Quality indicators of palliative care for cardiovascular intensive care
AbstractHealthcare providers working for cardiovascular intensive care often face challenges and they play an essential role in palliative care and end-of-life care because of the high mortality rates in the cardiac intensive care unit. Unfortunately, there are several barriers to integrating palliative care, cardiovascular care, and intensive care. The main reasons are as follows: cardiovascular disease-specific trajectories differ from cancer, there is uncertainty associated with treatments and diagnoses, aggressive treatments are necessary for symptom relief, and there is ethical dilemma regarding withholding and withdr...
Source: Journal of Intensive Care - March 14, 2022 Category: Intensive Care Source Type: research
A prospective observational cohort study to identify inflammatory biomarkers for the diagnosis and prognosis of patients with sepsis
ConclusionSeveral differentially expressed inflammatory proteins were identified that could be used as biomarkers for sepsis. These proteins are mostly related to disease severity. Within the setting of an emergency department, they could be used for outcome prediction, patient monitoring, and directing diagnostics.Trail registration number: clinicaltrial.gov identifier NCT03841162. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 9, 2022 Category: Intensive Care Source Type: research
Recombinant human soluble thrombomodulin for acute exacerbation of idiopathic pulmonary fibrosis: a nationwide observational study
ConclusionsIn patients with AE-IPF who developed severe respiratory failure, rTM in addition to high-dose mPSL was not associated with a better outcome. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 9, 2022 Category: Intensive Care Source Type: research
Ultraprotective versus apneic ventilation in acute respiratory distress syndrome patients with extracorporeal membrane oxygenation: a physiological study
ConclusionsIn patients with severe ARDS managed with ECMO, ultraprotective ventilation compared to apneic ventilation improved oxygenation, but increased stress, strain, and mechanical power. Apneic ventilation might be considered as one of the options in the initial phase of ECMO treatment in severe ARDS patients to facilitate lung rest and prevent ventilator-induced lung injury.Trial registration: German Clinical Trials Register (DRKS00013967). Registered 02/09/2018.https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013967. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 7, 2022 Category: Intensive Care Source Type: research
New avenues of sepsis research: obtaining perspective by analyzing and comparing SSCG 2021 and J-SSCG 2020
AbstractRecently, revisions of two sepsis guidelines, namely, the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 and the Surviving Sepsis Campaign Guidelines 2021, were published. Although both guidelines were created in accordance with the Grading of Recommendations, Assessment, Development and Evaluation approach, the evidence-to-decision tables differed between them. In addition, certain recommendations may differ between these guidelines for similar clinical questions because of differences in the “PICO” criteria. Other differences in recommendations between the two guidelines ...
Source: Journal of Intensive Care - March 7, 2022 Category: Intensive Care Source Type: research
Incidence and outcomes of in-hospital cardiac arrest in Japan 2011 –2017: a nationwide inpatient database study
ConclusionsWe found substantial associations between mortality and loss of health and IHCA in Japan. The incidence of IHCA showed a decreasing trend over time, the percentage of treated cardiac arrest patients also had a decreasing trend, and the overall survival to discharge rate improved over time. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - March 3, 2022 Category: Intensive Care Source Type: research
Body position for preventing ventilator-associated pneumonia for critically ill patients: a systematic review and network meta-analysis
ConclusionsCautiously, semi-recumbent seems to be the best position to reduce VAP incidence, hospital length of stay and the duration of MV. Prone is the most effective position to reduce the risk of mortality and the ICU length of stay, but it showed no effect on the VAP incidence.Registration PROSPERO CRD42021247547 (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 22, 2022 Category: Intensive Care Source Type: research
Is it time to reconsider the administration of thiamine alone or in combination with vitamin C in critically ill patients? A meta-analysis of clinical trial studies
ConclusionIn contrast to HVT, thiamine supplementation alone was associated with increased mortality rate in ICU. However, co-supplementation of thiamine and vitamin C had a significant decreasing effect on SOFA score. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 17, 2022 Category: Intensive Care Source Type: research
Association between the presence of delirium during intensive care unit admission and cognitive impairment or psychiatric problems: the Korean ICU National Data Study
ConclusionsAmong patients received ICU care, those who experienced delirium during hospitalization had an increased risk of developing cognitive impairment or psychiatric problems post-discharge. Many patients showed multiple cognitive impairment and psychiatric problems during the follow-up period. Efforts to decrease these problems should be made to increase the quality of life of these ICU survivors. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 14, 2022 Category: Intensive Care Source Type: research
Recommendations for long-term outcomes in sepsis and septic shock: a comparison between Japanese and international guidelines
AbstractThe International Guidelines for Management of Sepsis and Septic Shock 2021 and the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2020 share a common issue on long-term outcomes of patients with sepsis and septic shock and their families; however, the focus of the clinical questions and recommendations between the two guidelines varies. Although this may be due to differences in medical resources and healthcare systems between countries and regions, the essence of providing continuous patient- and family-centered care remains unchanged, and both guidelines can be utilized to provid...
