Serum lactate poorly predicts central venous oxygen saturation in critically ill patients: a retrospective cohort study
The objective of our study was to evaluate whether simultaneous or near-simultaneous measurements of lactate and ScvO2 reveal a consistent relationship between these two biomarkers.MethodsA retrospective cohort study was conducted in an urban, academic US hospital. All adults in ICUs between March 2007 and March 2017 who had a lactate measurement and ScvO2 or mixed venous oxygen saturation (SvO2) measurement made +/ − 1 h from the lactate were included. Linear and non-linear correlations of ScvO2 and lactate were assessed in a variety of shock states.ResultsTwo thousand sixty-two patients were included....
Source: Journal of Intensive Care - September 5, 2019 Category: Intensive Care Source Type: research

Robustness of sepsis-3 criteria in critically ill patients
AbstractBackgroundEarly recognition of sepsis is challenging, and diagnostic criteria have changed repeatedly. We assessed the robustness of sepsis-3 criteria in intensive care unit (ICU) patients.MethodsWe studied the apparent incidence and associated mortality of sepsis-3 among patients who were prospectively enrolled in the Molecular Diagnosis and Risk Stratification of Sepsis (MARS) cohort in the Netherlands, and explored the effects of minor variations in the precise definition and timing of diagnostic criteria for organ failure.ResultsAmong 1081 patients with suspected infection upon ICU admission, 648 (60%) were con...
Source: Journal of Intensive Care - August 29, 2019 Category: Intensive Care Source Type: research

A 2-year multicenter, observational, prospective, cohort study on extracorporeal CO 2 removal in a large metropolis area
We report a collaborative initiative in a large metropolis.MethodsTo assess on a structural basis the rate of utilization as well as efficacy and safety parameters of 2 ECCO2R devices in 10 intensive care units (ICU) during a 2-year period.ResultsSeventy patients were recruited in 10 voluntary and specifically trained centers. The median utilization rate was 0.19 patient/month/center (min 0.04; max 1.20). ECCO2R was started under invasive mechanical ventilation (IMV) in 59 patients and non-invasive ventilation in 11 patients. The Hemolung Respiratory Assist System (Alung) was used in 53 patients and the iLA Activve iLA kit...
Source: Journal of Intensive Care - August 20, 2019 Category: Intensive Care Source Type: research

Artificial neural networks improve and simplify intensive care mortality prognostication: a national cohort study of 217,289 first-time intensive care unit admissions
AbstractPurposeWe investigated if early intensive care unit (ICU) scoring with the Simplified Acute Physiology Score (SAPS 3) could be improved using artificial neural networks (ANNs).MethodsAll first-time adult intensive care admissions in Sweden during 2009 –2017 were included. A test set was set aside for validation. We trained ANNs with two hidden layers with random hyper-parameters and retained the best ANN, determined using cross-validation. The ANNs were constructed using the same parameters as in the SAPS 3 model. The performance was assessed w ith the area under the receiver operating characteristic curve (A...
Source: Journal of Intensive Care - August 16, 2019 Category: Intensive Care Source Type: research

Publisher Correction to: Journal of Intensive Care, volume 7
An error occurred during the publication of a number of articles inJournal of Intensive Care. Several articles were published in volume 7 with a duplicate citation number. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 12, 2019 Category: Intensive Care Source Type: research

Association between fluid overload and SOFA score kinetics in septic shock patients: a retrospective multicenter study
AbstractBackgroundFluid infusion represents one of the cornerstones of resuscitation therapies in order to increase oxygen delivery during septic shock. Fluid overload as a consequence of excessive fluid administration seems to be linked to worse long-term outcome. However, its immediate effect on patient ’s clinical state is poorly described. The goal of this study was to assess the impact of FO on SOFA score kinetics as a surrogate marker of organ dysfunction from day 0 to day 5.Material and methodsRetrospective, multicenter, investigator-initiated study. All adult patients (>  18 years old) admitt...
Source: Journal of Intensive Care - August 9, 2019 Category: Intensive Care Source Type: research

