Acute and Critical Care

Guideline

Pulmonary
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 Crit Care. 2024;39(1):1-23. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2024.00052

2,666 View
499 Download

Abstract PDF Supplementary Material: Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator. Methods: Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations. Results: Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation. Conclusions: We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

Review Articles

Meta-analysis
The impact of ketamine on outcomes in critically ill patients: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials: Yerkin Abdildin, Karina Tapinova, Assel Nemerenova, Dmitriy Viderman; Acute Crit Care. 2024;39(1):34-46. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2023.00829

1,242 View
108 Download

Abstract PDF: Background
This meta-analysis aims to evaluate the effects of ketamine in critically ill intensive care unit (ICU) patients.
Methods
We searched for randomized controlled trials (RCTs) in PubMed, Scopus, and the Cochrane Library; the search was performed initially in January but was repeated in December of 2023. We focused on ICU patients of any age. We included studies that compared ketamine with other traditional agents used in the ICU. We synthesized evidence using RevMan v5.4 and presented the results as forest plots. We also used trial sequential analysis (TSA) software v. 0.9.5.10 Beta and presented results as TSA plots. For synthesizing results, we used a random-effects model and reported differences in outcomes of two groups in terms of mean difference (MD), standardized MD, and risk ratio with 95% confidence interval. We assessed the risk of bias using the Cochrane RoB tool for RCTs. Our outcomes were mortality, pain, opioid and midazolam requirements, delirium rates, and ICU length of stay.
Results
Twelve RCTs involving 805 ICU patients (ketamine group, n=398; control group, n=407) were included in the meta-analysis. The ketamine group was not superior to the control group in terms of mortality (in five studies with 318 patients), pain (two studies with 129 patients), mean and cumulative opioid consumption (six studies with 494 patients), midazolam consumption (six studies with 304 patients), and ICU length of stay (three studies with 270 patients). However, the model favored the ketamine group over the control group in delirium rate (four studies with 358 patients). This result is significant in terms of conventional boundaries (alpha=5%) but is not robust in sequential analysis. The applicability of the findings is limited by the small number of patients pooled for each outcome.
Conclusions
Our meta-analysis did not demonstrate differences between ketamine and control groups regarding any outcome except delirium rate, where the model favored the ketamine group over the control group. However, this result is not robust as sensitivity analysis and trial sequential analysis suggest that more RCTs should be conducted in the future.

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

2,026 View
215 Download

Abstract 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.

Original Articles

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

1,655 View
104 Download
2 Web of Science
1 Crossref

Abstract 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

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

Liver
Alcohol use disorder in the intensive care unit a highly morbid condition, but chemical dependency discussion improves outcomes: Kristin Colling, Alexandra K. Kraft, Melissa L. Harry; Acute Crit Care. 2023;38(1):122-133. Published online January 10, 2023; DOI: https://doi.org/10.4266/acc.2022.00584

2,272 View
86 Download
1 Web of Science
1 Crossref

Abstract PDF

Background
Alcohol use disorders (AUD) are common in patients admitted to intensive care units (ICU) and increase the risk for worse outcomes. In this study, we describe factors associated with patient mortality after ICU admission and the effect of chemical dependency (CD) counseling on outcomes in the year following ICU admission. Methods: We retrospectively reviewed patient demographics, hospital data, and documentation of CD counseling by medical providers for all ICU patients with AUD admitted to our institution between January 2017 and March 2019. Primary outcomes were in-hospital and 1-year mortality. Results: Of the 527 patients with AUD requiring ICU care, median age was 56 years (range, 18–86). Both in-hospital (12%) and 1-year mortality rates (27%) were high. Rural patients, comorbidities, older age, need for mechanical ventilation, and complications were associated with increased risk of in-hospital and 1-year mortality. CD counseling was documented for 73% of patients, and 50% of these patients accepted alcohol treatment or resources prior to discharge. CD evaluation and acceptance was associated with a significantly decreased rate of readmission for liver or alcohol-related issues (36% vs. 58%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.27–0.61) and 1-year mortality (7% vs. 19.5%; OR, 0.32; 95% CI, 0.16–0.64). CD evaluation alone, regardless of patient acceptance, was associated with a significantly decreased 1-year post-discharge mortality rate (12% vs. 23%; OR, 0.44; 95% CI, 0.25–0.77). Conclusions: ICU patients with AUD had high in-hospital and 1-year mortality. CD evaluation, regardless of patient acceptance, was associated with a significant decrease in 1-year mortality

Citations

Citations to this article as recorded by

Identifying excessive chronic alcohol use with phosphatidylethanol in patients with suspected severe injury-results from the IDART study
Benedicte M Jørgenrud, Camilla C Bråthen, Jo Steinson Stenehjem, Thomas Kristiansen, Leiv Arne Rosseland, Stig Tore Bogstrand
Alcohol and Alcoholism.2024;[Epub] CrossRef

Nutrition
Effect of a nutritional support protocol on enteral nutrition and clinical outcomes of critically ill patients: a retrospective cohort study: Heemoon Park, Sung Yoon Lim, Sebin Kim, Hyung-Sook Kim, Soyeon Kim, Ho Il Yoon, Young-Jae Cho; Acute Crit Care. 2022;37(3):382-390. Published online July 19, 2022; DOI: https://doi.org/10.4266/acc.2022.00220

3,207 View
244 Download
2 Crossref

Abstract PDF Supplementary Material

Background
Enteral nutrition (EN) supply within 48 hours after intensive care unit (ICU) admission improves clinical outcomes. The “new ICU evaluation & development of nutritional support protocol (NICE-NST)” was introduced in an ICU of tertiary academic hospital. This study showed that early EN through protocolized nutritional support would supply more nutrition to improve clinical outcomes.
Methods
This study screened 170 patients and 62 patients were finally enrolled; patients who were supplied nutrition without the protocol were classified as the control group (n=40), while those who were supplied according to the protocol were classified as the test group (n=22).
Results
In the test group, EN started significantly earlier (3.7±0.4 days vs. 2.4±0.5 days, P=0.010). EN calorie (4.0±1.0 kcal/kg vs. 6.7±0.9 kcal/kg, P=0.006) and protein (0.17±0.04 g/kg vs. 0.32±0.04 g/kg, P=0.002) supplied were significantly higher in the test group. Although EN was supplied through continuous feeding in the test group, there was no difference in complications such as feeding hold due to excessive gastric residual volume or vomit, and hyper- or hypo-glycemia between the two groups. Hospital mortality was significantly lower in the group that started EN within 1.5 days (42.9% vs. 11.8%, P=0.018). The proportion of patients who started EN within 1.5 days was higher in the test group (40.9% vs. 17.5%, P=0.044).
Conclusions
The NICE-NST may improve EN supply and mortality of critically ill patients without increasing complications.

