Intravascular Versus Surface Cooling in Patients Resuscitated From Cardiac Arrest: A Systematic Review and Network Meta-Analysis With Focus on Temperature Feedback
CONCLUSIONS: Our results suggest that in patients resuscitated from CA and treated with TTM at 32–34°C, IC has the highest probability of being the most beneficial cooling method for survival and neurologic outcome. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Review Articles Source Type: research

Low Tidal Volume Ventilation for Emergency Department Patients: A Systematic Review and Meta-Analysis on Practice Patterns and Clinical Impact*
OBJECTIVES: Data suggest that low tidal volume ventilation (LTVV) initiated in the emergency department (ED) has a positive impact on outcome. This systematic review and meta-analysis quantify the impact of ED-based LTVV on outcomes and ventilator settings in the ED and ICU. DATA SOURCES: We systematically reviewed MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, references, conferences, and ClinicalTrials.gov. STUDY SELECTION: Randomized and nonrandomized studies of mechanically ventilated ED adults were eligible. DATA EXTRACTION: Tw...
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Review Articles Source Type: research

ICU Versus High-Dependency Care Unit for Patients With Acute Myocardial Infarction: A Nationwide Propensity Score-Matched Cohort Study
CONCLUSIONS: Critical care in the ICU compared with that in the HDU was not associated with reduced inhospital mortality among the entire cohort of patients with acute myocardial infarction but was associated with reduced inhospital mortality among the subsets of patients with Killip class IV, intubation, or mechanical circulatory support. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

CytoSorb Rescue for COVID-19 Patients With Vasoplegic Shock and Multiple Organ Failure: A Prospective, Open-Label, Randomized Controlled Pilot Study*
CONCLUSIONS: In severely ill COVID-19 patients, CytoSorb did not improve resolution of vasoplegic shock or predefined secondary endpoints. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Patient-Centered Outcomes Following COVID-19: Frailty and Disability Transitions in Critical Care Survivors*
CONCLUSIONS: Frailty and disability were more frequent 90 days after hospital discharge compared with baseline in COVID-19 patients admitted to the ICU. Our results show that most COVID-19 critical care survivors transition to poorer health status, highlighting the importance of long-term medical follow-up for this population. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Sleep and Circadian Health of Critical COVID-19 Survivors 3 Months After Hospital Discharge
OBJECTIVES: To evaluate the sleep and circadian rest-activity pattern of critical COVID-19 survivors 3 months after hospital discharge. DESIGN: Observational, prospective study. SETTING: Single-center study. PATIENTS: One hundred seventy-two consecutive COVID-19 survivors admitted to the ICU with acute respiratory distress syndrome. INTERVENTIONS: Seven days of actigraphy for sleep and circadian rest-activity pattern assessment; validated questionnaires; respiratory tests at the 3-month follow-up. MEASUREMENTS AND MAIN RESULTS: The cohort included 172 patients, mostly males (67.4%) wi...
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Association of Metformin Use During Hospitalization and Mortality in Critically Ill Adults With Type 2 Diabetes Mellitus and Sepsis*
CONCLUSIONS: Metformin exposure during hospitalization is associated with a decrease in 90-day mortality in patients with type 2 diabetes mellitus and sepsis. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Therapeutic Hyperthermia Is Associated With Improved Survival in Afebrile Critically Ill Patients With Sepsis: A Pilot Randomized Trial
CONCLUSIONS: Participants randomized to external forced-air warming did not have a difference in HLA-DR expression or IFN-γ production. In this pilot study, however, 28-day mortality was lower in the intervention group. Future research should seek to better elucidate the impact of temperature modulation on immune and nonimmune organ failure pathways in sepsis. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Sex Differences in Treatment of Adult Intensive Care Patients: A Systematic Review and Meta-Analysis
CONCLUSIONS: Women were less likely than men to receive mechanical ventilation or renal replacement therapy and had shorter ICU length of stay than men. There is substantial heterogeneity and risk of bias in the literature; however, these findings persisted in sensitivity analyses. (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
OBJECTIVES: Major postintensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a statewide cohort of children who survived PICU during childhood. DESIGN: Multicenter population-based study on children less than 5 years admitted to PICU. Using the National Assessment Program—Literacy and Numeracy database, the primary outcome was educational achievement below the National Minimum Standard (NMS) in year 3 of primary school. Cases were compared with con...
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Key Role of Gut Microbiota in Neuroinflammation of Septic Patients
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 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 - April 21, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Refractory Anaphylaxis Needing Emergency Intubation Supported by Expert Opinion and Published Guidelines: Could We Use Off-Label Drugs to Avoid It?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Impact of the Coronavirus Disease 2019 Pandemic on Moral Distress Among Nurses and Physicians in Spanish ICUs
OBJECTIVES: To assess the impact of COVID-19 pandemic on moral distress (MD) among healthcare professionals (HCPs) (physicians and nurses) in Spanish ICUs. DESIGN: Cross-sectional, prospective study. SETTING: ICUs in Spain. PARTICIPANTS: HCPs currently working in Spanish ICUs. INTERVENTIONS: Data were collected via electronic survey with the use of a 50-item questionnaire in two different periods: prepandemic (October-December 2019) and during the second wave of COVID-19 (September-November 2020). MEASUREMENTS AND MAIN RESULTS: During the prepandemic and pandemic periods, 1,065 (57.1%...
Source: Critical Care Medicine - April 21, 2022 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research