Oxygen Therapy Lowers Right Ventricular Afterload in Experimental Acute Pulmonary Embolism
OBJECTIVES: To investigate if oxygen could unload the right ventricle and improve right ventricle function in a porcine model mimicking intermediate-high risk acute pulmonary embolism. DESIGN: Controlled, blinded, animal study. SETTING: Tertiary university hospital, animal research laboratory. SUBJECTS: Female, Danish pigs (n = 16, approximately 60 kg). INTERVENTIONS: Acute autologous pulmonary embolism was induced until doubling of baseline mean pulmonary arterial pressure. Group 1 animals (n = 8) received increasing Fio2 (40%, 60%, and 100%) for time intervals of 15 minutes returning to at...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Laboratory Investigations Source Type: research

Mitochondria-Rich Fraction Isolated From Mesenchymal Stromal Cells Reduces Lung and Distal Organ Injury in Experimental Sepsis*
CONCLUSIONS: Mitotherapy decreased lung, liver, and kidney injury and increased survival rate in cecal ligation and puncture-induced sepsis. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Laboratory Investigations Source Type: research

Diagnostic Performance of Hemophagocytic Lymphohistiocytosis Criteria and HScore in Critically Ill Patients With Severe Hemophagocytic Syndrome
OBJECTIVES: To assess whether critically ill hematologic patients without diagnosis of hemophagocytic lymphohistiocytosis may have features mimicking hemophagocytic lymphohistiocytosis according to both diagnostic scores. DESIGN: A retrospective case-control study. SETTING: Hemophagocytic syndrome diagnosis was standardized and based on a consensual diagnosis by at least two experts of a university hospital which is a reference center for hemophagocytic syndrome. PATIENTS: Cases (hemophagocytic syndrome+) consisted in a group of consecutive patients (n = 150) admitted in our ICU between 2007 and 20...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Brief Report Source Type: research

Using Nonheparin Anticoagulant to Treat a Near-Fatal Case With Multiple Venous Thrombotic Lesions During ChAdOx1 nCoV-19 Vaccination-Related Vaccine-Induced Immune Thrombotic Thrombocytopenia
CONCLUSIONS: This case of vaccine-induced immune thrombotic thrombocytopenia shows that a good outcome can be obtained even with multiple and life-threatening venous thrombotic lesions. Argatroban and high-dose IV immunoglobulin along with management of severe cerebral venous thrombosis played a major role in this epilogue. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Case Report Source Type: research

Mobilization During Critical Illness: A Higher Level of Mobilization Improves Health Status at 6 Months, a Secondary Analysis of a Prospective Cohort Study
CONCLUSIONS: In critically ill survivors, achieving higher levels of mobilization, but not increasing the number of active mobilization sessions, improved health status 6 months after ICU admission. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Associations Between Socioeconomic Status, Patient Risk, and Short-Term Intensive Care Outcomes
OBJECTIVES: To investigate the association of socioeconomic status as measured by the average socioeconomic status of the area where a person resides on short-term mortality in adults admitted to an ICU in Queensland, Australia. DESIGN: Secondary data analysis using de-identified data from the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation linked to the publicly available area-level Index of Relative Socioeconomic Advantage and Disadvantage from the Australian Bureau of Statistics. SETTING: Adult ICUs from 35 hospitals in Queensland, Australia, from 2006 to 20...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Outcomes, Time-Trends, and Factors Associated With Ancillary Study Use for the Determination of Brain Death
CONCLUSIONS: A large number of ancillary studies were performed despite a clinical determination of brain death; patients with hypoxic-ischemic brain injury are more likely to undergo ancillary studies for brain death determination, and neurologists were less likely to use ancillary studies for brain death. Recently, the use of electroencephalograms for brain death determination has decreased, likely reflecting significant concerns regarding its validity and reliability. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Pediatric Acute Alcohol Intoxication Admitted to the ICU: A Review of 102 Cases in France
OBJECTIVES: To describe the profile and clinical outcomes of children ( (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