Prognostic accuracy of SOFA, qSOFA and SIRS criteria in hematological cancer patients: a retrospective multicenter study
AbstractBackgroundWith Sepsis-3, the increase in sequential organ failure assessment (SOFA) as a clinical score for the identification of patients with sepsis and quickSOFA (qSOFA) for the identification of patients at risk of sepsis outside the intensive care unit (ICU) were introduced in 2016. However, their validity has been questioned, and their applicability in different settings and subgroups, such as hematological cancer patients, remains unclear. We therefore assessed the validity of SOFA, qSOFA, and the  systemic inflammatory response syndrome (SIRS) criteria regarding the diagnosis of sepsis and the pre...
Source: Journal of Intensive Care - August 7, 2019 Category: Intensive Care Source Type: research

Correction to: Neutrophils are a main source of circulating suPAR predicting outcome in critical illness
In the original publication of this article [1], the content of Authors ’ contributions needs to be revised as below: (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 2, 2019 Category: Intensive Care Source Type: research

Impact of the academic calendar cycle on survival outcome of injured patients: a retrospective cohort study at a community emergency department in Japan
We examined whether a new academic cycle affects the survival outcomes of injured patients in a typical Japanese teaching hospital.MethodsThis historical cohort study was conducted at a Japanese community emergency department (ED). All injured patients brought to the ED from April 2002 to March 2018 were included in the analysis. The primary exposure was presentation to the ED during the first quartile of the academic cycle (April –June). The primary outcome measure was the hospital mortality rate.ResultsOf the 20,945 eligible patients, 5282 (25.2%) were admitted during the first quartile. In the univariable analysis...
Source: Journal of Intensive Care - August 1, 2019 Category: Intensive Care Source Type: research

Long-stay pediatric patients in Japanese intensive care units: their significant presence and a newly developed, simple predictive score
AbstractBackgroundThe length of stay (LOS) in intensive care units (ICUs) has been used as a good indicator not only for resource consumption but also for health outcomes of patients. However, data regarding pediatric LOS in Japanese ICUs are limited. The primary aim of this study was to characterize the Japanese pediatric ICU patients based on their LOS. Second, we aimed to develop a simple scoring system to predict long-stay pediatric ICU patients on admission.MethodsWe performed a retrospective cohort study using consecutive pediatric data (aged  14 days) were identified using multiple regression analysis,...
Source: Journal of Intensive Care - July 29, 2019 Category: Intensive Care Source Type: research

The effect of a rapid molecular blood test on the use of antibiotics for nosocomial sepsis: a randomized clinical trial
AbstractBackgroundAppropriate use of antimicrobials is essential to improve outcomes in sepsis. The aim of this study was to determine whether the use of a rapid molecular blood test —SeptiFast (SF) reduces the antibiotic consumption through early de-escalation in patients with nosocomial sepsis compared with conventional blood cultures (BCs).MethodsThis was a prospective, randomized, superiority, controlled trial conducted at Sao Paulo Heart Institute in the period October 2012 –May 2016. Adult patients admitted to the hospital for at least 48 h with a diagnosis of nosocomial sepsis underwent microorganis...
Source: Journal of Intensive Care - July 22, 2019 Category: Intensive Care Source Type: research

Risk factors and the resistance mechanisms involved in Pseudomonas aeruginosa mutation in critically ill patients
ConclusionThe duration of ventilation and the presence of resistance as soon asP. aeruginosa is identified are predictive factors of mutation in ICU patients. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - July 19, 2019 Category: Intensive Care Source Type: research

Differential effect of lactate in predicting mortality in septic patients with or without disseminated intravascular coagulation: a multicenter, retrospective, observational study
ConclusionsIn patients with DIC, a high lactate level significantly predicted 90-day mortality; no such association was found in the non-DIC group. Thus, DIC status may serve as a possible effect modifier of lactate level in predicting mortality in patients with sepsis. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - June 24, 2019 Category: Intensive Care Source Type: research

Correction to: The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data
In the original publication of this article [1], the figure legends of Fig.  2 and Fig. 3 are wrong and should be changed as below: (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - June 11, 2019 Category: Intensive Care Source Type: research

Relationship between community walking ability and in-hospital mortality in elderly patients with sepsis: a single-center retrospective cohort study
ConclusionsIn this single-center study, frailty assessed by LS was independently associated with a higher in-hospital mortality. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - May 21, 2019 Category: Intensive Care Source Type: research

