Clinical significance of lactate clearance in patients with cardiogenic shock: results from the RESCUE registry
ConclusionsHigher LC during the early phase of CS was associated with reduced risk of in-hospital and 12 month all-cause mortalities. Patients with LC ≥ 64% during the 24 h after CS onset could expect a favorable prognosis, especially those with an initial serum lactate > 5 mmol/L.Trial registration: RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016 —retrospectively and prospectively registered,https://clinicaltrials.gov/ct2/show/re...
Source: Journal of Intensive Care - October 18, 2021 Category: Intensive Care Source Type: research
Effects of dexamethasone on immune dysfunction and ventilator-associated pneumonia in COVID-19 acute respiratory distress syndrome: an observational study
AbstractDexamethasone improves survival of patients with COVID-19 acute respiratory distress syndrome, but might shorten the delay between the start of invasive mechanical ventilation and the occurrence of ventilator-associated pneumonia, suggesting possible worsening of COVID-19-induced immune dysfunction with this treatment. In a prospective observational study, we found that mechanically ventilated patients with COVID-19 treated with dexamethasone presented earlier ventilator-associated pneumonia, had significantly lower monocyte Human Leukocyte Antigen-DR expression and number of circulating CD4 + cells after ICU ...
Source: Journal of Intensive Care - October 18, 2021 Category: Intensive Care Source Type: research
Efficacy of probiotics in the prevention of diarrhea in ventilated critically ill ICU patients: meta-analysis of randomized control trials: author ’s reply
(Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 15, 2021 Category: Intensive Care Source Type: research
Efficacy of probiotics in the prevention of diarrhea in ventilated critically ill ICU patients: meta-analysis of randomized control trials
AbstractWe comment on the study by Batra et al. on the efficacy of probiotics in the prevention of ventilator-associated pneumonia in critically ill ICU patients. They also reported that probiotics administration was not associated with a statistically significant reduction in the incidence of diarrhea (OR 0.59; CI 0.34, 1.03;P = 0.06;I2 = 38%). However, their meta-analysis missed one RCT, and when we repeated the analysis including this RCT, we found that probiotics administration significantly reduced the incidence of diarrhea (OR 0.51; CI 0.28, 0.92;P = 0.02;I2 = 45.6%). We thus believe that probiotics a...
Source: Journal of Intensive Care - October 15, 2021 Category: Intensive Care Source Type: research
Multivariate analysis of factors associated with first-pass success in blind placement of a post-pyloric feeding tube: a retrospective study
ConclusionsIn critically ill patients, the position of the greater curvature of the stomach caudal to L1 − L2 may be associated with a lower first-pass success rate of the blind method for post-pyloric enteral feeding tube placement. Further studies are needed to verify our results because the position of the stomach was estimated by radiographs after enteral feeding tube placement.Trial registration: University Hospital Medical Information Network Clinical Trials Registry (UMIN000036549; April 20, 2019). (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 7, 2021 Category: Intensive Care Source Type: research
The story of critical care in Asia: a narrative review
ConclusionsCritical care in Asia has progressed through the years, but multiple challenges remain. These challenges should be addressed through a collaborative approach across disciplines, ICUs, hospitals, societies, governments, and countries. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 7, 2021 Category: Intensive Care Source Type: research
Immature granulocytes can help the diagnosis of pulmonary bacterial infections in patients with severe COVID-19 pneumonia
AbstractDuring COVID-19, immature granulocyte (IG) concentration is heterogeneous with higher concentrations than those found in bacterial sepsis. We investigated the relationship between IG levels at ICU admission and on days 7 ( ± 2) and 15 (± 2) and associated pulmonary bacterial infections in intensive care unit (ICU) patients hospitalized for an acute respiratory distress syndrome (ARDS) related to SARS-CoV-2. Patients with associated pulmonary bacterial infection had a peak of IGs. IG thresholds of 18% or 2 G/L a llowed discriminating patients with ventilator associated pneumonia with 100% sensitivity and spec...
