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
Acute respiratory distress syndrome (ARDS) and hospital-acquired pneumonia (HAP) are major problems of public health in intensive care units (ICUs), occurring in 15% of critically ill patients. Among the facto...
Authors: Nathalie De Freitas Caires, Alexandre Gaudet, Lucie Portier, Anne Tsicopoulos, Daniel Mathieu and Philippe Lassalle
Recent randomized trials have not found that polymyxin B hemoperfusion (PMX-HP) improves outcomes for patients with sepsis. However, it remains unclear whether the therapy could provide benefit for highly sele...
Authors: Nattachai Srisawat, Somkanya Tungsanga, Nuttha Lumlertgul, Chalermchai Komaenthammasophon, Sadudee Peerapornratana, Nicha Thamrongsat, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Kriang Tungsanga and John A. Kellum
The continuous administration of opioids in critical care patients is a common therapy for the tolerance of mechanical ventilation. Opioid choice has a crucial impact on the length of mechanical ventilation. O...
Authors: Daniel A Klaus, Albert M de Bettignies, Rudolf Seemann, Claus G Krenn and Georg A Roth
Central line-associated bloodstream infections (CLABSIs) are associated with increased mortality, hospital length of stay, and cost. Antimicrobial treatment guidelines for CLABSIs are primarily based on expert...
Authors: Luis E Huerta, George E Nelson, Thomas G Stewart and Todd W Rice
Authors: João Gabriel Rosa Ramos, Roberto D’Oliveira Vieira, Fernanda Correia Tourinho, Andre Ismael, Diaulas Costa Ribeiro, Humberto Jacques de Medeiro and Daniel Neves Forte
Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currentl...
Authors: M Consuelo Bachmann, Caio Morais, Guillermo Bugedo, Alejandro Bruhn, Arturo Morales, João B Borges, Eduardo Costa and Jaime Retamal
Sepsis is one of the leading causes of morbidity and mortality worldwide. It is characterized by a dysregulated immune response to infections that results in life-threatening organ dysfunction and even death. ...
Authors: Ghada Ankawi, Mauro Neri, Jingxiao Zhang, Andrea Breglia, Zaccaria Ricci and Claudio Ronco
The rationale for the provision of nitrogen from proteins given via the enteral route or from intravenous amino acids is to boost the synthesis of muscle proteins, and thereby to limit the severity of intensiv...
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...
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...
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
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
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…
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
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