Citations

Citations to this article as recorded by

Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?
Natalya P. Shen, Svetlana Yu. Mukhacheva
Clinical nutrition and metabolism.2023; 3(4): 181. CrossRef
Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
Annals of Clinical Nutrition and Metabolism.2022; 14(2): 66. CrossRef

Neurology
Muscle Growth and Anabolism in Intensive Care Survivors (GAINS) trial: a pilot randomised controlled trial: Matthew H Anstey, Rashmi Rauniyar, Ethan Fitzclarence, Natalie Tran, Emma Osnain, Bianca Mammana, Angela Jacques, Robert N Palmer, Andrew Chapman, Bradley Wibrow; Acute Crit Care. 2022;37(3):295-302. Published online June 27, 2022; DOI: https://doi.org/10.4266/acc.2021.01767

4,361 View
308 Download

Abstract PDF Supplementary Material: Background
To explore the feasibility, safety, and potential benefits of administration of the anabolic steroid nandrolone to patients in the recovery phase from critical illness weakness.
Methods
In this phase II, double blind, randomized, controlled trial, adult critically ill patients admitted to one of two tertiary Intensive Care Units in Western Australia for longer than 7 days with significant weakness were enrolled. Patients received nandrolone (200 mg males, 100 mg females) intramuscularly or placebo weekly for up to 3 weeks in addition to standard care. The primary outcome measures were improvement in grip strength, Medical Research Council muscle strength sum score, and functional activity level (Chelsea critical care assessment tool [CPAx]).
Results
A total of 22 patients was enrolled between September 2017 and May 2019. No significant adverse events were detected. Median grip strength change was non-significantly greater in the nandrolone group (8.5 vs. 13.0, P=0.185), while hospital length of stay (36 vs. 26 days, P=0.023) and duration of mechanical ventilation (377 vs. 168, P=0.032) were lower. The discharge CPAx and intensive care unit mobility scores were higher in the nandrolone group, although there was no difference in the change in CPAx score (17.0 vs. 17.7, P=0.865). There were no changes in ultrasound-detected muscle thickness between the two groups.
Conclusions
In patients with prolonged critical illness, nandrolone appears to be safe. However, a larger study, potentially combined with resistance exercise, is needed to definitively address the potential benefits of nandrolone.

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

5,644 View
263 Download
8 Web of Science
9 Crossref

Abstract PDF Supplementary 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
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

Ethics
Outcomes of critically ill patients according to the perception of intensivists on the appropriateness of intensive care unit admission: Youjin Chang, Kyoung Ran Kim, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim; Acute Crit Care. 2021;36(4):351-360. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00283

4,905 View
135 Download
4 Web of Science
4 Crossref

Abstract PDF Supplementary Material

Background
It is important for intensivists to determine which patient may benefit from intensive care unit (ICU) admission. We aimed to assess the outcomes of patients perceived as non-beneficially or beneficially admitted to the ICU and evaluate whether their prognosis was consistent with the intensivists’ perception.
Methods
A prospective observational study was conducted on patients admitted to the medical ICU of a tertiary referral center between February and April 2014. The perceptions of four intensivists at admission (day 1) and on day 3 were investigated as non-beneficial admission, beneficial admission, or indeterminate state.
Results
A total of 210 patients were enrolled. On days 1 and 3, 22 (10%) and 23 (11%) patients were judged as having non-beneficial admission; 166 (79%) and 159 (79%), beneficial admission; and 22 (10%) and 21 (10%), indeterminate state, respectively. The ICU mortality rates of each group were 64%, 22%, and 57%, respectively; their 6-month mortality rates were 100%, 46%, and 81%, respectively. The perceptions of non-beneficial admission or indeterminate state were the significant predictors of ICU mortality (day 3, odds ratio [OR], 4.049; 95% confidence interval [CI], 1.892–8.664; P<0.001) and 6-month mortality (day 1: OR, 4.983; 95% CI, 1.260–19.703; P=0.022; day 3: OR, 4.459; 95% CI, 1.162–17.121; P=0.029).
Conclusions
The outcomes of patients perceived as having non-beneficial admission were extremely poor. The intensivists’ perception was important in predicting patients’ outcomes and was more consistent with long-term prognosis than with immediate outcomes. The intensivists’ role can be reflected in limited ICU resource utilization.

Citations

Citations to this article as recorded by

Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study
Carla Marchini Dias da Silva, Bruno Adler Maccagnan Pinheiro Besen, Antônio Paulo Nassar Jr
Journal of Critical Care.2024; 79: 154468. CrossRef
Characteristics, ICU Interventions, and Clinical Outcomes of Patients With Palliative Care Triggers in a Mixed Community-Based Intensive Care Unit
Michele M. Iguina, Aunie M. Danyalian, Ilko Luque, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers
Journal of Palliative Care.2023; 38(2): 126. CrossRef
Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients
Carla Marchini Dias Silva, Janaina Naiara Germano, Anna Karolyne de Araujo Costa, Giovanna Alves Gennari, Pedro Caruso, Antonio Paulo Nassar Jr
Internal and Emergency Medicine.2023; 18(4): 1191. CrossRef
Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
SeungYong Park
Acute and Critical Care.2021; 36(4): 388. CrossRef

Review Article

Epidemiology
Influence of sarcopenia focused on critically ill patients: Belgin Akan; Acute Crit Care. 2021;36(1):15-21. Published online February 2, 2021; DOI: https://doi.org/10.4266/acc.2020.00745

6,544 View
268 Download
9 Web of Science
13 Crossref

Abstract PDF

A systemic review was performed to evaluate the epidemiological, pathophysiological, and clinical features of sarcopenia, the relationship of sarcopenia with critical illness and its impact on mortality, and diagnostic methods and treatment modalities. Generally, in the presence of critical illness, sarcopenia is not included in the treatment approach strategies. An intensivist should be aware that sarcopenia may be present in critically ill patients. Although the main modalities against sarcopenia are early mobilization and nutritional support, they can only prevent its development and may have positive effects on prognosis rather than treating the existing sarcopenia.