The Impact of Earplugs and Eye Masks on Sleep Quality in Surgical ICU Patients at Risk for Frequent Awakenings
CONCLUSIONS: These results suggest that earplugs and eye masks are effective in improving sleep quality in ICU patients undergoing frequent assessments. The results strengthen the evidence for nonpharmacologic sleep-promoting adjuncts in the ICU. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Utilization of ICU Rehabilitation Services in Pediatric Patients With a Prolonged ICU Stay*
OBJECTIVES: To describe rehabilitation practice patterns among critically ill children with prolonged ICU stays and explore the association between institution-level utilization of rehabilitative services and patient outcomes. DESIGN: Retrospective cohort study using an administrative database of inpatient clinical and resource utilization data from participating pediatric hospitals in the United States. Center-level utilization of physical therapy and occupational therapy among critically ill patients was used to divide hospitals by quartile into high utilization centers or standard utilization centers. SETT...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Freshly Isolated Mitochondria as Therapeutic Agents in Sepsis: Can They Go Home Again?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Rehabilitation Utilization in the PICU: A Complicated Picture*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Do Our Sedation Practices Contribute to Increased Mortality in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Personalized Sepsis Treatment: Are We There Yet?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

High-Sensitivity Troponin: Revealing the Ominous Implications of Myocardial Injury in Critical Illness*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Advancing Telehealth-Based Screening for Postintensive Care Syndrome: A Coronavirus Disease 2019 Paradigm Shift*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Critical Illness and Your Beloved Ones*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Editorials Source Type: research

Acute Cardiac Injury in Coronavirus Disease 2019 and Other Viral Infections—A Systematic Review and Meta-Analysis
The objective was to compare the rates of cardiac injury by angiotensin-converting enzyme-2–binding viruses from viruses that do not bind to angiotensin-converting enzyme-2. DATA SOURCES: We performed a systematic review of coronavirus disease 2019 literature on PubMed and EMBASE. STUDY SELECTION: We included studies with ten or more hospitalized adults with confirmed coronavirus disease 2019 or other viral pathogens that described the occurrence of acute cardiac injury. This was defined by the original publication authors or by: 1) myocardial ischemia, 2) new cardiac arrhythmia on echocardiogram, or 3)...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Review Article Source Type: research

Skeletal Muscle Changes, Function, and Health-Related Quality of Life in Survivors of Pediatric Critical Illness
CONCLUSIONS: Muscle decreased in critically ill children, which was associated with energy inadequacy and impaired muscle growth postdischarge. Muscle changes correlated with change in mobility, which was associated with child health-related quality of life. Mobility, child health-related quality of life, and parental health-related quality of life appeared to be interlinked. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