Sepsis-associated disseminated intravascular coagulation and its differential diagnoses
AbstractDisseminated intravascular coagulation (DIC) is a common complication in sepsis. Since DIC not only promotes organ dysfunction but also is a strong prognostic factor, its diagnosis at the earliest possible timing is important. Thrombocytopenia is often present in patients with DIC but can also occur in a number of other critical conditions. Of note, many of the rare thrombocytopenic diseases require prompt diagnoses and specific treatments. To differentiate these diseases correctly, the phenotypic expressions must be considered and the different disease pathophysiologies must be understood. There are three major pl...
Source: Journal of Intensive Care - May 20, 2019 Category: Intensive Care Source Type: research

The wind changed direction and the big river still flows: from EUPHRATES to TIGRIS
AbstractThe overall result of the randomized controlled double-blinded trial for polymyxin B-immobilized fiber column on septic shock (EUPHRATES trial) was disappointing. However, post hoc analysis showed benefits for patients with certain Endotoxin Activity Assay (EAA) levels. Thus, the study will be repeated, and the data will be added to the former trial. Using a precision medicine approach, eligibility criteria have been modified in TIGRIS to include patients with MODS score  >  9 and EAA levels between 0.60 and 0.89. We are currently feeling the change in the wind as the rivers continue to flow toward...
Source: Journal of Intensive Care - May 16, 2019 Category: Intensive Care Source Type: research

Enteral tolerance in critically ill patients
AbstractEnteral nutrition (EN) can maintain the structure and function of the gastrointestinal mucosa better than parenteral nutrition. In critically ill patients, EN must be discontinued or interrupted, if gastrointestinal complications, particularly vomiting and bowel movement disorders, do not resolve with appropriate management. To avoid such gastrointestinal complications, EN should be started as soon as possible with a small amount of EN first and gradually increased. EN itself may also promote intestinal peristalsis. The measures to decrease the risk of reflux and aspiration include elevation the head of the bed (30...
Source: Journal of Intensive Care - May 7, 2019 Category: Intensive Care Source Type: research

Quantitative capillary refill time predicts sepsis in patients with suspected infection in the emergency department: an observational study
ConclusionsIn this study, Q-CRT/qSOFA combination had better sensitivity than the qSOFA score alone and better specificity than the SIRS score alone. There was no significant difference in accuracy between Q-CRT/qSOFA combination and the qSOFA score or lactate concentration. The ability of the Q-CRT to predict sepsis may be similar to that of the qSOFA score or serum lactate concentration; therefore, measurement of the Q-CRT may be an alternative for invasive measurement of the blood lactate concentration in evaluating patients with suspected sepsis. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - May 6, 2019 Category: Intensive Care Source Type: research

The development and validation of a “5A” severity scale for predicting in-hospital mortality after accidental hypothermia from J-point registry data
ConclusionOur “5A” severity scoring system could accurately predict the risk of in-hospital mortality among patients with accidental hypothermia. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - May 3, 2019 Category: Intensive Care Source Type: research

Variations in infection sites and mortality rates among patients in intensive care units with severe sepsis and septic shock in Japan
ConclusionsIn-hospital mortality and clinical features of patients with severe sepsis and septic shock were heterogeneous according to sites of infection. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - May 3, 2019 Category: Intensive Care Source Type: research

Neutrophils are a main source of circulating suPAR predicting outcome in critical illness
ConclusionsThe inverse correlation between low uPAR surface expression on neutrophils and high serum suPAR in critically ill patients supports that neutrophils are a main source of shed suPAR proteins in systemic inflammation. Furthermore, high suPAR levels and low neutrophilic uPAR expression predict mortality in ICU patients. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - April 27, 2019 Category: Intensive Care Source Type: research

International Analgesia, Sedation, and Delirium Practices: a prospective cohort study
AbstractBackgroundWhile understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing analgesia and sedation usage and occurrence of delirium in different years and international regions.MethodsWe performed a retrospective analysis of two multicenter, international, prospective cohort studies. Mechanically ventilated adults were followed for up to 28  days in 2010 and 2016. Proportion of days utilizing sedation, analgesia, and performance of a spontaneous awakening trial (SAT)...
Source: Journal of Intensive Care - April 24, 2019 Category: Intensive Care Source Type: research

ICU staffing models and patient outcomes
AbstractThe study by Ogura et al. investigated the association between the structures of intensive care units (ICUs) affecting patient outcomes. A major limitation of this study is that the types of ICUs had not clearly been defined, and the provided definition had been made subjectively. Making an additional questionnaire or site-visits to completely define the types and to clarify the time-coverage is suggested. It would also be worthwhile to analyze whether the existence and density of “certified intensivists” and their involvement contribute to the outcome to determine whether physician quality affects crit...
Source: Journal of Intensive Care - April 24, 2019 Category: Intensive Care Source Type: research

