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Covert Consciousness in the ICU. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-15 Brian L Edlow, David K Menon
For critically ill patients with acute severe brain injuries, consciousness may reemerge before behavioral responsiveness. The phenomenon of covert consciousness (i.e., cognitive motor dissociation) may be detected by advanced neurotechnologies such as task-based functional MRI (fMRI) and electroencephalography (EEG) in patients who appear unresponsive on the bedside behavioral examination. In this
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Toward Precision in Critical Care Research: Methods for Observational and Interventional Studies. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-15 Emma J Graham Linck, Ewan C Goligher, Matthew W Semler, Matthew M Churpek
Critical care trials evaluate the effect of interventions in patients with diverse personal histories and causes of illness, often under the umbrella of heterogeneous clinical syndromes, such as sepsis or acute respiratory distress syndrome. Given this variation, it is reasonable to expect that the effect of treatment on outcomes may differ for individuals with variable characteristics. However, in
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Healthcare Use and Expenditures in Rural Survivors of Hospitalization for Sepsis. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-13 Kyle R Stinehart, J Madison Hyer, Shivam Joshi, Nathan E Brummel
Sepsis survivors have greater healthcare use than those surviving hospitalizations for other reasons, yet factors associated with greater healthcare use in this population remain ill-defined. Rural Americans are older, have more chronic illnesses, and face unique barriers to healthcare access, which could affect postsepsis healthcare use. Therefore, we compared healthcare use and expenditures among
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Combination of Hydrogen Inhalation and Hypothermic Temperature Control After Out-of-Hospital Cardiac Arrest: A Post hoc Analysis of the Efficacy of Inhaled Hydrogen on Neurologic Outcome Following Brain Ischemia During PostCardiac Arrest Care II Trial. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-12 Tomoyoshi Tamura, Hiromichi Narumiya, Koichiro Homma, Masaru Suzuki
The Efficacy of Inhaled Hydrogen on Neurologic Outcome Following Brain Ischemia During Post-Cardiac Arrest Care (HYBRID) II trial (jRCTs031180352) suggested that hydrogen inhalation may reduce post-cardiac arrest brain injury (PCABI). However, the combination of hypothermic target temperature management (TTM) and hydrogen inhalation on outcomes is unclear. The aim of this study was to investigate the
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Machine Learning Tools for Acute Respiratory Distress Syndrome Detection and Prediction. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-12 Francesca Rubulotta, Sahar Bahrami, Dominic C Marshall, Matthieu Komorowski
Machine learning (ML) tools for acute respiratory distress syndrome (ARDS) detection and prediction are increasingly used. Therefore, understanding risks and benefits of such algorithms is relevant at the bedside. ARDS is a complex and severe lung condition that can be challenging to define precisely due to its multifactorial nature. It often arises as a response to various underlying medical conditions
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ICU-Electroencephalogram Unit Improves Outcome in Status Epilepticus Patients: A Retrospective Before-After Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-08-09 Francesco Misirocchi, Hervé Quintard, Andreas Kleinschmidt, Karl Schaller, Jérôme Pugin, Margitta Seeck, Pia De Stefano
Continuous electroencephalogram (cEEG) monitoring is recommended for status epilepticus (SE) management in ICU but is still underused due to resource limitations and inconclusive evidence regarding its impact on outcome. Furthermore, the term "continuous monitoring" often implies continuous recording with variable intermittent review. The establishment of a dedicated ICU-electroencephalogram unit may
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Beneficial Effect of Calcium Treatment for Hyperkalemia Is Not Due to "Membrane Stabilization". Crit. Care Med. (IF 7.7) Pub Date : 2024-07-24 Joseph S Piktel, Xiaoping Wan, Shalen Kouk, Kenneth R Laurita, Lance D Wilson
Hyperkalemia is a common life-threatening condition causing severe electrophysiologic derangements and arrhythmias. The beneficial effects of calcium (Ca2+) treatment for hyperkalemia have been attributed to "membrane stabilization," by restoration of resting membrane potential (RMP). However, the underlying mechanisms remain poorly understood. Our objective was to investigate the mechanisms underlying
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From Traditional Typing to Intelligent Insights: A Narrative Review of Directions Toward Targeted Therapies in Delirium. Crit. Care Med. (IF 7.7) Pub Date : 2024-07-15 Kelly M Potter, Niall T Prendergast, J Gordon Boyd
Delirium is a heterogeneous syndrome characterized by an acute change in level of consciousness that is associated with inattention and disorganized thinking. Delirium affects most critically ill patients and is associated with poor patient-oriented outcomes such as increased mortality, longer ICU and hospital length of stay, and worse long-term cognitive outcomes. The concept of delirium and its subtypes
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Society of Critical Care Medicine and American Society of Health-System Pharmacists Guideline for the Prevention of Stress-Related Gastrointestinal Bleeding in Critically Ill Adults. Crit. Care Med. (IF 7.7) Pub Date : 2024-07-15 Robert MacLaren, Joanna C Dionne, Anders Granholm, Waleed Alhazzani, Paul M Szumita, Keith Olsen, Jeffrey F Barletta, Morten Hylander Møller, Constantine J Karvellas, Paul Wischmeyer, Ashley DePriest, Victor Carlos, Debora Argetsinger, John J Carothers, Rosemary Lee, Lena Napolitano, Dan Perri, Douglas F Naylor
Critically ill adults can develop stress-related mucosal damage from gastrointestinal hypoperfusion and reperfusion injury, predisposing them to clinically important stress-related upper gastrointestinal bleeding (UGIB).