Citations

Citations to this article as recorded by

High prevalence of pre-existing sarcopenia in critically ill patients with hematologic malignancies admitted to the intensive care unit for sepsis or septic shock
Antoine Herault, Emilie Lévêque, Simon Draye-Carbonnier, Pierre Decazes, Alexandra Zduniak, Romain Modzelewski, Julie Libraire, Najate Achamrah, Anne-Lise Ménard, Pascal Lenain, Nathalie Contentin, Maximilien Grall, Stéphane Leprêtre, Emilie Lemasle, Hélè
Clinical Nutrition ESPEN.2023; 55: 373. CrossRef
Acute Changes in Body Muscle Mass and Fat Depletion in Hospitalized Young Trauma Patients: A Descriptive Retrospective Study
Hassan Al-Thani, Bianca M. Wahlen, Ayman El-Menyar, Mohammad Asim, Lena Ribhi Nassar, Mohamed Nadeem Ahmed, Syed Nabir, Monira Mollazehi, Husham Abdelrahman
Diseases.2023; 11(3): 120. CrossRef
The relationship between body mass index and mortality is not linear in patients requiring venovenous extracorporeal support
Elwin Tham, Stuart Campbell, Heather Hayanga, Jeffrey Ammons, Wei Fang, Penny Sappington, Paul McCarthy, Alper Toker, Vinay Badhwar, J.W. Awori Hayanga
The Journal of Thoracic and Cardiovascular Surgery.2023;[Epub] CrossRef
The importance of sarcopenia in critically ill patients in intensive care units
Sanja Tomanović-Vujadinović
Galenika Medical Journal.2023; 2(8): 25. CrossRef
Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment
I.A. Osuna-Padilla, N.C. Rodríguez-Moguel, S. Rodríguez-Llamazares, C.E. Orsso, C.M. Prado, M.A. Ríos-Ayala, O. Villanueva-Camacho, A. Aguilar-Vargas, L.E. Pensado-Piedra, F. Juárez-Hernández, C.M. Hernández-Cárdenas
Clinical Nutrition.2022; 41(12): 2910. CrossRef
A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults
Bethan Jenkins, Philip C. Calder, Luise V. Marino
Clinical Nutrition ESPEN.2022; 49: 92. CrossRef
The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review
I. Nies, L.L.G.C. Ackermans, M. Poeze, T.J. Blokhuis, Jan A. Ten Bosch
Injury.2022; 53: S23. CrossRef
Intra-Aortic Balloon Pump Placement in the Axillary Artery: Where are We?
Gustavo André Boeing Boros, Claudia Yanet San Martin de Bernoche, Pedro Felipe Gomes Nicz
ABC: Heart Failure & Cardiomyopathy.2022; 2(2): 209. CrossRef
Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan: A nationwide, web-based cross-sectional study
Keishi Nawata, Nobuto Nakanishi, Shigeaki Inoue, Keibun Liu, Masafumi Nozoe, Yuko Ono, Isamu Yamada, Hajime Katsukawa, Joji Kotani, Supat Chupradit
PLOS ONE.2022; 17(11): e0276855. CrossRef
A scoping review considering potential biomarkers or functional measures of gastrointestinal dysfunction and enteral feeding intolerance in critically ill adults
Bethan Jenkins, Philip C. Calder, Luise V. Marino
Clinical Nutrition ESPEN.2022; 52: 331. CrossRef
ICU Acquired Weakness in patients with respiratory failure
Sergei A. Andreichenko, Mikhail V. Bychinin, Dmitriy I. Korshunov, Tatiana V. Klypa
Journal of Clinical Practice.2021; 12(2): 5. CrossRef
Predicting outcome in abdominal sepsis: putting the puzzle together
Catherine S. Reid, Vanessa M. Banz, Joerg C. Schefold, Markus M. Luedi
Journal of Cachexia, Sarcopenia and Muscle.2021; 12(5): 1119. CrossRef
Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission: A retrospective study
Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto
Clinical Nutrition ESPEN.2021; 45: 177. CrossRef

Original Articles

Infection
Risk factors for intensive care unit admission and mortality in hospitalized COVID-19 patients: Ahmed Ayaz, Ainan Arshad, Hajra Malik, Haris Ali, Erfan Hussain, Bushra Jamil; Acute Crit Care. 2020;35(4):249-254. Published online November 11, 2020; DOI: https://doi.org/10.4266/acc.2020.00381

6,979 View
219 Download
18 Web of Science
20 Crossref

Abstract PDF

Background
This study investigated the clinical features and outcome of hospitalized coronavirus disease 2019 (COVID-19) patients admitted to our quaternary care hospital.
Methods
In this retrospective cohort study, we included all adult patients with COVID-19 infection admitted to a quaternary care hospital in Pakistan from March 1 to April 15, 2020. The extracted variables included demographics, comorbidities, presenting symptoms, laboratory tests and radiological findings during admission. Outcome measures included in-hospital mortality and length of stay.
Results
Sixty-six COVID-19 patients were hospitalized during the study period. Sixty-one percent were male and 39% female; mean age was 50.6±19.1 years. Fever and cough were the most common presenting symptoms. Serial chest X-rays showed bilateral pulmonary opacities in 33 (50%) patients. The overall mortality was 14% and mean length of stay was 8.4±8.9 days. Ten patients (15%) required intensive care unit (ICU) care during admission, of which six (9%) were intubated. Age ≥60 years, diabetes, ischemic heart disease, ICU admission, neutrophil to lymphocyte ratio ≥3.3, and international normalized ratio ≥1.2 were associated with increased risk of mortality.
Conclusions
We found a mortality rate of 14% in hospitalized COVID-19 patients. COVID-19 cases are still increasing exponentially around the world and may overwhelm healthcare systems in many countries soon. Our findings can be used for early identification of patients who may require intensive care and aggressive management in order to improve outcomes.