Loss of sphingosine 1-phosphate (S1P) in septic shock is predominantly caused by decreased levels of high-density lipoproteins (HDL)
AbstractBackgroundSphingosine 1-phosphate (S1P) is a signaling lipid essential in regulating processes involved in sepsis pathophysiology, including endothelial permeability and vascular tone. Serum S1P is progressively reduced in sepsis patients with increasing severity. S1P function depends on binding to its carriers: serum albumin (SA) and high-density lipoproteins (HDL). The aim of this single-center prospective observational study was to determine the contribution of SA- and HDL-associated S1P (SA-S1P and HDL-S1P) to sepsis-induced S1P depletion in plasma with regard to identify future strategies to supplement vasopro...
Source: Journal of Intensive Care - April 17, 2019 Category: Intensive Care Source Type: research

Diagnostic value of procalcitonin and presepsin for sepsis in critically ill adult patients: a systematic review and meta-analysis
ConclusionOur meta-analysis provided evidence that the diagnostic accuracy of procalcitonin and presepsin in detecting infection was similar and that both are useful for early diagnosis of sepsis and subsequent reduction of mortality in critically ill adult patients.Systematic review registrationThe study was registered in PROSPERO under the registration numberCRD42016035784. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - April 15, 2019 Category: Intensive Care Source Type: research

Disagreement in cardiac output measurements between fourth-generation FloTrac and critical care ultrasonography in patients with circulatory shock: a prospective observational study
AbstractBackgroundCardiac output measurements may inform diagnosis and provide guidance of therapeutic interventions in patients with hemodynamic instability. The FloTrac ™ algorithm uses uncalibrated arterial pressure waveform analysis to estimate cardiac output. Recently, a new version of the algorithm has been developed. The aim was to assess the agreement between FloTrac™ and routinely performed cardiac output measurements obtained by critical care ultrasonog raphy in patients with circulatory shock.MethodsA prospective observational study was performed in a tertiary hospital from June 2016 to January 2017....
Source: Journal of Intensive Care - April 11, 2019 Category: Intensive Care Source Type: research

Timing of administration of epinephrine predicts the responsiveness to epinephrine in norepinephrine-refractory septic shock: a retrospective study
This study aimed to evaluate the factors associated with response to epinephrine in norepinephrine-refractory septic shock.MethodsA retrospective single-center observational study was performed using data from adult patients ( ≥ 18 years old) admitted to our emergency and medical intensive care unit (ICU) from January 2014 to December 2017 who had received epinephrine to treat norepinephrine-refractory septic shock. The response was considered positive if there was increase in mean arterial pressure of 10 mmHg or de crease in arterial lactate level 3 h after epinephrine administration.ResultsForty-o...
Source: Journal of Intensive Care - April 5, 2019 Category: Intensive Care Source Type: research

A retrospective observational analysis of red blood cell transfusion practices in stable, non-bleeding adult patients admitted to nine medical-surgical intensive care units
ConclusionsOver half of the examined RBC transfusions may not have aligned with recommended best practice; this suggests significant opportunity for improvement. The present findings are an essential step towards optimizing RBC transfusions in the ICU. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - April 4, 2019 Category: Intensive Care Source Type: research

Correction to: The lactate clearance calculated using serum lactate level 6  h after is an important prognostic predictor after extracorporeal cardiopulmonary resuscitation: a single-center retrospective observational study
In the original publication of this article [1], the values of PH in the Table 4 are wrong. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 21, 2019 Category: Intensive Care Source Type: research

Gut integrity in critical illness
ConclusionThe gut plays a complex role in both health and critical illness. Here, we review gut integrity in both health and illness and highlight potential strategies for targeting the intestine for therapeutic gain in the intensive care unit. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 20, 2019 Category: Intensive Care Source Type: research

Terlipressin for septic shock patients: a meta-analysis of randomized controlled study
ConclusionsCurrent results suggest terlipressin did not show added survival benefit in septic shock therapy when compared with catecholamines. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 12, 2019 Category: Intensive Care Source Type: research