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The Impact of Multi-Institution Datasets on the Generalizability of Machine Learning Prediction Models in the ICU. Crit. Care Med. (IF 7.7) Pub Date : 2024-07-03 Patrick Rockenschaub, Adam Hilbert, Tabea Kossen, Paul Elbers, Falk von Dincklage, Vince Istvan Madai, Dietmar Frey
To evaluate the transferability of deep learning (DL) models for the early detection of adverse events to previously unseen hospitals.
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Benefits and Harms of Procalcitonin- or C-Reactive Protein-Guided Antimicrobial Discontinuation in Critically Ill Adults With Sepsis: A Systematic Review and Network Meta-Analysis. Crit. Care Med. (IF 7.7) Pub Date : 2024-07-01 Kenji Kubo, Masaaki Sakuraya, Hiroshi Sugimoto, Nozomi Takahashi, Ken-Ichi Kano, Jumpei Yoshimura, Moritoki Egi, Yutaka Kondo
In sepsis treatment, antibiotics are crucial, but overuse risks development of antibiotic resistance. Recent guidelines recommended the use of procalcitonin to guide antibiotic cessation, but solid evidence is insufficient. Recently, concerns were raised that this strategy would increase recurrence. Additionally, optimal protocol or difference from the commonly used C-reactive protein (CRP) are uncertain
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The Association Between Elevated Myocardial Injury-Related Biomarker (TnI) and Increased Mortality in Patients With Severe Fever With Thrombocytopenia Syndrome. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-28 Boyun Liang, Ling Xu, Mingyue Li, Hua Wang, Sihong Lu, Lei Fan, Tong Wang, Junyuan Li, Bin Zhu, Junzhong Wang, Baoju Wang, Cheng Peng, Shu Shen, Xin Zheng
The objective of this study was to investigate the dynamic profiles of myocardial injury biomarkers and their association with mortality in patients with severe fever with thrombocytopenia syndrome (SFTS).
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Child Opportunity Index and Pediatric Extracorporeal Membrane Oxygenation Outcomes; the Role of Diagnostic Category. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-26 Faraz Alizadeh, Kimberlee Gauvreau, Jessica A Barreto, Matt Hall, Emily Bucholz, Meena Nathan, Jane W Newburger, Sally Vitali, Ravi R Thiagarajan, Titus Chan, Katie M Moynihan
To study the impact of social determinants of health (SDoH) on pediatric extracorporeal membrane oxygenation (ECMO) outcomes.
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Lung-Protective Ventilation for Pediatric Acute Respiratory Distress Syndrome: A Nonrandomized Controlled Trial. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-26 Judith Ju Ming Wong, Hongxing Dang, Chin Seng Gan, Phuc Huu Phan, Hiroshi Kurosawa, Kazunori Aoki, Siew Wah Lee, Jacqueline Soo May Ong, Lijia Fan, Chian Wern Tai, Soo Lin Chuah, Pei Chuen Lee, Yek Kee Chor, Louise Ngu, Nattachai Anantasit, Chunfeng Liu, Wei Xu, Dyah Kanya Wati, Suparyatha Ida Bagus Gede, Muralidharan Jayashree, Felix Liauw, Kah Min Pon, Li Huang, Jia Yueh Chong, Xuemei Zhu, Kam Lun
Despite the recommendation for lung-protective mechanical ventilation (LPMV) in pediatric acute respiratory distress syndrome (PARDS), there is a lack of robust supporting data and variable adherence in clinical practice. This study evaluates the impact of an LPMV protocol vs. standard care and adherence to LPMV elements on mortality. We hypothesized that LPMV strategies deployed as a pragmatic protocol
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Characteristics of Patients Hospitalized in Rural and Urban ICUs From 2010 to 2019. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-26 Emily A Harlan, Muhammad Ghous, Ira S Moscovice, Thomas S Valley
Rural hospitals are threatened by workforce shortages and financial strain. To optimize regional critical care delivery, it is essential to understand what types of patients receive intensive care in rural and urban hospitals.
