Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this...
Following a fatal intensive care unit (ICU) outbreak of carbapenem-resistant Acinetobacter baumanii (CRAB) in 2015, an aggressive infection control intervention was instituted. We outline the intervention and lon...
Authors: Eli Ben-Chetrit, Yonit Wiener-Well, Emil Lesho, Puah Kopuit, Chaya Broyer, Liora Bier, Marc V. Assous, Shmuel Benenson, Matan J. Cohen, Patrick T. McGann, Erik Snesrud and Phillip D. Levin
Patients in refractory status epilepticus (RSE) may require treatment with continuous intravenous anesthetic drugs (cIVADs) for seizure control. The use of cIVADs, however, was recently associated with poor ou...
Authors: Dominik Madžar, Caroline Reindl, Antje Giede-Jeppe, Tobias Bobinger, Maximilian I. Sprügel, Ruben U. Knappe, Hajo M. Hamer and Hagen B. Huttner
Iron deficiency is difficult to diagnose in critically ill patients, but may be frequent and may impair recovery. Measurement of hepcidin could help in the diagnosis of iron deficiency. We aim to assess if iro...
The interaction between hyperaldosteronism and immune dysfunction has been reported and glucocorticoid co-secretion is frequently found in primary aldosteronism (PA). The aforementioned conditions raise the po...
Septic shock is the most severe complication of sepsis and this syndrome is associated with high mortality. Treatment of septic shock remains largely supportive of hemodynamics and tissue perfusion. Early chan...
Reports of increasing incidence rates of delirium in critically ill children are reason for concern. We evaluated the measurement properties of the pediatric delirium component (PD-scale) of the Sophia Observa...
Authors: Erwin Ista, Babette van Beusekom, Joost van Rosmalen, Martin C. J. Kneyber, Joris Lemson, Arno Brouwers, Gwen C. Dieleman, Bram Dierckx, Matthijs de Hoog, Dick Tibboel and Monique van Dijk
We sought to determine the effects of alternative resuscitation strategies on microcirculatory perfusion and examine any association between microcirculatory perfusion and mortality in sepsis.
Authors: Michael J. Massey, Peter C. Hou, Michael Filbin, Henry Wang, Long Ngo, David T. Huang, William C. Aird, Victor Novack, Stephen Trzeciak, Donald M. Yealy, John A. Kellum, Derek C. Angus and Nathan I. Shapiro
Despite modern intensive care with standardized strategies against acute respiratory distress syndrome (ARDS), Pneumocystis pneumonia (PcP) remains a life-threatening disease with a high mortality rate. Here, we ...
Authors: Julius J. Schmidt, Catherina Lueck, Stefan Ziesing, Matthias Stoll, Hermann Haller, Jens Gottlieb, Matthias Eder, Tobias Welte, Marius M. Hoeper, André Scherag and Sascha David
We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation.
Authors: Ernest van Veen, Mathieu van der Jagt, Maryse C. Cnossen, Andrew I. R. Maas, Inez D. de Beaufort, David K. Menon, Giuseppe Citerio, Nino Stocchetti, Wim J. R. Rietdijk, Jeroen T. J. M. van Dijck and Erwin J. O. Kompanje
Acute kidney injury (AKI) is associated with high morbidity and mortality in surgical patients. Nonrecovery from AKI may increase mortality and early risk stratification seems key to improving clinical outcome...
Authors: Hui-Miao Jia, Yue Zheng, Li-Feng Huang, Xin Xin, Wen-Liang Ma, Yi-Jia Jiang, Xi Zheng, Shu-Yan Guo and Wen-Xiong Li
High tidal volume ventilation of healthy lungs or exacerbation of existing acute lung injury (ALI) by more moderate mechanical ventilation (MTV) produces ventilator-induced lung injury. It is less clear whethe...
Authors: Xibing Ding, Yao Tong, Shuqing Jin, Zhixia Chen, Tunliang Li, Timothy R. Billiar, Bruce R. Pitt, Quan Li and Li-Ming Zhang
Aerosolized antibiotics have been proposed as a novel and promising treatment option for the treatment of ventilator-associated pneumonia (VAP). However, the optimum aerosolized antibiotics for VAP remain unce...
