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Volume 37 (1); February 2022
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Guideline
Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
Acute Crit Care. 2022;37(1):1-25.   Published online February 28, 2022
DOI: https://doi.org/10.4266/acc.2022.00094
Correction in: Acute Crit Care 2023;38(1):149
  • 18,073 View
  • 1,770 Download
  • 15 Web of Science
  • 23 Crossref
AbstractAbstract PDF
We revised and expanded the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).” We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding. The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.

Citations

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  • Potentially inappropriate medications with older people in intensive care and associated factors: a historic cohort study
    Karina Sichieri, Danilo Donizetti Trevisan, Ricardo Luís Barbosa, Silvia Regina Secoli
    Sao Paulo Medical Journal.2024;[Epub]     CrossRef
  • Psychiatric Consults Associated With Longer Length of Stay in Trauma Patients—A Retrospective Study
    Sanjay Balijepalli, Kathryn Mansuri, Cindy Gonzalez, Oveys Mansuri
    Journal of Surgical Research.2024; 293: 46.     CrossRef
  • Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality
    Adrienne E. van der Hoeven, Denise Bijlenga, Ernst van der Hoeven, Mink S. Schinkelshoek, Floor W. Hiemstra, Laura Kervezee, David J. van Westerloo, Rolf Fronczek, Gert Jan Lammers
    Intensive and Critical Care Nursing.2024; 81: 103603.     CrossRef
  • Cross-cultural adaptation and validation of the Indonesian version of the Critical-care Pain Observation Tool
    Luthfi Fauzy Asriyanto, Nur Chayati
    International Journal of Nursing Sciences.2024; 11(1): 113.     CrossRef
  • Postoperative Psychoses in Patients with Brain Gliomas
    O. S. Zaitsev, N. P. Ilyaev, O. A. Maksakova
    Psikhiatriya.2024; 21(7): 65.     CrossRef
  • Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
    Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
    Acute and Critical Care.2024; 39(1): 1.     CrossRef
  • Prevalence and risk factors of delirium of older adults after cardiac surgery at the intensive care unit: A retrospective study
    Jeong-Ok Ryu, Gwi-Ryung Son Hong
    Journal of Korean Gerontological Nursing.2024; 26(1): 113.     CrossRef
  • Factors that influence critical care nurses’ management of sedation for ventilated patients in critical care: A qualitative study
    Danielle Macpherson, Anastasia Hutchinson, Melissa J. Bloomer
    Intensive and Critical Care Nursing.2024; 83: 103685.     CrossRef
  • Content analysis of NOC outcomes related to mechanical ventilation in people with COVID-19
    Erika Silva de Sá, Aline Batista Maurício, Larissa Giardini Bruni, Larissa Gabrielle Dias Vieira, Vinicius Batista Santos, Agueda Maria Ruiz Zimmer Cavalcante, Alba Lucia Bottura Leite de Barros, Viviane Martins da Silva
    Revista da Escola de Enfermagem da USP.2024;[Epub]     CrossRef
  • Análise de conteúdo de resultados NOC relacionados à ventilação mecânica em pessoas com COVID-19
    Erika Silva de Sá, Aline Batista Maurício, Larissa Giardini Bruni, Larissa Gabrielle Dias Vieira, Vinicius Batista Santos, Agueda Maria Ruiz Zimmer Cavalcante, Alba Lucia Bottura Leite de Barros, Viviane Martins da Silva
    Revista da Escola de Enfermagem da USP.2024;[Epub]     CrossRef
  • From the Intensive Care Unit to Recovery: Managing Post-intensive Care Syndrome in Critically Ill Patients
    Mfonido Ekong, Tejbir Singh Monga, Jean Carlo Daher, Mutyala Sashank, Setareh Reza Soltani, Nkiruka Lauretta Nwangene, Cara Mohammed, Fellipe Feijo Halfeld, Leen AlShelh, Fernanda Ayumi Fukuya, Manju Rai
    Cureus.2024;[Epub]     CrossRef
  • End‐of‐life care in the intensive care unit
    M. Tanaka Gutiez, N. Efstathiou, R. Innes, V. Metaxa
    Anaesthesia.2023; 78(5): 636.     CrossRef
  • The Profile of Early Sedation Depth and Clinical Outcomes of Mechanically Ventilated Patients in Korea
    Dong-gon Hyun, Jee Hwan Ahn, Ha-Yeong Gil, Chung Mo Nam, Choa Yun, Jae-Myeong Lee, Jae Hun Kim, Dong-Hyun Lee, Ki Hoon Kim, Dong Jung Kim, Sang-Min Lee, Ho-Geol Ryu, Suk-Kyung Hong, Jae-Bum Kim, Eun Young Choi, JongHyun Baek, Jeoungmin Kim, Eun Jin Kim, T
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • The relationship between the PRE-DELIRIC score and the prognosis in COVID-19 ICU patients
    Bilge Banu Taşdemir Mecit
    Journal of Surgery and Medicine.2023; 7(5): 343.     CrossRef
  • Systemic Nonsteroidal Anti-Inflammatories for Analgesia in Postoperative Critical Care Patients: A Systematic Review and Meta-Analysis of Randomized Control Trials
    Chen Hsiang Ma, Kimberly B. Tworek, Janice Y. Kung, Sebastian Kilcommons, Kathleen Wheeler, Arabesque Parker, Janek Senaratne, Erika Macintyre, Wendy Sligl, Constantine J. Karvellas, Fernando G. Zampieri, Demetrios Jim Kutsogiannis, John Basmaji, Kimberle
    Critical Care Explorations.2023; 5(7): e0938.     CrossRef
  • Pain Control and Sedation in Neuro Intensive Critical Unit
    Soo-Hyun Park, Yerim Kim, Yeojin Kim, Jong Seok Bae, Ju-Hun Lee, Wookyung Kim, Hong-Ki Song
    Journal of the Korean Neurological Association.2023; 41(3): 169.     CrossRef
  • Preoperative Anxiety and Its Postoperative Associated Factors in Patients Receiving Post Anesthetic Recovery Care at Surgical Intensive Care Unit
    Yul Ha Lee, Hye-Ja Park
    Journal of Health Informatics and Statistics.2023; 48(3): 267.     CrossRef
  • Diagnostic Value of the Bispectral Index to Assess Sleep Quality after Elective Surgery in Intensive Care Unit
    Naricha Chirakalwasan, Pongpol Sirilaksanamanon, Thammasak Thawitsri, Somrat Charuluxananan
    Indian Journal of Critical Care Medicine.2023; 27(11): 795.     CrossRef
  • Sedation of patients in intensive care units. Guidelines
    V.I. Potievskaya, I.B. Zabolotskikh, I.E. Gridchik, A.I. Gritsan, A.A. Eremenko, I.A. Kozlov, A.L. Levit, V.A. Mazurok, I.V. Molchanov
    Anesteziologiya i reanimatologiya.2023; (5): 6.     CrossRef
  • Sedation for Patients with Sepsis: Towards a Personalised Approach
    José Miguel Marcos-Vidal, Rafael González, María Merino, Eva Higuera, Cristina García
    Journal of Personalized Medicine.2023; 13(12): 1641.     CrossRef
  • Performance, Knowledge, and Barrier Awareness of Medical Staff Regarding the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Critical Care Patients: A Cross-Sectional Study
    Hyo-Geun Song, Duckhee Chae, Sung-Hee Yoo
    Korean Journal of Adult Nursing.2023; 35(4): 379.     CrossRef
  • ICU-Induced Disability Persists With or Without COVID-19—This Is a Call for F to A Bundle Action*
    Heidi Engel
    Critical Care Medicine.2022; 50(11): 1665.     CrossRef
  • Actigraphy-Based Assessment of Sleep Parameters in Intensive Care Unit Patients Receiving Respiratory Support Therapy
    Jiyeon Kang, Yongbin Kwon
    Journal of Korean Critical Care Nursing.2022; 15(3): 115.     CrossRef
Review Articles
Pulmonary
Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
Su Hwan Lee
Acute Crit Care. 2022;37(1):26-34.   Published online February 22, 2022
DOI: https://doi.org/10.4266/acc.2022.00031
  • 4,849 View
  • 263 Download
  • 6 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Although the rate of lung transplantation (LTx), the last treatment option for end-stage lung disease, is increasing, some patients waiting for LTx need a bridging strategy for LTx due to the limited number of available donor lungs. For a long time, mechanical ventilation has been employed as a bridge to LTx because the outcome of using extracorporeal membrane oxygenation (ECMO) as a bridging strategy has been poor. However, the outcome after mechanical ventilation as a bridge to LTx was poor compared with that in patients without bridges. With advances in technology and the accumulation of experience, the outcome of ECMO as a bridge to LTx has improved, and the rate of ECMO use as a bridging strategy has increased over time. However, whether the use of ECMO as a bridge to LTx can achieve survival rates similar to those of non-bridged LTx patients remains controversial. In 2010, one center introduced awake ECMO strategy for LTx bridging, and its use as a bridge to LTx has been showing favorable outcomes to date. Awake ECMO has several advantages, such as maintenance of physical activity, spontaneous breathing, avoidance of endotracheal intubation, and reduced use of sedatives and analgesics, but it may cause serious problems. Nonetheless, several studies have shown that awake ECMO performed by a multidisciplinary team is safe. In cases where ECMO or mechanical ventilation is required due to unavoidable exacerbation in patients awaiting LTx, the application of awake ECMO performed by an appropriately trained ECMO multi-disciplinary team can be useful.