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Clinicians' Use of Choice Framing in ICU Family Meetings. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-24 Joanna L Hart, Leena Malik, Carrie Li, Amy Summer, Lon Ogunduyile, Jay Steingrub, Bernard Lo, Julian Zlatev, Douglas B White
To quantify the frequency and patterns of clinicians' use of choice frames when discussing preference-sensitive care with surrogate decision-makers in the ICU.
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Albumin Versus Balanced Crystalloid for the Early Resuscitation of Sepsis: An Open Parallel-Group Randomized Feasibility Trial. The ABC-Sepsis Trial. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-24 Alasdair J Gray, Katherine Oatey, Julia Grahamslaw, Sîan Irvine, John Cafferkey, Titouan Kennel, John Norrie, Tim Walsh, Nazir Lone, Daniel Horner, Andy Appelboam, Peter Hall, Richard J E Skipworth, Derek Bell, Kevin Rooney, Manu Shankar-Hari, Alasdair R Corfield
International guidelines recommend IV crystalloid as the primary fluid for sepsis resuscitation, with 5% human albumin solution (HAS) as the second line. However, it is unclear which fluid has superior clinical effectiveness. We conducted a trial to assess the feasibility of delivering a randomized controlled trial comparing balanced crystalloid against 5% HAS as sole early resuscitation fluid in patients
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Comparison of Catheter Malposition Between Left and Right Ultrasound-Guided Infraclavicular Subclavian Venous Catheterizations: A Randomized Controlled Trial. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-24 Kyung Won Shin, Seyong Park, Woo-Young Jo, Seungeun Choi, Yoon Jung Kim, Hee-Pyoung Park, Hyongmin Oh
Catheter malposition after subclavian venous catheterization (SVC) is not uncommon and can lead to serious complications. This study hypothesized that the left access is superior to the right access in terms of catheter malposition after ultrasound-guided infraclavicular SVC due to the asymmetry of the bilateral brachiocephalic veins.
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Extracorporeal Membrane Oxygenation and Reperfusion Strategies in High-Risk Pulmonary Embolism Hospitalizations. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-21 Ioannis T Farmakis, Ingo Sagoschen, Stefano Barco, Karsten Keller, Luca Valerio, Johannes Wild, George Giannakoulas, Gregory Piazza, Stavros V Konstantinides, Lukas Hobohm
To investigate the contemporary use of extracorporeal membrane oxygenation (ECMO) in conjunction with reperfusion strategies in high-risk pulmonary embolism (PE).
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A Core Outcome Set for Research Evaluating Interventions to Enable Communication in Patients With an Artificial Airway: An International Delphi Consensus Study (Comm-COS). Crit. Care Med. (IF 7.7) Pub Date : 2024-06-20 Amy Freeman-Sanderson, Martin B Brodsky, Craig Dale, Anushua Gupta, Kimberley Haines, Mary Beth Happ, Nicholas Hart, Bronwyn Hemsley, Laura Istanboulian, Peter Spronk, Rebecca Sullivan, Anna-Liisa Sutt, Louise Rose
Critically ill adults requiring artificial airways experience profound communication deficits. Studies of interventions supporting communication report disparate outcomes, creating subsequent challenges in the interpretation of their effectiveness. Therefore, we aimed to develop international consensus for a communication core outcome set (Comm-COS) for future trials of communication interventions
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The Road to Precision Medicine for Acute Kidney Injury. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-13 Bethany C Birkelo, Jay L Koyner, Marlies Ostermann, Pavan K Bhatraju
Acute kidney injury (AKI) is a common form of organ dysfunction in the ICU. AKI is associated with adverse short- and long-term outcomes, including high mortality rates, which have not measurably improved over the past decade. This review summarizes the available literature examining the evidence of the need for precision medicine in AKI in critical illness, highlights the current evidence for heterogeneity
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Validation of Math Model Using Porous Media for Determining Alveolar co2 in Ventilated Patients. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-10 L D Jiménez-Posada, A F Palacio-Sánchez, Y J Montagut-Ferizzola, M Ardila-Villegas, Juan C Maya
To validate a mathematical model using porous media theory for alveolar CO2 determination in ventilated patients.