Citations

Citations to this article as recorded by

Healthcare-associated infection management in 62 ICUs for patients with congenital heart disease in China: a survey study
Xiaofeng Wang, Shuo Li, Da Huo, Shilin Wang, Wenlong Wang, Hongxia He, Qian Zhang, Jiantao Li, Xu Wang
International Journal of Surgery.2024; 110(4): 2025. CrossRef
Incidence and clinical outcomes of bacterial superinfections in critically ill patients with COVID-19
Si Mong Yoon, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
Frontiers in Medicine.2023;[Epub] CrossRef
Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal: possible impact of healthcare burden and hospital bed occupancy on clinical management and outcomes, March–December 2020
Vasco Ricoca Peixoto, André Vieira, Pedro Aguiar, Carlos Carvalho, Daniel Thomas, Paulo Sousa, Carla Nunes, Alexandre Abrantes
Frontiers in Public Health.2023;[Epub] CrossRef
Early Death Among COVID-19 Patients: A Cross-sectional Analysis of the First 10,000 COVID-19 Deaths from the Indian State of Tamil Nadu
Zarin Pilakkadavath, Janice M. Weinberg, Serin Kuriakose, Shahul H. Ebrahim, Lekha D. Bhat, Bindhya Vijayan, Salman Khan, Soji D. Jose, Premini Rajeev, Jinbert L. Azariah, Shaffi Fazaludeen Koya
Dr. Sulaiman Al Habib Medical Journal.2023; 5(4): 151. CrossRef
Global prevalence of COVID-19-induced acute respiratory distress syndrome: systematic review and meta-analysis
Abere Woretaw Azagew, Zerko Wako Beko, Yohannes Mulu Ferede, Habtamu Sewunet Mekonnen, Hailemichael Kindie Abate, Chilot Kassa Mekonnen
Systematic Reviews.2023;[Epub] CrossRef
Drinking patterns, alcoholic beverage types, and esophageal cancer risk in Africa: a comprehensive systematic review and meta-analysis
Eugene Jamot Ndebia, Gabriel Tchuente Kamsu
Frontiers in Oncology.2023;[Epub] CrossRef
The clinical association between Periodontitis and COVID-19
Shipra Gupta, Ritin Mohindra, Mohita Singla, Sagar Khera, Vaibhav Sahni, Poonam Kanta, Roop Kishor Soni, Amit Kumar, Krishan Gauba, Kapil Goyal, Mini P. Singh, Arnab Ghosh, Kamal Kajal, Varun Mahajan, Ashish Bhalla, Timo Sorsa, Ismo Räisänen
Clinical Oral Investigations.2022; 26(2): 1361. CrossRef
Prothrombin time, international normalized rate and in-hospital mortality in COVID-19
Panagiotis PALIOGIANNIS, Angelo ZINELLU, Arduino A. MANGONI, Antonio PAZZOLA, Francesco L. BANDIERA, Antonio SPANO, Chiara SANNA, Valentina SCANO, Sara S. FOIS, Verdiana MUSCAS, Elena MASOTTO, Stefano DORE, Vito FIORE, Pietro PIRINA, Ciriaco CARRU, Alessa
Minerva Respiratory Medicine.2022;[Epub] CrossRef
Patterns of presentation, prevalence and associated factors of mortality in ICU among adult patients during the pandemic of COVID 19: A retrospective cross-sectional study
Shimelis Seid, Habtu Adane, Getachew Mekete
Annals of Medicine and Surgery.2022; 77: 103618. CrossRef
Hospital length of stay for COVID-19 patients: A systematic review and meta-analysis
Yousef Alimohamadi, Elahe Mansouri Yekta, Mojtaba Sepandi, Maedeh Sharafoddin, Maedeh Arshadi, Elahe Hesari
Multidisciplinary Respiratory Medicine.2022;[Epub] CrossRef
Evaluation of the models generated from clinical features and deep learning-based segmentations: Can thoracic CT on admission help us to predict hospitalized COVID-19 patients who will require intensive care?
Mutlu Gülbay, Aliye Baştuğ, Erdem Özkan, Büşra Yüce Öztürk, Bökebatur Ahmet Raşit Mendi, Hürrem Bodur
BMC Medical Imaging.2022;[Epub] CrossRef
Characterization and determinant factors of critical illness and in-hospital mortality of COVID-19 patients: A retrospective cohort of 1,792 patients in Kenya
Isinta M Elijah, Endawoke Amsalu, Xuening Jian, Mingyang Cao, Eric K Mibei, Danvas O Kerosi, Francis G Mwatsahu, Wei Wang, Faith Onyangore, Youxin Wang
Biosafety and Health.2022; 4(5): 330. CrossRef
SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death
Giuliano Pasquale Ramadori
Medical Sciences.2022; 10(4): 58. CrossRef
Risk factors for SARS-CoV-2 related mortality and hospitalization before vaccination: A meta-analysis
Hannah N. Marmor, Mindy Pike, Zhiguo (Alex) Zhao, Fei Ye, Stephen A. Deppen, Julio Croda
PLOS Global Public Health.2022; 2(11): e0001187. CrossRef
Risk factors of early mortality among COVID-19 deceased patients in Addis Ababa COVID-19 care centers, Ethiopia
Taye Ashine Mezgebu, Migbar Mekonnen Sibhat, Melsew Tsegaw Getnet, Kassie Tiruneh Gebeyehu, Wuletaw Zewde Chane, Edmialem Mesfin Getahun, Asaminew Sane Habtamu, Hailu Beyene Asmare, Melke Mengistie Ambaw, Zivanai Cuthbert Chapanduka
PLOS ONE.2022; 17(9): e0275131. CrossRef
Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis
Liqin Shi, Jiahao Ren, Yujia Wang, Huifen Feng, Fang Liu, Haiyan Yang
Vaccines.2022; 11(1): 89. CrossRef
Outcomes of nutritionally at-risk Coronavirus Disease 2019 (COVID 19) patients admitted in a tertiary government hospital: A follow-up study of the MalnutriCoV study
Ramon B. Larrazabal, Harold Henrison C. Chiu, Lia Aileen M. Palileo-Villanueva
Clinical Nutrition ESPEN.2021; 43: 239. CrossRef
Prognostic value of neutrophil‐to‐lymphocyte ratio in COVID‐19 patients: A systematic review and meta‐analysis
Juan R. Ulloque‐Badaracco, W. Ivan Salas‐Tello, Ali Al‐kassab‐Córdova, Esteban A. Alarcón‐Braga, Vicente A. Benites‐Zapata, Jorge L. Maguiña, Adrian V. Hernandez
International Journal of Clinical Practice.2021;[Epub] CrossRef
A meta-analysis on the risk factors adjusted association between cardiovascular disease and COVID-19 severity
Jie Xu, Wenwei Xiao, Xuan Liang, Li Shi, Peihua Zhang, Ying Wang, Yadong Wang, Haiyan Yang
BMC Public Health.2021;[Epub] CrossRef
Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
Acute and Critical Care.2021; 36(3): 223. CrossRef

