Toward More Rational Time-to-Antibiotic Metrics for Suspected Sepsis: Erratum
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Erratum Source Type: research

Is Mortality Rate of Ventilated Patients With Coronavirus Disease 2019 So High?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Higher Levels of S-100β-a Biomarker of Astrocyte and Glial Activation Were Associated With a Greater Delirium Duration in Sepsis and Traumatic Brain Injury Patients: Beware of Some Confounders!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Heparin-Binding Protein Performs Better for Detecting Sepsis Among Patients Presenting With Signs of Systemic Infection Compared With Procalcitonin, C-Reactive Protein, and Lactate Level, and Heparin-Binding Protein Is Sufficient for Both Ruling in and Out Sepsis With Organ Dysfunction: Beware of Potential Confounding Factors!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Early Latency Somatosensory Evoked Potentials Are Considered Robust Tests That Are Relatively Insensitive to Some Confounders After Cardiac Arrest That Received Targeted Temperature Management: Today We Are Not Sure Anymore!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Is the Pao2:Fio2 Ratio the Best Marker to Monitor the Blood-Air Barrier Function in Acute Respiratory Distress Syndrome?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The author replies
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Understanding the Underlying Mechanisms of Hyponatremia in Coronavirus Disease 2019 Is Critical Since Treatment Varies Based on Etiology: Let Us Not Forget Critical Illness-Related Corticosteroid Insufficiency As the Treatment Is Very Different and Often Lifesaving!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Unclear Benefit of Early Tracheostomy In Patients With Coronavirus Disease 2019
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Potential Endotype Transition for Coronavirus Disease 2019–Related Sepsis With Longitudinal Transcriptome Profiling
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Exploring Patients’ Perceptions on ICU Diaries: A Systematic Review and Qualitative Data Synthesis
Conclusion: This qualitative synthesis shows that patients recommend having an ICU diary, enlightening benefits such as better coping with the slow recovery from critical illness, strengthening family ties, and humanizing the ICU staff. It also identifies characteristics of the diary valued by the patients, in order to standardize the ICU diary according to their perspectives, and allowing future comparability between randomized controlled trials. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Review Article Source Type: research

Coronavirus Disease 2019 ICU Patients Have Higher-Than-Expected Acute Physiology and Chronic Health Evaluation–Adjusted Mortality and Length of Stay Than Viral Pneumonia ICU Patients
CONCLUSIONS: Severity-adjusted mortality and length of stay are higher for coronavirus disease 2019 patients than for viral pneumonia patients admitted to ICU. Coronavirus disease patients also have longer time on ventilator and ICU length of stay, comparable with the subset of viral pneumonia patients with concurrent acute respiratory distress syndrome. Mortality and length of stay increase with age and higher scores in both populations, but observed to predicted mortality and length of stay are higher than expected with coronavirus disease patients across all severity of illness levels. These findings have implicatio...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Brief Report Source Type: research

Exhalation Spreading During Nasal High-Flow Therapy at Different Flow Rates
CONCLUSIONS: Nasal high-flow therapy increases the range of the expiratory air up to more than 4 meters. The risk to pick up infectious particles could be increased within this range. Attachment of a surgical mask over the nasal high-flow cannula blocks the expiratory airstream. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Clinical Investigation Source Type: research

Acute Kidney Injury Recovery Patterns in Critically Ill Patients: Results of a Retrospective Cohort Study*
CONCLUSIONS: In this study, we demonstrate Acute Disease Quality Initiative to allow recovery pattern classification in 75% of critically ill patients. Our study underlines the need to take into account competing risk factors when assessing recovery pattern in critically ill patients. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Clinical Investigation Source Type: research

Determining the Electronic Signature of Infection in Electronic Health Record Data
CONCLUSIONS: Published criteria have a wide range of accuracy for identifying infected patients, with the Sepsis-3 criteria being the most sensitive and Rhee criteria being the most specific. These findings have important implications for studies investigating the burden of sepsis on a local and national level. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Clinical Investigation Source Type: research

A Comparison of Thrombosis and Hemorrhage Rates in Patients With Severe Respiratory Failure Due to Coronavirus Disease 2019 and Influenza Requiring Extracorporeal Membrane Oxygenation
OBJECTIVES: Extracorporeal membrane oxygenation is a lifesaving therapy for patients with severe acute respiratory distress syndrome refractory to conventional mechanical ventilation. It is frequently complicated by both thrombosis and hemorrhage. A markedly prothrombotic state associated with high rates of venous thromboembolism has been described in patients with severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) infection. These rates have currently not been described during extracorporeal membrane oxygenation in comparison to other viral pneumonias. DESIGN: Retrospective observational...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Online Clinical Investigation Source Type: research

