Article
Multidisciplinary Sciences
Insiyah Campwala, Francis X. Guyette, Joshua B. Brown, Mark H. Yazer, Brian J. Daley, Richard S. Miller, Brian G. Harbrecht, Jeffrey A. Claridge, Herbert A. Phelan, Brian Eastridge, Raminder Nirula, Gary A. Vercruysse, Terence O'Keeffe, Bellal Joseph, Matthew D. Neal, Brian S. Zuckerbraun, Jason L. Sperry
Summary: A secondary analysis of data from two large prehospital randomized controlled trials was conducted to study the effects of multiorgan failure (MOF) and nosocomial infection (NI) on delayed mortality and resource utilization in severely injured patients. MOF was found to be an independent predictor of mortality, while NI was associated with higher resource utilization.
SCIENTIFIC REPORTS
(2023)
Article
Critical Care Medicine
Martin Cour, Kada Klouche, Bertrand Souweine, Jean-Pierre Quenot, Carole Schwebel, Sophie Perinel, Camille Amaz, Marielle Buisson, Michel Ovize, Nathan Mewton, Laurent Argaud
Summary: The study did not find that remote ischemic conditioning (RECO) reduces the severity of organ failure in patients with septic shock, but the cumulative mortality within 90 days was slightly lower in the RECO group compared to the control group.
INTENSIVE CARE MEDICINE
(2022)
Review
Gastroenterology & Hepatology
Constantine J. J. Karvellas, Thierry Gustot, Javier Fernandez
Summary: Acute on chronic liver failure (ACLF) is the development of organ failure(s) in cirrhosis patients and has a high short-term mortality rate. Medical management of ACLF needs to consider the relationship between the underlying chronic liver disease/cirrhosis, precipitating insult, and involved organ systems. Intensive care management of ACLF focuses on promptly recognizing and treating triggering events and providing aggressive support for failing organs to ensure successful liver transplantation or recovery. The complexity of managing ACLF patients arises from their propensity to develop new organ failures and complications like infections or bleeding. A multidisciplinary team with expertise in critical care and transplant medicine is best suited for the management of critically ill ACLF patients. This review aims to identify common complications of ACLF and describe the appropriate management for critically ill patients awaiting liver transplantation, including organ support, prognostic assessment, and determining the likelihood of recovery.
LIVER INTERNATIONAL
(2023)
Article
Critical Care Medicine
Sergei Rey, Vladimir M. Kulabukhov, Alexander Popov, Olga Nikitina, Gennady Berdnikov, Marat Magomedov, Timur Kim, Sergei Masolitin, Olga Ignatenko, Nikolai Krotenko, Anastasia Marysheva, Nikolai Chaus, Leonid Ohinko, Makarii Mendibaev, Anastasia Chumachenko, Vladimir Pisarev
Summary: Extracorporeal hemoperfusion (EHP) with Efferon LPS cartridges effectively improved the course and outcomes of patients with septic shock. EHP led to increased MAP and arterial oxygenation, decreased norepinephrine doses, and improved organ function. However, there were no significant improvements in survival rates at 14 and 28 days. Laboratory tests showed rapid reductions in inflammatory biomarkers only in the Efferon LPS group.
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
Multidisciplinary Sciences
Jon Olinder, Alex Borjesson, Jakob Norrman, Tobias West, Joakim Carlstrom, Alexander Gustafsson, Martin Annborn, Heiko Herwald, Cecilia Ryden
Summary: This study investigated the relevance of hepcidin as a diagnostic and prognostic tool for sepsis. The results showed that hepcidin levels can be used to differentiate sepsis and have predictive value for mortality in patients admitted to the intensive care unit.