Pulmonary
Clinical characteristics and outcomes of critically Ill patients with COVID-19 in Northeast Ohio: low mortality and length of stay: Francois Abi Fadel, Mohammed Al-Jaghbeer, Sany Kumar, Lori Griffiths, Xiaofeng Wang, Xiaozhen Han, Robert Burton; Acute Crit Care. 2020;35(4):242-248. Published online October 12, 2020; DOI: https://doi.org/10.4266/acc.2020.00619

6,091 View
275 Download
9 Web of Science
9 Crossref

Abstract PDF

Background
Published coronavirus disease 2019 (COVID-19) reports suggest higher mortality with increasing age and comorbidities. Our study describes the clinical characteristics and outcomes for all intensive care unit (ICU) patients admitted across the Cleveland Clinic enterprise, a 10-hospital health care system in Northeast Ohio, serving more than 2.7 million people.
Methods
We analyzed the quality data registry for clinical characteristics and outcomes of all COVID-19-confirmed ICU admissions. Differences in outcomes from other health care systems and published cohorts from other parts of the world were delineated.
Results
Across our health care system, 495 COVID-19 patients were admitted from March 15 to June 1, 2020. Mean patient age was 67.3 years, 206 (41.6%) were females, and 289 (58.4%) were males. Mean Acute Physiology Score was 45.3, and mean Acute Physiology and Chronic Health Evaluation III score was 60.5. In total, 215 patients (43.3%) were intubated for a mean duration of 9.2 days. Mean ICU and hospital length of stay were 7.4 and 13.9 days, respectively, while mean ICU and hospital mortality rates were 18.4% and 23.8%.
Conclusions
Our health care system cohort is the fourth largest to be reported. Lower ICU and hospital mortality and length of stay were seen compared to most other published reports. Better preparedness and state-level control of the surge in COVID-19 infections are likely the reasons for these better outcomes. Future research is needed to further delineate differences in mortality and length of stay across health care systems and over time.

Citations

Citations to this article as recorded by

Racial inequality in COVID-treatment and in-hospital length of stay in the US over time
Benjamin M. Althouse, Charlotte Baker, Peter D. Smits, Samuel Gratzl, Ryan H. Lee, Brianna M. Goodwin Cartwright, Michael Simonov, Michael D. Wang, Nicholas L. Stucky
Frontiers in Public Health.2023;[Epub] CrossRef
Effects of race on the outcome of COVID-19 in hospitalized patients
Getahun Abate, Aniruddh Kapoor, Edward Charbek, Bryan Beck, Qian Wang, Grace C. Wang, Mackenzie Steck, Jason Zoglman, Robin R. Chambeg, Sharon Frey, Daniel F. Hoft, Timothy L. Wiemken
Journal of the National Medical Association.2022; 114(1): 56. CrossRef
Hospital length of stay for COVID-19 patients: A systematic review and meta-analysis
Yousef Alimohamadi, Elahe Mansouri Yekta, Mojtaba Sepandi, Maedeh Sharafoddin, Maedeh Arshadi, Elahe Hesari
Multidisciplinary Respiratory Medicine.2022;[Epub] CrossRef
Learning from the First Wave of the Pandemic in England, Wales, and Northern Ireland
David Pilcher, Matthew Durie
American Journal of Respiratory and Critical Care Medicine.2021; 203(5): 532. CrossRef
Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study
Muhammed Elhadi, Ahmed Alsoufi, Abdurraouf Abusalama, Akram Alkaseek, Saedah Abdeewi, Mohammed Yahya, Alsnosy Mohammed, Mohammed Abdelkabir, Mohammed Huwaysh, Emad Amkhatirah, Kamel Alshorbaji, Samer Khel, Marwa Gamra, Abdulmueti Alhadi, Taha Abubaker, Mo
PLOS ONE.2021; 16(4): e0251085. CrossRef
A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients
Abhishek Bhardwaj, Mahmoud Alwakeel, Talha Saleem, Saira Afzal, Sura Alqaisi, Aisha R. Saand, Hanan Al. Najjar, Lori Griffiths, Xiaozhen Han, Xiaofeng Wang, Silvia Perez-Protto, Benjamin S. Abella, David F. Gaieski, Abhijit Duggal, Francois Abi Fadel
Critical Care Explorations.2021; 3(5): e0425. CrossRef
Overcoming gaps: regional collaborative to optimize capacity management and predict length of stay of patients admitted with COVID-19
Michael G Usher, Roshan Tourani, Gyorgy Simon, Christopher Tignanelli, Bryan Jarabek, Craig E Strauss, Stephen C Waring, Niall A M Klyn, Burke T Kealey, Rabindra Tambyraja, Deepti Pandita, Karyn D Baum
JAMIA Open.2021;[Epub] CrossRef
Examining the Clinical Prognosis of Critically Ill Patients with COVID-19 Admitted to Intensive Care Units: A Nationwide Saudi Study
Abbas Al Mutair, Alyaa Elhazmi, Saad Alhumaid, Gasmelseed Ahmad, Ali Rabaan, Mohammed Alghadeer, Hiba Chagla, Raghavendra Tirupathi, Amit Sharma, Kuldeep Dhama, Khulud Alsalman, Zainab Alalawi, Ziyad Aljofan, Alya Al Mutairi, Mohammed Alomari, Mansour Awa
Medicina.2021; 57(9): 878. CrossRef
Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
Acute and Critical Care.2021; 36(3): 223. CrossRef

