Skip Navigation
Skip to contents

ACC : Acute and Critical Care

OPEN ACCESS
SEARCH
Search

Most cited articles

Page Path
HOME > Issue > Most cited articles
81 Most cited articles
Filter
Filter
Article category
Keywords
Publication year
Authors
Funded articles

From articles published in Acute and Critical Care during the past two years (2023 ~ ).

Case Report
Neurosurgery
What should an intensivist know about pneumocephalus and tension pneumocephalus?
Bhushan Sudhakar Wankhade, Maged Mohsen Kamel Beniamein, Zeyad Faoor Alrais, Jyoti Ittoop Mathew, Ghaya Zeyad Alrais
Acute Crit Care. 2023;38(2):244-248.   Published online April 13, 2022
DOI: https://doi.org/10.4266/acc.2021.01102
  • 30,591 View
  • 522 Download
  • 7 Web of Science
  • 10 Crossref
AbstractAbstract PDF
Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can produce a life-threatening condition comparable to tension pneumothorax, which is termed tension pneumocephalus. We report a case of tension pneumocephalus after drainage of a cerebrospinal fluid hygroma. The tension pneumocephalus was treated with decompression craniotomy, but the patient later died due to the complications related to critical care. Traumatic brain injury and neurosurgical intervention are the most common causes of pneumocephalus. Pneumocephalus and tension pneumocephalus are neurosurgical emergencies, and anesthetics and intensive care management like the use of nitrous oxide during anesthesia and positive pressure ventilation have important implications in their development and progress. Clinically, patients can present with various nonspecific neurological manifestations that are indistinguishable from a those of a primary neurological condition. If the diagnosis is questionable, patients should be investigated using computed tomography of the brain. Immediate neurosurgical consultation with decompression is the treatment of choice.

Citations

Citations to this article as recorded by  
  • A case of cerebrospinal fluid (CSF) leak and pneumocephalus in a 52-year-old with a pituitary adenoma
    Barbara Magid, Lauren Titone, Tyler Wise
    Visual Journal of Emergency Medicine.2025; 38: 102153.     CrossRef
  • A Rare Case of Post-lumbar Discectomy Pneumocephalus: An Anatomically Informed Case Report
    Yasir H Elhassan, Mustafa Alhasan, Yasser S Abdulghani
    Cureus.2025;[Epub]     CrossRef
  • Sudden-onset, non-traumatic large volume pneumocephalus following presentation of acute bacterial meningitis
    Alexandra Krez, Michael Malinzak, Colby Feeney
    BMJ Case Reports.2024; 17(1): e256194.     CrossRef
  • Fatal postoperative tension pneumocephalus after acute subdural hematoma evacuation: a case report
    Nikolaos Gkantsinikoudis, Panagiotis Monioudis, Elias Antoniades, Vassilios Tsitouras, Ioannis Magras
    International Journal of Neuroscience.2024; : 1.     CrossRef
  • Pro-Con Debate: Air or Saline for Loss-of-Resistance Technique of Interlaminar Epidural Access with Fluoroscopy-Guided Pain Medicine Procedures
    David Hao, Kirk Bonner, Taylor Burnham, Milan P. Stojanovic
    Anesthesia & Analgesia.2024;[Epub]     CrossRef
  • Pneumocephalus After Lumbar Epidural Steroid Injection: A Rare Complication With Spontaneous Resolution
    Yasser Hegazy, Natalie N Balassiano, Ishank Gupta, Roger Stern, Muhammad Ghallab
    Cureus.2024;[Epub]     CrossRef
  • Pneumocephalus; a rare cause of coma
    Elisavet Simoulidou, Vivian Georgopoulou, Panagiotis Kalmoukos, Dimitrios Kouroupis, Nikoleta Moscha, Maria Sidiropoulou, Sofia Chatzimichailidou, Konstantinos Petidis, Athina Pyrpasopoulou
    The American Journal of Emergency Medicine.2023; 68: 215.e1.     CrossRef
  • Pneumocephalus secondary to epidural analgesia: a case report
    Maira Ahmad, Shannay Bellamy, William Ott, Rany Mekhail
    Journal of Medical Case Reports.2023;[Epub]     CrossRef
  • Transnasal Endoscopic Treatment of Tension Pneumocephalus Caused by Posttraumatic or Iatrogenic Ethmoidal Damage
    Goran Latif Omer, Riccardo Maurizi, Beatrice Francavilla, Kareem Rekawt Hama Rashid, Gianluca Velletrani, Hasan Mustafa Salah, Giulia Marzocchella, Mohammed Ibrahim Mohialdeen Gubari, Stefano Di Girolamo, Rong-San Jiang
    Case Reports in Otolaryngology.2023; 2023: 1.     CrossRef
  • Tension pneumocephalus as a complication of surgical evacuation of chronic subdural hematoma: case report and literature review
    Mohammed A. Azab, Ahmed Hazem, Brandon Lucke-Wold
    Exploration of Neuroprotective Therapy.2023; 3(4): 177.     CrossRef
Review Article
Cardiology
Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it
Seung-Jae Joo
Acute Crit Care. 2023;38(3):251-260.   Published online August 31, 2023
DOI: https://doi.org/10.4266/acc.2023.00955
  • 21,055 View
  • 2,689 Download
  • 5 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Most of the evidences for beneficial effects of beta-blockers in patients with acute myocardial infarction (AMI) were from the clinical studies published in the pre-reperfusion era when anti-platelet drugs, statins or inhibitors of renin-angiotensin-aldosterone system which are known to reduce cardiovascular mortality of patients with AMI were not introduced. In the reperfusion era, beta-blockers’ benefit has not been clearly shown except in patients with reduced ejection fraction (EF; ≤40%). In the era of the early reperfusion therapy for AMI, a number of patients with mildly reduced EF (>40%, <50%) or preserved EF (≥50%) become increasing. However, because no randomized clinical trials are available until now, the benefit and the optimal duration of oral treatment with beta-blockers in patients with mildly reduced or preserved EF are questionable. Registry data have not showed the association of oral beta-blocker therapy with decreased mortality in survivors without heart failure or left ventricular systolic dysfunction after AMI. In the Korea Acute Myocardial Infarction Registry-National Institute of Health of in-hospital survivors after AMI, the benefit of beta-blocker therapy at discharge was shown in patients with reduced or mildly reduced EF, but not in those with preserved EF, which provides new information about beta-blocker therapy in patients without reduced EF. However, clinical practice can be changed when the results of appropriate randomized clinical trials are available. Ongoing clinical trials may help to answer the unresolved issues of beta-blocker therapy in patients with AMI.