Acute Kidney Injury in Transition*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

The Era of Evidence-Based ICU Telemedicine*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Be Careful and Protect Yourself, It Is in the Air*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Sedation and Neuromuscular Blockade in Acute Respiratory Distress Syndrome: A Step Toward Disentangling Best Practices*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Bivalirudin in Venovenous Extracorporeal Membrane Oxygenation: Moving Forward in the Real World*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

You Give Me Fever: Is Dexmedetomidine (or Another Medication) the Cause?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Venoarterial Extracorporeal Membrane Oxygenation for Postcardiomyotomy Shock in ICU Patients: The Jury Is Still Out!*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Brain-Lung Conflicts and Patterns of Mechanical Ventilation*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

When the Sprint Becomes a Marathon: Stress and Gender in Critical Care Physicians During a Pandemic*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Tracheostomy for Coronavirus Disease 2019 Patients on Mechanical Ventilation Should Not Be Arbitrarily Delayed*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

We Are Not Waiting for a Cure for Sepsis—We Are Waiting for Leadership*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Capacity Strain and Response During Coronavirus Disease 2019: One Size Does Not Fit All, and One Size Does Not Fit One*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Prone Positioning in Coronavirus Disease 2019: Just Do It!*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Convalescent Plasma and Coronavirus Disease 2019: Time for Reassessment*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Decision-Making Authority During Tele-ICU Care Reduces Mortality and Length of Stay—A Systematic Review and Meta-Analysis*
CONCLUSIONS: In contrast to expert tele-consultations, decision-making authority during tele-ICU care reduces mortality and length of stay in the ICU. This work confirms the urgent need for evidence-based ICU telemedicine guidelines and reveals potential benefits of uniform regulations regarding the level of authority when providing tele-ICU care. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Review Articles Source Type: research

Transmission of Severe Acute Respiratory Syndrome Coronavirus 1 and Severe Acute Respiratory Syndrome Coronavirus 2 During Aerosol-Generating Procedures in Critical Care: A Systematic Review and Meta-Analysis of Observational Studies*
OBJECTIVES: To assess the risk of coronavirus transmission to healthcare workers performing aerosol-generating procedures and the potential benefits of personal protective equipment during these procedures. DATA SOURCES: MEDLINE, EMBASE, and Cochrane CENTRAL were searched using a combination of related MeSH terms and keywords. STUDY SELECTION: Cohort studies and case controls investigating common anesthetic and critical care aerosol-generating procedures and transmission of severe acute respiratory syndrome coronavirus 1, Middle East respiratory syndrome coronavirus, and severe acute respiratory syndrome ...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Review Articles Source Type: research

Plasma Nucleosomes Are Associated With Mortality in Pediatric Acute Respiratory Distress Syndrome
OBJECTIVES: Circulating nucleosomes and their component histones have been implicated as pathogenic in sepsis and acute respiratory distress syndrome in adults. However, their role in pediatric acute respiratory distress syndrome is unknown. DESIGN: We performed a prospective cohort study in children with acute respiratory distress syndrome, with plasma collection within 24 hours of acute respiratory distress syndrome onset. We associated nucleosome levels with severity of acute respiratory distress syndrome and with nonpulmonary organ failures and tested for association of nucleosomes with PICU mortality and ve...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Optimal Sedation in Patients Who Receive Neuromuscular Blocking Agent Infusions for Treatment of Acute Respiratory Distress Syndrome—A Retrospective Cohort Study From a New England Health Care Network*
OBJECTIVES: Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular blocking agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ROSE trial between treatment and control groups. We hypothesized that the proportion of deeper sedation is a mediator of the effect of neuromuscular blocking agent infusions on mortality. DESIGN: Retrospective cohor...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Comparison of Anticoagulation Strategies in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation: Heparin Versus Bivalirudin*
OBJECTIVES: Extracorporeal membrane oxygenation is a life-sustaining therapy for severe respiratory failure. Extracorporeal membrane oxygenation circuits require systemic anticoagulation that creates a delicate balance between circuit-related thrombosis and bleeding-related complications. Although unfractionated heparin is most widely used anticoagulant, alternative agents such as bivalirudin have been used. We sought to compare extracorporeal membrane oxygenation circuit thrombosis and bleeding-related outcomes in respiratory failure patients receiving either unfractionated heparin or bivalirudin for anticoagulation o...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