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Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-10 Jeroen J H Bunge, Silvia Mariani, Christiaan Meuwese, Bas C T van Bussel, Michele Di Mauro, Dominik Wiedeman, Diyar Saeed, Matteo Pozzi, Antonio Loforte, Udo Boeken, Robertas Samalavicius, Karl Bounader, Xiaotong Hou, Hergen Buscher, Leonardo Salazar, Bart Meyns, Daniel Herr, Sacha Matteucci, Sandro Sponga, Graeme MacLaren, Claudio Russo, Francesco Formica, Pranya Sakiyalak, Antonio Fiore, Daniele
Most post-cardiotomy (PC) extracorporeal membrane oxygenation (ECMO) runs last less than 7 days. Studies on the outcomes of longer runs have provided conflicting results. This study investigates patient characteristics and short- and long-term outcomes in relation to PC ECMO duration, with a focus on prolonged (> 7 d) ECMO.
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Optic Nerve Sheath Diameter Point-of-Care Ultrasonography Quality Criteria Checklist: An International Consensus Statement on Optic Nerve Sheath Diameter Imaging and Measurement. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-05 Mohammad I Hirzallah, Piergiorgio Lochner, Muhammad Ubaid Hafeez, Andrew G Lee, Christos Krogias, Deepa Dongarwar, Nicholas D Hartman, Michael Ertl, Chiara Robba, Branko Malojcic, Jurgita Valaikiene, Aarti Sarwal, Ryan Hakimi, Felix Schlachetzki
To standardize optic nerve sheath diameter (ONSD) point-of-care ultrasonography (POCUS) and improve its research and clinical utility by developing the ONSD POCUS Quality Criteria Checklist (ONSD POCUS QCC).
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Association of Postarrest Hypotension Burden With Unfavorable Neurologic Outcome After Pediatric Cardiac Arrest. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-04 Raymond Liu, Tanmay Majumdar, Monique M Gardner, Ryan Burnett, Kathryn Graham, Forrest Beaulieu, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Ryan W Morgan, Alexis A Topjian, Matthew P Kirschen
Quantify hypotension burden using high-resolution continuous arterial blood pressure (ABP) data and determine its association with outcome after pediatric cardiac arrest.
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Quality Evaluation of Guidelines for the Diagnosis and Treatment of Liver Failure. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-04 Xia Wang, Meng-Yao Zheng, Hai-Yu He, Hui-Ling Zhu, Ya-Fang Zhao, Yu-Hang Chen, Zhi-Yuan Xu, Jin-Hui Yang, Da-Li Sun
This study aimed to systematically assess the methodological quality and key recommendations of the guidelines for the diagnosis and treatment of liver failure (LF), furnishing constructive insights for guideline developers and equipping clinicians with evidence-based information to facilitate informed decision-making.
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Beyond Unplanned ICU Transfers: Linking a Revised Definition of Deterioration to Patient Outcomes. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-04 Thomas F Byrd, Tom A Phelan, Nicholas E Ingraham, Benjamin W Langworthy, Ajay Bhasin, Abhinab Kc, Genevieve B Melton-Meaux, Christopher J Tignanelli
To develop an electronic descriptor of clinical deterioration for hospitalized patients that predicts short-term mortality and identifies patient deterioration earlier than current standard definitions.
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Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-06-04 Martha F Kienzle, Ryan W Morgan, Ron W Reeder, Tageldin Ahmed, Robert A Berg, Robert Bishop, Matthew Bochkoris, Joseph A Carcillo, Todd C Carpenter, Kellimarie K Cooper, J Wesley Diddle, Myke Federman, Richard Fernandez, Deborah Franzon, Aisha H Frazier, Stuart H Friess, Meg Frizzola, Kathryn Graham, Mark Hall, Christopher Horvat, Leanna L Huard, Tensing Maa, Arushi Manga, Patrick S McQuillen, Kathleen
Data to support epinephrine dosing intervals during cardiopulmonary resuscitation (CPR) are conflicting. The objective of this study was to evaluate the association between epinephrine dosing intervals and outcomes. We hypothesized that dosing intervals less than 3 minutes would be associated with improved neurologic survival compared with greater than or equal to 3 minutes.
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Digital Twins of Acute Hypoxemic Respiratory Failure Patients Suggest a Mechanistic Basis for Success and Failure of Noninvasive Ventilation. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-29 Liam Weaver, Hossein Shamohammadi, Sina Saffaran, Roberto Tonelli, Marianna Laviola, John G Laffey, Luigi Camporota, Timothy E Scott, Jonathan G Hardman, Enrico Clini, Declan G Bates
To clarify the mechanistic basis for the success or failure of noninvasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF).
