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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 - January 4, 2022 Category: Intensive Care Source Type: research

β1-blocker in sepsis
ConclusionAccumulating evidence is supporting the use of ultrashort-acting β1-blockers while larger randomized controlled trials to clarify the effect of ultrashort-acting β1-blockers are still warranted.
Source: Journal of Intensive Care - May 8, 2021 Category: Intensive Care Source Type: research

Thromboembolic disease in COVID-19 patients: A brief narrative review
AbstractCorona virus 2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. Incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease and is seen in a multitude of organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and over production of proinflammatory cytokines mimicking a “cytokine storm” which leads to multiorgan failure. This brief narrative review highlights the pathophysiolo...
Source: Journal of Intensive Care - September 13, 2020 Category: Intensive Care Source Type: research

Enhanced renal clearance and impact on vancomycin pharmacokinetic parameters in patients with hemorrhagic stroke
ConclusionsPatients with hemorrhagic stroke and enhanced renal clearance displayed PK alterations favoring an increased elimination of vancomycin than expected. This may result in underexposure to vancomycin, leading to treatment failure.
Source: Journal of Intensive Care - November 20, 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 - January 15, 2019 Category: Intensive Care Source Type: research

Immunosenescence in neurocritical care
ConclusionIn neuro ICUs, several neuro-related diseases including stroke and sepsis-associated encephalopathy are related to immunosenescence and neuroinflammation in the elderly. Several advanced countries with superaged societies face the new challenge of improving the long-term prognosis of neurocritical patients.
Source: Journal of Intensive Care - October 12, 2018 Category: Intensive Care Source Type: research

Transient hyperlactatemia during intravenous administration of glycerol: a prospective observational study
ConclusionsIntravenous administration of glycerol leads to higher blood lactate levels that persist for up to 120  min. Although hyperlactatemia is an essential indicator of sepsis and/or impaired tissue perfusion, physicians should be aware of this phenomenon when assessing the blood lactate levels.
Source: Journal of Intensive Care - August 28, 2018 Category: Intensive Care Source Type: research

Extrasystoles for fluid responsiveness prediction in critically ill patients
ConclusionsBased on standard critical care monitoring, analysis of the extrasystolic post-ectopic beat predicts fluid responsiveness in critical care patients with good accuracy. The presented results are considered preliminary proof-of-concept results, and further validation is needed to confirm these preliminary findings.
Source: Journal of Intensive Care - August 22, 2018 Category: Intensive Care Source Type: research

Heat stroke
ConclusionThe effectiveness of cooling devices, drugs, and therapies in heat stroke remains inconclusive. Further large studies are required to continue to evaluate these treatment strategies.
Source: Journal of Intensive Care - May 22, 2018 Category: Intensive Care Source Type: research

Early versus late tracheostomy after decompressive craniectomy for stroke
ConclusionEarly tracheostomy shortens duration of mechanical ventilation and length of stay after surgical decompression for stroke, but it did not impact mortality or VAP rates. A decision tree is a practical tool that may be helpful in guiding pre-operative decision-making with patients ’ families.
Source: Journal of Intensive Care - January 4, 2018 Category: Intensive Care Source Type: research

Passive leg raising test with minimally invasive monitoring: the way forward for guiding septic shock resuscitation?
ConclusionsThe passive leg raising maneuver in combination with real-time measurement of cardiac output changes is an easy-to-use, fast, relatively unbiased, and accurate bedside test to guide fluid management during septic shock.
Source: Journal of Intensive Care - June 8, 2017 Category: Intensive Care Source Type: research

Predicting the Need for Fluid Therapy —Does Fluid Responsiveness Work?
AbstractFluid overdose can be harmful in critically ill patients. Since central venous pressure (CVP) is currently considered to be an inappropriate indicator of preload, much attention is being given to predicting fluid responsiveness, i.e., the response of stroke volume (SV) or cardiac output (CO) to fluid challenge. However, when fluid responsiveness was evaluated in critically ill patients, including sepsis, only 40 –50% of the patients responded. Moreover, most fluid responders do not show significant hemodynamic improvement after fluid administration. In this review, we discuss why fluid responsiveness based on the...
Source: Journal of Intensive Care - June 6, 2017 Category: Intensive Care Source Type: research

Heat stroke with bimodal rhabdomyolysis: a case report and review of the literature
ConclusionsPhysicians should pay special attention to the stress of rehabilitation exercises, which may cause collapsed muscles that are injured by severe heat stroke to repeatedly flare up.
Source: Journal of Intensive Care - November 30, 2016 Category: Intensive Care Source Type: research

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