Citations

Citations to this article as recorded by  
  • Beta-Blockers in Patients With Myocardial Infarction: A Meta-Analysis
    Mushood Ahmed, Areeba Ahsan, Aimen Shafiq, Hasan Ahmad, Raheel Ahmed, Jamal S. Rana, Marat Fudim, Gregg C. Fonarow
    American Journal of Therapeutics.2025;[Epub]     CrossRef
  • Neuroimmune Interactions and Their Role in Immune Cell Trafficking in Cardiovascular Diseases and Cancer
    Yutang Wang, Jack C. Anesi, Indu S. Panicker, Darcy Cook, Prapti Bista, Yan Fang, Ernesto Oqueli
    International Journal of Molecular Sciences.2025; 26(6): 2553.     CrossRef
  • Elevated serum amylase concentrations are associated with worse in-hospital outcomes among patients with acute myocardial infarction
    Marijana Mikacic, Marko Kumric, Iva Rancic Vidic, Duska Glavas, Tina Ticinovic Kurir, Josko Bozic, Josip Andelo Borovac
    BMC Cardiovascular Disorders.2025;[Epub]     CrossRef
  • Cardiac arrhythmia following acute myocardial infarction: a retrospective analysis of 27,648 hospitalized patients in a tertiary heart hospital
    Nidal Asaad, Ayman El-Menyar, Rajvir Singh, Betsy Varughese, Shahul Hameed Khan, Hajar AlBinali, Jassim Al Suwaidi
    Monaldi Archives for Chest Disease.2025;[Epub]     CrossRef
  • In-hospital cardiac arrest after STEMI: prevention strategies and post-arrest care
    Walker Boyd, Wesley Young, Mehmet Yildiz, Timothy D. Henry, Kari Gorder
    Expert Review of Cardiovascular Therapy.2024; 22(8): 379.     CrossRef
  • Association between Inflammation and New-Onset Atrial Fibrillation in Acute Coronary Syndromes
    Ruxandra-Maria Băghină, Simina Crișan, Silvia Luca, Oana Pătru, Mihai-Andrei Lazăr, Cristina Văcărescu, Alina Gabriela Negru, Constantin-Tudor Luca, Dan Gaiță
    Journal of Clinical Medicine.2024; 13(17): 5088.     CrossRef
  • Use of Early Intravenous Beta Blockers in Patients with Acute ST-Segment Elevation Myocardial Infarction Without Heart Failure—Revival or Requiem?
    Azka Latif, Xiaoming Jia
    Cardiovascular Drugs and Therapy.2024; 38(5): 973.     CrossRef
  • Progress in Disease Modeling for Myocardial Infarction and Coronary Artery Disease: Bridging In Vivo and In Vitro Approaches
    Riya Kar, Debabrata Mukhopadhyay, Ramcharan Singh Angom
    Hearts.2024; 5(4): 429.     CrossRef
  • Optimal duration of medical therapy for patients with acute myocardial infarction
    Ki Yung Boo, Seung-Jae Joo, Jae-Geun Lee, Joon-Hyouk Choi, Song-Yi Kim, Geum Ko, Hae Eun Yun, Myung Ho Jeong
    Medicine.2024; 103(48): e40697.     CrossRef
Case Report
Pulmonary
A fatal case report of invasive pulmonary aspergillosis and mucormycosis coinfection in an immunocompetent patient with coronavirus disease 2019 in Korea
Jin Hyoung Kim, Misung Kim, Soyeoun Lim, Sun Young Park, Yangjin Jegal, Taehoon Lee, Byung Ju Kang
Acute Crit Care. 2023;38(3):382-388.   Published online June 27, 2022
DOI: https://doi.org/10.4266/acc.2021.01340
  • 4,533 View
  • 125 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Systemic glucocorticoid treatment is highly recommended in critically ill coronavirus disease 2019 (COVID-19) patients. However, secondary fungal infections are of concern in such patients. Here, we describe the first case of COVID-19-associated invasive pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) coinfection in a COVID-19 positive immunocompetent patient in Korea. A 69-year-old man was admitted to our hospital with COVID-19 pneumonia. He had no underlying comorbidities and was not taking medications. He received remdesivir, dexamethasone, and antibiotic therapy under mechanical ventilation. Although his condition improved temporarily, multiple cavities were observed on chest computed tomography, and Aspergillus fumigatus was cultured from tracheal aspiration culture. He was diagnosed with probable CAPA and received voriconazole therapy. However, his condition was not significantly improved despite having received voriconazole therapy for 4 weeks. After release from COVID-19 quarantine, he underwent bronchoscopy examination and was then finally diagnosed with CAPA and CAM coinfection on bronchoscopic biopsy. Antifungal treatment was changed to liposomal amphotericin B. However, his progress deteriorated, and he died 4 months after admission. This case highlights that clinical suspicion and active checkups are required to diagnose secondary fungal infections in immunocompetent COVID-19 patients who receive concurrent glucocorticoid therapy.