Citations

Citations to this article as recorded by  
  • Extracorporeal membrane oxygenation as a bridge to lung transplantation: Practice patterns and patient outcomes
    Hannah J. Rando, Jonathon P. Fanning, Sung-Min Cho, Bo S. Kim, Glenn Whitman, Errol L. Bush, Steven P. Keller
    The Journal of Heart and Lung Transplantation.2024; 43(1): 77.     CrossRef
  • Anesthetic considerations for perioperative ECMO in lung transplantation
    Julien Fessler, Jaromir Vajter, Archer Kilbourne Martin
    Best Practice & Research Clinical Anaesthesiology.2024; 38(1): 58.     CrossRef
  • Long-Term Follow-Up of Patients Needing Extracorporeal Membrane Oxygenation Following a Critical Course of COVID-19
    Samuel Genzor, Pavol Pobeha, Martin Šimek, Petr Jakubec, Jan Mizera, Martin Vykopal, Milan Sova, Jakub Vaněk, Jan Praško
    Life.2023; 13(4): 1054.     CrossRef
  • Dangers in using beta-blockers in patients with venovenous extracorporeal membrane oxygenation
    Diego Rodríguez Álvarez, Elena Pérez-Costa, Juan José Menéndez Suso
    Acute and Critical Care.2022; 37(4): 683.     CrossRef
Neurosurgery
Brain-lung interaction: a vicious cycle in traumatic brain injury
Ariana Alejandra Chacón-Aponte, Érika Andrea Durán-Vargas, Jaime Adolfo Arévalo-Carrillo, Iván David Lozada-Martínez, Maria Paz Bolaño-Romero, Luis Rafael Moscote-Salazar, Pedro Grille, Tariq Janjua
Acute Crit Care. 2022;37(1):35-44.   Published online February 11, 2022
DOI: https://doi.org/10.4266/acc.2021.01193
  • 15,939 View
  • 932 Download
  • 15 Web of Science
  • 18 Crossref
AbstractAbstract PDF
The brain-lung interaction can seriously affect patients with traumatic brain injury, triggering a vicious cycle that worsens patient prognosis. Although the mechanisms of the interaction are not fully elucidated, several hypotheses, notably the “blast injury” theory or “double hit” model, have been proposed and constitute the basis of its development and progression. The brain and lungs strongly interact via complex pathways from the brain to the lungs but also from the lungs to the brain. The main pulmonary disorders that occur after brain injuries are neurogenic pulmonary edema, acute respiratory distress syndrome, and ventilator-associated pneumonia, and the principal brain disorders after lung injuries include brain hypoxia and intracranial hypertension. All of these conditions are key considerations for management therapies after traumatic brain injury and need exceptional case-by-case monitoring to avoid neurological or pulmonary complications. This review aims to describe the history, pathophysiology, risk factors, characteristics, and complications of brain-lung and lung-brain interactions and the impact of different old and recent modalities of treatment in the context of traumatic brain injury.