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The Impact of Common Variations in Sequential Organ Failure Assessment Score Calculation on Sepsis Measurement Using Sepsis-3 Criteria: A Retrospective Analysis Using Electronic Health Record Data. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-23 Mohammad Alrawashdeh, Michael Klompas, Chanu Rhee
To assess the impact of different methods of calculating Sequential Organ Failure Assessment (SOFA) scores using electronic health record data on the incidence, outcomes, agreement, and predictive validity of Sepsis-3 criteria.
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Utilization and Outcomes in U.S. ICU Hospitalizations. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-23 Sneha Kannan, Mia Giuriato, Zirui Song
Despite its importance, detailed national estimates of ICU utilization and outcomes remain lacking. We aimed to characterize trends in ICU utilization and outcomes over a recent 12-year period in the United States.
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Cardiopulmonary Resuscitation Without Aortic Valve Compression Increases the Chances of Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest: A Prospective Observational Cohort Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-23 Sheng-En Chu, Chun-Yen Huang, Chiao-Yin Cheng, Chun-Hsiang Chan, Hsuan-An Chen, Chin-Ho Chang, Kuang-Chau Tsai, Kuan-Ming Chiu, Matthew Huei-Ming Ma, Wen-Chu Chiang, Jen-Tang Sun
Following current cardiopulmonary resuscitation (CPR) guidelines, which recommend chest compressions at "the center of the chest," ~50% of patients experiencing out-of-hospital cardiac arrest (OHCA) undergo aortic valve (AV) compression, obstructing blood flow. We used resuscitative transesophageal echocardiography (TEE) to elucidate the impact of uncompressed vs. compressed AV on outcomes of adult
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Association of Fluid Balance and Hemoglobin Decline With Neurological Outcome After Aneurysmal Subarachnoid Hemorrhage. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-21 Peter Truckenmueller, Stefan Wolf, David Wasilewski, Peter Vajkoczy, Anton Früh
To explore the relationship between fluid balance and hemoglobin decline with secondary infarctions and neurologic outcome in aneurysmal subarachnoid hemorrhage (aSAH) patients.
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Prophylactic Antibiotics Delivered Via the Respiratory Tract to Reduce Ventilator-Associated Pneumonia: A Systematic Review, Network Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-09 Jie Li, Shan Lyu, Jian Luo, Ping Liu, Fai A Albuainain, Omar A Alamoudi, Violaine Rochette, Stephan Ehrmann
To assess the effects of antibiotics delivered via the respiratory tract in preventing ventilator-associated pneumonia (VAP).
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Two Weeks Versus One Week of Maximal Patient-Intensivist Continuity for Adult Medical Intensive Care Patients: A Two-Center Target Trial Emulation. Crit. Care Med. (IF 7.7) Pub Date : 2024-05-07 Andrew J Admon, Shirley Cohen-Mekelburg, Megan Opatrny, Kathleen T Lee, Anica C Law, Hayley B Gershengorn, Thomas S Valley, Hallie C Prescott, Michael J Wiktor, Jayashree Neeluru, Colin R Cooke, Gary E Weissman
To compare outcomes for 2 weeks vs. 1 week of maximal patient-intensivist continuity in the ICU.
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Exploring the Impact of Age, Frailty, and Multimorbidity on the Effect of ICU Interventions: A Systematic Review of Randomized Controlled Trials. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-25 Andrew Perrella, Olivia Geen, Manan Ahuja, Stephanie Scott, Ramya Kaushik, Lauren E Ferrante, Nathan E Brummel, John Muscedere, Bram Rochwerg
To date, age, frailty, and multimorbidity have been used primarily to inform prognosis in older adults. It remains uncertain, however, whether these patient factors may also predict response to critical care interventions or treatment outcomes.
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Low Versus High Blood Pressure Targets in Critically Ill and Surgical Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-24 Filippo D'Amico, Alessandro Pruna, Zbigniew Putowski, Sara Dormio, Silvia Ajello, Anna Mara Scandroglio, Todd C Lee, Alberto Zangrillo, Giovanni Landoni
Hypotension is associated with adverse outcomes in critically ill and perioperative patients. However, these assumptions are supported by observational studies. This meta-analysis of randomized controlled trials aims to compare the impact of lower versus higher blood pressure targets on mortality.
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Association of Relative Dysglycemia With Hospital Mortality in Critically Ill Patients: A Retrospective Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-24 Tomoya Okazaki, Tadanori Nabeshima, Takushi Santanda, Yuiko Hoshina, Yuki Kondo, Yu Yaegashi, Taichi Nakazawa, Yasuharu Tokuda, Yasuhiro Norisue
Relative dysglycemia has been proposed as a clinical entity among critically ill patients in the ICU, but is not well studied. This study aimed to clarify associations of relative hyperglycemia and hypoglycemia during the first 24 hours after ICU admission with in-hospital mortality and the respective thresholds.