The Effect of Early Sedation With Dexmedetomidine on Body Temperature in Critically Ill Patients*
OBJECTIVES: Previous case series reported an association between dexmedetomidine use and hyperthermia. Temperature data have not been systematically reported in previous randomized controlled trials evaluating dexmedetomidine. A causal link between dexmedetomidine administration and elevated temperature has not been demonstrated. DESIGN: Post hoc analysis. SETTING: Four ICUs in Australia and New Zealand. PATIENTS: About 703 mechanically ventilated ICU patients. INTERVENTIONS: Early sedation with dexmedetomidine versus usual care. MEASUREMENTS AND MAIN RESULTS: The primary outcome was ...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Venoarterial Extracorporeal Membrane Oxygenation for Postcardiotomy Shock—Analysis of the Extracorporeal Life Support Organization Registry*
OBJECTIVES: Refractory postcardiotomy cardiogenic shock complicating cardiac surgery yields nearly 100% mortality when untreated. Use of venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock has increased worldwide recently. The aim of the current analysis was to outline the trends in use, changing patient profiles, and in-hospital outcomes including complications in patients undergoing venoarterial extracorporeal membrane oxygenation for postcardiotomy cardiogenic shock. DESIGN: Analysis of extracorporeal life support organization registry from January 2010 to December 2018. S...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Evolution Over Time of Ventilatory Management and Outcome of Patients With Neurologic Disease*
OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologi...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Trajectory of Cognitive Decline After Sepsis
OBJECTIVES: Cognitive impairment is an important consequence of sepsis. We sought to determine long-term trajectories of cognitive function after sepsis. DESIGN: Prospective study of the Reasons for Geographic and Racial Differences in Stroke cohort. SETTING: United States. PATIENTS: Twenty-one thousand eight-hundred twenty-three participants greater than or equal to 45 years, mean (sd) age 64.3 (9.2) years at first cognitive assessment, 30.9% men, and 27.1% Black. MEASUREMENTS AND MAIN RESULTS: The main exposure was time-dependent sepsis hospitalization. The primary outcome was global cogni...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Changes in Stress and Workplace Shortages Reported by U.S. Critical Care Physicians Treating Coronavirus Disease 2019 Patients*
CONCLUSIONS: Stress, staffing, and, to a lesser degree, personal protective equipment shortages faced by U.S. critical care physicians remain high. Stress levels were higher among women. Considering the persistence of these findings, rising levels of infection nationally raise concerns about the capacity of the U.S. critical care system to meet ongoing and future demands. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Percutaneous Dilational Tracheostomy for Coronavirus Disease 2019 Patients Requiring Mechanical Ventilation*
OBJECTIVES: To assess the impact of percutaneous dilational tracheostomy in coronavirus disease 2019 patients requiring mechanical ventilation and the risk for healthcare providers. DESIGN: Prospective cohort study; patients were enrolled between March 11, and April 29, 2020. The date of final follow-up was July 30, 2020. We used a propensity score matching approach to compare outcomes. Study outcomes were formulated before data collection and analysis. SETTING: Critical care units at two large metropolitan hospitals in New York City. PATIENTS: Five-hundred forty-one patients with confirmed severe ...
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Epidemiology of Sepsis Among Children and Neonates in Germany: Results From an Observational Study Based on Nationwide Diagnosis-Related Groups Data Between 2010 and 2016*
CONCLUSIONS: Sepsis is also in Germany a common and frequently fatal condition in pediatric patients, particularly among neonates and children with comorbidities. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Variation in Initial U.S. Hospital Responses to the Coronavirus Disease 2019 Pandemic*
CONCLUSIONS: The coronavirus disease 2019 pandemic prompted widespread system-level changes, but front-line clinical care varied widely according to specific hospital needs and infrastructure. Linking operational changes to care delivery processes is a necessary step to understand the impact of the coronavirus disease 2019 pandemic on patient outcomes. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Prone Positioning and Survival in Mechanically Ventilated Patients With Coronavirus Disease 2019–Related Respiratory Failure*
CONCLUSIONS: In-hospital mortality was lower in mechanically ventilated hypoxemic patients with coronavirus disease 2019 treated with early proning compared with patients whose treatment did not include early proning. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 28, 2021 Category: Emergency Medicine Tags: Feature Articles Source Type: research