Citations

Citations to this article as recorded by  
  • Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision-Making
    Luis Rafael Moscote-Salazar, William A. Florez-Perdomo, Tariq Janjua
    Indian Journal of Neurotrauma.2024; 21(01): 092.     CrossRef
  • Manejo postoperatorio de resección de tumores cerebrales en la unidad de cuidado intensivo
    Andrés Felipe Naranjo Ramírez, Álvaro de Jesús Medrano Areiza, Bryan Arango Sánchez, Juan Carlos Arango Martínez, Luis Fermín Naranjo Atehortúa
    Acta Colombiana de Cuidado Intensivo.2024; 24(2): 140.     CrossRef
  • Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review
    Greta Zunino, Denise Battaglini, Daniel Agustin Godoy
    Journal of Intensive Medicine.2024; 4(2): 247.     CrossRef
  • Acute brain injury increases pulmonary capillary permeability via sympathetic activation-mediated high fluid shear stress and destruction of the endothelial glycocalyx layer
    Na Zhao, Chao Liu, Xinxin Tian, Juan Yang, Tianen Wang
    Experimental Cell Research.2024; 434(2): 113873.     CrossRef
  • Oral administration of lysozyme protects against injury of ileum via modulating gut microbiota dysbiosis after severe traumatic brain injury
    Weijian Yang, Caihua Xi, Haijun Yao, Qiang Yuan, Jun Zhang, Qifang Chen, Gang Wu, Jin Hu
    Frontiers in Cellular and Infection Microbiology.2024;[Epub]     CrossRef
  • Pulmonary Effects of Traumatic Brain Injury in Mice: A Gene Set Enrichment Analysis
    Wei-Hung Chan, Shih-Ming Huang, Yi-Lin Chiu
    International Journal of Molecular Sciences.2024; 25(5): 3018.     CrossRef
  • Beyond the brain: General intensive care considerations in pediatric neurocritical care
    Thao L. Nguyen, Dennis W. Simon, Yi-Chen Lai
    Seminars in Pediatric Neurology.2024; 49: 101120.     CrossRef
  • Research Progress of Hemorrhagic Stroke Combined with Stroke-Associated Pneumonia
    松 刘
    Advances in Clinical Medicine.2024; 14(05): 2336.     CrossRef
  • The Impact of Pulmonary Disorders on Neurological Health (Lung-Brain Axis)
    Hongryeol Park, Chan Hee Lee
    Immune Network.2024;[Epub]     CrossRef
  • Modeling of the brain-lung axis using organoids in traumatic brain injury: an updated review
    Jong-Tae Kim, Kang Song, Sung Woo Han, Dong Hyuk Youn, Harry Jung, Keun-Suh Kim, Hyo-Jung Lee, Ji Young Hong, Yong-Jun Cho, Sung-Min Kang, Jin Pyeong Jeon
    Cell & Bioscience.2024;[Epub]     CrossRef
  • Ventilatory targets following brain injury
    Shaurya Taran, Sarah Wahlster, Chiara Robba
    Current Opinion in Critical Care.2023; 29(2): 41.     CrossRef
  • Targeted Nanocarriers Co-Opting Pulmonary Intravascular Leukocytes for Drug Delivery to the Injured Brain
    Jia Nong, Patrick M. Glassman, Jacob W. Myerson, Viviana Zuluaga-Ramirez, Alba Rodriguez-Garcia, Alvin Mukalel, Serena Omo-Lamai, Landis R. Walsh, Marco E. Zamora, Xijing Gong, Zhicheng Wang, Kartik Bhamidipati, Raisa Y. Kiseleva, Carlos H. Villa, Colin F
    ACS Nano.2023; 17(14): 13121.     CrossRef
  • Modulation of MAPK/NF-κB Pathway and NLRP3 Inflammasome by Secondary Metabolites from Red Algae: A Mechanistic Study
    Asmaa Nabil-Adam, Mohamed L. Ashour, Mohamed Attia Shreadah
    ACS Omega.2023; 8(41): 37971.     CrossRef
  • American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma clinical protocol for management of acute respiratory distress syndrome and severe hypoxemia
    Jason A. Fawley, Christopher J. Tignanelli, Nicole L. Werner, George Kasotakis, Samuel P. Mandell, Nina E. Glass, David J. Dries, Todd W. Costantini, Lena M. Napolitano
    Journal of Trauma and Acute Care Surgery.2023; 95(4): 592.     CrossRef
  • The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury
    Mabrouk Bahloul, Karama Bouchaala, Najeh Baccouche, Kamilia Chtara, Hedi Chelly, Mounir Bouaziz
    Acute and Critical Care.2022; 37(2): 266.     CrossRef
  • Allocation of Donor Lungs in Korea
    Hye Ju Yeo
    Journal of Chest Surgery.2022; 55(4): 274.     CrossRef
  • Mapping brain endophenotypes associated with idiopathic pulmonary fibrosis genetic risk
    Ali-Reza Mohammadi-Nejad, Richard J. Allen, Luke M. Kraven, Olivia C. Leavy, R. Gisli Jenkins, Louise V. Wain, Dorothee P. Auer, Stamatios N. Sotiropoulos
    eBioMedicine.2022; 86: 104356.     CrossRef
  • Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness
    Ivan David Lozada-Martinez, Isabela Zenilma Daza-Patiño, Gerardo Jesus Farley Reina-González, Sebastián Rojas-Pava, Ailyn Zenith Angulo-Lara, María Paola Carmona-Rodiño, Olga Gissela Sarmiento-Najar, Jhon Mike Romero-Madera, Yesid Alonso Ángel-Hernandez
    Revista Investigación en Salud Universidad de Boyacá.2022;[Epub]     CrossRef
Original Articles
Basic science and research
A machine learning model for predicting favorable outcome in severe traumatic brain injury patients after 6 months
Mehdi Nourelahi, Fardad Dadboud, Hosseinali Khalili, Amin Niakan, Hossein Parsaei
Acute Crit Care. 2022;37(1):45-52.   Published online January 21, 2022
DOI: https://doi.org/10.4266/acc.2021.00486
  • 4,358 View
  • 232 Download
  • 9 Web of Science
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AbstractAbstract PDF
Background
Traumatic brain injury (TBI), which occurs commonly worldwide, is among the more costly of health and socioeconomic problems. Accurate prediction of favorable outcomes in severe TBI patients could assist with optimizing treatment procedures, predicting clinical outcomes, and result in substantial economic savings. Methods: In this study, we examined the capability of a machine learning-based model in predicting “favorable” or “unfavorable” outcomes after 6 months in severe TBI patients using only parameters measured on admission. Three models were developed using logistic regression, random forest, and support vector machines trained on parameters recorded from 2,381 severe TBI patients admitted to the neuro-intensive care unit of Rajaee (Emtiaz) Hospital (Shiraz, Iran) between 2015 and 2017. Model performance was evaluated using three indices: sensitivity, specificity, and accuracy. A ten-fold cross-validation method was used to estimate these indices. Results: Overall, the developed models showed excellent performance with the area under the curve around 0.81, sensitivity and specificity of around 0.78. The top-three factors important in predicting 6-month post-trauma survival status in TBI patients are “Glasgow coma scale motor response,” “pupillary reactivity,” and “age.” Conclusions: Machine learning techniques might be used to predict the 6-month outcome in TBI patients using only the parameters measured on admission when the machine learning is trained using a large data set.