Citations

Citations to this article as recorded by  
  • Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
    Sin Young Ham, Seungjae Lee, Min-Kyung Kim, Jaehyun Jeon, Eunyoung Lee, Subin Kim, Jae-Phil Choi, Hee-Chang Jang, Sang-Won Park
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Mucormycosis coinfection in patients with proven aspergillosis
    Hyeon Mu Jang, Ji Yeun Kim, Joon Seon Song, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim, Sung-Han Kim
    Medical Mycology.2025;[Epub]     CrossRef
  • Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review
    Elahe Sasani, Farzad Pakdel, Sadegh Khodavaisy, Mohammadreza Salehi, Amir Salami, Marjan Sohrabi, Pouyan Aminishakiba, Iman Amirafzali, Arezoo Salami Khaneshan
    Mycopathologia.2024;[Epub]     CrossRef
  • Prevalence of co‐existent COVID‐19‐associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID‐19‐associated pulmonary mucormycosis (CAPM)
    Valliappan Muthu, Ritesh Agarwal, Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K. Patel, Prakash Srinivas Shastri, Ashwini Tayade, Sudhir Bhandari, Vishwanath Gella, Jayanthi Savio, Surabhi Madan, Vinaykumar Hallur,
    Mycoses.2024;[Epub]     CrossRef
  • Aspergillosis coinfection in patients with proven mucormycosis
    Sang Hyun Ra, Ji Yeun Kim, Joon Seon Song, Hyeon Mu Jang, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
    Medical Mycology.2024;[Epub]     CrossRef
  • Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review
    Fei-Xiang Ling, Dong-Ming Qu, Ye-Quan Lu, Rou Li, Lei Zhao
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
  • The impact of pulmonary tuberculosis on SARS-CoV-2 infection: a nationwide cohort study
    Sang Hwan Lee, Yun Jin Kim, Jaehoon Oh, Hyunggoo Kang, Kyung Hun Yoo, Byuk Sung Ko, Tae Ho Lim, Bo-Guen Kim, Hyun Lee, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Yongil Cho, Dong Won Park
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Dual Disseminated Aspergillosis and Mucormycosis Diagnosed at Autopsy: A Report of Two Cases of Coinfection and a Review of the Literature
    Jason Murray, Zhen A. Lu, Karin Miller, Alex Meadows, Marissa Totten, Sean X. Zhang
    Journal of Fungi.2023; 9(3): 357.     CrossRef
  • COVID-19 and Fungal infections: a double debacle
    Sara Mina, Hajar Yaakoub, Cédric Annweiler, Vincent Dubée, Nicolas Papon
    Microbes and Infection.2022; 24(8): 105039.     CrossRef
Review Article
Infection
Microbial infections in burn patients
Souvik Roy, Preeti Mukherjee, Sutrisha Kundu, Debashrita Majumder, Vivek Raychaudhuri, Lopamudra Choudhury
Acute Crit Care. 2024;39(2):214-225.   Published online May 24, 2024
DOI: https://doi.org/10.4266/acc.2023.01571
  • 15,746 View
  • 825 Download
  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Polymicrobial infections are the leading causes of complications incurred from injuries that burn patients develop. Such patients admitted to the hospital have a high risk of developing hospital-acquired infections, with longer patient stays leading to increased chances of acquiring such drug-resistant infections. Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis are the most common multidrug-resistant (MDR) Gram-negative bacteria identified in burn wound infections (BWIs). BWIs caused by viruses, like Herpes Simplex and Varicella Zoster, and fungi-like Candida spp. appear to occur occasionally. However, the preponderance of infection by opportunistic pathogens is very high in burn patients. Variations in the causative agents of BWIs are due to differences in geographic location and infection control measures. Overall, burn injuries are characterized by elevated serum cytokine levels, systemic immune response, and immunosuppression. Hence, early detection and treatment can accelerate the wound-healing process and reduce the risk of further infections at the site of injury. A multidisciplinary collaboration between burn surgeons and infectious disease specialists is also needed to properly monitor antibiotic resistance in BWI pathogens, help check the super-spread of MDR pathogens, and improve treatment outcomes as a result.

Citations

Citations to this article as recorded by  
  • Postacute Overview of Burn Injuries
    Tuba Sengul, Holly Kirkland-Kyhn, Asiye Gul
    Nursing Clinics of North America.2025; 60(1): 15.     CrossRef
  • Phage treatment of multidrug-resistant bacterial infections in humans, animals, and plants: The current status and future prospects
    Omor Faruk, Zilhas Ahmed Jewel, Sanjoy Bairagi, Mohammad Rasheduzzaman, Hindol Bagchi, Akber Subahan Mahbub Tuha, Imran Hossain, Ayon Bala, Sarafat Ali
    Infectious Medicine.2025; 4(1): 100168.     CrossRef
  • Lavandula dentata leaves as potential natural antibiofilm agents against Pseudomonas aeruginosa
    Maram M. Aboulwafa, Nada M. Mostafa, Fadia S. Youssef, Omayma A. Eldahshan, Abdel Nasser B. Singab
    Scientific Reports.2025;[Epub]     CrossRef
  • Larval zebrafish burn wound infection model reveals conserved innate immune responses against diverse pathogenic fungi
    Nayanna M. Mercado Soto, Adam Horn, Nancy P. Keller, Anna Huttenlocher, Andrew S. Wagner, Gustavo H. Goldman
    mBio.2025;[Epub]     CrossRef
  • Unveiling the potential antibacterial action of acetylcysteine for managing Staphylococcus aureus wound infections: in vitro and in vivo study
    Rehab Ahmed, Engy Elekhnawy
    World Journal of Microbiology and Biotechnology.2025;[Epub]     CrossRef
  • Enhancing clinical outcomes in burn and surgical intensive care unit patients
    Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi
    Burns.2024; 50(8): 2137.     CrossRef
  • Development of a Stringent Ex Vivo-Burned Porcine Skin Wound Model to Screen Topical Antimicrobial Agents
    Ping Chen, Eliza A. Sebastian, S. L. Rajasekhar Karna, Kai P. Leung
    Antibiotics.2024; 13(12): 1159.     CrossRef
  • The SOS Response Activation and the Risk of Antibiotic Resistance Enhancement in Proteus spp. Strains Exposed to Subinhibitory Concentrations of Ciprofloxacin
    Agnieszka Zabłotni, Marek Schmidt, Małgorzata Siwińska
    International Journal of Molecular Sciences.2024; 26(1): 119.     CrossRef
Original Article
Pulmonary
Characteristics and outcomes of patients with chronic obstructive pulmonary disease admitted to the intensive care unit due to acute hypercapnic respiratory failure
Türkay Akbaş, Harun Güneş
Acute Crit Care. 2023;38(1):49-56.   Published online February 27, 2023
DOI: https://doi.org/10.4266/acc.2022.01011
  • 5,332 View
  • 278 Download
  • 9 Web of Science
  • 7 Crossref
AbstractAbstract PDF
Background
The study aimed to describe the clinical course, outcomes, and prognostic factors of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure.
Methods
This retrospective study involved patients with acute hypercapnic respiratory failure due to COPD of any cause admitted to the intensive care unit (ICU) for non-invasive or invasive mechanical ventilation (IMV) support between December 2015 and February 2020.
Results
One hundred patients were evaluated. The main causes of acute hypercapnic respiratory failure were bronchitis, pneumonia, and heart failure. The patients’ mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 23.0±7.2, and their IMV rate was 43%. ICU, in-hospital, and 90-day mortality rates were 21%, 29%, and 39%, respectively. Non-survivors had more pneumonia, shock within the first 24 hours of admission, IMV, vasopressor use, and renal replacement therapy, along with higher APACHE II scores, lower admission albumin levels and PaO2/ FiO2 ratios, and longer ICU and hospital stays than survivors. Logistic regression analysis identified APACHE II score (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.017–1.317; P=0.026), admission PaO2/FiO2 ratio (OR, 0.989; 95% CI, 0.978–0.999; P=0.046), and vasopressor use (OR, 8.827; 95% CI, 1.650–47.215; P=0.011) as predictors of ICU mortality. APACHE II score (OR, 1.099; 95% CI, 1.021–1.182; P=0.011) and admission albumin level (OR, 0.169; 95% CI, 0.056–0.514; P=0.002) emerged as predictors of 90-day mortality.
Conclusions
APACHE II scores, the PaO2/FiO2 ratio, vasopressor use, and albumin levels are significant short-term mortality predictors in severely ill COPD patients with acute hypercapnic respiratory failure.