Review Article

Pulmonary
Pulmonary and Physical Rehabilitation in Critically Ill Patients: Myung Hun Jang, Myung-Jun Shin, Yong Beom Shin; Acute Crit Care. 2019;34(1):1-13. Published online February 28, 2019; DOI: https://doi.org/10.4266/acc.2019.00444

20,289 View
1,214 Download
35 Web of Science
35 Crossref

Abstract PDF

Some patients admitted to the intensive care unit (ICU) because of an acute illness, complicated surgery, or multiple traumas develop muscle weakness affecting the limbs and respiratory muscles during acute care in the ICU. This condition is referred to as ICU-acquired weakness (ICUAW), and can be evoked by critical illness polyneuropathy (CIP), critical illness myopathy (CIM), or critical illness polyneuromyopathy (CIPNM). ICUAW is diagnosed using the Medical Research Council (MRC) sum score based on bedside manual muscle testing in cooperative patients. The MRC sum score is the sum of the strengths of the 12 regions on both sides of the upper and lower limbs. ICUAW is diagnosed when the MRC score is less than 48 points. However, some patients require electrodiagnostic studies, such as a nerve conduction study, electromyography, and direct muscle stimulation, to differentiate between CIP and CIM. Pulmonary rehabilitation in the ICU can be divided into modalities intended to remove retained airway secretions and exercise therapies intended to improve respiratory function. Physical rehabilitation, including early mobilization, positioning, and limb exercises, attenuates the weakness that occurs during critical care. To perform mobilization in mechanically ventilated patients, pretreatment by removing secretions is necessary. It is also important to increase the strength of respiratory muscles and to perform lung recruitment to improve mobilization in patients who are weaned from the ventilator. For these reasons, pulmonary rehabilitation is important in addition to physical therapy. Early recognition of CIP, CIM, and CIPNM and early rehabilitation in the ICU might improve patients’ functional recovery and outcomes.