Citations

Citations to this article as recorded by  
  • Enhancing hospital course and outcome prediction in patients with traumatic brain injury: A machine learning study
    Guangming Zhu, Burak B Ozkara, Hui Chen, Bo Zhou, Bin Jiang, Victoria Y Ding, Max Wintermark
    The Neuroradiology Journal.2024; 37(1): 74.     CrossRef
  • Machine Learning in Neuroimaging of Traumatic Brain Injury: Current Landscape, Research Gaps, and Future Directions
    Kevin Pierre, Jordan Turetsky, Abheek Raviprasad, Seyedeh Mehrsa Sadat Razavi, Michael Mathelier, Anjali Patel, Brandon Lucke-Wold
    Trauma Care.2024; 4(1): 31.     CrossRef
  • Science fiction or clinical reality: a review of the applications of artificial intelligence along the continuum of trauma care
    Olivia F. Hunter, Frances Perry, Mina Salehi, Hubert Bandurski, Alan Hubbard, Chad G. Ball, S. Morad Hameed
    World Journal of Emergency Surgery.2023;[Epub]     CrossRef
  • Gastrointestinal failure, big data and intensive care
    Pierre Singer, Eyal Robinson, Orit Raphaeli
    Current Opinion in Clinical Nutrition & Metabolic Care.2023; 26(5): 476.     CrossRef
  • Prediction performance of the machine learning model in predicting mortality risk in patients with traumatic brain injuries: a systematic review and meta-analysis
    Jue Wang, Ming Jing Yin, Han Chun Wen
    BMC Medical Informatics and Decision Making.2023;[Epub]     CrossRef
  • Predicting return to work after traumatic brain injury using machine learning and administrative data
    Helena Van Deynse, Wilfried Cools, Viktor-Jan De Deken, Bart Depreitere, Ives Hubloue, Eva Kimpe, Maarten Moens, Karen Pien, Ellen Tisseghem, Griet Van Belleghem, Koen Putman
    International Journal of Medical Informatics.2023; 178: 105201.     CrossRef
  • Fluid-Based Protein Biomarkers in Traumatic Brain Injury: The View from the Bedside
    Denes V. Agoston, Adel Helmy
    International Journal of Molecular Sciences.2023; 24(22): 16267.     CrossRef
  • Predicting Outcome in Patients with Brain Injury: Differences between Machine Learning versus Conventional Statistics
    Antonio Cerasa, Gennaro Tartarisco, Roberta Bruschetta, Irene Ciancarelli, Giovanni Morone, Rocco Salvatore Calabrò, Giovanni Pioggia, Paolo Tonin, Marco Iosa
    Biomedicines.2022; 10(9): 2267.     CrossRef
Policy/Pulmonary
Association between the National Health Insurance coverage benefit extension policy and clinical outcomes of ventilated patients: a retrospective study
Wanho Yoo, Saerom Kim, Soohan Kim, Eunsuk Jeong, Kwangha Lee
Acute Crit Care. 2022;37(1):53-60.   Published online February 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01389
  • 4,229 View
  • 168 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
This study aimed to investigate the association between the Korean National Health Insurance coverage benefit extension policy and clinical outcomes of patients who were ventilated owing to various respiratory diseases. Methods: Data from 515 patients (male, 69.7%; mean age, 69.8±12.1 years; in-hospital mortality rate, 28.3%) who were hospitalized in a respiratory intensive care unit were retrospectively analyzed over 5 years. Results: Of total enrolled patients, 356 (69.1%) had one benefit items under this policy during their hospital stay. They had significantly higher medical expenditure (total: median, 23,683 vs. 12,742 U.S. dollars [USD], P<0.001), out-of-pocket (median, 5,932 vs. 4,081 USD; P<0.001), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (median, 26.0% vs. 32.2%; P<0.001). Patients without benefit items associated with higher in-hospital mortality (hazard ratio [HR], 2.794; 95% confidence interval [CI], 1.980–3.941; P<0.001). In analysis of patients with benefit items, patients with three items (“cancer,” “tuberculosis,” and “disability”) had significantly lower out-of-pocket medical expenditure (3,441 vs. 6,517 USD, P<0.001), and a lower percentage of out-of-pocket medical expenditure relative to total medical expenditure (17.2% vs. 27.7%, P<0.001). They were associated with higher in-hospital mortality (HR, 3.904; 95% CI, 2.533–6.039; P<0.001). Conclusions: Our study showed patients with benefit items had more medical resources and associated improved in-hospital survival. Patients with the aforementioned three benefit items had lower out-of-pocket medical expenditure due to the implementation of this policy, but higher in-hospital mortality.

Citations

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  • The effect of socioeconomic status, insurance status, and insurance coverage benefits on mortality in critically ill patients admitted to the intensive care unit
    Moo Suk Park
    Acute and Critical Care.2022; 37(1): 118.     CrossRef
Infection
Nosocomial meningitis in intensive care: a 10-year retrospective study and literature review
Sofia R. Valdoleiros, Cristina Torrão, Laura S. Freitas, Diana Mano, Celina Gonçalves, Carla Teixeira
Acute Crit Care. 2022;37(1):61-70.   Published online January 26, 2022
DOI: https://doi.org/10.4266/acc.2021.01151
  • 6,649 View
  • 278 Download
  • 9 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary Material
Background
Nosocomial meningitis is a medical emergency that requires early diagnosis, prompt initiation of therapy, and frequent admission to the intensive care unit (ICU). Methods: A retrospective study was conducted in adult patients diagnosed with nosocomial meningitis who required admission to the ICU between April 2010 and March 2020. Meningitis/ventriculitis and intracranial infection were defined according to Centers for Disease Control and Prevention guidelines. Results: An incidence of 0.75% of nosocomial meningitis was observed among 70 patients. The mean patient age was 59 years and 34% were ≥65 years. Twenty-two percent of patients were in an immunocompromised state. A clear predisposing factor for nosocomial meningitis (traumatic brain injury, basal skull fracture, brain hemorrhage, central nervous system [CNS] invasive procedure or device) was present in 93% of patients. Fever was the most frequent clinical feature. A microbiological agent was identified in 30% of cases, of which 27% were bacteria, with a predominance of Gram-negative over Gram-positive. Complications developed in 47% of cases, 24% of patients were discharged with a Glasgow coma scale <14, and 37% died. There were no clear clinical predictors of complications. Advanced age (≥65 years old) and the presence of complications were associated with higher hospital mortality. Conclusions: Nosocomial meningitis in critical care has a low incidence rate but high mortality and morbidity. In critical care patients with CNS-related risk factors, a high level of suspicion for meningitis is warranted, but diagnosis can be hindered by several confounding factors.