Source: Journal of Intensive Care - February 5, 2022 Category: Intensive Care Source Type: research
Efficacy of combination triple therapy with vasopressin, steroid, and epinephrine in cardiac arrest: a systematic review and meta-analysis of randomized-controlled trials
ConclusionsVSE combination therapy during and after IHCA may have beneficial effects in terms of the ROSC, renal and circulatory failure free days, and MAP.Prospero registration: CRD42020178297 (05/07/2020). (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - February 2, 2022 Category: Intensive Care Source Type: research
Nevertheless, the importance of coagulation abnormalities should be emphasized in international sepsis guidelines
AbstractIt is generally accepted that a coagulation/fibrinolysis disorder is involved in the pathogenesis of sepsis, and the association of disseminated intravascular coagulation (DIC) and poor outcomes have been reported. Based on these findings, recently released “Japanese Surviving Sepsis Campaign guidelines 2020” recommend the diagnosis of DIC and the application of anticoagulants for sepsis-associated DIC. Meanwhile, the updated “International Guidelines for the Management of Sepsis and Septic Shock 2021” did not mention coagulation abnormalities or DIC. Because management strategies continue to evolve to prov...
Source: Journal of Intensive Care - January 21, 2022 Category: Intensive Care Source Type: research
Noninvasive respiratory support for COVID-19 patients: when, for whom, and how?
AbstractThe significant mortality rate and prolonged ventilator days associated with invasive mechanical ventilation (IMV) in patients with severe COVID-19 have incited a debate surrounding the use of noninvasive respiratory support (NIRS) (i.e., HFNC, CPAP, NIV) as a potential treatment strategy. Central to this debate is the role of NIRS in preventing intubation in patients with mild respiratory disease and the potential beneficial effects on both patient outcome and resource utilization. However, there remains valid concern that use of NIRS may prolong time to intubation and lung protective ventilation in patients with ...
Source: Journal of Intensive Care - January 15, 2022 Category: Intensive Care Source Type: research
Association between the plasma-to-red blood cell ratio and survival in geriatric and non-geriatric trauma patients undergoing massive transfusion: a retrospective cohort study
ConclusionThe association of the non-geriatric age category and plasma-to-RBC ratio for in-hospital mortality was clearly demonstrated. However, the relationship between the plasma-to-RBC ratio with mortality among geriatric patients remains inconclusive. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 11, 2022 Category: Intensive Care Source Type: research
Esmolol response in septic shock patients in relation to vascular waterfall phenomenon measured by critical closure pressure and mean systemic filling pressure: a prospective observational study
ConclusionPatients with septic shock whose heart rate is greater than 95 beats/min after hemodynamic optimization were treated with esmolol, which could effectively control heart rate and reduce CI, as well as improve Pcc and increase the difference between Pcc and Pmsf (known as “vascular waterfall” phenomenon), without affecting MAP, CVP, Pmsf and arteriovenous vascular resistance, and improve the balance of oxygen supply and demand in the body. (Source: Journal of Intensive Care)
Source: Journal of Intensive Care - January 4, 2022 Category: Intensive Care Source Type: research