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Mortality Due to Acute Respiratory Distress Syndrome in Latin America. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-18 Roberto Santa Cruz, Amelia Matesa, Antonella Gómez, Juan Nadur, Fernando Pagano, Daniel Prieto, Oswald Bolaños, Beatriz Solis, Sara Yusta, Edilzar González-Velásquez, Elisa Estenssoro, Alexandre Cavalcanti
Mortality due to acute respiratory distress syndrome (ARDS) is a major global health problem. Knowledge of epidemiological data on ARDS is crucial to design management, treatment strategies, and optimize resources. There is ample data regarding mortality of ARDS from high-income countries; in this review, we evaluated mortality due to ARDS in Latin America.
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Impact and Feasibility of Mechanical Ventilation at a Surgical Center in Sierra Leone: Experience From EMERGENCY's Hospital in Goderich. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-15 Ornella Spagnolello, Richmond Dixon Cole, Jalloh Unisa, Hawa Vandi, Marian Macarthy, Sofia Gatti, Manuela Cormio, Gina Portella, Martina Baiardo Redaelli
Despite the large burden of critically ill patients in developing countries, mechanical ventilation (MV) is scarce in these low-resource settings. In the absence of data, issues like costs and lack of training are often felt to outweigh the benefits of potential MV implementation in such places. We aimed to investigate the impact and feasibility of MV in a surgical ICU in West Africa.
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Sleep and Circadian Health of Critical Survivors: A 12-Month Follow-Up Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-10 Mario Henríquez-Beltrán, Rafaela Vaca, Iván D Benítez, Jessica González, Sally Santisteve, Maria Aguilà, Olga Minguez, Anna Moncusí-Moix, Clara Gort-Paniello, Gerard Torres, Gonzalo Labarca, Jesús Caballero, Carme Barberà, Antoni Torres, David de Gonzalo-Calvo, Ferran Barbé, Adriano D S Targa
To investigate the sleep and circadian health of critical survivors 12 months after hospital discharge and to evaluate a possible effect of the severity of the disease within this context.
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One-Year Recovery Among Survivors of Prolonged Severe COVID-19: A National Multicenter Cohort. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-10 Anil N Makam, Judith Burnfield, Ed Prettyman, Oanh Kieu Nguyen, Nancy Wu, Edie Espejo, Cinthia Blat, W John Boscardin, E Wesley Ely, James C Jackson, Kenneth E Covinsky, John Votto
Understanding the long-term effects of severe COVID-19 illness on survivors is essential for effective pandemic recovery planning. Therefore, we investigated impairments among hospitalized adults discharged to long-term acute care hospitals (LTACHs) for prolonged severe COVID-19 illness who survived 1 year.
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Visualization of Cerebral Pressure Autoregulatory Insults in Traumatic Brain Injury. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-08 Teodor Svedung Wettervik, Erta Beqiri, Anders Hånell, Stefan Yu Bögli, Michal Placek, Joseph Donnelly, Mathew R Guilfoyle, Adel Helmy, Andrea Lavinio, Peter J Hutchinson, Peter Smielewski
The first aim was to investigate the combined effect of insult intensity and duration of the pressure reactivity index (PRx) and deviation from the autoregulatory cerebral perfusion pressure target (∆CPPopt = actual CPP - optimal CPP [CPPopt]) on outcome in traumatic brain injury. The second aim was to determine if PRx influenced the association between intracranial pressure (ICP), CPP, and ∆CPPopt
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An Approach to Diversifying the Selection of a Guideline Panel-The Process Utilized for the Updated Adult Critical Care Ultrasound Guidelines. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-08 Sara Nikravan, Michael J Lanspa, Enyo Ablordeppey, Anthony T Gerlach, Lori Shutter, Hariyali Patel, Karin Reuter-Rice, Kim Lewis, Sameer Sharif, José L Díaz-Gómez
Clinical practice guidelines are essential for promoting evidence-based healthcare. While diversification of panel members can reduce disparities in care, processes for panel selection lack transparency. We aim to share our approach in forming a diverse expert panel for the updated Adult Critical Care Ultrasound Guidelines.
