Review
Medicine, General & Internal
Giorgio Berlot, Silvia Zanchi, Edoardo Moro, Ariella Tomasini, Mattia Bixio
Summary: The administration of Polyclonal Intravenous Immunoglobulins (IvIg) to critically ill patients is often based on faith rather than relevant clinical studies. Despite investigations proving their beneficial effects in different subsets of patients, current guidelines recommend against their use in the treatment of sepsis and septic shock. This review aims to provide a comprehensive understanding of the biology, mechanisms of action, and clinical experience related to IvIg administration in order to clarify their possible indications in sepsis and septic shock patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Francois Lamontagne, Marie-Helene Masse, Julie Menard, Sheila Sprague, Ruxandra Pinto, Daren K. Heyland, Deborah J. Cook, Marie-Claude Battista, Andrew G. Day, Gordon H. Guyatt, Salmaan Kanji, Rachael Parke, Shay P. McGuinness, Bharath-Kumar Tirupakuzhi Vijayaraghavan, Djillali Annane, Dian Cohen, Yaseen M. Arabi, Brigitte Bolduc, Nicole Marinoff, Bram Rochwerg, Tina Millen, Maureen O. Meade, Lori Hand, Irene Watpool, Rebecca Porteous, Paul J. Young, Frederick D'Aragon, Emilie P. Belley-Cote, Elaine Carbonneau, France Clarke, David M. Maslove, Miranda Hunt, Michael Chasse, Martine Lebrasseur, Francois Lauzier, Sangeeta Mehta, Hector Quiroz-Martinez, Oleksa G. Rewa, Emmanuel Charbonney, Andrew J. E. Seely, Demetrios J. Kutsogiannis, Remi LeBlanc, Armand Mekontso-Dessap, Tina S. Mele, Alexis F. Turgeon, Gordon Wood, Sandeep S. Kohli, Jason Shahin, Pawel Twardowski, Neill K. J. Adhikari
Summary: A study on the use of intravenous vitamin C in adult sepsis patients receiving vasopressor therapy in the ICU showed that there is a higher risk of death or persistent organ dysfunction compared to placebo.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Critical Care Medicine
Sophia Bonnin, John J. Radosevich, Yong Gu Lee, Jeremy P. Feldman, Jeffrey F. Barletta
Summary: This multi-center retrospective study compared the shock reversal outcomes between low dose and high dose hydrocortisone regimens in patients with septic shock. High dose steroids were found to be associated with shock reversal, but this was not confirmed in propensity score matched analysis. High dose steroids were also associated with reduced need for additional vasopressor therapy and lower shock recurrence rates.
JOURNAL OF CRITICAL CARE
(2021)
Review
Nutrition & Dietetics
Huoyan Liang, Qingqing Mu, Wenju Sun, Liming Liu, Simin Qiu, Zili Xu, Yuqing Cui, Yan Yan, Tongwen Sun
Summary: This systematic review and meta-analysis showed that intravenous vitamin C (IVVC) treatment did not improve the 28-day mortality in septic patients. Subgroup analysis indicated a trend of reducing the 28-day mortality in patients with sepsis but not septic shock. IVVC monotherapy was found to decrease the 28-day mortality in septic patients. The study suggests that the combination therapy of Hydrocortisone, Ascorbic acid, Thiamine (HAT) is not superior to IVVC monotherapy for septic patients. Further research is needed to confirm these findings and explore the mechanisms underlying the enhanced efficacy of IVVC monotherapy in septic patients.
FRONTIERS IN NUTRITION
(2023)
Article
Engineering, Biomedical
Fudan Zheng, Luhao Wang, Yuxian Pang, Zhiguang Chen, Yutong Lu, Yuedong Yang, Jianfeng Wu
Summary: Septic shock has become the leading cause of morbidity and mortality in the ICU. However, currently there is no model to predict the mortality of septic shock patients. We aim to develop such a model.
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
(2023)
Article
Medicine, Research & Experimental
Xue-song Zhao, Zhao-li Meng, Tuo Zhang, Hong-na Yang, Ji-cheng Zhang, Wei Fang, Chun-ting Wang, Man Chen
Summary: The combined measurement of procalcitonin (PCT), thromboelastography (TEG), and platelet (PLT) count can predict the development of septic shock in high-risk patients. Compared to the sepsis group, the septic shock group had lower PLT count and TEG measurements, longer prothrombin time (DT), longer activated partial thromboplastin time (APTT), and higher PCT levels. Multivariate logistic regression analysis revealed that PCT, TEG, and PLT count were associated with the development of septic shock. Area under the curve analysis showed that the combined measurement of PCT, TEG, and PLT count was more accurate in predicting the development of septic shock compared to individual measurements.