Authors: Feng Xu, Lu-Lu He, Luan-Qing Che, Wen Li, Song-Min Ying, Zhi-Hua Chen and Hua-Hao Shen
Glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) are incretin hormones. By lowering blood glucose in a glucose-dependent manner, incretin-based therapies represent a novel and...
Authors: Abraham H Hulst, Mark P Plummer, Markus W Hollmann, J Hans DeVries, Benedikt Preckel, Adam M Deane and Jeroen Hermanides
Whether goal-directed fluid therapy based on dynamic predictors of fluid responsiveness (GDFTdyn) alone improves clinical outcomes in comparison with standard fluid therapy among patients undergoing surgery re...
Available evidence from randomized controlled trials including adult critically ill patients tends to show that percutaneous dilatational tracheostomy (PDT) techniques are performed faster and reduce stoma inf...
Authors: Maria Vargas, Pasquale Buonanno, Lina Giorgiano, Giovanna Sorriento, Carmine Iacovazzo and Giuseppe Servillo
Selective decontamination of the digestive tract (SDD) has been with us since the early days of our specialty, and in some ways it marks our progression and maturation. How we have dealt with SDD to date range...
Shift work can disturb circadian homeostasis and result in fatigue, excessive sleepiness, and reduced quality of life. Light therapy has been shown to impart positive effects in night shift workers. We sought ...
Authors: John E. Griepentrog, Hanna E. Labiner, Scott R. Gunn and Matthew R. Rosengart
Procalcitonin (PCT) testing can help in safely reducing antibiotic treatment duration in intensive care patients with sepsis. However, the cost-effectiveness of such PCT guidance is not yet known.
Authors: Michelle M. A. Kip, Jos A. van Oers, Arezoo Shajiei, Albertus Beishuizen, A. M. Sofie Berghuis, Armand R. Girbes, Evelien de Jong, Dylan W. de Lange, Maarten W. N. Nijsten, Maarten J. IJzerman, Hendrik Koffijberg and Ron Kusters
Community-acquired pneumonia (CAP) remains a major cause of death worldwide. Mechanisms underlying the detrimental outcome despite adequate antibiotic therapy and comorbidity management are still not fully und...
Authors: Sarah Berger, Cengiz Goekeri, Shishir K. Gupta, Julio Vera, Kristina Dietert, Ulrike Behrendt, Jasmin Lienau, Sandra-Maria Wienhold, Achim D. Gruber, Norbert Suttorp, Martin Witzenrath and Geraldine Nouailles
Acute respiratory failure occurs frequently in hospitalized patients and often starts before ICU admission. A risk stratification tool to predict mortality and risk for mechanical ventilation (MV) may allow fo...
Authors: Mikhail A Dziadzko, Paul J Novotny, Jeff Sloan, Ognjen Gajic, Vitaly Herasevich, Parsa Mirhaji, Yiyuan Wu and Michelle Ng Gong
Given the pathophysiological key role of the host response to an infection rather than the infection per se, an ideal therapeutic strategy would also target this response. This study was designed to demonstrat...
Authors: Hannah Knaup, Klaus Stahl, Bernhard M. W. Schmidt, Temitayo O. Idowu, Markus Busch, Olaf Wiesner, Tobias Welte, Hermann Haller, Jan T. Kielstein, Marius M. Hoeper and Sascha David
Intensive care unit (ICU) outcome prediction models, such as Acute Physiology And Chronic Health Evaluation (APACHE), were designed in general critical care populations and their use in obstetric populations i...
Authors: Beth A. Payne, Helen Ryan, Jeffrey Bone, Laura A. Magee, Alice B. Aarvold, J. Mark Ansermino, Zulfiqar A. Bhutta, Mary Bowen, J. Guilherme Cecatti, Cynthia Chazotte, Tim Crozier, Anne-Cornélie J. M. de Pont, Oktay Demirkiran, Tao Duan, Marlot Kallen, Wessel Ganzevoort…
Whether perioperative hyperchloremia can induce postoperative acute kidney injury (AKI) is controversial. We investigated the association between perioperative hyperchloremia and postoperative AKI in patients ...