Citations

Citations to this article as recorded by  
  • Breaking new ground: machine learning enhances survival forecasts in hypercapnic respiratory failure
    Zhongxiang Liu, Bingqing Zuo, Jianyang Lin, Zhixiao Sun, Hang Hu, Yuan Yin, Shuanying Yang
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Efficacy and safety of medroxyprogesterone acetate on noninvasive ventilation -treated exacerbated COPD patients: a double-blind randomized clinical trial
    Mohsen Gholinataj Jelodar, Mohammadreza Malek-Ahmadi, Adeleh Sahebnasagh, Farhad Mohammadi, Fatemeh Saghafi
    BMC Pulmonary Medicine.2025;[Epub]     CrossRef
  • Antibiotics in COPD exacerbations requiring mechanical ventilation: a dogma to be re-evaluated
    Sebastian Osorio-Rico, Daniel Perez-Marin, John Cardeño-Sanchez
    Internal and Emergency Medicine.2024; 19(5): 1505.     CrossRef
  • Opportunities and perspectives of small molecular phosphodiesterase inhibitors in neurodegenerative diseases
    Qi Li, Qinghong Liao, Shulei Qi, He Huang, Siyu He, Weiping Lyu, Jinxin Liang, Huan Qin, Zimeng Cheng, Fan Yu, Xue Dong, Ziming Wang, Lingfei Han, Yantao Han
    European Journal of Medicinal Chemistry.2024; 271: 116386.     CrossRef
  • Development and Validation of an In-Hospital Mortality Prediction Model for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease
    Wenjie Sun, Yeshan Li, Shuxin Tan
    International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1303.     CrossRef
  • Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients
    Liuhua Pan
    American Journal of Translational Research.2024; 16(12): 7830.     CrossRef
  • COPD Exacerbation: Why It Is Important to Avoid ICU Admission
    Irene Prediletto, Gilda Giancotti, Stefano Nava
    Journal of Clinical Medicine.2023; 12(10): 3369.     CrossRef
Review Article
Surgery
Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review
Hanan Elkalawy, Pavan Sekhar, Wael Abosena
Acute Crit Care. 2023;38(4):409-424.   Published online November 30, 2023
DOI: https://doi.org/10.4266/acc.2023.00703
  • 6,598 View
  • 457 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.

Citations

Citations to this article as recorded by  
  • Advancing Nutritional Care Through Bioelectrical Impedance Analysis in Critical Patients
    Ana Maria Dumitriu, Cristian Cobilinschi, Bogdan Dumitriu, Sebastian Vâlcea, Raluca Ungureanu, Angela Popa, Rǎzvan Ene, Radu Țincu, Ioana Marina Grințescu, Liliana Mirea
    Nutrients.2025; 17(3): 380.     CrossRef
  • Potential diagnostic tools for intensive care unit acquired weakness: A systematic review
    Chen Xin, Yubiao Gai, Lili Wei, Yanqiu Wang, Yuhong Luo, Binru Han
    International Journal of Nursing Studies Advances.2025; 8: 100301.     CrossRef
  • Characteristics of the Cerebrospinal Fluid in Septic Patients with Critical Illness Polyneuropathy - A Retrospective Cohort Study
    Yanyang Zhang, Jinfu Ma, Qing Zhao, Hui Liu
    The Journal of Critical Care Medicine.2024; 10(2): 130.     CrossRef
  • Advancing critical care recovery: The pivotal role of machine learning in early detection of intensive care unit-acquired weakness
    Georges Khattar, Elie Bou Sanayeh
    World Journal of Clinical Cases.2024; 12(21): 4455.     CrossRef
  • Construction and evaluation of acquired weakness nomogram model in patients with mechanical ventilation in intensive care unit
    Chen Lu, Jiang Wenjuan
    DIGITAL HEALTH.2024;[Epub]     CrossRef
  • A scoping review of preclinical intensive care unit-acquired weakness models
    Qingmei Yu, Jiamei Song, Luying Yang, Yanmei Miao, Leiyu Xie, Xinglong Ma, Peng Xie, Shaolin Chen
    Frontiers in Physiology.2024;[Epub]     CrossRef
Original Articles
Pulmonary
Factors influencing sleep quality in the intensive care unit: a descriptive pilot study in Korea
Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2023;38(3):278-285.   Published online August 11, 2023
DOI: https://doi.org/10.4266/acc.2023.00514
  • 5,053 View
  • 293 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDFSupplementary Material
Background
As sleep disturbances are common in the intensive care unit (ICU), this study assessed the sleep quality in the ICU and identified barriers to sleep.
Methods
Patients admitted to the ICUs of a tertiary hospital between June 2022 and December 2022 who were not mechanically ventilated at enrollment were included. The quality of sleep (QoS) at home was assessed on a visual analog scale as part of an eight-item survey, while the QoS in the ICU was evaluated using the Korean version of the Richards-Campbell Sleep Questionnaire (K-RCSQ). Good QoS was defined by a score of ≥50.
Results
Of the 30 patients in the study, 19 reported a QoS score <50. The Spearman correlation coefficient showed no meaningful relationship between the QoS at home and the overall K-RCSQ QoS score in the ICU (r=0.16, P=0.40). The most common barriers to sleep were physical discomfort (43%), being awoken for procedures (43%), and feeling unwell (37%); environmental factors including noise (30%) and light (13%) were also identified sources of sleep disruption. Physical discomfort (median [interquartile range]: 32 [28.0–38.0] vs. 69 [42.0–80.0], P=0.004), being awoken for procedures (36 [20.0–48.0] vs. 54 [36.0–80.0], P=0.04), and feeling unwell (31 [18.0–42.0] vs. 54 [40.0–76.0], P=0.01) were associated with lower K-RCSQ scores.
Conclusions
In the ICU, physical discomfort, patient care interactions, and feeling unwell were identified as barriers to sleep.