SCIENTIFIC REPORTS
(2022)
Article
Critical Care Medicine
Fumitaka Yanase, Sofia Spano, Akinori Maeda, Anis Chaba, Thummaporn Naorungroj, Connie Pei Chen Ow, Yugeesh R. Lankadeva, Clive N. May, Ashenafi H. Betrie, Darius J. R. Lane, Glenn M. Eastwood, Mark P. Plummer, Rinaldo Bellomo
Summary: In patients with septic shock, mega-dose NaAscorbate did not significantly increase cumulative 24-h urine output. However, it induced a significantly greater increase in urine output and a greater reduction in vasopressor dose and SOFA score over time. One episode of hypernatremia and one of hemolysis were observed in the NaAscorbate group. These findings support further cautious investigation of this novel intervention.
Article
Critical Care Medicine
Julien Vaidie, Edwige Peju, Louise-Marie Jandeaux, Mathieu Lesouhaitier, Jean-Claude Lacherade, Antoine Guillon, Xavier Wittebole, Pierre Asfar, Bruno Evrard, Thomas Daix, Philippe Vignon, Bruno Francois
Summary: The PACIFIC study aimed to assess the impact of immunosuppressive therapy on the prognosis of patients admitted to the ICU for septic shock. The study found that long-term immunosuppressive therapy excluding chemotherapy was not associated with significantly higher or lower ICU and 3-month mortality in patients admitted to the ICU for septic shock.
Article
Critical Care Medicine
Ari Moskowitz, Katherine M. Berg, Anne V. Grossestreuer, Lakshman Balaji, Xiaowen Liu, Michael N. Cocchi, Maureen Chase, Michelle Ng Gong, Jonathan Gong, Samir M. Parikh, Long Ngo, Noa Berlin, Michael W. Donnino
Summary: Thiamine supplementation does not significantly attenuate kidney injury in patients with septic shock, but it does increase ICU-free days.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Medicine, General & Internal
Jonathan E. Sevransky, Richard E. Rothman, David N. Hager, Gordon R. Bernard, Samuel M. Brown, Timothy G. Buchman, Laurence W. Busse, Craig M. Coopersmith, Christine DeWilde, Wesley Ely, Lindsay M. Eyzaguirre, Alpha A. Fowler, David F. Gaieski, Michelle N. Gong, Alex Hall, Jeremiah S. Hinson, Michael H. Hooper, Gabor D. Kelen, Akram Khan, Mark A. Levine, Roger J. Lewis, Chris J. Lindsell, Jessica S. Marlin, Anna McGlothlin, Brooks L. Moore, Katherine L. Nugent, Samuel Nwosu, Carmen C. Polito, Todd W. Rice, Erin P. Ricketts, Caroline C. Rudolph, Fred Sanfilippo, Kert Viele, Greg S. Martin, David W. Wright
Summary: A trial on the effects of a combination treatment of vitamin C, thiamine, and hydrocortisone on ventilator- and vasopressor-free days in patients with sepsis did not show a significant increase within 30 days. However, the trial was terminated early and may have been underpowered to detect a clinically important difference.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2021)
Article
Critical Care Medicine
Michael N. Cocchi, James Dargin, Maureen Chase, Parth Patel, Anne Grossestreuer, Lakshman Balaji, Xiaowen Liu, Ari Moskowitz, Katherine Berg, Michael W. Donnino
Summary: In patients with septic shock, the use of esmolol did not improve vasopressor requirements or time to shock reversal, but it was associated with decreased levels of C-reactive protein over 24 hours.
Article
Multidisciplinary Sciences
Stefanie Vandervelden, Lina Wauters, Jan Breuls, Steffen Fieuws, Philippe Vanhove, Ives Hubloue, Magali Bartiaux, Jacques Creteur, Francois Stifkens, Koen Monsieurs, Didier Desruelles
Summary: Sepsis is a potentially life-threatening condition that can lead to septic shock if not recognized and treated timely. This phase 3b multi-center trial in Belgium aims to investigate the potential benefits of early administration of high doses of Vitamin C in patients with sepsis or septic shock, with the primary outcome being the average post-baseline patient SOFA score.