Authors: Tak Kyu Oh, In-Ae Song, Se Joong Kim, Sung Yoon Lim, Sang-Hwan Do, Jung-Won Hwang, Jinhee Kim and Young-Tae Jeon
Critical illness results in millions of deaths each year. Care for those with critical illness is often neglected due to a lack of prioritisation, co-ordination, and coverage of timely identification and basic...
Authors: Carl Otto Schell, Martin Gerdin Wärnberg, Anna Hvarfner, Andreas Höög, Ulrika Baker, Markus Castegren and Tim Baker
The combination of thiamine, ascorbic acid, and hydrocortisone has recently emerged as a potential adjunctive therapy to antibiotics, infectious source control, and supportive care for patients with sepsis and...
Authors: Ari Moskowitz, Lars W. Andersen, David T. Huang, Katherine M. Berg, Anne V. Grossestreuer, Paul E. Marik, Robert L. Sherwin, Peter C. Hou, Lance B. Becker, Michael N. Cocchi, Pratik Doshi, Jonathan Gong, Ayan Sen and Michael W. Donnino
Antibiotic exposure alters the microbiota, which can impact the inflammatory immune responses. Critically ill patients frequently receive antibiotic treatment and are often subjected to mechanical ventilation,...
Authors: Sandra-Maria Wienhold, Mario Macrì, Geraldine Nouailles, Kristina Dietert, Corinne Gurtner, Achim D Gruber, Markus M Heimesaat, Jasmin Lienau, Fabian Schumacher, Burkhard Kleuser, Bastian Opitz, Norbert Suttorp, Martin Witzenrath and Holger C Müller-Redetzky
The burgeoning literature on vitamin D deficiency and supplementation over the past decade or so has generated a greater understanding of some areas but also an appreciation of the many areas of equipoise. Thi...
Authors: Priya Nair, Balasubramaniam Venkatesh and Jacqueline R Center
Metabolic alkalosis is common in patients with respiratory failure and may delay weaning in mechanically ventilated patients. Carbonic anhydrase inhibitors block renal bicarbonate reabsorption, and thus revers...
Authors: Bassem Y Tanios, Maryam O Omran, Carlos Noujeim, Tamara Lotfi, Samir S Mallat, Pierre K Bou-Khalil, Elie A Akl and Houssam S Itani
Sepsis is a life-threatening medical emergency requiring early diagnosis and urgent treatment. Knowledge is crucial, especially in major risk groups such as the elderly. We therefore assessed sophisticated kno...
Authors: Sarah Eitze, Carolin Fleischmann-Struzek, Cornelia Betsch and Konrad Reinhart
Pathogenic enteric bacteria aspirated from the oropharynx are the main cause of ventilator-associated pneumonia (VAP). Using chlorhexidine (CHX) orally or selective decontamination has been shown to reduce VAP...
Authors: Bengt Klarin, Anne Adolfsson, Anders Torstensson and Anders Larsson
Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically...
Authors: Jerrold H. Levy, Matthew D. Neal and Jay H. Herman
Extracorporeal membrane oxygenation (ECMO) is a cardiorespiratory support technique for patients with circulatory or pulmonary failure. Frequently, large-volume fluid resuscitation is needed to ensure sufficie...
Authors: Hyoungnae Kim, Jin Hyuk Paek, Joo Han Song, Hajeong Lee, Jong Hyun Jhee, Seohyun Park, Hae-Ryong Yun, Youn Kyung Kee, Seung Hyeok Han, Tae-Hyun Yoo, Shin-Wook Kang, Sejoong Kim and Jung Tak Park
Sepsis and related multiple organ dysfunction result in high morbidity and mortality. Angiotensin (Ang)-(1–7), a biologically active peptide, has various opposing effects of Ang II. Because the effect of Ang-(...
Authors: Hsin-Jung Tsai, Mei-Hui Liao, Chih-Chin Shih, Shuk-Man Ka, Cheng-Ming Tsao and Chin-Chen Wu
Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The...
Authors: Andrew J. Boyle, Fabiana Madotto, John G. Laffey, Giacomo Bellani, Tài Pham, Antonio Pesenti, B. Taylor Thompson, Cecilia M. O’Kane, Adam M. Deane and Daniel F. McAuley