Source: Journal of Intensive Care - September 20, 2021 Category: Intensive Care Source Type: research
Association between lymphocyte count in bronchoalveolar lavage fluid and mortality
AbstractThis is a comment on the paper by Dr. Hirasawa et al. on the predictive value of lymphocyte counts in bronchoalveolar lavage fluid in patients with acute respiratory failure. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 15, 2021 Category: Intensive Care Source Type: research
Response to commentary
AbstractThis is a response to the issues raised in the commentary by Dr. Yifu Si et al. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 15, 2021 Category: Intensive Care Source Type: research
Effect of the COVID-19 pandemic on cardiac arrest resuscitation practices and outcomes in non-COVID-19 patients
AbstractThe effect of changes to cardiopulmonary resuscitation (CPR) procedures in response to Coronavirus disease 2019 (COVID-19) on in-hospital cardiac arrest (IHCA) management and outcomes are unreported. In this multicenter retrospective study, we showed that median time to arrival of resuscitation team has increased and proportion of patients receiving first-responder CPR has lowered during this pandemic. IHCA during the pandemic was independently associated with lower return of spontaneous circulation OR 0.63 (95% CI 0.43 –0.91), despite adjustment for lowered patient comorbidity and increased time to resuscitation...
Source: Journal of Intensive Care - September 10, 2021 Category: Intensive Care Source Type: research
Adjunctive ketamine for sedation in critically ill mechanically ventilated patients: an active-controlled, pilot, feasibility clinical trial
ConclusionsKetamine as an adjunct analgosedative agent appeared to be feasible and safe with no negative impact on outcomes, including hemodynamics. This pilot RCT identified areas of improvement in study protocol before conducting a large, adequately powered, multicenter RCT which is likely justified to investigate ketamine association with patient-centered outcomes further.Trial registration ClinicalTrials.gov: NCT04075006. Registered on 30 August 2019. Current controlled trials: ISRCTN14730035. Registered on 3 February 2020 (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 30, 2021 Category: Intensive Care Source Type: research
The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020)
AbstractThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 (J-SSCG 2020), a Japanese-specific set of clinical practice guidelines for sepsis and septic shock created as revised from J-SSCG 2016 jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in September 2020 and published in February 2021. An English-language version of these guidelines was created based on the contents of the original Japanese-language version. The purpose of this guideline is to assist medical staff in making appropriate decisions to impr...
Source: Journal of Intensive Care - August 25, 2021 Category: Intensive Care Source Type: research
Circulating dipeptidyl peptidase 3 on intensive care unit admission is a predictor of organ dysfunction and mortality
ConclusionCirculating DPP3 on admission is a SAPS-3 independent prognostic factor of day-two organ dysfunction and 30-day mortality in a mixed ICU population and needs further evaluation. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 24, 2021 Category: Intensive Care Source Type: research
The Ichikado CT score as a prognostic tool for coronavirus disease 2019 pneumonia: a retrospective cohort study
ConclusionsIchikado CT score is an independent predictor of both requiring invasive mechanical ventilation and all-cause mortality in patients hospitalized with COVID-19 pneumonia. Further prospective evaluation is necessary to confirm these findings.Trial registration: The WCG institutional review board approved this retrospective study and patient consent was waived due to its non-interventional nature (Identifier: 20210799). (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 21, 2021 Category: Intensive Care Source Type: research
Patient –ventilator asynchrony, impact on clinical outcomes and effectiveness of interventions: a systematic review and meta-analysis
ConclusionsPVA may be associated with longer MV duration, higher ICU mortality, and higher hospital mortality. Physicians may consider monitoring PVA and adjusting ventilator settings and sedatives to reduce PVA. Further studies with adjustment for confounding factors are warranted to determine the impact of PVA on clinical outcomes.Trial registration protocols.io (URL:https://www.protocols.io/view/the-impact-of-patient-ventilator-asynchrony-in-adu-bsqtndwn, 08/27/2020). (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - August 16, 2021 Category: Intensive Care Source Type: research