Article
Critical Care Medicine
Miguel Ibarra-Estrada, Eduardo Kattan, Pavel Aguilera-Gonzalez, Laura Sandoval-Plascencia, Uriel Rico-Jauregui, Carlos A. Gomez-Partida, Iris X. Ortiz-Macias, Jose A. Lopez-Pulgarin, Quetzalcoatl Chavez-Pena, Julio C. Mijangos-Mendez, Guadalupe Aguirre-Avalos, Glenn Hernandez
Summary: This study aimed to assess the impact of early adjunctive methylene blue (MB) on the time to vasopressor discontinuation in patients with septic shock. The results showed that early adjunctive MB can reduce the time to vasopressor discontinuation, increase vasopressor-free days, and decrease length of stay in ICU and hospital without adverse effects.
Article
Biology
Vasiliki Tsolaki, George E. Zakynthinos, John Papanikolaou, Vasileios Vazgiourakis, Kyriaki Parisi, George Fotakopoulos, Demosthenes Makris, Epaminondas Zakynthinos
Summary: This study compared the treatment of severe septic cardiomyopathy (SCM) with levosimendan and the best available therapy. The results showed that patients receiving levosimendan had better recovery of cardiac function and a decrease in lactate levels, although there was no statistically significant difference in survival rates. This suggests that levosimendan treatment may be effective in patients with severe SCM.
Article
Nursing
Luciana Ramos Correa Pinto, Karina de Oliveira Azzolin, Amalia de Fatima Lucena, Miriane M. S. Moretti, Jaqueline S. Haas, Rafael B. Moraes, Gilberto Friedman
Summary: The study identified clinical indicators of septic shock in critical care patients, including hypotension, mechanical ventilation, lactate levels, hypothermia, radiotherapy-associated chemotherapy, Sequential Organ Failure Assessment score, and admittance through the emergency unit. Patients with septic shock presented hyperlactataemia and greater organic dysfunction compared to those with sepsis. Mechanical ventilation, chemotherapy, and radiotherapy were found to increase the risk of developing septic shock.
JOURNAL OF CLINICAL NURSING
(2021)
Review
Immunology
Sang Ho Choi, Antoni Cesar, Timothy Arthur Chandos Snow, Naveed Saleem, Nishkantha Arulkumaran, Mervyn Singer
Summary: This study found that the efficacy of doxycycline is comparable to macrolides or fluoroquinolones in adult patients with mild-to-moderate community-acquired pneumonia (CAP), suggesting that it is a viable treatment option. However, larger trials are needed to confirm these findings due to the lack of recent studies.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Nursing
Lyvonne N. Tume, Bronagh Blackwood, Daniel F. McAuley, Kevin Morris, Mark J. Peters, Joanne Jordan, Timothy Simon Walsh, Lisa McIlmurray
Summary: This paper describes the experience of using the TIDieR checklist in reporting a trial on sedation and ventilation weaning in critically ill children. The checklist provides a structured way to report complex interventions, which aids replication and adoption into practice.
NURSING IN CRITICAL CARE
(2023)
Article
Critical Care Medicine
Bruno A. M. P. Besen, Otavio T. Ranzani, Mervyn Singer
INTENSIVE CARE MEDICINE
(2023)
Review
Anesthesiology
W. Pisciotta, P. Arina, D. Hofmaenner, M. Singer
Summary: Dealing with uncertain or missed diagnoses in the intensive care unit is common. It can lead to a decrease in quality of care and increase the risk of poor outcomes for affected patients. The diagnostic process is complex, especially in critically ill patients where history may be unclear and clinical features may not be specific. This review aims to analyze common causes of diagnostic errors and suggest a diagnostic framework, emphasizing the importance of debiasing strategies and multidisciplinary teamwork to improve patient care and outcomes.
