Maria Mermiri, Georgios Mavrovounis, Dimitrios Chatzis, Ioannis Mpoutsikos, Aristea Tsaroucha, Maria Dova, Zacharoula Angelopoulou, Dimitrios Ragias, Athanasios Chalkias, Ioannis Pantazopoulos
Acute Crit Care. 2021;36(1):22-28. Published online January 28, 2021
Critical emergency medicine is the medical field concerned with management of critically ill patients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU) overcrowding has a negative impact on patient care and outcome. It has been proposed that implementation of critical care services in the ED can negate this effect. Two main Critical Emergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU” models. The resource intensivist model is based on constant presence of an intensivist in the traditional ED setting, while the ED-ICU model encompasses the notion of a separate ED-based unit, with monitoring and therapeutic capabilities similar to those of an ICU. Critical emergency medicine has the potential to improve patient care and outcome; however, establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.
Citations
Citations to this article as recorded by
Inhaled anaesthetic gas for severe bronchospasm at the emergency department Osman Adi, Farah Nuradhwa Apoo, Chan Pei Fong, Azma Haryaty Ahmad, Nurul Liana Roslan, Faheem Ahmed Khan, Shahridan Fathil The American Journal of Emergency Medicine.2024; 75: 179. CrossRef
Patients’ Expectations in Emergency Department at King Abdulaziz University Hospital: A Cross-Sectional Survey-Based Study Ahmad H Bakhribah, Ghaida A. Eissa, Dania W Alsulami, Marah A Alotaibi, Htoun M Abdulmannan, Imad M Khojah Cureus.2024;[Epub] CrossRef
CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients Abuzer Özkan Eurasian Journal of Critical Care.2024; 6(1): 38. CrossRef
Rearranging the furniture: A blueprint for reappropriating fixed resources to create an emergency department resuscitative care unit Angela Barskaya, Liliya Abrukin, Christopher McStay Journal of the American College of Emergency Physicians Open.2024;[Epub] CrossRef
The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study Ahmed Faidh Ramzee, Ayman El-Menyar, Mohammad Asim, Ahad Kanbar, Khalid Ahmed, Bahaa Daoud, Saji Mathradikkal, Ahmad Kloub, Hassan Al-Thani, Sandro Rizoli World Journal of Emergency Medicine.2023; 14(2): 96. CrossRef
Value of Intensive Nursing Detail Management in Intensive Care Unit Nursing Yansong Li, Lehong Zhou, Qin Wei, Zhaoqi Dong Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis Qidong Jiang, Tao Xu, Dinesh Rokaya BioMed Research International.2022; 2022: 1. CrossRef
Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model Elizabeth Powell, Iana Sahadzic, Daniel Najafali, Emilie Berman, Katie Andersen, Leenah Z. Afridi, Zoe Gasparotti, Erin Niles, Jeffrey Rea, Thomas Scalea, Daniel J. Haase, Quincy K. Tran, Edward A. Bittner Critical Care Research and Practice.2022; 2022: 1. CrossRef
Background Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient’s volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf’s association with vasopressor-free resuscitation.
Methods Ten healthy Landrace/Large-White piglets aged 10–12 weeks with average weight 20±1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5–7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤4 mm Hg. No vasopressors were used.
Results The mean volume of blood removed was 860±20 ml (blood loss, ~61%) and the bleeding time was 43.2±2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09±1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5–7.5 seconds and 3.72±0.23 mm Hg at 55– 57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1±1.7 minutes and mean administered volume being 394±20 ml.
Conclusions For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.
Citations
Citations to this article as recorded by
COMPARISON BETWEEN ACTIVE ABDOMINAL COMPRESSION-DECOMPRESSION CARDIOPULMONARY RESUSCITATION AND STANDARD CARDIOPULMONARY RESUSCITATION IN ASPHYCTIC CARDIAC ARREST RATS WITH MULTIPLE RIB FRACTURES Zhichu Dai, Sisen Zhang, Hongyu Wang, Liwei He, Jiankun Liao, Xuanyu Wu Shock.2024; 61(2): 266. CrossRef
Effects of Vasopressin Receptor Agonists during the Resuscitation of Hemorrhagic Shock: A Systematic Review and Meta-Analysis of Experimental and Clinical Studies Eleni Laou, Nikolaos Papagiannakis, Androniki Papadopoulou, Theodora Choratta, Minas Sakellakis, Mariachiara Ippolito, Ioannis Pantazopoulos, Andrea Cortegiani, Athanasios Chalkias Journal of Personalized Medicine.2023; 13(7): 1143. CrossRef
Hemodynamic Effects of Cardiovascular Medications in a Normovolemic and Hemorrhaged Yorkshire-cross Swine Model Jacob H Cole, Scott B Hughey, Phillip G Geiger, Kamala J Rapp-Santos, Gregory J Booth Comparative Medicine.2022; 72(1): 38. CrossRef
Determinants of venous return in steady-state physiology and asphyxia-induced circulatory shock and arrest: an experimental study Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Giolanda Varvarousi, Dimitrios Ragias, Anastasios Koutsovasilis, Demosthenes Makris, Dimitrios Varvarousis, Nicoletta Iacovidou, Ioannis Pantazopoulos, Theodoros Xanthos Intensive Care Medicine Experimental.2022;[Epub] CrossRef
Assessment of Dynamic Changes in Stressed Volume and Venous Return during Hyperdynamic Septic Shock Athanasios Chalkias, Eleni Laou, Nikolaos Papagiannakis, Vaios Spyropoulos, Evaggelia Kouskouni, Kassiani Theodoraki, Theodoros Xanthos Journal of Personalized Medicine.2022; 12(5): 724. CrossRef
A Critical Appraisal of the Effects of Anesthetics on Immune-system Modulation in Critically Ill Patients With COVID-19 Athanasios Chalkias, Erin F. Barreto, Eleni Laou, Konstantina Kolonia, Marc H. Scheetz, Konstantinos Gourgoulianis, Ioannis Pantazopoulos, Theodoros Xanthos Clinical Therapeutics.2021; 43(3): e57. CrossRef
Resuscitative Effect of Centhaquine (Lyfaquin®) in Hypovolemic Shock Patients: A Randomized, Multicentric, Controlled Trial Anil Gulati, Dinesh Jain, Nilesh Radheshyam Agrawal, Prashant Rahate, Rajat Choudhuri, Soumen Das, Deba Prasad Dhibar, Madhav Prabhu, Sameer Haveri, Rohit Agarwal, Manish S. Lavhale Advances in Therapy.2021; 38(6): 3223. CrossRef
A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin®) as a Resuscitative Agent in Hypovolemic Shock Patients Anil Gulati, Rajat Choudhuri, Ajay Gupta, Saurabh Singh, S. K. Noushad Ali, Gursaran Kaur Sidhu, Parvez David Haque, Prashant Rahate, Aditya R. Bothra, Gyan P. Singh, Sanjiv Maheshwari, Deepak Jeswani, Sameer Haveri, Apurva Agarwal, Nilesh Radheshyam Agra Drugs.2021; 81(9): 1079. CrossRef