Glycoprotein IIb/IIIa inhibitors for cardiogenic shock complicating acute myocardial infarction: a systematic review, meta-analysis, and meta-regression
ConclusionGPI therapy as an adjunct to standard treatment in cardiogenic shock was associated with better outcomes, including both short- and long-term survival, without increasing the risk of bleeding. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - November 11, 2020 Category: Intensive Care Source Type: research
Accuracy of circulating microRNAs in diagnosis of sepsis: a systematic review and meta-analysis
ConclusionsOur meta-analysis indicated that the level of circulating miRNAs, particularly the miR-223, could be used as an indicator for sepsis. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - November 2, 2020 Category: Intensive Care Source Type: research
Non-catecholamine vasopressors in the treatment of adult patients with septic shock —evidence from meta-analysis and trial sequential analysis of randomized clinical trials
ConclusionsCurrent pooled results suggest that the addition of NE to non-catecholamine vasopressors was associated with a marginally significant reduction in 28-day mortality. Moreover, they were able to shorten the length of MV, improved renal function, decreased HR, and increased the 6-h shock reversal success rate at the expense of increased the risk of hyponatremia and digital ischemia. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 31, 2020 Category: Intensive Care Source Type: research
The mortality of critically ill patients was not associated with inter-hospital transfer due to a shortage of ICU beds - a single-centre retrospective analysis
ConclusionMortality at 90 days in critically ill patients treated in a tertiary centre was not affected by transfer to another intensive care units due to a shortage of beds. We found this conclusion to be valid under the assumption that patients are carefully selected and that the transports are safely performed. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 30, 2020 Category: Intensive Care Source Type: research
Efficacy of probiotics in the prevention of VAP in critically ill ICU patients: an updated systematic review and meta-analysis of randomized control trials
DiscussionOur meta-analysis shows that probiotic administration has a promising role in lowering the incidence of VAP, the duration of mechanical ventilation, length of ICU stay, and in-hospital mortality. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 15, 2020 Category: Intensive Care Source Type: research
Factors influencing liberation from mechanical ventilation in coronavirus disease 2019: multicenter observational study in fifteen Italian ICUs
ConclusionsAge, SOFA score at ICU admission, CRS, PaO2/FiO2, renal and cardiovascular complications, and late-onset VAP were all independent risk factors for prolonged mechanical ventilation in patients with COVID-19.Trial registrationNCT04411459 (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 15, 2020 Category: Intensive Care Source Type: research
Oxygen administration for postoperative surgical patients: a narrative review
AbstractMost postoperative surgical patients routinely receive supplemental oxygen therapy to prevent the potential development of hypoxemia due to incomplete lung re-expansion, reduced chest wall, and diaphragmatic activity caused by surgical site pain, consequences of hemodynamic impairment, and residual effects of anesthetic drugs (most notably residual neuromuscular blockade), which may result in atelectasis, ventilation –perfusion mismatch, alveolar hypoventilation, and impaired upper airway patency. Additionally, the World Health Organization guidelines for reducing surgical site infection have recommended the peri...
Source: Journal of Intensive Care - October 14, 2020 Category: Intensive Care Source Type: research
Fluid management in ARDS: an evaluation of current practice and the association between early diuretic use and hospital mortality
ConclusionsIn this sample of ARDS patients, volume overload was common, and early diuretic use was independently associated with lower hospital mortality. These findings support the importance of fluid management in ARDS and suggest opportunities for further study and implementation of conservative fluid strategies into usual care. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 12, 2020 Category: Intensive Care Source Type: research
Prolonged versus intermittent β-lactam antibiotics intravenous infusion strategy in sepsis or septic shock patients: a systematic review with meta-analysis and trial sequential analysis of randomized trials
ConclusionsThe prolonged infusion of β-lactam antibiotics significantly improved upon attaining the target plasma concentration and clinical cure without increasing the adverse event or the occurrence of antibiotic-resistant bacteria. Prolonged infusion could not improve hospital mortality although an improvement was shown for studies published in or after 2015. Further studies are warranted as suggested by our TSA results. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - October 5, 2020 Category: Intensive Care Source Type: research
Linkage of alterations in systemic iron homeostasis to patients ’ outcome in sepsis: a prospective study
ConclusionsOur study could show an important impact of serum iron parameters on the outcome of sepsis. Furthermore, we identified transferrin saturation as a stand-alone predictor of sepsis survival and as a parameter of iron metabolism which may in a combined model improve the prediction power of the SOFA score.Trial registrationThe study was carried out in accordance with the recommendations of the Declaration of Helsinki on biomedical research. The study was approved by the institutional ethics review board of the Medical University Innsbruck (studyAN2013-0006). (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 30, 2020 Category: Intensive Care Source Type: research
Sex-specific prevalence and outcomes of frailty in critically ill patients
ConclusionsAlthough frailty and sex were individually associated with mortality and differences in organ support in the ICU, there does not appear to be a significant interaction between sex and frailty with regards to these outcomes. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 28, 2020 Category: Intensive Care Source Type: research
Acute kidney injury after aneurysmal subarachnoid hemorrhage: is chloride really responsible?
AbstractSadan et al. find an association between acute kidney injury and high chloride containing a hypertonic solution. Recent large prospective non-randomized studies bring conflicting results on the relationship between chloride and acute kidney injury. We discuss Sadan et al. ’s results according to the recent literature. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 25, 2020 Category: Intensive Care Source Type: research
The authors ’ response
AbstractIn response to comments raised, we acknowledge the shortcomings of our study. It is a small study. However, it is a pilot study, which is not meant to create generalizable data, rather to explore new potential directions. To this end, our conclusions were clearly supported by the results. We demonstrated that administration of 16.4% NaCl/Na-acetate solution was feasible, safe, and was associated with lower rates of AKI. We share the call that large RCTs are required to follow this pilot study and hope that our data will stimulate the ongoing discussion regarding the role of chloride in AKI mechanism. (Source: Journ...
Source: Journal of Intensive Care - September 25, 2020 Category: Intensive Care Source Type: research
Endothelial glycocalyx shedding in the acute respiratory distress syndrome after flu syndrome
ConclusionsEvidence of EG shedding was found in ARDS established after flu syndrome. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - September 20, 2020 Category: Intensive Care Source Type: research
Perspective on fibrinolytic therapy in COVID-19: the potential of inhalation therapy against suppressed-fibrinolytic-type DIC
AbstractA high rate of thrombotic complications, such as pulmonary embolism, has been linked to mortality in COVID-19, and appropriate treatment of thrombosis is important for lifesaving. Although heparin is frequently used to treat thrombotic pathology in COVID-19, pulmonary embolism is still seen in severe cases. Although systemic fibrinolytic therapy is a focus of attention because a thrombotic pathology is the cause of death in severe COVID-19, it should be kept in mind that fibrinolytic therapy might be harmful at advanced stage of COVID-19 where the status of disseminated intravascular coagulation (DIC) has been tran...
Source: Journal of Intensive Care - September 17, 2020 Category: Intensive Care Source Type: research