CURRENT MEDICAL SCIENCE
(2023)
Article
Medicine, General & Internal
Isao Nagata, Toshikazu Abe, Hiroshi Ogura, Shigeki Kushimoto, Seitaro Fujishima, Satoshi Gando
Summary: The study aimed to determine the association between ICU model and in-hospital mortality of patients with severe sepsis and septic shock. Patients in the closed ICU group had higher severity scores, but there was no significant difference in in-hospital mortality compared to the open ICU group.
Article
Immunology
Chanu Rhee, Kathleen Chiotos, Sara E. Cosgrove, Emily L. Heil, Sameer S. Kadri, Andre C. Kalil, David N. Gilbert, Henry Masur, Edward J. Septimus, Daniel A. Sweeney, Jeffrey R. Strich, Dean L. Winslow, Michael Klompas
Summary: The Infectious Diseases Society of America (IDSA) is concerned about the potential for antibiotic overuse due to the SEP-1 measure and has outlined recommendations to limit its application to patients with septic shock. The IDSA believes that managing possible sepsis without shock should be guided by more appropriate guidelines that allow for individualized patient care.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Critical Care Medicine
Patrice Rosengrave, Emma Spencer, Jonathan Williman, Jan Mehrtens, Stacey Morgan, Tara Doyle, Kymbalee van der Heyden, Anna Morris, Geoff Shaw, Anitra C. Carr
Summary: This study investigated the effect of intravenous vitamin C administration on vasopressor requirements and outcomes in patients with septic shock. The results showed that intravenous vitamin C did not significantly decrease vasopressor dosage or duration. There were also no significant differences in SOFA scores, length of stay, and mortality between the intervention and placebo groups. Further research is needed to consider factors such as intervention timing, dosage, duration, and trial location to provide more definitive evidence.
Article
Radiology, Nuclear Medicine & Medical Imaging
Swarnima Pandey, Mohd Adnan Siddiqui, Afzal Azim, Neeraj Sinha
Summary: This study identified metabolic signatures associated with treatment responsiveness, which can aid in the development of personalized treatment protocols and targeted therapy for ICU patients.
MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE
(2022)
Article
Immunology
Marcela Hortova-Kohoutkova, Monika Skotakova, Isaac G. Onyango, Miriam Slezakova, Roman Panovsky, Lukas Opatril, Peter Slanina, Marco De Zuani, Ondrej Mrkva, Ivana Andrejcinova, Petra Laznickova, Martina Dvoncova, Alexandra Mytnikova, Vaughn Ostland, Michal Sitina, Gorazd B. Stokin, Vladimir Sramek, Marcela Vlkova, Martin Helan, Jan Fric
Summary: This study investigated the dynamics of iron regulation in different clinical settings and determined the suitability of hepcidin and/or ferritin levels as biomarkers of inflammatory disease severity. The results showed that hepcidin levels reflect overall immune cell activation driven by intrinsic stimuli, while ferritin levels are more strongly influenced by pathogen-induced inflammation. Furthermore, the hepcidin-to-ferritin ratio has the ability to predict mortality in septic shock.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Medicine, General & Internal
T. S. Meyhoff, P. B. Hjortrup, J. Wetterslev, P. Sivapalan, J. H. Laake, M. Cronhjort, S. M. Jakob, M. Cecconi, M. Nalos, M. Ostermann, M. Malbrain, V Pettila, M. H. Moller, M-B N. Kjaer, T. Lange, C. Overgaard-Steensen, B. A. Brand, M. Winther-Olesen, J. O. White, L. Quist, B. Westergaard, A. B. Jonsson, C. J. S. Hjortso, N. Meier, T. S. Jensen, J. Engstrom, L. Nebrich, N. C. Andersen-Ranberg, J. Jensen, N. A. Joseph, L. M. Poulsen, L. S. Herlov, C. G. Solling, S. K. Pedersen, K. K. Knudsen, T. S. Straarup, M. L. Vang, H. Bundgaard, B. S. Rasmussen, S. R. Aagaard, T. Hildebrandt, L. Russell, M. H. Bestle, M. Schonemann-Lund, A. C. Brochner, C. F. Elvander, S. K. L. Hoffmann, M. L. Rasmussen, Y. K. Martin, F. F. Friberg, H. Seter, T. N. Aslam, S. Adnoy, P. Seidel, K. Strand, B. Johnstad, E. Joelsson-Alm, J. Christensen, C. Ahlstedt, C. A. Pfortmueller, M. Siegemund, M. Greco, J. Radej, M. Kriz, D. W. Gould, K. M. Rowan, P. R. Mouncey, A. Perner
Summary: The study found that restricting intravenous fluid therapy in adult patients with septic shock in the ICU did not lead to fewer deaths at 90 days compared to standard intravenous fluid therapy. Other survival indicators during ICU stay and at 90 days were similar in both groups.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Critical Care Medicine
John A. Kellum, Claudio Ronco
Summary: Septic shock, caused by bacterial toxins like endotoxin, is a severe disease that can lead to organ failure. It is important to note that endotoxin may play a role in all types of septic shock, including non-bacterial causes such as COVID-19. Diagnosis relies on measuring endotoxin activity in addition to clinical assessment. Treatment options are limited, with immune modulating therapies and extracorporeal blood purification still being investigated.
