Acute and Critical Care

Review Article

March 17, 2022

Oxygen therapy for sepsis and prevention of complications

Hayk Minasyan

Acute Crit Care. 2022;37(2):137-150.

Patients with sepsis have a wide range of respiratory disorders that can be treated with oxygen therapy. Experimental data in animal sepsis models show that oxygen therapy significantly increases survival,...

Review Article

May 30, 2022

Review of remimazolam and sedatives in the intensive care unit

Hey-Ran Choi, In-Ae Song

Acute Crit Care. 2022;37(2):151-158.

-Remimazolam is a novel intravenous ultra-short acting benzodiazepine, which can be reversed by flumazenil.
-Dosing adjustment for older adults and for patients with renal or liver impairment patients (except for those with severe hepatic impairment) are not required because remimazolam is rapidly metabolized by tissue esterase.
-Use of remimazolam results in a lower incidence of cardiorespiratory depression and less pain at injection site, as well as no fatal adverse effects such as propofol infusion syndrome and malignant hyperthermia of volatile anesthetics.

Original Article

March 11, 2022

Association of pulmonary arterial pressure with volume status in patients with acute respiratory distress syndrome receiving extracorporeal membrane oxygenation

Tae Hwa Hong, Hyoung Soo Kim, Sunghoon Park

Acute Crit Care. 2022;37(2):159-167.

∙ Net fluid balance was weakly but significantly correlated with systolic and diastolic pulmonary arterial pressure (PAP) in patients with refractory acute respiratory distress syndrome receiving extracorporeal membrane oxygenation.
∙ Systolic PAP was higher in non-survivors than in survivors, but was not associated with hospital mortality in multivariable analysis.

Original Article

March 11, 2022

Comparison of critically ill COVID-19 and influenza patients with acute respiratory failure

Mehmet Yildirim, Burcin Halacli, Mehmet Yasir Pektezel, Berrin Er, Ismail Tuna Geldigitti, Gulay Tok, Ebru Ortac Ersoy, Arzu Topeli

Acute Crit Care. 2022;37(2):168-176.

• There was no significant difference in hospital mortality between critically ill coronavirus disease 2019 (COVID-19) and influenza patients.
• Critically ill influenza patients had worse performance status and disease severity than patients with COVID-19.
• Secondary bacterial infection, admission acute kidney injury, procalcitonin level above 0.2 ng/ml were the independent factors distinguishing influenza from COVID-19 while prone positioning differentiated COVID-19 from influenza.

Original Article

April 20, 2022

The role of nafamostat mesilate as a regional anticoagulant during extracorporeal membrane oxygenation

Jae Ha Lee, Jin Han Park, Ji Hoon Jang, Se Hun Kim, Sung Yong Hong, Woon Heo, Dong-Hwan Lee, Hye Sook Choi, Ki Hoon Kim, Hang-Jea Jang

Acute Crit Care. 2022;37(2):177-184.

∙ Nafamostat mesilate showed efficacy as a regional anticoagulation method by sustaining a lower activated partial thromboplastin time (aPTT) value compared to that measured at the extracorporeal membrane oxygenation (ECMO) site during veno-arterial ECMO (VA-ECMO).
∙ Nafamostat mesilate should be considered as a regional anticoagulation alternative for patients at high risk of bleeding during VA-ECMO.

Original Article

April 22, 2022

Measured versus estimated creatinine clearance in critically ill patients with acute kidney injury: an observational study

Sara Kadivarian, Fatemeh Heydarpour, Hasanali Karimpour, Foroud Shahbazi

Acute Crit Care. 2022;37(2):185-192.

• None of the available formulations have a high or very high correlation with measured creatinine clearance.
• In patients with acute kidney injury (AKI) dynamic methods like kinet-glomerular filtration rate (GFR) may be a better prediction for GFR.
• Using Cockcroft-gault in patients with AKI overestimate GFR.

Original Article

February 11, 2022

Incidence and risk factors associated with early death in patients with emergency department septic shock

Matthew S. Reaven, Nigel L. Rozario, Maggie S. J. McCarter, Alan C. Heffner

Acute Crit Care. 2022;37(2):193-201.

• A significant focus is placed on early recognition and treatment of sepsis.
• Few studies evaluate early mortality (within 72 hours of presentation).
• Several identifiable factors have been shown to correlate with early mortality.
• Identifying patients at high risk of early mortality may aid in their management.

