Measurement of arterial pressure is one of the most basic elements of patient management. Arterial pressure is determined by the volume ejected by the heart into the arteries, the elastance of the walls of the...
In critical care when unconscious patients are assisted by machines, humanity is mainly ensured by respect for autonomy, realised through advance directives or, mostly, reconstructed by cooperation with relati...
Authors: Nicola Grignoli, Valentina Di Bernardo and Roberto Malacrida
Subsequent bloodstream infections (sBSI) occur with a delay after removal of the intravascular catheter (IVC) whose tip revealed microbial growth. Here we describe the epidemiology of sBSI in the intensive car...
Authors: Niccolò Buetti, Elia Lo Priore, Rami Sommerstein, Andrew Atkinson, Andreas Kronenberg and Jonas Marschall
Two recent publications by Sheikh and Horner and Teng et al. reviewed studies on incorporating vitamin C to treat septic patients; however, a meta-analysis was not offered in either report. This commentary ext...
Research on acute kidney injury (AKI) has focused on identifying early biomarkers. However, whether AKI could be diagnosed in the absence of the classic signs of clinical AKI and whether the condition of subcl...
Authors: Fang Fang, Xiaohan Hu, Xiaomei Dai, Sanfeng Wang, Zhenjiang Bai, Jiao Chen, Jian Pan, Xiaozhong Li, Jian Wang and Yanhong Li
Despite aggressive application of continuous renal replacement therapy (CRRT) in critically ill patients with acute kidney injury (AKI), there is no consensus on diuretic therapy when discontinuation of CRRT i...
Authors: Junseok Jeon, Do Hee Kim, Song In Baeg, Eun Jeong Lee, Chi Ryang Chung, Kyeongman Jeon, Jung Eun Lee, Wooseong Huh, Gee Young Suh, Yoon-Goo Kim, Dae Joong Kim, Ha Young Oh and Hye Ryoun Jang
Acute-on-chronic liver failure (ACLF) is a severe complication of cirrhosis and is defined by organ failure and high rates of short-term mortality. Patients with ACLF are managed with multiorgan support in the...
Authors: Cornelius Engelmann, Karen Louise Thomsen, Nekisa Zakeri, Mohammed Sheikh, Banwari Agarwal, Rajiv Jalan and Rajeshwar P. Mookerjee
Ischemic stroke causes brain inflammation, which we postulate may result in lung damage. Several studies have focused on stroke-induced immunosuppression and lung infection; however, the possibility that strok...
Authors: Cynthia S. Samary, Alane B. Ramos, Lígia A. Maia, Nazareth N. Rocha, Cíntia L. Santos, Raquel F. Magalhães, Amanda L. Clevelario, Pedro M. Pimentel-Coelho, Rosália Mendez-Otero, Fernanda F. Cruz, Vera L. Capelozzi, Tatiana P. T. Ferreira, Thea Koch, Marcelo Gama de Abreu, Claudia C. dos Santos, Paolo Pelosi…
This study investigated changes in plasma level of soluble endothelial protein C receptor (sEPCR) in association with outcome in patients with septic shock. We explored sEPCR for early sepsis prognosis assessm...
High noise levels in the intensive care unit (ICU) are a well-known problem. Little is known about the effect of noise on sleep quality in ICU patients. The study aim is to determine the effect of noise on sub...
Authors: Koen S. Simons, Eva Verweij, Paul M. C. Lemmens, Sam Jelfs, Munhum Park, Peter E. Spronk, Johannes P. C. Sonneveld, Hilde-Marieken Feijen, Marijke S. van der Steen, Armin G. Kohlrausch, Mark van den Boogaard and Cornelis P. C. de Jager
Previous studies have identified critical roles of IL-27 in the pathological mechanisms of sepsis, and blockade of IL-27 may be a promising alternative therapy for sepsis. The purpose of this study was to eval...
Authors: Junbing He, Quanfu Zhang, Wenying Zhang, Feng Chen, Tian Zhao, Yao Lin, Jia Li, Yansong Liu, Yuchun Liu and Yiming Shao
Nutritional support continues to receive much attention as a possible intervention to prevent loss of lean tissue mass, promote recovery and re-establish proper immune function in critical care patients. Yet t...