Citations

Citations to this article as recorded by  
  • Effects of nursing interventions applied at night on sleep quality and sleep effort of patients in the intensive care unit
    Aynur Bahar, Mina Güner Muşluoğlu, Hilal Uygur
    Psychology, Health & Medicine.2025; : 1.     CrossRef
  • Could fever dreams influence sleep in intensive care units?
    Jeng Swen Ng, Sheryn Tan, Sanjana Santhosh, Brandon Stretton, Joshua Kovoor, Aashray Gupta, Stephen Bacchi
    Acute and Critical Care.2024; 39(2): 327.     CrossRef
  • Effects of ICU diaries on psychological disorders and sleep quality in critically ill patients and their family members: A systematic review and meta-analysis
    Wenjie Huang, Yang Gao, Lingjun Zhou, Xiaojuan Xiao, Hong Xu, Lizhou Lu, Jinhao Deng, Juan Wu
    Sleep Medicine.2024; 122: 84.     CrossRef
  • Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review
    Issa M. Hweidi, Omar H. Jebreel, Hossam N. Alhawatmeh, Mohamad I. Jarrah, Awwad A. Abu‐Awwad, Mohammed I. Hweidi
    Journal of Clinical Nursing.2024; 33(12): 4528.     CrossRef
  • Nursing Sleep Promotion in Intensive Care Unit
    Orlando Fernandes, Válter Gonçalves, Leonardo Ribeiro, Elsa Sousa, Michelle Viríssimo, Abel Viveiros, Ana Alves
    European Journal of Theoretical and Applied Sciences.2024; 2(6): 238.     CrossRef
  • Different nursing interventions on sleep quality among critically ill patients: A systematic review and network meta-analysis
    Daijin Huang, Yumei Li, Jing Ye, Chang Liu, Dongyan Shen, Yunhui Lv
    Medicine.2023; 102(52): e36298.     CrossRef
Nursing
Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan
Khaldoun Mohammad Hamdan, Ahmad M. Al-Bashaireh, Mohammad Al-Dalahmeh, Ahmad Rajeh Saifan, Maha Alkaid Albqoor, Abeer M. Shaheen
Acute Crit Care. 2023;38(4):469-478.   Published online November 28, 2023
DOI: https://doi.org/10.4266/acc.2023.00430
  • 5,503 View
  • 237 Download
  • 2 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods
A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results
We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions
ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Citations

Citations to this article as recorded by  
  • Core competency in palliative care among intensive care unit nurses: A latent profile analysis
    Qin Guan, Xiaoling Zhu, Zhipeng Xue, Mengyun Peng
    Nursing in Critical Care.2025;[Epub]     CrossRef
  • Knowledge, attitudes, and self-efficacy regarding palliative care among Palestinian nurses in intensive care units
    Bilal Awad, Ahmad Batran, Malakeh Z. Malak, Ahmad Ayed, Anas Shehadeh, Bahaa Alassoud, Moath Abu Ejheisheh
    BMC Nursing.2025;[Epub]     CrossRef
  • Soulful support: Exploring critical care nurses' spiritual caregiving towards end‐of‐life scenario
    Ayman Mohamed El‐Ashry, Sameh Eltyebani, Shimmaa Mohamed Elsayed, Mahmoud Abdelwahab Khedr, Mona Metwally El‐Sayed, Mohamed Adel Ghoneam, Haitham Mokhtar Mohamed Abdallah
    Nursing in Critical Care.2025;[Epub]     CrossRef
  • Investigation of the Relationship between Personality Traits of Intensive Care Nurses and Their Attitudes and Behaviours towards End-of-life Care
    Fırat Demir, Cansu Polat Dünya, İlknur Özkan
    Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2024; 6(3): 243.     CrossRef
  • Knowledge and attitude towards palliative care and associated factors among nurse: a cross-sectional descriptive study
    Saeedeh Rafiee, Ismail Azizi-Fini, Zahra-Sadat Banihashemi, Safoura Yadollahi
    BMC Nursing.2024;[Epub]     CrossRef
Review Article
Trauma
Mobilization phases in traumatic brain injury
Tommy Alfandy Nazwar, Ivan Triangto, Gutama Arya Pringga, Farhad Bal’afif, Donny Wisnu Wardana
Acute Crit Care. 2023;38(3):261-270.   Published online August 1, 2023
DOI: https://doi.org/10.4266/acc.2023.00640
  • 8,804 View
  • 399 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Mobilization in traumatic brain injury (TBI) have shown the improvement of length of stay, infection, long term weakness, and disability. Primary damage as a result of trauma’s direct effect (skull fracture, hematoma, contusion, laceration, and nerve damage) and secondary damage caused by trauma’s indirect effect (microvasculature damage and pro-inflammatory cytokine) result in reduced tissue perfusion & edema. These can be facilitated through mobilization, but several precautions must be recognized as mobilization itself may further deteriorate patient’s condition. Very few studies have discussed in detail regarding mobilizing patients in TBI cases. Therefore, the scope of this review covers the detail of physiological effects, guideline, precautions, and technique of mobilization in patients with TBI.

Citations

Citations to this article as recorded by  
  • Reversing Persistent PTEN Activation after Traumatic Brain Injury Fuels Long‐Term Axonal Regeneration via Akt/mTORC1 Signaling Cascade
    Ziyu Shi, Leilei Mao, Shuning Chen, Zhuoying Du, Jiakun Xiang, Minghong Shi, Yana Wang, Yuqing Wang, Xingdong Chen, Zhi‐Xiang Xu, Yanqin Gao
    Advanced Science.2025;[Epub]     CrossRef
  • Falls in a single brain rehabilitation center: a 3-year retrospective chart review
    Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • Effects of using conventional assistive devices on spatiotemporal gait parameters of adults with neurological disorders: A systematic review protocol
    Jordana de Paula Magalhães, Sheridan Ayessa Ferreira de Brito, Merrill Landers, Aline Alvim Scianni, Poliana do Amaral Yamaguchi Benfica, Carolina Luisa de Almeida Soares, Christina Danielli Coelho de Morais Faria, Anne E. Martin
    PLOS ONE.2025; 20(4): e0321019.     CrossRef
  • Acute orthostatic responses during early mobilisation of patients with acquired brain injury - Innowalk pro versus standing frame
    Matthijs F Wouda, Espen I Bengtson, Ellen Høyer, Alhed P Wesche, Vivien Jørgensen
    Journal of Rehabilitation and Assistive Technologies Engineering.2024;[Epub]     CrossRef
  • Aktuelle Aspekte der intensivmedizinischen Versorgung bei Schädel-Hirn-Trauma – Teil 2
    André Hagedorn, Helge Haberl, Michael Adamzik, Alexander Wolf, Matthias Unterberg
    AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie.2024; 59(07/08): 466.     CrossRef
Original Articles
Trauma
Comparison of admission GCS score to admission GCS-P and FOUR scores for prediction of outcomes among patients with traumatic brain injury in the intensive care unit in India
Nishant Agrawal, Shivakumar S Iyer, Vishwanath Patil, Sampada Kulkarni, Jignesh N Shah, Prashant Jedge
Acute Crit Care. 2023;38(2):226-233.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2023.00570
  • 6,218 View
  • 260 Download
  • 7 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
This study aimed to determine the predictive power of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale Pupil (GCS-P) score in determining outcomes for traumatic brain injury (TBI) patients. The Glasgow Outcome Scale (GOS) was used to evaluate patients at 1 month and 6 months after the injury.
Methods
We conducted a 15-month prospective observational study. It included 50 TBI patients admitted to the ICU who met our inclusion criteria. We used Pearson’s correlation coefficient to relate coma scales and outcome measures. The predictive value of these scales was determined using the receiver operating characteristic (ROC) curve, calculating the area under the curve with a 99% confidence interval. All hypotheses were two-tailed, and significance was defined as P<0.01.
Results
In the present study, the GCS-P and FOUR scores among all patients on admission as well as in the subset of patients who were mechanically ventilated were statistically significant and strongly correlated with patient outcomes. The correlation coefficient of the GCS score compared to GCS-P and FOUR scores was higher and statistically significant. The areas under the ROC curve for the GCS, GCS-P, and FOUR scores and the number of computed tomography abnormalities were 0.912, 0.905, 0.937, and 0.324, respectively.
Conclusions
The GCS, GCS-P, and FOUR scores are all excellent predictors with a strong positive linear correlation with final outcome prediction. In particular, the GCS score has the best correlation with final outcome.