Original Article

April 28, 2022

The effect of time management education on critical care nurses’ prioritization: a randomized clinical trial

Fatemeh Vizeshfar, Mahnaz Rakhshan, Fatemeh Shirazi, Roya Dokoohaki

Acute Crit Care. 2022;37(2):202-208.

• Time management is an important part of effective patient care in intensive care units.
• Time management techniques are learnable.
• Time management training helped nurses adjust the time required to perform and prioritize various tasks.

Original Article

March 8, 2022

Hearing screening outcomes in pediatric critical care survivors: a 1-year report

Pattita Suwannatrai, Chanapai Chaiyakulsil

Acute Crit Care. 2022;37(2):209-216.

- Approximately 28.3% of the participants were found to have abnormal transitory evoked otoacoustic emission (TEOAE) screening responses.
- Associations were found in children younger than 12 months of age and in children with genetic comorbidities.
- High prevalence of abnormal TEOAE hearing screening responses was demonstrated in critically ill children.

Original Article

February 3, 2022

Early postoperative arrhythmias after pediatric congenital heart disease surgery: a 5-year audit from a lower- to middle-income country

Sidra Ishaque, Saleem Akhtar, Asma Akbar Ladak, Russell Seth Martins, Muhammad Kamran Younis Memon, Alisha Raza Kazmi, Fatima Mahmood, Anwar ul Haque

Acute Crit Care. 2022;37(2):217-223.

-We report a 22.8% rate of postoperative arrhythmias in patients who underwent surgery for congenital heart disease.
-Junctional ectopic tachycardia was the most common arrhythmia (65%), followed by complete heart block (18%).
-Postoperative arrhythmia was seen most commonly in patients with atrioventricular septal defects (63.6%) and transposition of the great arteries (36.4%).

Original Article

February 3, 2022

Determining the diagnostic value of tracheal intubation by palpation and auscultation methods compared to the chest X-ray method in children

Gholamreza Masoumi, Mojtaba Mansouri, Omid Fathali

Acute Crit Care. 2022;37(2):224-229.

-Due to the higher interclass correlation coefficient of palpation method than auscultation one, the palpation method was found to be relatively better than the auscultation method.
-In the present study, height was the most effective variable in locating the tracheal tube in the auscultation method.

Original Article

February 4, 2022

Cinematic virtual reality for anxiety management in mechanically ventilated patients: a feasibility and pilot study

Alexander C. Haley, David A. Wacker

Acute Crit Care. 2022;37(2):230-236.

A pilot design of a cinematic virtual reality environment to relieve anxiety was implemented according to protocol for a pilot cohort of mechanically ventilated patients without incidence of prespecified safety outcomes including accidental extubation, and without incidence of cybersickness.
-A 100-point visual analog scale was successfully applied to assess subjects’ anxiety levels before and after virtual reality interventions, demonstrating feasibility of this scale for future studies.

Original Article

February 24, 2022

Changes in the incidence of cardiopulmonary resuscitation before and after implementation of the Life-Sustaining Treatment Decisions Act

Hyunjae Im, Hyun Woo Choe, Seung-Young Oh, Ho Geol Ryu, Hannah Lee

Acute Crit Care. 2022;37(2):237-246.

 Implementation of life-sustaining treatment (LST) decisions did not affect the incidence of cardiopulmonary resuscitation in hospitalized patients at 2 years after enforcement of the Act.
 Cardiac arrests that occurred in terminally ill patients who had a written document regarding withholding and withdrawal of LST comprised a small proportion of the total cardiac arrests in our center, and the proportions before and after implementation of the Act were the same.
 Proactive preparation of documentation regarding withholding and withdrawal of LST with universalization of the Act will be needed to avoid unnecessary resuscitation at end-of-life stages.

Original Article

April 22, 2022

Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture

Kang Min Kim, Myoung Jun Kim, Jae Sik Chung, Ji Wool Ko, Young Un Choi, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Kwangmin Kim

Acute Crit Care. 2022;37(2):247-255.

 Repacking and combined bladder-urethra injury are potential risk factors for surgical-site infection in patients with unstable pelvic fracture.
 Close observation is recommended for up to 8 days in patients with these risk factors.
 At 48 hours after preperitoneal pelvic packing, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent surgical site infection.

Current Issue: Volume 37(2); May 2022

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