Citations

Citations to this article as recorded by  
  • Procalcitonin As Diagnostic Tool for CNS Infections—Overall, Not Good Enough (Yet?)*
    Michael A. Pizzi, Katharina M. Busl
    Critical Care Medicine.2024; 52(1): 163.     CrossRef
  • A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020
    Joseph Donovan, Abena Glover, John Gregson, Andrew W. Hitchings, Emma C. Wall, Robert S. Heyderman
    BMC Infectious Diseases.2024;[Epub]     CrossRef
  • Clinical Characteristics, Treatment, and Outcomes of Veterans with Cerebrospinal Fluid Culture Positive for Gram-Negative Rod Bacteria: A Retrospective Analysis over 18 Years in 125 Veterans Health Administration Hospitals
    Shinya Hasegawa, Eiyu Matsumoto, Jennifer R. Carlson, Hiroyuki Suzuki
    Current Microbiology.2024;[Epub]     CrossRef
  • Confronting multidrug-resistantKlebsiellameningitis after mid-clival Cerebrospinal Fluid leak repair: a therapeutic odyssey
    Anbarasi Madoure, Dharanya Gopalakrishnan Srinivasan, Tejaswi Mishra, Lokesh Kumar Penubarthi
    BMJ Case Reports.2024; 17(6): e257872.     CrossRef
  • Glioma grade and post-neurosurgical meningitis risk
    Sakke Niemelä, Jarmo Oksi, Jussi Jero, Eliisa Löyttyniemi, Melissa Rahi, Jaakko Rinne, Jussi P. Posti, Dan Laukka
    Acta Neurochirurgica.2024;[Epub]     CrossRef
  • Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland
    Sakke Niemelä, Laura Lempinen, Eliisa Löyttyniemi, Jarmo Oksi, Jussi Jero
    BMC Infectious Diseases.2023;[Epub]     CrossRef
  • Bacterial meningitis in children with an abnormal craniocerebral structure
    Jiali Pan, Wei Xu, Wenliang Song, Tao Zhang
    Frontiers in Pediatrics.2023;[Epub]     CrossRef
  • Fieber in der Intensivmedizin
    Jan-Hendrik Naendrup, Boris Böll, Jorge Garcia Borrega
    Intensivmedizin up2date.2023; 19(01): 17.     CrossRef
  • Neurosurgical management of penetrating brain injury during World War I: A historical cohort
    Rayan Fawaz, Mathilde Schmitt, Philémon Robert, Nathan Beucler, Jean-Marc Delmas, Nicolas Desse, Aurore Sellier, Arnaud Dagain
    Neurochirurgie.2023; 69(3): 101439.     CrossRef
  • Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study
    Hana Panic, Branimir Gjurasin, Marija Santini, Marko Kutlesa, Neven Papic
    Infectious Disease Reports.2022; 14(3): 420.     CrossRef
  • Healthcare-associated central nervous system infections
    Mariachiara Ippolito, Antonino Giarratano, Andrea Cortegiani
    Current Opinion in Anaesthesiology.2022; 35(5): 549.     CrossRef
Pulmonary
Comparison of high-flow nasal oxygen therapy and noninvasive ventilation in COVID-19 patients: a systematic review and meta-analysis
Glenardi Glenardi, Febie Chriestya, Bambang J Oetoro, Ghea Mangkuliguna, Natalia Natalia
Acute Crit Care. 2022;37(1):71-83.   Published online February 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01326
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AbstractAbstract PDFSupplementary Material
Background
Acute respiratory failure (ARF) is a major adverse event commonly encountered in severe coronavirus disease 2019 (COVID-19). Although noninvasive mechanical ventilation (NIV) has long been used in the management of ARF, it has several adverse events which may cause patient discomfort and lead to treatment complication. Recently, high-flow nasal cannula (HFNC) has the potential to be an alternative for NIV in adults with ARF, including COVID-19 patients. The objective was to investigate the efficacy of HFNC compared to NIV in COVID-19 patients. Methods: This meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Literature search was carried out in electronic databases for relevant articles published prior to June 2021. The protocol used in this study has been registered in International Prospective Register of Systematic Reviews (CRD42020225186). Results: Although the success rate of NIV is higher compared to HFNC (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16–0.97; P=0.04), this study showed that the mortality in the NIV group is also significantly higher compared to HFNC group (OR, 0.49; 95% CI, 0.39–0.63; P<0.001). Moreover, this study also demonstrated that there was no significant difference in intubation rates between the two groups (OR, 1.35; 95% CI, 0.86–2.11; P=0.19). Conclusions: Patients treated with HFNC showed better outcomes compared to NIV for ARF due to COVID-19. Therefore, HFNC should be considered prior to NIV in COVID-19–associated ARF. However, further studies with larger sample sizes are still needed to better elucidate the benefit of HFNC in COVID-19 patients.