A Core Outcome Set for Research Evaluating Interventions to Prevent and/or Treat Delirium in Critically Ill Adults: An International Consensus Study (Del-COrS)
CONCLUSIONS: This core outcome set, endorsed by the American and Australian Delirium Societies and European Delirium Association, is recommended for future clinical trials evaluating delirium prevention or treatment interventions in critically ill adults. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Association of Sedation, Coma, and In-Hospital Mortality in Mechanically Ventilated Patients With Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: A Retrospective Cohort Study*
OBJECTIVES: In patients with coronavirus disease 2019–associated acute respiratory distress syndrome, sedatives and opioids are commonly administered which may lead to increased vulnerability to neurologic dysfunction. We tested the hypothesis that patients with coronavirus disease 2019–associated acute respiratory distress syndrome are at higher risk of in-hospital mortality due to prolonged coma compared with other patients with acute respiratory distress syndrome matched for disease severity. DESIGN: Propensity-matched cohort study. SETTING: Seven ICUs in an academic hospital network, Beth ...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Expression of Exhaustion Markers on CD8+ T-Cell Patterns Predict Outcomes in Septic Patients Admitted to the ICU*
CONCLUSIONS: Easy-to-use multicolor flow cytometry assessing 2B4, PD-1, and CD160 expression on CD8+ T cells at day 1 identifies septic patients with poor outcome and discriminates patient subsets in who immunomodulatory drugs should be tested. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Mechanism of a Flexible ICU Visiting Policy for Anxiety Symptoms Among Family Members in Brazil: A Path Mediation Analysis in a Cluster-Randomized Clinical Trial
CONCLUSIONS: A flexible ICU visiting policy reduces anxiety symptoms among family members and appears to work by increasing satisfaction. However, increased participation in some activities of patient care as a result of flexible visitation was associated with higher severity of anxiety symptoms. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Association Between Premorbid Beta-Blocker Exposure and Sepsis Outcomes—The Beta-Blockers in European and Australian/American Septic Patients (BEAST) Study
CONCLUSIONS: This study suggests that β-blocker exposure prior to sepsis, especially to noncardioselective β blockers, may be associated with better outcome. The findings suggest prospective evaluation of β-blocker use in the management of sepsis. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Comparison of Bivalirudin Versus Heparin for Maintenance Systemic Anticoagulation During Adult and Pediatric Extracorporeal Membrane Oxygenation
OBJECTIVES: To provide a comparative analysis of conventional heparin-versus bivalirudin-based systemic anticoagulation in adult and pediatric patients supported on extracorporeal membrane oxygenation. DESIGN: Retrospective chart review study of adult and pediatric patients receiving extracorporeal membrane oxygenation from January 1, 2014, to October 1, 2019. SETTING: A large, high-volume tertiary referral adult and pediatric extracorporeal membrane oxygenation center. PATIENTS: Four hundred twenty-four individuals requiring extracorporeal membrane oxygenation support and systemically anticoagulat...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Depression and Long-Term Survival Among South Korean Sepsis Survivors: A Nationwide Cohort Study From 2011 to 2014
OBJECTIVES: We investigated the prevalence of pre- and postsepsis depression and examined the association between diagnosis of pre- and postsepsis depression and 5-year all-cause mortality among survivors of sepsis. DESIGN: A population-based cohort study. SETTING: Data were obtained from the National Health Insurance Service database in South Korea. PATIENTS: Sepsis survivors were defined as those who were admitted with a main diagnosis of sepsis or septic shock and had survived for over 365 days. MEASUREMENTS AND MAIN RESULTS: Sepsis survivors who were diagnosed with depression before seps...
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Clusters of Double Triggering Impact Clinical Outcomes: Insights From the EPIdemiology of Patient-Ventilator aSYNChrony (EPISYNC) Cohort Study
CONCLUSIONS: Clusters of double triggering are common and were associated with worse clinical outcomes. Patients who had a high cumulative duration of clusters had fewer ventilator-free days, longer duration of mechanical ventilation, longer ICU length of stay, and shorter survival than patients with low cumulative duration of cluster. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Distribution of High-Sensitivity Troponin Taken Without Conventional Clinical Indications in Critical Care Patients and Its Association With Mortality*
CONCLUSIONS: High-sensitivity troponin elevation, taken outside the context of conventional clinical indications, was common in the critically ill. Such elevations were associated with increasing age, comorbidity, illness severity, and the need for organ support. Admission high-sensitivity troponin concentration is an independent predictor of critical care mortality and as such may represent a novel prognostic biomarker at admission. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Surge and Mortality in ICUs in New York City’s Public Healthcare System
CONCLUSIONS: Patients admitted to ICUs with higher surge scores were at greater risk of death. Impact of surge levels on mortality varied across sociodemographic groups. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Postintensive Care Syndrome in Survivors of Critical Illness Related to Coronavirus Disease 2019: Cohort Study From a New York City Critical Care Recovery Clinic*
CONCLUSIONS: Survivors of critical illness related to coronavirus disease 2019 are at high risk of developing postintensive care syndrome. These findings highlight the importance of planning for appropriate post-ICU care to diagnose and treat this population. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Mental Health Interventions to Improve Psychological Outcomes in Informal Caregivers of Critically Ill Patients: A Systematic Review and Meta-Analysis*
CONCLUSIONS: Mental health interventions for caregivers of critically ill patients improved short-term anxiety, depression, humanity, and transcendence while increasing burden. Clinicians should consider short-term prescriptions of mental health interventions to informal caregivers of critically ill patients with capacity to manage interventions. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: Feature Article Source Type: research

