FUR). To score VC, each patient received 1 point for any of the following: (1)
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Effects of prone positioning on lung mechanical power components in patients with acute respiratory distress syndrome: a physiologic study Crit. Care (IF 15.1) Pub Date : 2024-03-15 Christoph Boesing, Joerg Krebs, Alice Marguerite Conrad, Matthias Otto, Grietje Beck, Manfred Thiel, Patricia R. M. Rocco, Thomas Luecke, Laura Schaefer
Prone positioning (PP) homogenizes ventilation distribution and may limit ventilator-induced lung injury (VILI) in patients with moderate to severe acute respiratory distress syndrome (ARDS). The static and dynamic components of ventilation that may cause VILI have been aggregated in mechanical power, considered a unifying driver of VILI. PP may affect mechanical power components differently due to
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Trends in pre-hospital volume resuscitation of blunt trauma patients: a 15-year analysis of the British (TARN) and German (TraumaRegister DGU®) National Registries Crit. Care (IF 15.1) Pub Date : 2024-03-15 M. F. Bath, J. Schloer, J. Strobel, W. Rea, R. Lefering, M. Maegele, H. De’Ath, Z. B. Perkins
Fluid resuscitation has long been a cornerstone of pre-hospital trauma care, yet its optimal approach remains undetermined. Although a liberal approach to fluid resuscitation has been linked with increased complications, the potential survival benefits of a restrictive approach in blunt trauma patients have not been definitively established. Consequently, equipoise persists regarding the optimal fluid
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Scrutinizing mechanical circulatory support in cardiogenic shock: Have we jumped the gun? Crit. Care (IF 15.1) Pub Date : 2024-03-15 Enzo Lüsebrink, Hugo Lanz, Holger Thiele
Despite increasing therapeutic options and disposable resources, cardiogenic shock (CS) remains a formidable condition with high mortality. Today, veno-arterial extracorporeal membrane oxygenation and microaxial flow devices (Impella, Abiomed, Danvers, USA) are established forms of mechanical circulatory support (MCS) in CS, with increasing application over the years. Despite this trend, incorporation
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Albumin for sepsis-related peripheral tissue hypoperfusion Crit. Care (IF 15.1) Pub Date : 2024-03-14 Mingqiang Wang, Lin Zhong
We read with interest the manuscript by Gabarre et al. regarding albumin infusion [1]. Here, I believe there is a minor issue that needs clarification. The sample size in each group of this study is quite small. On this basis, there is a difference in the need for vasopressor between the two groups, although it did not reach statistical significance (0.4 vs. 0.7, P = 0.06). Considering that all patients