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Anaerobic Lactate Production Is Associated With Decreased Microcirculatory Blood Flow and Decreased Mitochondrial Respiration Following Cardiovascular Surgery With Cardiopulmonary Bypass. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-05 John C Greenwood, Fatima M Talebi, David H Jang, Audrey E Spelde, Emily K Gordon, Jiri Horak, Michael A Acker, Todd J Kilbaugh, Frances S Shofer, John G T Augoustides, Jacob S Brenner, Vladimir R Muzykantov, Jan Bakker, Benjamin S Abella
Quantify the relationship between perioperative anaerobic lactate production, microcirculatory blood flow, and mitochondrial respiration in patients after cardiovascular surgery with cardiopulmonary bypass.
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Evaluating the Sum of Eye and Motor Components of the Glasgow Coma Score As a Predictor of Extubation Failure in Patients With Acute Brain Injury. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-01 Shaurya Taran, Bastien Perrot, Federico Angriman, Raphael Cinotti
To evaluate the association between the pre-extubation sum of eye and motor components of the Glasgow Coma Score (GCS-EM) and odds of extubation failure in patients with acute brain injury being liberated from mechanical ventilation.
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Quantifying the Impact of Alternative Definitions of Sepsis-Associated Acute Kidney Injury on its Incidence and Outcomes: A Systematic Review and Meta-Analysis. Crit. Care Med. (IF 7.7) Pub Date : 2024-04-01 Lachlan H Donaldson, Ruan Vlok, Ken Sakurai, Morgan Burrows, Gabrielle McDonald, Karthik Venkatesh, Sean M Bagshaw, Rinaldo Bellomo, Anthony Delaney, John Myburgh, Naomi E Hammond, Balasubramanian Venkatesh
To derive a pooled estimate of the incidence and outcomes of sepsis-associated acute kidney injury (SA-AKI) in ICU patients and to explore the impact of differing definitions of SA-AKI on these estimates.
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Clinical Efficacy of Beta-1 Selective Beta-Blockers Versus Propranolol in Patients With Thyroid Storm: A Retrospective Cohort Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-29 Yuichiro Matsuo, Taisuke Jo, Hideaki Watanabe, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
Thyroid storm is the most severe manifestation of thyrotoxicosis. Beta-blockers are among the standard treatment regimens for this condition, with propranolol being the historically preferred option. However, 2016 guidelines issued by the Japan Thyroid Association and the Japan Endocrine Society recommend the use of beta-1 selective beta-blockers over nonselective beta-blockers, such as propranolol
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Survival of Critically Ill COVID-19 Patients in Sweden During the First Two and a Half Years of the Pandemic. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-28 Ailiana Santosa, Jonatan Oras, Huiqi Li, Chioma Nwaru, Brian Kirui, Fredrik Nyberg
Some studies have examined survival trends among critically ill COVID-19 patients, but most were case reports, small cohorts, and had relatively short follow-up periods. We aimed to examine the survival trend among critically ill COVID-19 patients during the first two and a half years of the pandemic and investigate potential predictors across different variants of concern periods.
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Machine Learning Identifies Higher Survival Profile In Extracorporeal Cardiopulmonary Resuscitation. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-27 Ruben Crespo-Diaz, Julian Wolfson, Demetris Yannopoulos, Jason A Bartos
Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to improve neurologically favorable survival in patients with refractory out-of-hospital cardiac arrest (OHCA) caused by shockable rhythms. Further refinement of patient selection is needed to focus this resource-intensive therapy on those patients likely to benefit. This study sought to create a selection model using machine learning
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Pragmatic Approach to In Situ Simulation to Identify Latent Safety Threats Before Moving to a Newly Built ICU. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-27 Aarti Sarwal, Nicholas A Morris, Janet Crumpler, Terri Gordon, Ian Saunders, James E Johnson, Jeff E Carter
Transitions to new care environments may have unexpected consequences that threaten patient safety. We undertook a quality improvement project using in situ simulation to learn the new patient care environment and expose latent safety threats before transitioning patients to a newly built adult ICU.
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Validation of Adult Sepsis Event and Epidemiologic Analysis of Sepsis Prevalence and Mortality Using Adult Sepsis Event's Electronic Health Records-Based Sequential Organ Failure Assessment Criteria: A Single-Center Study in South Korea. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-26 Su Yeon Lee, Mi Hyeon Park, Dong Kyu Oh, Chae-Man Lim
In 2018, the Centers for Disease Control and Prevention introduced the Adult Sepsis Event (ASE) definition, using electronic health records (EHRs) data for surveillance and sepsis quality improvement. However, data regarding ASE outside the United States remain limited. We therefore aimed to validate the diagnostic accuracy of the ASE and to assess the prevalence and mortality of sepsis using ASE.