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  • High-flow nasal cannula therapy in patients with COVID-19 in intensive care units in a country with limited resources: a single-center experience
    Anh-Minh Vu Phan, Hai-Yen Thi Hoang, Thanh-Son Truong Do, Trung Quoc Hoang, Thuan Van Phan, Nguyet-Anh Phuong Huynh, Khoi Minh Le
    Journal of International Medical Research.2023;[Epub]     CrossRef
  • Evaluating the use of the respiratory-rate oxygenation index as a predictor of high-flow nasal cannula oxygen failure in COVID-19
    Scott Weerasuriya, Savvas Vlachos, Ahmed Bobo, Namitha Birur Jayaprabhu, Lauren Matthews, Adam R Blackstock, Victoria Metaxa
    Acute and Critical Care.2023; 38(1): 31.     CrossRef
  • Does the variant positivity and negativity affect the clinical course in COVID-19?: A cohort study
    Erkan Yildirim, Levent Kilickan, Suleyman Hilmi Aksoy, Ramazan Gozukucuk, Hasan Huseyin Kilic, Yakup Tomak, Orhan Dalkilic, Ibrahim Halil Tanboga, Fevzi Duhan Berkan Kilickan
    Medicine.2023; 102(9): e33132.     CrossRef
  • The COVID-19 Driving Force: How It Shaped the Evidence of Non-Invasive Respiratory Support
    Yorschua Jalil, Martina Ferioli, Martin Dres
    Journal of Clinical Medicine.2023; 12(10): 3486.     CrossRef
  • Descriptive account of the first use of the LeVe CPAP System, a new frugal CPAP System, in adult patients with COVID-19 Pneumonitis in Uganda
    Anna Littlejohns, Helen Please, Racheal Musasizi, Stuart Murdoch, Gorret Nampiina, Ian Waters, William Davis Birch, Gregory de Boer, Nikil Kapur, Tumwesigye Ambrozi, Ninsiima Carol, Nakigudde Noel, Jiten Parmar, Peter Culmer, Tom Lawton, Edith Namulema
    Tropical Medicine and Health.2023;[Epub]     CrossRef
  • Comparison between high-flow nasal cannula and noninvasive ventilation in COVID-19 patients: a systematic review and meta-analysis
    Yun Peng, Bing Dai, Hong-wen Zhao, Wei Wang, Jian Kang, Hai-jia Hou, Wei Tan
    Therapeutic Advances in Respiratory Disease.2022; 16: 175346662211136.     CrossRef
  • Does High Flow Nasal Cannula avoid intubation and improve the mortality of adult patients in acute respiratory failure in the intensive care setting, when compared to others methods as Conventional Oxygen Therapy or Non-Invasive Ventilation? A narrative r
    P Fosseur, A Renard, P Mateu, J Rosman
    Acta Anaesthesiologica Belgica.2022; 73(Supplement): 97.     CrossRef
Infection
Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia
Mabrouk Bahloul, Sana Kharrat, Kamilia Chtara, Malek Hafdhi, Olfa Turki, Najeh Baccouche, Rania Ammar, Nozha Kallel, Majdi Hsairi, Olfa Chakroun-Walha, Chokri Ben Hamida, Hedi Chelly, Khaiereddine Ben Mahfoudh, Abelhamid Karoui, Hela Karray, Noureddine Rekik, Mounir Bouaziz
Acute Crit Care. 2022;37(1):84-93.   Published online November 16, 2021
DOI: https://doi.org/10.4266/acc.2021.00129
  • 14,552 View
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  • 5 Web of Science
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AbstractAbstract PDF
Background
Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods: We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection— admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results: A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions: In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome.

Citations

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  • Cost Effectiveness of Strategies for Caring for Critically Ill Patients with COVID-19 in Tanzania
    Hiral Anil Shah, Tim Baker, Carl Otto Schell, August Kuwawenaruwa, Khamis Awadh, Karima Khalid, Angela Kairu, Vincent Were, Edwine Barasa, Peter Baker, Lorna Guinness
    PharmacoEconomics - Open.2023; 7(4): 537.     CrossRef
  • Prognostic Value of Serum Cholinesterase Activity in Severe SARS-CoV-2–Infected Patients Requiring Intensive Care Unit Admission
    Mabrouk Bahloul, Sana Kharrat, Saba Makni, Najeh Baccouche, Rania Ammar, Aida Eleuch, Lamia Berrajah, Amel Chtourou, Olfa Turki, Chokri Ben Hamida, Hedi Chelly, Kamilia Chtara, Fatma Ayedi, Mounir Bouaziz
    The American Journal of Tropical Medicine and Hygiene.2022; 107(3): 534.     CrossRef
Pulmonary
Diaphragm ultrasound as a better predictor of successful extubation from mechanical ventilation than rapid shallow breathing index
Mohammad Jhahidul Alam, Simanta Roy, Mohammad Azmain Iktidar, Fahmida Khatun Padma, Khairul Islam Nipun, Sreshtha Chowdhury, Ranjan Kumar Nath, Harun-Or Rashid
Acute Crit Care. 2022;37(1):94-100.   Published online January 11, 2022
DOI: https://doi.org/10.4266/acc.2021.01354
  • 7,599 View
  • 398 Download
  • 14 Web of Science
  • 15 Crossref
AbstractAbstract PDF
Background
In 3%–19% of patients, reintubation is needed 48–72 hours following extubation, which increases intensive care unit (ICU) morbidity, mortality, and expenses. Extubation failure is frequently caused by diaphragm dysfunction. Ultrasonography can be used to determine the mobility and thickness of the diaphragm. This study looked at the role of diaphragm excursion (DE) and thickening fraction in predicting successful extubation from mechanical ventilation.
Methods
Thirty-one patients were extubated with the advice of an ICU consultant using the ICU weaning regimen and diaphragm ultrasonography was performed. Ultrasound DE and thickening fraction were measured three times: at the commencement of the t-piece experiment, at 10 minutes, and immediately before extubation. All patients' parameters were monitored for 48 hours after extubation. Rapid shallow breathing index (RSBI) was also measured at the same time.
Results
Successful extubation was significantly correlated with DE (P=0.01). Receiver curve analysis for DE to predict successful extubation revealed good properties (area under the curve [AUC], 0.83; P<0.001); sensitivity, 77.8%; specificity, 84.6%, positive predictive value (PPV), 87.5%; negative predictive value (NPV), 73.3% while cut-off value, 11.43 mm. Diaphragm thickening fraction (DTF) also revealed moderate curve properties (AUC, 0.69; P=0.06); sensitivity, 61.1%; specificity, 84.6%; PPV, 87.5%; NPV, 61.1% with cut-off value 22.33% although former one was slightly better. RSBI could not reach good receiver operating characteristic value at cut-off points 100 b/min/L (AUC, 0.58; P=0.47); sensitivity, 66.7%; specificity, 53.8%; PPV, 66.7%; NPV, 53.8%).
Conclusions
To decrease the rate of reintubation, DE and DTF are better indicators of successful extubation. DE outperforms DTF.