Citations

Citations to this article as recorded by  
  • Development of a Novel Neurological Score Combining GCS and FOUR Scales for Assessment of Neurosurgical Patients with Traumatic Brain Injury: GCS-FOUR Scale
    Ali Ansari, Sina Zoghi, Amirabbas Khoshbooei, Mohammad Amin Mosayebi, Maryam Feili, Omid Yousefi, Amin Niakan, Seyed Amin Kouhpayeh, Reza Taheri, Hosseinali Khalili
    World Neurosurgery.2024; 182: e866.     CrossRef
  • Comparison of Glasgow Coma Scale Full Outline of UnResponsiveness and Glasgow Coma Scale: Pupils Score for Predicting Outcome in Patients with Traumatic Brain Injury
    Indu Kapoor, Hemanshu Prabhakar, Arvind Chaturvedi, Charu Mahajan, Abraham L Chawnchhim, Tej P Sinha
    Indian Journal of Critical Care Medicine.2024; 28(3): 256.     CrossRef
  • Machine learning for the prediction of in-hospital mortality in patients with spontaneous intracerebral hemorrhage in intensive care unit
    Baojie Mao, Lichao Ling, Yuhang Pan, Rui Zhang, Wanning Zheng, Yanfei Shen, Wei Lu, Yuning Lu, Shanhu Xu, Jiong Wu, Ming Wang, Shu Wan
    Scientific Reports.2024;[Epub]     CrossRef
  • The assessment of consciousness status in primary brainstem hemorrhage (PBH) patients can be achieved by monitoring changes in basic vital signs
    Shiyi Zuo, Yuting Feng, Juan Sun, Guofang Liu, Hanxu Cai, Xiaolong Zhang, Zhian Hu, Yong Liu, Zhongxiang Yao
    Geriatric Nursing.2024; 59: 498.     CrossRef
  • Traumatic brain injury in companion animals: Pathophysiology and treatment
    Molly Wart, Thomas H. Edwards, Julie A. Rizzo, Geoffrey W. Peitz, Armi Pigott, Jonathan M. Levine, Nicholas D. Jeffery
    Topics in Companion Animal Medicine.2024; 63: 100927.     CrossRef
Gastroenterology
The diagnostic accuracy of ultrasonography over manual aspiration for gastric reserve volume estimation in critically ill patients
Rahul Sharma, Ravi Kant Dogra, Jyoti Pathania, Arti Sharma
Acute Crit Care. 2023;38(1):134-141.   Published online February 22, 2023
DOI: https://doi.org/10.4266/acc.2022.00955
  • 3,418 View
  • 159 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Background
Although gastric reserve volume (GRV) is a surrogate marker of gastrointestinal dysfunction and feeding intolerance, there is ambiguity in its estimation due to problems associated with its measurement. Introduction of point-of-care ultrasound as a tool for anesthetists kindled interest in its use for GRV estimation.
Methods
In this prospective observational study, we recruited 57 critically ill patients and analyzed 586 samples of GRV obtained by both ultrasonography (USG) and manual aspiration.
Results
The analysis showed that USG-guided GRV was significantly correlated (r=0.788, P<0.001) and in positive agreement with manual aspiration based on Bland-Altman plot, with a mean difference of 8.50±14.84 (95% confidence interval, 7.389–9.798). The upper and lower limits of agreement were 37.7 and –20.5, respectively, within the ±1.96 standard deviation (P<0.001). The respective sensitivity and positive predictive value, specificity and negative predictive value, and area under the curve of USG for feeding intolerance were 66.67%, 98.15%, and 0.82%, with 96.49% diagnostic accuracy.
Conclusions
Ultrasonographic estimation of GRV was positively, significantly correlated and in agreement with the manual aspiration method and estimated feeding intolerance earlier. Routine use of gastric USG could avoid clinical situations where feeding status is unclear and there is high risk of aspiration and could become a standard practice of critical care.

Citations

Citations to this article as recorded by  
  • Assessing gastrointestinal system dysfunction in intensive care
    Kaspar F. Bachmann, Varsha M. Asrani, Annika Reintam Blaser
    Current Opinion in Critical Care.2025; 31(2): 172.     CrossRef
  • Correlación de volumen residual gástrico medido y ultrasonido gástrico para identificar intolerancia gástrica en pacientes neurocríticos con nutrición enteral en la unidad de cuidados intensivos
    Mauricio Pérez-Macías, Roxana Vázquez-Ramírez, Marcela Pinedo-Lechuga
    Medicina Crítica.2024; 38(2): 102.     CrossRef
  • Is pre-extubation fasting in ICU justified? Insights from a prospective observational study using gastric ultrasound
    Mohd Saif Khan, Barun Ram, Amit Kumar, Kamel Bousselmi, Priyesh Kumar, Dumini Soren, Priyanka Shrivastava, Naveen Kumar
    Trends in Anaesthesia and Critical Care.2024; 58: 101497.     CrossRef
  • Early initiation of gastric tube feeding: ultrasound assessment. A prospective interventional study
    Islam M. Elbardan, Ahmed A. Alla Ossman, Nada El Kayal, Assem A. ElRazek Abd-Rabih
    Research and Opinion in Anesthesia & Intensive Care.2024; 11(4): 270.     CrossRef
  • Gastrointestinal function in critically ill patients
    Annika Reintam Blaser, Kaspar F. Bachmann, Adam M. Deane
    Current Opinion in Clinical Nutrition & Metabolic Care.2023; 26(5): 463.     CrossRef
Cardiology
Diagnostic accuracy of left ventricular outflow tract velocity time integral versus inferior vena cava collapsibility index in predicting post-induction hypotension during general anesthesia: an observational study
Vibhuti Sharma, Arti Sharma, Arvind Sethi, Jyoti Pathania
Acute Crit Care. 2024;39(1):117-126.   Published online February 23, 2024
DOI: https://doi.org/10.4266/acc.2023.00913
  • 2,932 View
  • 170 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Point of care ultrasound (POCUS) is being explored for dynamic measurements like inferior vena cava collapsibility index (IVC-CI) and left ventricular outflow tract velocity time integral (LVOT-VTI) to guide anesthesiologists in predicting fluid responsiveness in the preoperative period and in treating post-induction hypotension (PIH) with varying accuracy.
Methods
In this prospective, observational study on included 100 adult patients undergoing elective surgery under general anesthesia, the LVOT-VTI and IVC-CI measurements were performed in the preoperative room 15 minutes prior to surgery, and PIH was measured for 20 minutes in the post-induction period.
Results
The incidence of PIH was 24%. The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the two techniques at 95% confidence interval was 0.613, 30.4%, 93.3%, 58.3%, 81.4%, 73.6% for IVC-CI and 0.853, 83.3%, 80.3%, 57.1%, 93.8%, 77.4% for LVOT-VTI, respectively. In multivariate analysis, the cutoff value for IVC-CI was >51.5 and for LVOT-VTI it was ≤17.45 for predicting PIH with odd ratio [OR] of 8.491 (P=0.025) for IVCCI and OR of 17.427 (P<0.001) for LVOT. LVOT-VTI assessment was possible in all the patients, while 10% of patients were having poor window for IVC measurements.
Conclusions
We recommend the use of POCUS using LVOT-VTI or IVC-CI to predict PIH, to decrease the morbidity of patients undergoing surgery. Out of these, we recommend LVOT-VTI measurements as it has showed a better diagnostic accuracy (77.4%) with no failure rate.