Strategies for optimal calorie administration in critically ill patients
AbstractNutritional therapy is one of the important treatments in critically ill patients. How to estimate calorie consumption and how to determine an optimal calorie dose are clinical questions of great importance. Although indirect calorimetry is the gold standard for assessing energy expenditure, many intensivists are unable to use this technique. Therefore, the use of formulas, such as the Harris-Benedict equation, or the simple predictive value of 25  kcal/kg/day is reasonable. Several studies and guidelines have shown that the strategies for nutritional therapy depend on the nutritional risk of patients. If pa...
Source: Journal of Intensive Care - March 12, 2019 Category: Intensive Care Source Type: research

Physician agreement on the diagnosis of sepsis in the intensive care unit: estimation of concordance and analysis of underlying factors in a multicenter cohort
ConclusionsConsiderable uncertainty surrounds the differential clinical diagnosis of sepsis vs. SIRS, especially before organ damage has become highly evident, and for patients presenting with respiratory clinical signs. Our findings underscore the need to provide physicians with accurate, timely diagnostic information in evaluating possible sepsis. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 21, 2019 Category: Intensive Care Source Type: research

A simplified definition of diastolic function in sepsis, compared against standard definitions
ConclusionsThe ASE 2016 definition categorizes more septic patients than the ASE 2009 definition, but it does not categorize the diastolic function of a third of septic patients. ASE 2016 designates many patients with elevatedE/e′ as normal. A simplified definition categorized patients with less ambiguity and is associated with relevant comorbidities. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 20, 2019 Category: Intensive Care Source Type: research

Synergistic cytoprotection by co-treatment with dexamethasone and rapamycin against proinflammatory cytokine-induced alveolar epithelial cell injury
ConclusionsA synergistic protective effect of dexamethasone and rapamycin was observed against cytokine-induced cytotoxicity in A549 cells. Augmentation of both of c-Jun inhibition and Akt activation were likely responsible for the cytoprotective effect. The combined administration of anti-inflammatory drugs such as dexamethasone and rapamycin offers a promising treatment option for alveolar epithelial injury associated with sepsis. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 7, 2019 Category: Intensive Care Source Type: research

Establishing extracorporeal membrane oxygenation team increased number of patients and improved data recording
ConclusionsFollowing the establishment of an ECMO team, the survival rate of patients treated with ECMO, ECMO duration, and length of hospital stay were not improved. However, the number of ECMO cases increased and the recording of clinical data was improved. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 7, 2019 Category: Intensive Care Source Type: research

The downside of aggressive volume administration in critically ill patients —“aggressive” may lead to “excessive”
AbstractManagement of fluid therapy in an intensive care unit (ICU) tends to be volume restriction after initial fluid resuscitation, since it has been the consensus that volume overload is associated with complications and poor clinical outcomes. Aggressive volume administration without cautious monitoring should be avoided in the ICU, because it could lead to excessive volume administration. However, there are limited consensus on determining the completion of resuscitation phase, in other words, when to stop aggressive infusion and initiate infusion restriction. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 2, 2019 Category: Intensive Care Source Type: research

Aggressive fluid management in the critically ill: Pro
ConclusionsPerforming aggressive fluid management is important to infuse a sufficient fluid volume proactively during the hemodynamically instable early phase of a critical illness. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 2, 2019 Category: Intensive Care Source Type: research

Correction to: ECMO-treatment in patients with acute lung failure, cardiogenic, and septic shock: mortality and ECMO-learning curve over a 6-year period
In the original publication of this article [1], an Author ’s Note section is missing in Declaration. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 31, 2019 Category: Intensive Care Source Type: research

Volume-outcome relationship on survival and cost benefits in severe burn injury: a retrospective analysis of a Japanese nationwide administrative database
ConclusionsAnalysis of Japanese nationwide administrative database demonstrated that high burn patient volume was significantly associated with increased in-hospital mortality, high healthcare costs, and few hospital-free days. Further studies are needed to validate our results. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 30, 2019 Category: Intensive Care Source Type: research

Is red blood cell distribution width a marker of severity in patients discharged from the ICU?
AbstractWe have read the study about the association between high red blood cell distribution width and higher ward mortality after intensive care unit discharge. The study increases the evidence that RDW may be a marker of severity for patients discharged from the ICU. However, in this letter, we comment on issues that need further discussion. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 29, 2019 Category: Intensive Care Source Type: research