Citations

Citations to this article as recorded by

Novel Method for Sealing Tracheostomies Immediately after Decannulation—An Acute Clinical Feasibility Study
Rasmus Ellerup Kraghede, Karen Juelsgaard Christiansen, Alexander Emil Kaspersen, Michael Pedersen, Johanne Juel Petersen, John Michael Hasenkam, Louise Devantier
Biomedicines.2024; 12(4): 852. CrossRef
Clinical impact of rehabilitation and ICU diary on critically ill patients: A systematic review and meta‐analysis
Tomohiro Ishinuki, Ling Zhang, Keisuke Harada, Hiroomi Tatsumi, Nobuaki Kokubu, Yoshika Kuno, Kanon Kumasaka, Rina Koike, Toshio Ohyanagi, Hirofumi Ohnishi, Eichi Narimatsu, Yoshiki Masuda, Toru Mizuguchi
Nursing in Critical Care.2023; 28(4): 554. CrossRef
Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: A national cohort study
Ignacio Zaragoza-García, Susana Arias-Rivera, María Jesús Frade-Mera, Joan Daniel Martí, Elisabet Gallart, Alicia San José-Arribas, Tamara Raquel Velasco-Sanz, Eva Blazquez-Martínez, Marta Raurell-Torredà, Sebastien Kenmoe
PLOS ONE.2023; 18(6): e0286598. CrossRef
THE EFFECTIVENESS OF PASSIVE EXERCISES ON ARTERIAL BLOOD GASES IN MECHANICALLY VENTILATED SUBJECTS FROM INTENSIVE CARE UNITS
Delia-Claudia STAN, Iosif SANDOR
Studia Universitatis Babeş-Bolyai Educatio Artis Gymnasticae.2023; 67(4): 183. CrossRef
Pulmonary rehabilitation in the intensive care unit using surface electromyography in a patient with diaphragmatic injury: A case report
Ho Jeong Shin, Myung Hun Jang, Myung Jun Shin, Jun Woo Lee
Turkish Journal of Physical Medicine and Rehabilitation.2023; 69(2): 248. CrossRef
Enhancing pulmonary function and arterial blood gas readings through immediate chest physiotherapy among extubated patients in ICU
Fadia Ahmed Abdelkader Reshia, Basma Salameh, Nourah Alsadaan, Mohammed Alqahtani, Ahmad Ayed, Maysa Fareed Kassabry, Asmaa Ibrahem Abo Seada
Journal of International Medical Research.2023;[Epub] CrossRef
The effects of respiratory exercises on partial pressures of gases and anxiety in the acute phase of COVID-19 infection
Vesna Grbovic, Natasa Markovic, Predrag Bogojevic, Jovana Nikolic, Jelena Milosevic, Stefan Simovic, Ivan Cekerevac, Aleksandra Jurišić-Škevin, Nebojša Zdravkovic, Sara Mijailovic, Natasa Zdravkovic
Physiotherapy Theory and Practice.2022; 38(13): 2736. CrossRef
Reliability and validity of the Korean version of the Functional Status Score for the ICU after translation and cross-cultural adaptation
Jong Geol Do, Gee Young Suh, Yu Hui Won, Won Hyuk Chang, Stephanie Hiser, Dale M. Needham, Chi Ryang Chung
Disability and Rehabilitation.2022; 44(24): 7528. CrossRef
The Investigation of Pulmonary Function Changes of COVID-19 Patients in Three Months
Lingyan Ye, Guifei Yao, Shuangxiang Lin, Yicheng Fang, Xi Chen, Liangxing Wang, Susu He, Gu Xiaoqing
Journal of Healthcare Engineering.2022; 2022: 1. CrossRef
Intensive care‐related cognitive impairment: A biopsychosocial overview
Jamie L. Tingey, Nickolas A. Dasher, Aaron E. Bunnell, Amy J. Starosta
PM&R.2022; 14(2): 259. CrossRef
Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
Su Hwan Lee
Acute and Critical Care.2022; 37(1): 26. CrossRef
The impact of physical medicine and rehabilitation consultation on clinical outcomes in the surgical intensive care unit
Onuma Chaiwat, Benjaporn Sathitkarnmanee, Piyapat Dajpratham, Chayanan Thanakiattiwibun, Sunit Jarungjitaree, Suchera Rattanamung
Medicine.2022; 101(9): e28990. CrossRef
Role of Physiotherapyin Respiratory Rehabilitation and Managing COVID-19 Patients in All Stages of the Disease
Petty Miyanda
Journal of Preventive and Rehabilitative Medicine.2022; 4(1): 21. CrossRef
The validity, reliability and feasibility of four instruments for assessing the consciousness of stroke patients in a neurological intensive care unit compared
Xiaoxiang Yan, Lingjun Xiao, Meixin Liao, Jiajian Huang, Zhijie He, Tiebin Yan
BMC Medical Research Methodology.2022;[Epub] CrossRef
Functional assessment and rehabilitation protocol in acute patients affected by SARS-CoV-2 infection hospitalized in the Intensive Care Unit and in the Medical Care Unit
Susanna RICOTTI, Lucia PETRUCCI, Gabriella CARENZIO, Ettore CARLISI, Giuseppe DI NATALI, Annalisa DE SILVESTRI, Claudio LISI
European Journal of Physical and Rehabilitation Medicine.2022;[Epub] CrossRef
Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill Patients—A Systematic Review
Maryam Balke, Marc Teschler, Hendrik Schäfer, Pantea Pape, Frank C. Mooren, Boris Schmitz
Frontiers in Physiology.2022;[Epub] CrossRef
Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis
Lorenzo Lippi, Alessandro de Sire, Francesco D’Abrosca, Biagio Polla, Nicola Marotta, Luigi Mario Castello, Antonio Ammendolia, Claudio Molinari, Marco Invernizzi
Frontiers in Medicine.2022;[Epub] CrossRef
Expert consensus on liver transplantation perioperative evaluation and rehabilitation for acute-on-chronic liver failure
Haijin Lv, Haiqing Zheng, Jianrong Liu, Qing Cai, Yuji Ren, Huimin Yi, Yang Yang, Xiquan Hu, Guihua Chen
Liver Research.2022; 6(3): 121. CrossRef
Case report: Personalized adapted motor activity in a COVID-19 patient complicated by critical illness polyneuropathy and myopathy
Oscar Crisafulli, Marta Baroscelli, Luca Grattarola, Giuseppe Tansini, Cristian Zampella, Giuseppe D’Antona
Frontiers in Physiology.2022;[Epub] CrossRef
Letter to the Editor: Comparison Between Inspiratory Muscle Training and Early Mobilization on Weaning of Mechanical Ventilation
Rodrigo Torres-Castro, Gonzalo Rivera-Lillo, Jordi Vilaró, Homero Puppo
Archives of Physical Medicine and Rehabilitation.2021; 102(3): 556. CrossRef
The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation
Simon Wernhart, Jürgen Hedderich, Svenja Wunderlich, Kunigunde Schauerte, Eberhard Weihe, Dominic Dellweg, Karsten Siemon
Sports Medicine - Open.2021;[Epub] CrossRef
Could Physical Therapy Interventions Be Adopted in the Management of Critically Ill Patients with COVID-19? A Scoping Review
Carlos Bernal-Utrera, Ernesto Anarte-Lazo, Juan Jose Gonzalez-Gerez, Elena De-La-Barrera-Aranda, Manuel Saavedra-Hernandez, Cleofas Rodriguez-Blanco
International Journal of Environmental Research and Public Health.2021; 18(4): 1627. CrossRef
Feasibility of subacute rehabilitation for mechanically ventilated patients with COVID-19 disease: a retrospective case series
Simone Pancera, Luca N. C. Bianchi, Roberto Porta, Silvia Galeri, Maria Chiara Carrozza, Jorge H. Villafañe
International Journal of Rehabilitation Research.2021; 44(1): 77. CrossRef
Clinical Characteristics and Early Interventional Responses in Patients with Severe COVID-19 Pneumonia
Susu He, Lina Fang, Lingzhen Xia, Shuangxiang Lin, Junhui Ye, Dinghai Luo, Kaijian Xia
Computational and Mathematical Methods in Medicine.2021; 2021: 1. CrossRef
Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019
Dae-Won Gwak, Jong-Moon Hwang
Medicine.2021; 100(23): e26317. CrossRef
The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients
Christine Eimer, Katharina Freier, Norbert Weiler, Inéz Frerichs, Tobias Becher
Frontiers in Physiology.2021;[Epub] CrossRef
Post–Intensive Care Syndrome in Covid-19 Patients Discharged From the Intensive Care Unit
Sevda Gardashkhani, Mehdi Ajri-Khameslou, Mehdi Heidarzadeh, SeyedMohammad Rajaei Sedigh
Journal of Hospice & Palliative Nursing.2021; 23(6): 530. CrossRef
The Role of Physical Therapy in the Intensive Care Unit
Zofia Kosson, Marek Paśnicki, Marcin Kołacz
Emergency Medical Service.2021; 8(3): 171. CrossRef
Rehabilitación pulmonar en fase hospitalaria y ambulatoria
N. Carvajal Tello, A. Segura Ordoñez, A.J. Arias Balanta
Rehabilitación.2020; 54(3): 191. CrossRef
Guidance for the management of adult patients with coronavirus disease 2019
Jie-Ming Qu, Chen Wang, Bin Cao
Chinese Medical Journal.2020; 133(13): 1575. CrossRef
Recommendations for respiratory rehabilitation in adults with coronavirus disease 2019
Hong-Mei Zhao, Yu-Xiao Xie, Chen Wang
Chinese Medical Journal.2020; 133(13): 1595. CrossRef
Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience
Renato Fraga Righetti, Mirian Akemi Onoue, Flavia Vanessa Aurea Politi, Débora Trigo Teixeira, Patricia Nery de Souza, Claudia Seiko Kondo, Eliana Vieira Moderno, Igor Gutierrez Moraes, Ana Lígia Vasconcellos Maida, Laerte Pastore, Felipe Duarte Silva, Ch
Clinics.2020; 75: e2017. CrossRef
Approach to critical illness myopathy and polyneuropathy in the older SARS-CoV-2 patients
Brendan McClafferty, Ibrahim Umer, Gary Fye, Douglas Kepko, Ricci Kalayanamitra, Zainab Shahid, Devyani Ramgobin, Alice Cai, Andrew Groff, Abani Bhandari, Chander Shekher Aggarwal, Ravi Patel, Dhirisha Bhatt, Hyma Polimera, Nitasa Sahu, Ramarao Vunnam, Re
Journal of Clinical Neuroscience.2020; 79: 241. CrossRef
COVID-19 Pandemic: A Physiotherapy Update
Paolo Pedersini, Jorge Hugo Villafañe, Camilo Corbellini, Marcos Roberto Tovani-Palone
Electronic Journal of General Medicine.2020; 18(1): em264. CrossRef
Muscle weakness assessment in older intensive care unit patients
Amanda Colombo Peteck Lopes, Paulo Henrique Coltro, Vagner José Lopes, Sandra Mari Pistore Fiori, Jaqueline Santana Knapik, Tatiane Caroline Boumer
Geriatrics, Gerontology and Aging.2020; 14(3): 166. CrossRef