Authors: Gustav van Niekerk, Tanja Davis, Willem de Villiers and Anna-Mart Engelbrecht
Percutaneous tracheostomy (PT) is a common procedure in critical care medicine. No definite clinical practice guidelines recommended on the choice of the direction of skin incision, vertical or transverse for ...
Authors: Sung Yoon Lim, Won Gun Kwack, Youlim Kim, Yeon Joo Lee, Jong Sun Park, Ho Il Yoon, Jae Ho Lee, Choon-Taek Lee and Young-Jae Cho
The use of in vivo videomicroscopy at the bedside has demonstrated microcirculatory flow disturbances in sepsis. The ability of in vivo videomicroscopy to detect changes in the prevalence of rolling and adhere...
Authors: Bjorn K. Fabian-Jessing, Michael J. Massey, Michael R. Filbin, Peter C. Hou, Henry E. Wang, Hans Kirkegaard, Donald M. Yealy, William C. Aird, John A. Kellum, Derek C. Angus and Nathan I. Shapiro
Preparing an antibiotic stewardship program requires detailed information on overall antibiotic use, prescription indication and ecology. However, longitudinal data of this kind are scarce. Computerization of ...
Authors: Liesbet De Bus, Bram Gadeyne, Johan Steen, Jerina Boelens, Geert Claeys, Dominique Benoit, Jan De Waele, Johan Decruyenaere and Pieter Depuydt
Concepts for optimizing mechanical ventilation focus mainly on modifying the inspiratory phase. We propose flow-controlled expiration (FLEX) as an additional means for lung protective ventilation and hypothesi...
Authors: Silke Borgmann, Johannes Schmidt, Ulrich Goebel, Joerg Haberstroh, Josef Guttmann and Stefan Schumann
The prognosis in refractory out-of-hospital cardiac arrest (OHCA) with ongoing cardiopulmonary resuscitation (CPR) at hospital arrival is often considered dismal. The use of extracorporeal cardiopulmonary resu...
Authors: Emilie Gregers, Jesper Kjærgaard, Freddy Lippert, Jakob H. Thomsen, Lars Køber, Michael Wanscher, Christian Hassager and Helle Søholm
Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) reduce colonization with antibiotic-resistant Gram-negative bacteria (ARGNB), incidence of nosocomial in...
Authors: E. de Jonge, R. B. P. de Wilde, N. P. Juffermans, E. A. N. Oostdijk, A. T. Bernards, E. H. R. van Essen, E. J. Kuijper, C. E. Visser, J. Kesecioglu and M. J. M. Bonten
There is controversy around the prescription of adjunct corticosteroids in patients with fluid-refractory septic shock, and studies provide mixed results, showing benefit, no benefit, and harm. Traditional mea...
Authors: Matthew N. Alder, Amy M. Opoka and Hector R. Wong
Commensal microbiota deteriorate in critically ill patients. The preventive effects of probiotic/synbiotic therapy on microbiota and septic complications have not been thoroughly clarified in patients with sep...
Diaphragm dysfunction develops frequently in ventilated intensive care unit (ICU) patients. Both disuse atrophy (ventilator over-assist) and high respiratory muscle effort (ventilator under-assist) seem to be ...
Authors: Diana Jansen, Annemijn H. Jonkman, Lisanne Roesthuis, Suvarna Gadgil, Johannes G. van der Hoeven, Gert-Jan J. Scheffer, Armand Girbes, Jonne Doorduin, Christer S. Sinderby and Leo M. A. Heunks
A reanalysis of the ALBIOS trial suggested that patients with septic shock - defined by vasopressor-dependent hypotension in the presence of severe sepsis (Shock-2) - had a survival benefit when treated with a...
Authors: Francesco Vasques, Eleonora Duscio, Federica Romitti, Iacopo Pasticci, Pietro Caironi, Jennifer Meessen, Roberto Latini, Massimo Cressoni, Luigi Camporota, Antonio Pesenti, Roberto Fumagalli, Michael Quintel and Luciano Gattinoni
Antimicrobials are among the most important and commonly prescribed drugs in the management of critically ill patients and beta-lactams are the most common antibiotic class used. Critically ill patient’s patho...
There is a lack of large-scale epidemiological data on the clinical practice of enteral nutrition (EN) feeding in China. This study aimed to provide such data on Chinese hospitals and to investigate factors as...