The Multiple Organ Dysfunction Syndrome: Syndrome, Metaphor, and Unsolved Clinical Challenge
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: 50th Anniversary Articles Source Type: research

Patient and Family Engagement in Critical Illness
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: 50th Anniversary Articles Source Type: research

Cardiopulmonary Resuscitation and Rescue Therapies
The history of cardiopulmonary resuscitation and the Society of Critical Care Medicine have much in common, as many of the founders of the Society of Critical Care Medicine focused on understanding and improving outcomes from cardiac arrest. We review the history, the current, and future state of cardiopulmonary resuscitation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - August 30, 2021 Category: Emergency Medicine Tags: 50th Anniversary Articles Source Type: research

Serum Agmatine Levels Were Negatively Correlated With the Severity of Sepsis: Beware of Potential Confounders!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Prolonged and Uninterrupted Prone Position in Acute Respiratory Distress Syndrome
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Appropriate Treatment of Ischemic Stroke That Is Essential for the Reduction of Mortality and Morbidity: Should We Use Hyperbaric Oxygen Therapy Together With Recombinant Tissue Plasminogen Activator for Improving Brain Oxygenation and Before Recombinant Tissue Plasminogen Activator to Minimize the Risk of Massive Bleeding?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Although None of the Resting Energy Expenditure Calculated From Predictive Equations Had Very Good Agreements, the Swinamer Equation Could Be Used to Predict Resting Energy Expenditure When Indirect Calorimetry Is Not Available: We Are Not Sure!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Cytokines Can Suppress Cardiac Output and Cytokine Storms Inhibit Oxygen Use by Mitochondria and Contribute to the Occurrence of Acute Heart Failure in Patients With Severe Infection Caused by Avian Influenza A (H7N9): We Are Not Sure!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Cardiopulmonary Resuscitation in Coronavirus Disease 2019: Far from Futile
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Questioning the Futility of Cardiopulmonary Resuscitation in Patients With Severe Coronavirus Disease 2019
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 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 - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Cardiopulmonary Resuscitation in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest: More Data Are Needed
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Time to Initiation of Renal Replacement Therapy Among Critically Ill Patients With Acute Kidney Injury: A Current Systematic Review and Meta-Analysis
CONCLUSIONS: Earlier or later initiation of renal replacement therapy did not affect mortality. However, earlier renal replacement therapy was associated with significantly shorter ICU and hospital length of stay, whereas later renal replacement therapy was associated with decreased use of renal replacement therapy and decreased risk of catheter-related blood stream infection. These findings can be used to guide the management of critically ill patients with acute kidney injury. (Source: Critical Care Medicine)
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Quality of Life and Long-Term Mortality Among Survivors of Extracorporeal Membrane Oxygenation: A Nationwide Cohort Study in South Korea
OBJECTIVES: The quality of life after extracorporeal membrane oxygenation therapy has emerged as an important issue for extracorporeal membrane oxygenation survival; however, its association with long-term prognosis has not been identified. We investigated the changes in the quality of life after extracorporeal membrane oxygenation among the survivors and examine the association between a worse quality of life and 3-year all-cause mortality. DESIGN: This was a population-based cohort study. SETTING: Data were obtained from the National Health Insurance Service database in South Korea. PATIENTS: Adu...
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research