Original Articles

Basic science and research
Prognostic Implication of Adrenocortical Response during the Course of Critical Illness: Jin Hwa Song, Jung Hee Kim, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2019;34(1):38-45. Published online January 30, 2019; DOI: https://doi.org/10.4266/acc.2018.00339

7,031 View
127 Download
5 Web of Science
4 Crossref

Abstract PDF Supplementary Material

Background
Critical illness-related corticosteroid insufficiency (CIRCI) and adrenocorticotropic hormone (ACTH)-cortisol dissociation are hormonal conditions frequently observed in patients in the intensive care unit (ICU). The aim of this study was to evaluate the association between ACTH-cortisol dissociation and clinical outcomes of critically ill patients. Methods: We retrospectively reviewed the medical records of 94 ICU patients who underwent two rapid cosyntropin tests during hospital admission and compared the clinical aspects of patients with and without ACTH-cortisol dissociation. ACTH-cortisol dissociation was defined as plasma ACTH and serum cortisol concentrations of <22 pmol/L and >600 nmol/L, respectively. Results: Dissociation was present in 30 of the 94 patients (31.9%). Patients with ACTH-cortisol dissociation in the initial test had significantly higher hospital mortality rate than those in the control group (55% vs. 25.7%, P=0.013) There was no difference in hospital mortality between patients classified as having CIRCI and those who were not. In multivariate adjusted Cox regression analysis, the mortality risk was higher in the group with ACTH-cortisol dissociation (hazard ratio, 2.98; 95% confidence interval, 1.34 to 6.63; P=0.007). Patients with dissociation in two consecutive stimulation tests showed the highest hospital mortality rate among groups classified according to stimulation test results (100% vs. 31.3%). Conclusions: The hospital mortality was higher in ICU patients diagnosed with ACTH-cortisol dissociation. It is clinically feasible to evaluate the presence of ACTH-cortisol dissociation by analyzing rapid ACTH stimulation test results in critically ill patients.

Citations

Citations to this article as recorded by

Serum ACTH and Cortisol Level is Associated with the Acute Gastrointestinal Injury Grade in ICU Patients
Wen Xu, Yuzhen Qiu, Hongping Qiu, Ming Zhong, Lei Li
International Journal of General Medicine.2024; Volume 17: 127. CrossRef
PROGNOSTIC VALUE OF LOW-DOSE ADRENOCORTICOTROPIC HORMONE TEST IN CRITICALLY ILL PATIENTS
Ahmad B. Abdelrehim, Fatma M. Mohsen, Mostafa A. Haredi, Zeinab Abdel Hameed, Walaa H. Ibrahim
Shock.2023; 59(6): 871. CrossRef
Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study
Lilian Rodrigues Henrique, Daisy Crispim, Tarsila Vieceli, Ariell Freires Schaeffer, Priscila Bellaver, Cristiane Bauermann Leitão, Tatiana Helena Rech, Antonio Palazón-Bru
PLOS ONE.2021; 16(4): e0250035. CrossRef
Comparison of salivary and serum cortisol levels in mechanically ventilated patients and non-critically ill patients
Jung Hee Kim, Yoon Ji Kim, Sang-Min Lee, Jinwoo Lee
Acute and Critical Care.2020; 35(3): 149. CrossRef

Neurology
The Effects of a Delirium Notification Program on the Clinical Outcomes of the Intensive Care Unit: A Preliminary Pilot Study: Jaesub Park, Seung-Taek Oh, Sunyoung Park, Won-Jung Choi, Cheung Soo Shin, Se Hee Na, Jae-Jin Kim, Jooyoung Oh, Jin Young Park; Acute Crit Care. 2018;33(1):23-33. Published online February 6, 2018; DOI: https://doi.org/10.4266/acc.2017.00584

9,178 View
185 Download
2 Web of Science
1 Crossref

Abstract PDF

Background
Delirium is common among intensive care unit (ICU) patients, so recent clinical guidelines recommended routine delirium monitoring in the ICU. But, its effect on the patient’s clinical outcome is still controversial. In particular, the effect of systems that inform the primary physician of the results of monitoring is largely unknown.
Methods
The delirium notification program using bedside signs and electronic chart notifications was applied to the pre-existing delirium monitoring protocol. Every patient was routinely evaluated for delirium, pain, and anxiety using validated tools. Clinical outcomes, including duration of delirium, ICU stay, and mortality were reviewed and compared for 3 months before and after the program implementation.
Results
There was no significant difference between the two periods of delirium, ICU stay, and mortality. However, anxiety, an important prognostic factor in the ICU survivor’s mental health, was significantly reduced and pain tended to decrease.
Conclusions
Increasing the physician’s awareness of the patient’s mental state by using a notification program could reduce the anxiety of ICU patients even though it may not reduce delirium. The results suggested that the method of delivering the results of monitoring was also an important factor in the success of the delirium monitoring program.

Citations

Citations to this article as recorded by

Adaptation and Validation of a Chart‐Based Delirium Detection Tool for the ICU (CHART‐DEL‐ICU)
Karla D. Krewulak, Carmen Hiploylee, E. W. Ely, Henry T. Stelfox, Sharon K. Inouye, Kirsten M. Fiest
Journal of the American Geriatrics Society.2021; 69(4): 1027. CrossRef

First
Prev
Page of 2
Next
Last

Search