Article
Medicine, General & Internal
Veronika Tomaskova, Alexandra Mytnikova, Marcela Hortova Kohoutkova, Ondrej Mrkva, Monika Skotakova, Michal Sitina, Katerina Helanova, Jan Fric, Jiri Parenica, Vladimir Sramek, Martin Helan
Summary: This study examined the ability of sEng to predict mortality and its correlation with other clinical characteristics in septic shock patients and severe COVID-19 patients. The results showed that sEng was not predictive of mortality or correlated with organ dysfunction markers in COVID-19 patients. However, in septic shock patients, sEng levels were significantly higher in patients with early mortality and correlated with signs of circulatory failure.
FRONTIERS IN MEDICINE
(2022)
Article
Infectious Diseases
Pedro Martinez-Paz, Marta Aragon-Camino, Esther Gomez-Sanchez, Mario Lorenzo-Lopez, Estefania Gomez-Pesquera, Alejandra Fadrique-Fuentes, Pilar Liu, Alvaro Tamayo-Velasco, Christian Ortega-Loubon, Marta Martin-Fernandez, Hugo Gonzalo-Benito, Emilio Garcia-Moran, Maria Heredia-Rodriguez, Eduardo Tamayo
Summary: The study aims to distinguish between septic shock and non-septic shock in postoperative patients through gene expression signature, providing personalized treatment and avoiding unnecessary antibiotic use and increased healthcare costs.
JOURNAL OF INFECTION
(2021)
Article
Critical Care Medicine
Fiona Coyer, Wendy Chaboyer, Frances Lin, Anna Doubrovsky, Michelle Barakat-Johnson, Wendy Brown, Ramanathan Lakshmanan, Gavin Leslie, Sarah L. Jones, India Pearse, Kerrie Martin, Elizabeth McInnes, Madeleine Powell, Marion L. Mitchell, Kellie Sosnowski, Mandy Tallot, Amy Thompson, Lorraine Thompson, Sonia Labeau, Stijn Blot
Summary: The prevalence of ICU-acquired pressure injuries in Australian ICUs was found to be 9.7%. Renal replacement therapy, impaired mobility, respiratory rate, length of ICU stay, and mechanical ventilation on admission were identified as significant factors associated with the development of ICU-acquired pressure injuries.
AUSTRALIAN CRITICAL CARE
(2022)
Letter
Critical Care Medicine
Stijn Blot, Elena Conoscenti
AUSTRALIAN CRITICAL CARE
(2023)
Article
Medicine, General & Internal
Sofie F. M. Vanderhaeghen, Johan M. Decruyenaere, Dominique D. Benoit, Sandra G. Oeyen
Summary: This study aimed to evaluate the organization and feasibility of post-ICU consultations and assess patients' satisfaction. The findings revealed that organizing consultations was difficult, but most attending patients appreciated the initiative. However, PICS-related problems were documented in both the consultation and non-consultation groups.