Citations

Citations to this article as recorded by  
  • Left Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value
    Frank L. Dini, Valentina Barletta, Piercarlo Ballo, Giovanni Cioffi, Nicola Riccardo Pugliese, Andrea Rossi, Gani Bajraktari, Stefano Ghio, Michael Y. Henein
    Echocardiography.2025;[Epub]     CrossRef
  • Perioperative Focused Transthoracic Echocardiogram Evaluations for Elderly Hip Fractures: A Narrative Review of Literature and Recommendations
    Michael Armaneous, John Bouz, Tiffany Ding, Christopher Baker, Alina Kim, Avoumia Mourkus, Charles Schoepflin, Justin Calvert
    A&A Practice.2025; 19(3): e01944.     CrossRef
  • The Use of the Perfusion Index to Predict Post-Induction Hypotension in Patients Undergoing General Anesthesia: A Systematic Review and Meta-Analysis
    Kuo-Chuan Hung, Shu-Wei Liao, Chia-Li Kao, Yen-Ta Huang, Jheng-Yan Wu, Yao-Tsung Lin, Chien-Ming Lin, Chien-Hung Lin, I-Wen Chen
    Diagnostics.2024; 14(16): 1769.     CrossRef
  • Where the Postanesthesia Care Unit and Intensive Care Unit Meet
    Mary Rose Gaylor, David N. Hager, Kathleen Tyson
    Critical Care Clinics.2024; 40(3): 523.     CrossRef
Meta-analysis
Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study in South Korea
Moon Seong Baek, Young Suk Kwon, Sang Soo Kang, Daechul Shim, Youngsang Yoon, Jong Ho Kim
Acute Crit Care. 2024;39(1):127-137.   Published online February 20, 2024
DOI: https://doi.org/10.4266/acc.2023.01613
  • 2,801 View
  • 140 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDFSupplementary Material
Background
The Controlling Nutritional Status (CONUT) score and the prognostic nutritional index (PNI) have emerged as important nutritional indices because they provide an objective assessment based on data. We aimed to investigate how these nutritional indices relate to outcomes in patients with sepsis.
Methods
Data were collected retrospectively at five hospitals for patients aged ≥18 years receiving treatment for sepsis between January 1, 2017, and December 31, 2021. Serum albumin and total cholesterol concentrations, and peripheral lymphocytes were used to calculate the CONUT score and PNI. To identify predictors correlated with 30-day mortality, analyses were conducted using univariate and multivariate Cox proportional hazards models.
Results
The 30-day mortality rate among 9,763 patients was 15.8% (n=1,546). The median CONUT score was 5 (interquartile range [IQR], 3–7) and the median PNI score was 39.6 (IQR, 33.846.4). Higher 30-day mortality rates were associated with individuals with moderate (CONUT score: 5–8; PNI: 35–38) or severe (CONUT: 9–12; PNI: <35) malnutrition compared with those with no malnutrition (CONUT: 0–1; PNI: >38). With CONUT scores, the hazard ratio (HR) associated with moderate malnutrition was 1.52 (95% confidence interval [CI], 1.24–1.87; P<0.001); for severe, HR=2.42 (95% CI, 1.95–3.02; P<0.001). With PNI scores, the HR for moderate malnutrition was 1.29 (95% CI, 1.09–1.53; P=0.003); for severe, HR=1.88 (95% CI, 1.67–2.12; P<0.001).
Conclusions
The nutritional indices CONUT score and PNI showed significant associations with mortality of sepsis patients within 30 days.

Citations

Citations to this article as recorded by  
  • Relationship between the geriatric nutritional risk index and sepsis in elderly critically ill patients: a retrospective cohort study
    Yujiao Jin, Tianyun Zhou, Chenshu Hou, Huihui Zhang, Binbin Xu
    European Journal of Medical Research.2025;[Epub]     CrossRef
  • Epidemiology and Microbiology of Healthcare-Associated Infections in Neurosurgery Department: A Cross-Sectional Study
    Renata Jabłońska, Paweł Sokal, Magdalena Zając, Agnieszka Królikowska, Karolina Filipska - Blejder, Irena Wrońska, Robert Ślusarz
    Biological Research For Nursing.2025;[Epub]     CrossRef
  • Development and validation of a predictive model for in-hospital mortality from perioperative bacteremia in gastrointestinal surgery
    Yusuke Taki, Shinsuke Sato, Masaya Watanabe, Ko Ohata, Hideyuki Kanemoto, Noriyuki Oba
    European Journal of Clinical Microbiology & Infectious Diseases.2024; 43(11): 2117.     CrossRef
  • Sepsis and Septic Shock Management and Care: A Case Presentation
    Myriam Jean Cadet
    MEDSURG Nursing.2024; 33(5): 214.     CrossRef
Cardiology
Evaluation of neopterin levels and kynurenine pathway in patients with acute coronary syndrome
Ibrahim Kember, Sonia Sanajou, Bilge Kilicarslan, Gözde Girgin, Terken Baydar
Acute Crit Care. 2023;38(3):325-332.   Published online August 30, 2023
DOI: https://doi.org/10.4266/acc.2023.00024
  • 2,876 View
  • 72 Download
  • 3 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Coronary atherosclerosis is the leading cause of coronary artery disease. Several investigations have indicated that tear-sensitive plaques contain macrophages and T cells. Neopterin is an essential cellular immune response biomarker. The main goal of this study was to see if there were any changes in biomarkers like unconjugated pteridines, neopterin, and biopterin, as well as kynurenine pathway enzymes like indoleamine 2,3-dioxygenase (IDO), which catalyzes the rate-limiting step in tryptophan degradation, in patients with the acute coronary syndrome (ACS) caused by angiographic atherosclerosis.
Methods
High-performance liquid chromatography was used to determine the amounts of neopterin, biopterin, and creatinine in urine samples, as well as tryptophan and kynurenine in serum samples. The enzyme-linked immunosorbent assay was used to assess the amounts of neopterin in serum samples. The measured parameters were evaluated between ACS patients and controls.
Results
The measured levels of neopterin, biopterin and the kynurenine to tryptophan ratio reflecting IDO activity, and the specifically known biomarkers such as cardiac troponin, creatine kinase, myoglobin, and natriuretic peptides are statistically higher in ACS patients compared to control subjects. On the other hand, the measured parameters are inadequate to classify the conventional kinds of ACS, ST-elevation- and non-ST-elevation- myocardial infarction.
Conclusions
The study found that determining and using neopterin and IDO parameters as biomarkers in individuals with the ACS can support traditional biomarkers. However, it can be concluded that evaluating pteridine biomarkers solely have no privilege to clinical findings in ACS diagnosis and classification.