Citations

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  • Rapid shallow breathing index predicting extubation outcomes: A systematic review and meta-analysis
    Donghui Jia, Hengyang Wang, Qian Wang, Wenrui Li, Xuhong Lan, Hongfang Zhou, Zhigang Zhang
    Intensive and Critical Care Nursing.2024; 80: 103551.     CrossRef
  • Ultrasonography to Access Diaphragm Dysfunction and Predict the Success of Mechanical Ventilation Weaning in Critical Care
    Marta Rafael Marques, José Manuel Pereira, José Artur Paiva, Gonzalo García de Casasola‐Sánchez, Yale Tung‐Chen
    Journal of Ultrasound in Medicine.2024; 43(2): 223.     CrossRef
  • The Role of Ultrasonography in the Process of Weaning from Mechanical Ventilation in Critically Ill Patients
    Lou’i Al-Husinat, Basil Jouryyeh, Ahlam Rawashdeh, Chiara Robba, Pedro Silva, Patricia Rocco, Denise Battaglini
    Diagnostics.2024; 14(4): 398.     CrossRef
  • Critical illness-associated limb and diaphragmatic weakness
    Valentine Le Stang, Nicola Latronico, Martin Dres, Michele Bertoni
    Current Opinion in Critical Care.2024; 30(2): 121.     CrossRef
  • Accuracy of respiratory muscle assessments to predict weaning outcomes: a systematic review and comparative meta-analysis
    Diego Poddighe, Marine Van Hollebeke, Yasir Qaiser Choudhary, Débora Ribeiro Campos, Michele R. Schaeffer, Jan Y. Verbakel, Greet Hermans, Rik Gosselink, Daniel Langer
    Critical Care.2024;[Epub]     CrossRef
  • Ultrasonographic Assessment of Diaphragmatic Function and Its Clinical Application in the Management of Patients with Acute Respiratory Failure
    Marina Saad, Stefano Pini, Fiammetta Danzo, Francesca Mandurino Mirizzi, Carmine Arena, Francesco Tursi, Dejan Radovanovic, Pierachille Santus
    Diagnostics.2023; 13(3): 411.     CrossRef
  • The ratio of respiratory rate to diaphragm thickening fraction for predicting extubation success
    Dararat Eksombatchai, Chalermwut Sukkratok, Yuda Sutherasan, Detajin Junhasavasdikul, Pongdhep Theerawit
    BMC Pulmonary Medicine.2023;[Epub]     CrossRef
  • Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis
    Henry M. Parada-Gereda, Adriana L. Tibaduiza, Alejandro Rico-Mendoza, Daniel Molano-Franco, Victor H. Nieto, Wanderley A. Arias-Ortiz, Purificación Perez-Terán, Joan R. Masclans
    Critical Care.2023;[Epub]     CrossRef
  • Value of Diaphragm Ultrasonography for Extubation: A Single-Blinded Randomized Clinical Trial
    T. G. Toledo, M. R. Bacci, Fred A. Luchette
    Critical Care Research and Practice.2023; 2023: 1.     CrossRef
  • Role of diaphragm ultrasound in weaning mechanically ventilated patients: A prospective observational study
    Ravi Saravanan, Krishnamurthy Nivedita, Krishnamoorthy Karthik, Rajagopalan Venkatraman
    Indian Journal of Anaesthesia.2022; 66(8): 591.     CrossRef
  • The role of diaphragmatic thickness measurement in weaning prediction and its comparison with rapid shallow breathing index: a single-center experience
    Lokesh Kumar Lalwani, Manjunath B Govindagoudar, Pawan Kumar Singh, Mukesh Sharma, Dhruva Chaudhry
    Acute and Critical Care.2022; 37(3): 347.     CrossRef
  • Diaphragm ultrasound in weaning from mechanical ventilation: a last step to predict successful extubation?
    Domenica Di Costanzo, Mariano Mazza, Antonio Esquinas
    Acute and Critical Care.2022; 37(4): 681.     CrossRef
  • Sonographic assessment of diaphragmatic thickening and excursion as predictors of weaning success in the intensive care unit: A prospective observational study
    Amandeep Kaur, Shruti Sharma, VikramP Singh, MRavi Krishna, ParshotamL Gautam, Gagandeep Singh
    Indian Journal of Anaesthesia.2022; 66(11): 776.     CrossRef
  • Comparison of assessment of diaphragm function using speckle tracking between patients with successful and failed weaning: a multicentre, observational, pilot study
    Qiancheng Xu, Xiao Yang, Yan Qian, Chang Hu, Weihua Lu, Shuhan Cai, Bo Hu, Jianguo Li
    BMC Pulmonary Medicine.2022;[Epub]     CrossRef
  • Ultrasonographic assessment of diaphragmatic function in preterm infants on non-invasive neurally adjusted ventilatory assist (NIV-NAVA) compared to nasal intermittent positive-pressure ventilation (NIPPV): a prospective observational study
    Mohamed Elkhouli, Liran Tamir-Hostovsky, Jenna Ibrahim, Nehad Nasef, Adel Mohamed
    European Journal of Pediatrics.2022; 182(2): 731.     CrossRef
Pulmonary
The feasibility and safety of percutaneous dilatational tracheostomy without endotracheal guidance in the intensive care unit
Ji Eun Kim, Dong Hyun Lee
Acute Crit Care. 2022;37(1):101-107.   Published online February 17, 2022
DOI: https://doi.org/10.4266/acc.2021.00906
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AbstractAbstract PDF
Background
Percutaneous dilatational tracheostomy (PDT) is a common procedure in intensive care units (ICUs). Although it is thought to be safe and easily performed at the bedside, PDT usually requires endotracheal guidance, such as bronchoscopy. Here, we assessed the clinical outcomes and safety of PDT conducted without endotracheal guidance.
Methods
In the ICU and coronary ICU at a tertiary hospital, PDT was routinely performed without endotracheal guidance by a single medical intensivist using the Griggs technique PDT kit (Portex Percutaneous Tracheostomy Kit). We retrospectively reviewed the electronic medical records of patients who underwent PDT without endotracheal guidance.
Results
From January 1 to December 31, 2018, 78 patients underwent PDT without endotracheal guidance in the ICU and coronary ICU. The mean age of these subjects was 71.9±11.5 years, and 29 (37.2%) were female. The mean Acute Physiology And Chronic Health Evaluation (APACHE) II score at 24 hours after admission was 25.9±5.8. Fifty patients (64.1%) were on mechanical ventilation during PDT. Failure of the initial PDT attempt occurred in 4 patients (5.1%). In two of them, PDT was aborted and converted to surgical tracheostomy; in the other two patients, PDT was reattempted after endotracheal reintubation, with success. Minor bleeding at the tracheostomy site requiring gauze changes was observed in five patients (6.4%). There were no airway problems requiring therapeutic interventions or procedure-related sequelae.
Conclusions
PDT without endotracheal guidance can be considered safe and feasible.