ACTA CLINICA BELGICA
(2023)
Letter
Critical Care Medicine
Ruben Houthoofdt, Zara Cuvelier, Brecht Serraes, Carl Haentjens, Nicolas Mpotos, Stijn Blot
AUSTRALIAN CRITICAL CARE
(2023)
Article
Public, Environmental & Occupational Health
Maja von Cube, Martin Schumacher, Jean Francois Timsit, Johan Decruyenaere, Johan Steen
Summary: This article introduces a method for defining and estimating PAF in time-to-event settings, and demonstrates how to reduce bias by using multi-state methodology and inverse probability weighting. The method is exemplarily applied to a real data set, showing its effectiveness.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2023)
Letter
Critical Care Medicine
S. Blot, M. Deschepper
MEDICINA INTENSIVA
(2023)
Editorial Material
Nursing
Karel E. Y. Claes, Ignace De Decker, Stijn Blot
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Review
Infectious Diseases
Marios Karvouniaris, Maria Panagiota Almyroudi, Mohd Hafiz Abdul-Aziz, Stijn Blot, Elisabeth Paramythiotou, Evdoxia Tsigou, Despoina Koulenti
Summary: Gram-negative bacterial resistance to antimicrobials has been increasing globally in recent decades, posing a daily challenge for hospital practice. Researchers and industry have made efforts to develop novel antimicrobials resilient to bacterial resistance mechanisms. Several new antimicrobials, including cefiderocol, imipenem-cilastatin-relebactam, eravacycline, omadacycline, and plazomicin, have become commercially available in the past five years. Other agents, such as aztreonam-avibactam, cefepime-enmetazobactam, cefepime-taniborbactam, cefepime-zidebactam, sulopenem, tebipenem, and benapenem, are in advanced development and have reached phase 3 clinical trials. This review critically discusses the characteristics, pharmacokinetic/pharmacodynamic properties, and current clinical data of these antimicrobials.
Article
Nursing
Elsa Afonso, Koenraad Smets, Mieke Deschepper, Evelien Verstraete, Stijn Blot
Summary: This study aimed to investigate the effect of late-onset sepsis on mortality in hospitalized neonatal patients of different gestational ages. The results showed that late-onset sepsis is an independent risk factor for mortality in very preterm and late preterm neonates.
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Editorial Material
Nursing
Zeynep Ture, Stijn Blot, Emine Alp
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Editorial Material
Nursing
Stijn Blot, Jean-Francois Timsit, Jean-Ralph Zahar
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Review
Microbiology
Georgios Papathanakos, Ioannis Andrianopoulos, Menelaos Xenikakis, Athanasios Papathanasiou, Despoina Koulenti, Stijn Blot, Vasilios Koulouras
Summary: Sepsis, a life-threatening infection-induced disorder of organ function, is a major cause of mortality worldwide, particularly in intensive care units. With an incomplete understanding of its complex pathophysiology, sepsis exhibits great heterogeneity in clinical expression, patient response to treatment, and outcomes. This heterogeneity poses a significant challenge for improving treatment in critical care. However, artificial intelligence and machine learning techniques offer promise for identifying clinical phenotypes and distinguishing individuals based on various factors such as temperature, hemodynamics, organ dysfunction, fluid status, ICU trajectories, and outcome. Ultimately, this approach may allow for targeted therapeutic interventions and optimal timing in septic patients.
Review
Obstetrics & Gynecology
Isabelle Dehaene, Johan Steen, Oliver Dukes, Camila Olarte Parra, Kris De Coen, Koenraad Smets, Kristien Roelens, Johan Decruyenaere
Summary: Administration of antenatal corticosteroids (ACS) is crucial for preventing neonatal mortality and morbidity, but current subgroup analysis methods suffer from methodological flaws. To address this issue, we propose a more principled approach that formulates the question about optimal timing of ACS treatment in terms of the protocol of a future randomised study, which can provide important guidance and help avoid design flaws in observational studies.
ARCHIVES OF GYNECOLOGY AND OBSTETRICS
(2023)
Correction
Pediatrics
Isabelle Dehaene, Tessa Van Steenstraeten, Kris De Coen, Stefanie De Buyser, Johan Decruyenaere, Koenraad Smets, Kristien Roelens
EUROPEAN JOURNAL OF PEDIATRICS
(2023)
Article
Ethics
Katerina Sideri, Julian Cockbain, Sigrid Sterckx, Johan Decruyenaere, Marc De Hert, Wim van Biesen
Summary: This article discusses the use of digital pills to enhance medication adherence, focusing on psychiatric conditions. It analyzes two public policies, patents and marketing authorization, that may encourage the development of remote monitoring systems for medication intake. The article identifies key stakeholders and their interests, questioning whether these policies disproportionately benefit certain groups. It concludes that these tracking systems prioritize revenue and compliance monitoring over patient autonomy, Shared Decision-Making, and privacy, and suggests the need for additional safeguards.
JOURNAL OF LAW AND THE BIOSCIENCES
(2022)