Real-time compression feedback for patients with in-hospital cardiac arrest: a multi-center randomized controlled clinical trial
AbstractObjectiveTo determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA).MethodsWe conducted a prospective, randomized, controlled, parallel study (no crossover) of patients with IHCA in the mixed medical –surgical intensive care units (ICUs) of eight academic hospitals. Patients received either standard manual chest compressions or compressions performed with real-time feedback using the Cardio First Angel™ (CFA) device. The primary outcome was sustained return of spontaneous circulation (ROSC), and secondary outcome...
Source: Journal of Intensive Care - January 22, 2019 Category: Intensive Care Source Type: research

Clinical implication of monitoring regional ventilation using electrical impedance tomography
AbstractMechanical ventilation can initiate ventilator-associated lung injury (VALI) and contribute to the development of multiple organ dysfunction. Although a lung protective strategy limiting both tidal volume and plateau pressure reduces VALI, uneven intrapulmonary gas distribution is still capable of increasing regional stress and strain, especially in non-homogeneous lungs, such as during acute respiratory distress syndrome. Real-time monitoring of regional ventilation may prevent inhomogeneous ventilation, leading to a reduction in VALI.Electrical impedance tomography (EIT) is a technique performed at the patient &r...
Source: Journal of Intensive Care - January 18, 2019 Category: Intensive Care Source Type: research

Early mobilisation in mechanically ventilated patients: a systematic integrative review of definitions and activities
ConclusionsThis review highlights the absence of an agreed definition and on what constitutes early mobilisation in mechanically ventilated patients. To advance research and practice an agreed and shared definition is a pre-requisite. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 17, 2019 Category: Intensive Care Source Type: research

Successful treatment for disseminated intravascular coagulation (DIC) corresponding to phenotype changes in a heat stroke patient
ConclusionThe present case may indicate the clinical significance of monitoring coagulifibrinolytic changes and the potential benefits of anticoagulants for heat stroke-induced DIC. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 15, 2019 Category: Intensive Care Source Type: research

Calibrated cardiac output monitoring versus standard care for fluid management in the shocked ICU patient: a pilot randomised controlled trial
ConclusionIt is feasible to perform a randomised controlled trial using calibrated cardiac output monitoring devices. In addition, there was no trend to suggest that the use of a cardiac monitors leads to lower IV fluid use in the shocked patient. Further trials will require study designs to optimise the use of a cardiac output monitor to determine the utility of these devices in the shocked patient.Trial registrationANZCTR,ACTRN12618001373268. Registered 15 August 2018 —retrospectively registered. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 10, 2019 Category: Intensive Care Source Type: research

Impaired right ventricular ejection fraction after cardiac surgery is associated with a complicated ICU stay
AbstractBackgroundRight ventricular (RV) dysfunction is a known risk factor for increased mortality in cardiac surgery. However, the association between RV performance and ICU morbidity is largely unknown.MethodsWe performed a single-centre, retrospective study including cardiac surgery patients equipped with a pulmonary artery catheter, enabling continuous right ventricular ejection fraction (RVEF) measurements. Primary endpoint of our study was ICU morbidity (as determined by ICU length of stay, duration of mechanical ventilation, usage of inotropic drugs and fluids, and kidney dysfunction) in relation to RVEF. Patients ...
Source: Journal of Intensive Care - December 27, 2018 Category: Intensive Care Source Type: research

ECMO-treatment in patients with acute lung failure, cardiogenic, and septic shock: mortality and ECMO-learning curve over a 6-year period
ConclusionFor the first time, a steep ECMO-learning curve using the CUSUM tool has been described. Obviously, the experience with ECMO has to be taken into account when defining the role of ECMO in ARDS, cardiogenic, and septic shock. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - December 18, 2018 Category: Intensive Care Source Type: research

Association of abnormal carbon dioxide levels with poor neurological outcomes in aneurysmal subarachnoid hemorrhage: a retrospective observational study
AbstractBackgroundIn patients with aneurysmal subarachnoid hemorrhage (SAH), an association between hypocapnia and poor clinical outcomes has been reported. However, the optimal arterial carbon dioxide tension (PaCO2) remains unknown. The present retrospective study aimed to examine the association of abnormal PaCO2 levels with neurological outcomes and investigate the optimal target PaCO2 level in patients with SAH.MethodsWe retrospectively selected consecutive adult patients hospitalized in the intensive care unit (ICU) for SAH between January 2009 and April 2017. Univariate and multivariate analyses were performed to id...
Source: Journal of Intensive Care - December 17, 2018 Category: Intensive Care Source Type: research