Although net ultrafiltration (UFNET) is frequently used for treatment of fluid overload in critically ill patients with acute kidney injury, the optimal intensity of UFNET is unclear. Among critically ill patient...
Authors: Raghavan Murugan, Vikram Balakumar, Samantha J. Kerti, Priyanka Priyanka, Chung-Chou H. Chang, Gilles Clermont, Rinaldo Bellomo, Paul M. Palevsky and John A. Kellum
Patients liberated from invasive mechanical ventilation are at risk of extubation failure, including inability to breathe without a tracheal tube (airway failure) or without mechanical ventilation (non-airway ...
Sepsis is a major contributor to the global burden of disease. The majority of sepsis cases and deaths are estimated to occur in low and middle-income countries. Barriers to reducing the global burden of sepsi...
Authors: Kristina E. Rudd, Niranjan Kissoon, Direk Limmathurotsakul, Sotharith Bory, Birungi Mutahunga, Christopher W. Seymour, Derek C. Angus and T. Eoin West
The open lung approach (OLA) reportedly has lung-protective effects against acute respiratory distress syndrome (ARDS). Recently, lowering of the driving pressure (ΔP), rather than improvement in lung aeration...
Authors: Kentaro Tojo, Tasuku Yoshida, Takuya Yazawa and Takahisa Goto
Frailty is a state of vulnerability to poor resolution of homeostasis after a stressor event and is strongly associated with adverse outcomes. Therefore, the assessment of frailty may be an essential part of e...
Authors: Ralph K. L. So, Jonathan Bannard-Smith, Chris P. Subbe, Daryl A. Jones, Joost van Rosmalen and Geoffrey K. Lighthall
For critically ill patients, effective airway management with a high first-attempt success rate for endotracheal intubation is essential to prevent hypoxic complications during securing of the airway. Video gu...
Authors: Jörn Grensemann, Lars Eichler, Nuowei Wang, Dominik Jarczak, Marcel Simon and Stefan Kluge
Electrical impedance tomography (EIT) has been used to guide mechanical ventilation in ICU patients with lung collapse. Its use in patients with obstructive pulmonary diseases has been rare since obstructions ...
Authors: Christian Karagiannidis, Andreas D. Waldmann, Péter L. Róka, Tina Schreiber, Stephan Strassmann, Wolfram Windisch and Stephan H. Böhm
Neurocritical illness is a growing healthcare problem with profound socioeconomic effects. We assessed differences in healthcare costs and long-term outcome for different forms of neurocritical illnesses treat...
Authors: R. Raj, S. Bendel, M. Reinikainen, S. Hoppu, R. Laitio, T. Ala-Kokko, S. Curtze and M. B. Skrifvars
Continuous electroencephalography (cEEG), interpreted by an experienced neurologist, has been reported to be useful in predicting neurological outcome in adult patients post cardiac arrest. Amplitude-integrate...
Nitric oxide (NO) regulates processes involved in sepsis progression, including vascular and immune function. NO is generated by nitric oxide synthases (NOS) from L-arginine. Cellular L-arginine uptake is inhi...
Authors: Martin Sebastian Winkler, Axel Nierhaus, Gilbert Rösler, Susanne Lezius, Olaf Harlandt, Edzard Schwedhelm, Rainer H. Böger and Stefan Kluge
Despite timely intervention, there exists a small subgroup of patients with septic shock who develop progressive multi-organ failure. Seemingly refractory to conventional therapy, they exhibit a very high mort...
Authors: Prashanth Nandhabalan, Nicholas Ioannou, Christopher Meadows and Duncan Wyncoll
Sudden cardiac arrest (SCA) accounts for half of all cardiac deaths in Europe. In recent years, large-scale SCA registries have been set up to enable observational studies into risk factors and the effect of t...
Authors: Marieke A. R. Bak, Marieke T. Blom, Hanno L. Tan and Dick L. Willems
Despite increasing female enrolment into medical schools, persistent gender gaps exist in the physician workforce. There are limited published data on female representation in the critical care medicine workfo...
Authors: Bala Venkatesh, Sangeeta Mehta, Derek C. Angus, Simon Finfer, Flavia R. Machado, John Marshall, Imogen Mitchell, Sandra Peake and Janice L. Zimmerman