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A Randomized Noninferiority Trial to Compare Enteral to Parenteral Phosphate Replacement on Biochemistry, Waste, and Environmental Impact and Healthcare Cost in Critically Ill Patients With Mild to Moderate Hypophosphatemia. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-25 Chinh D Nguyen, Haustine P Panganiban, Timothy Fazio, Amalia Karahalios, Melissa Akravs, Christopher M MacIsaac, Thomas Rechnitzer, Lucy Arno, An Tran-Duy, Scott McAlister, Yasmine Ali Abdelhamid, Adam M Deane
Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste.
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Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-22 Maniraj Neupane, Nathaniel De Jonge, Sahil Angelo, Sadia Sarzynski, Junfeng Sun, Bram Rochwerg, John Hick, Steven H Mitchell, Sarah Warner, Alex Mancera, Diane Cooper, Sameer S Kadri
COVID-19 pandemic surges strained hospitals globally. We performed a systematic review to examine measures of pandemic caseload surge and its impact on mortality of hospitalized patients.
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Analgesia and Sedation Use During Noninvasive Ventilation for Acute Respiratory Failure. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-20 Peter J Dunbar, Ryan Peterson, Max McGrath, Raymond Pomponio, Tyree H Kiser, P Michael Ho, R William Vandivier, Ellen L Burnham, Marc Moss, Peter D Sottile
To describe U.S. practice regarding administration of sedation and analgesia to patients on noninvasive ventilation (NIV) for acute respiratory failure (ARF) and to determine the association of this practice with odds of intubation or death.
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The Efficacy of Low-Titer Group O Whole Blood Compared With Component Therapy in Civilian Trauma Patients: A Meta-Analysis. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-14 Katrina M Morgan, Elissa Abou Khalil, Erin V Feeney, Philip C Spinella, Amelia C Lucisano, Barbara A Gaines, Christine M Leeper
To assess if transfusion with low-titer group O whole blood (LTOWB) is associated with improved early and/or late survival compared with component blood product therapy (CT) in bleeding trauma patients.
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Extracorporeal Versus Conventional Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest: A Propensity Score Matching Cohort Study. Crit. Care Med. (IF 7.7) Pub Date : 2024-03-05 Yuan Bian, Yuhui Pan, Jiaqi Zheng, Wen Zheng, Lijie Qin, Guangju Zhou, Xifeng Sun, Mingjie Wang, Chunyi Wang, Yuguo Chen, Feng Xu
Comparing the effects of extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) on outcomes in patients with in-hospital cardiac arrest (IHCA) in China. The benefits of ECPR over CCPR in patients with IHCA remain controversial.
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Impact of Lactate Clearance on Clinical and Neurological Outcomes of Patients With Out-of-Hospital Cardiac Arrest Treated With Extracorporeal Cardiopulmonary Resuscitation: A Secondary Data Analysis. Crit. Care Med. (IF 7.7) Pub Date : 2024-02-27 Momoko Sugimoto, Wataru Takayama, Akihiko Inoue, Toru Hifumi, Tetsuya Sakamoto, Yasuhiro Kuroda, Yasuhiro Otomo
Serial evaluations of lactate concentration may be more useful in predicting outcomes in patients with out-of-hospital cardiac arrest (OHCA) than a single measurement. This study aimed to evaluate the impact of lactate clearance (LC) on clinical and neurologic outcomes in patients with OHCA who underwent extracorporeal cardiopulmonary resuscitation (ECPR).
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Toward Equitable Kidney Function Estimation in Critical Care Practice. Guidance From the Society of Critical Care Medicine's Diversity, Equity, and Inclusion in Renal Clinical Practice Task Force. Crit. Care Med. (IF 7.7) Pub Date : 2024-02-26 Todd A Miano, Erin F Barreto, Molly McNett, Niels Martin, Ankit Sakhuja, Adair Andrews, Rajit K Basu, Enyo Ama Ablordeppey
Accurate glomerular filtration rate (GFR) assessment is essential in critically ill patients. GFR is often estimated using creatinine-based equations, which require surrogates for muscle mass such as age and sex. Race has also been included in GFR equations, based on the assumption that Black individuals have genetically determined higher muscle mass. However, race-based GFR estimation has been questioned
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Real-World Implications of Updated Surviving Sepsis Campaign Antibiotic Timing Recommendations. Crit. Care Med. (IF 7.7) Pub Date : 2024-02-22 Stephanie P Taylor, Marc A Kowalkowski, Sable Skewes, Shih-Hsiung Chou
To evaluate real-world implications of updated Surviving Sepsis Campaign (SSC) recommendations for antibiotic timing.