Citations

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  • Safety of percutaneous dilatational tracheostomy performed by intensivists versus surgeons: A retrospective cohort study
    Asaf Miller, Roee Noy, Omri Simchon, Natalia Gvozdev, Yotam Shkedy, Danny Epstein
    World Journal of Surgery.2024;[Epub]     CrossRef
Infection
Serum lactate levels in cirrhosis and non-cirrhosis patients with septic shock
Surat Tongyoo, Kamonlawat Sutthipool, Tanuwong Viarasilpa, Chairat Permpikul
Acute Crit Care. 2022;37(1):108-117.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.00332
  • 4,616 View
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AbstractAbstract PDFSupplementary Material
Background
In septic shock patients with cirrhosis, impaired liver function might decrease lactate elimination and produce a higher lactate level. This study investigated differences in initial lactate, lactate clearance, and lactate utility between cirrhotic and non-cirrhotic septic shock patients.
Methods
This is a retrospective cohort study conducted at a referral, university-affiliated medical center. We enrolled adults admitted during 2012–2018 who satisfied the septic shock diagnostic criteria of the Surviving Sepsis Campaign: 2012. Patients previously diagnosed with cirrhosis by an imaging modality were classified into the cirrhosis group. The initial lactate levels and levels 6 hours after resuscitation were measured and used to calculate lactate clearance. We compared initial lactate, lactate at 6 hours, and lactate clearance between the cirrhosis and non-cirrhosis groups. The primary outcome was in-hospital mortality.
Results
Overall 777 patients were enrolled, of whom 91 had previously been diagnosed with cirrhosis. Initial lactate and lactate at 6 hours were both significantly higher in cirrhosis patients, but there was no difference between the groups in lactate clearance. A receiver operating characteristic curve analysis for predictors of in-hospital mortality revealed cut-off values for initial lactate, lactate at 6 hours, and lactate clearance of >4 mmol/L, >2 mmol/L, and <10%, respectively, among non-cirrhosis patients. Among patients with cirrhosis, the cut-off values predicting in-hospital mortality were >5 mmol/L, >5 mmol/L, and <20%, respectively. Neither lactate level nor lactate clearance was an independent risk factor for in-hospital mortality among cirrhotic and non-cirrhotic septic shock patients.
Conclusions
The initial lactate level and lactate at 6 hours were significantly higher in cirrhosis patients than in non-cirrhosis patients.

Citations

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  • Serum lactate and mean arterial pressure thresholds in patients with cirrhosis and septic shock
    Thomas N. Smith, Chansong Choi, Puru Rattan, Laura Piccolo Serafim, Blake A. Kassmeyer, Ryan J. Lennon, Ognjen Gajic, Jody C. Olson, Patrick S. Kamath, Alice Gallo De Moraes, Douglas A. Simonetto
    Hepatology Communications.2024;[Epub]     CrossRef
  • Review article: Evaluation and care of the critically ill patient with cirrhosis
    Iva Kosuta, Madhumita Premkumar, K. Rajender Reddy
    Alimentary Pharmacology & Therapeutics.2024; 59(12): 1489.     CrossRef
  • Norepinephrine dose, lactate or heart rate: what impacts prognosis in sepsis and septic shock? Results from a prospective, monocentric registry
    Tobias Schupp, Kathrin Weidner, Jonas Rusnak, Schanas Jawhar, Jan Forner, Floriana Dulatahu, Lea Marie Brück, Ursula Hoffmann, Thomas Bertsch, Ibrahim Akin, Michael Behnes
    Current Medical Research and Opinion.2023; 39(5): 647.     CrossRef
  • Intensive care management of acute-on-chronic liver failure
    Giovanni Perricone, Thierry Artzner, Eleonora De Martin, Rajiv Jalan, Julia Wendon, Marco Carbone
    Intensive Care Medicine.2023; 49(8): 903.     CrossRef
Editorial
Policy/Pulmonary
The effect of socioeconomic status, insurance status, and insurance coverage benefits on mortality in critically ill patients admitted to the intensive care unit
Moo Suk Park
Acute Crit Care. 2022;37(1):118-119.   Published online February 28, 2022
DOI: https://doi.org/10.4266/acc.2022.00129
  • 2,382 View
  • 142 Download
  • 1 Web of Science
  • 1 Crossref
PDF

Citations

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  • Long-term recovery after critical illness in older adults
    Ramya Kaushik, Lauren E. Ferrante
    Current Opinion in Critical Care.2022; 28(5): 572.     CrossRef
Case Report
Pulmonary
Successful noninvasive ventilation in a severely acidotic and hypercapnic comatose COVID-19 patient with multiple comorbidities: a case report
Joseph Abraham Poonuraparampil, Habib Md Reazaul Karim, Manu P Kesavankutty, Porika Prashanth Nayak
Acute Crit Care. 2022;37(1):120-123.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2020.00983
  • 4,027 View
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  • 1 Web of Science
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AbstractAbstract PDF
Effective use of noninvasive ventilation in patients with chronic obstructive pulmonary disease is well-known. However, noninvasive ventilation in patients presenting with altered sensorium and severe acidosis (pH <7.1) has been rarely described. Invasive mechanical ventilation is associated with high mortality in coronavirus disease 2019 (COVID-19), and use of noninvasive ventilation over invasive ventilation is an area of investigation. We report a case of COVID-19-induced acute exacerbation of chronic obstructive pulmonary disease in a 66-year-old male. His past medical history included obstructive sleep apnea, hypertension, cor pulmonale, atrial fibrillation, and amiodarone-induced hypothyroidism. On presentation, he had acute hypercapnic respiratory failure, severe acidosis (partial pressure of carbon dioxide [PCO2], 147 mm Hg; pH, 7.06), and altered mentation. The patient was successfully managed with noninvasive ventilation, avoiding endotracheal intubation, invasive ventilation, and related complications. Although precarious, a trial of noninvasive ventilation can be considered in COVID-19-induced acute exacerbation of chronic obstructive pulmonary disease with hypercapnic respiratory failure, severe acidosis, and altered mentation.

Citations

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  • Lipid Emulsion-Mediated Improvement of Hemodynamic Depression Caused by Amlodipine Toxicity
    Ju-Tae Sohn
    Pediatric Emergency Care.2023; 39(3): 205.     CrossRef
Letters to the Editor
Neurology
Neurological complications during the course of severe COVID-19: is it just the tip of the iceberg?
Gulcin Koc Yamanyar, Burcin Halacli, Mehmet Yildirim, Arzu Topeli
Acute Crit Care. 2022;37(1):124-126.   Published online February 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01445
  • 2,840 View
  • 145 Download
  • 1 Web of Science
PDF
Pulmonary
Inhaled iloprost can improve oxygenation and shunt fraction in severe COVID-19
Christiaan M.C. Serbanescu-Kele Apor de Zalán, Norbert A. Foudraine, Jos L.M.L. Le Noble
Acute Crit Care. 2022;37(1):127-130.   Published online February 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01263
  • 3,147 View
  • 160 Download
PDFSupplementary Material

ACC : Acute and Critical Care