Citations

Citations to this article as recorded by  
  • Assessment of Inflammatory and Oxidative Stress Biomarkers for Predicting of Patients with Asymptomatic Carotid Artery Stenosis
    Abdullah Burak Karaduman, Sinem Ilgın, Özlem Aykaç, Mehmetcan Yeşilkaya, Serkan Levent, Atilla Özcan Özdemir, Gozde Girgin
    Journal of Clinical Medicine.2025; 14(3): 755.     CrossRef
  • Kynurenines as a Novel Target for the Treatment of Inflammatory Disorders
    Adrian Mor, Anna Tankiewicz-Kwedlo, Marianna Ciwun, Janina Lewkowicz, Dariusz Pawlak
    Cells.2024; 13(15): 1259.     CrossRef
  • Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease
    Armand N. Yazdani, Michaela Pletsch, Abraham Chorbajian, David Zitser, Vikrant Rai, Devendra K. Agrawal
    Expert Review of Cardiovascular Therapy.2023; 21(10): 675.     CrossRef
  • Evaluation of Neopterin as a Neuroinflammatory Marker for Peripheral Neuropathy in Type 2 Diabetic Patients
    Israa Abdelmalik Salem, Sura Ahmed Abdulsattar, Haider Fadhil Alrubaye
    Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2023; 5(1S): S183.     CrossRef
Cardiology
Risk factors for cannula-associated arterial thrombosis following extracorporeal membrane oxygenation support: a retrospective study
Ngan Hoang Kim Trieu, Xuan Thi Phan, Linh Thanh Tran, Huy Minh Pham, Dai Quang Huynh, Tuan Manh Nguyen, Anh Tuan Mai, Quan Quoc Minh Du, Bach Xuan Nguyen, Thao Thi Ngoc Pham
Acute Crit Care. 2023;38(3):315-324.   Published online August 23, 2023
DOI: https://doi.org/10.4266/acc.2023.00500
  • 4,309 View
  • 136 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
Hemostatic dysfunction during extracorporeal membrane oxygenation (ECMO) due to blood-circuit interaction and the consequences of shear stress imposed by flow rates lead to rapid coagulation cascade and thrombus formation in the ECMO system and blood vessels. We aimed to identify the incidence and risk factors for cannula-associated arterial thrombosis (CaAT) post-decannulation.
Methods
A retrospective study of patients undergoing arterial cannula removal following ECMO was performed. We evaluated the incidence of CaAT and compared the characteristics, ECMO machine parameters, cannula sizes, number of blood products transfused during ECMO, and daily hemostasis parameters in patients with and without CaAT. Multivariate analysis identified the risk factors for CaAT.
Results
Forty-seven patients requiring venoarterial ECMO (VA-ECMO) or hybrid methods were recruited for thrombosis screening. The median Sequential Organ Failure Assessment score was 11 (interquartile range, 8–13). CaAT occurred in 29 patients (61.7%), with thrombosis in the superficial femoral artery accounting for 51.7% of cases. The rate of limb ischemia complications in the CaAT group was 17.2%. Multivariate analysis determined that the ECMO flow rate–body surface area (BSA) ratio (100 ml/min/m2) was an independent factor for CaAT, with an odds ratio of 0.79 (95% confidence interval, 0.66–0.95; P=0.014).
Conclusions
We found that the incidence of CaAT was 61.7% following successful decannulation from VA-ECMO or hybrid modes, and the ECMO flow rate–BSA ratio was an independent risk factor for CaAT. We suggest screening for arterial thrombosis following VA-ECMO, and further research is needed to determine the risks and benefits of such screening.

Citations

Citations to this article as recorded by  
  • Machine learning‐based prediction of bleeding risk in extracorporeal membrane oxygenation patients using transfusion as a surrogate marker
    Tadashi Kamio, Masaru Ikegami, Megumi Mizuno, Seiichiro Ishii, Hayato Tajima, Yoshihito Machida, Kiyomitsu Fukaguchi
    Transfusion.2025;[Epub]     CrossRef
  • Has the role of veno-arterial extracorporeal membrane oxygenation in patients with cardiogenic shock following acute myocardial infarction been fully determined? A case report
    Kha Minh Nguyen, Hai Phuong Nguyen Tran, Vi Tuong Dang, Sy Van Hoang, Josip Andelo Borovac, Dmitry Duplyakov, Chiara De Biase, Pok-Tin Tang
    European Heart Journal - Case Reports.2024;[Epub]     CrossRef
  • Vaskuläre Komplikationen unter venoarterieller extrakorporaler Membranoxygenierung
    J. Ajouri, N. Abdal-Daem, V. Scriba, A. A. Peivandi, R. M. Muellenbach, Y. D. Sagban, T. A. Sagban
    Gefässchirurgie.2024; 29(7): 410.     CrossRef
  • Assessment of percutaneous closure for decannulation of veno-arterial extracorporeal membrane oxygenation: A retrospective study
    Diana Martins-Fernandes, João Rocha-Neves, Ana Rita Ferreira, Hélio Martins, Sérgio Gaião, José Artur Paiva
    The Journal of Vascular Access.2024;[Epub]     CrossRef

ACC : Acute and Critical Care
TOP