Review
Critical Care Medicine
Pedro Povoa, Luis Coelho, Felipe Dal-Pizzol, Ricard Ferrer, Angela Huttner, Andrew Conway Morris, Vandack Nobre, Paula Ramirez, Anahita Rouze, Jorge Salluh, Mervyn Singer, Daniel A. Sweeney, Antoni Torres, Grant Waterer, Andre C. Kalil
Summary: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Biomarkers can be used as indicators for infection, dysregulated host response, treatment response, and can aid in prognosticating patient risk. Over 250 biomarkers have been identified and evaluated, but none can accurately differentiate between sepsis and sepsis-like syndrome.
INTENSIVE CARE MEDICINE
(2023)
Editorial Material
Medicine, General & Internal
Michael Klompas, Chanu Rhee, Mervyn Singer
Summary: This viewpoint discusses the failure of SEP-1 sepsis outcome improvement initiative by Centers for Medicare & Medicaid Services in improving patients' sepsis outcomes, and suggests shifting the focus of sepsis quality metrics from processes to outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Medicine, General & Internal
Alisa M. Higgins, Lindsay R. Berry, Elizabeth Lorenzi, Srinivas Murthy, Zoe McQuilten, Paul R. Mouncey, Farah Al-Beidh, Djillali Annane, Yaseen M. Arabi, Abi Beane, Wilma Van Bentum-Puijk, Zahra Bhimani, Marc J. M. Bonten, Charlotte A. Bradbury, Frank M. Brunkhorst, Aiden Burrell, Adrian Buzgau, Meredith Buxton, Walton N. Charles, Matthew Cove, Michelle A. Detry, Lise J. Estcourt, Elizabeth O. Fagbodun, Mark Fitzgerald, Timothy D. Girard, Ewan C. Goligher, Herman Goossens, Rashan Haniffa, Thomas Hills, Christopher M. Horvat, David T. Huang, Nao Ichihara, Francois Lamontagne, John C. Marshall, Daniel F. McAuley, Anna McGlothlin, Shay P. McGuinness, Bryan J. McVerry, Matthew D. Neal, Alistair D. Nichol, Rachael L. Parke, Jane C. Parker, Karen Parry-Billings, Sam E. C. Peters, Luis F. Reyes, Kathryn M. Rowan, Hiroki Saito, Marlene S. Santos, Christina T. Saunders, Ary Serpa-Neto, Christopher W. Seymour, Manu Shankar-Hari, Lucy M. Stronach, Alexis F. Turgeon, Anne M. Turner, Frank L. van de Veerdonk, Ryan Zarychanski, Cameron Green, Roger J. Lewis, Derek C. Angus, Colin J. McArthur, Scott Berry, Lennie P. G. Derde, Anthony C. Gordon, Steve A. Webb, Patrick R. Lawler
Summary: The longer-term effects of therapies for critically ill COVID-19 patients are unknown. In this study, 4869 patients were randomized to receive different interventions, and it was found that treatment with IL-6 receptor antagonists and antiplatelet agents significantly improved survival rates after 180 days. These findings suggest that most therapies have consistent effects over a 6-month period.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Geochemistry & Geophysics
A. Baranov, A. Morelli
Summary: We have developed a new three-layer sediment model for Antarctica, based on geophysical data and a subglacial bedrock map. By combining this model with an existing global sediment model, we have created a comprehensive sediment model for Antarctica and the surrounding oceans. Our findings highlight significant differences in sedimentary basins in Antarctica, attributed to their age and origin.
Article
Geochemistry & Geophysics
Rosaria Tondi, Alessandra Borghi, Andrea Morelli
Summary: In this study, we investigate the influence of different Moho surfaces on the reconstruction of upper mantle geophysical parameters in the subsurface of Antarctica continent. Using the Sequential Integrated Inversion (SII) optimization program and gravity anomalies synthetized by a global Gravity Field Model (GFM), we reconstruct the density of the upper mantle and the 3D distribution of the p-v(SV) couplings at depths up to 400 km. Four models are built with four different Moho surfaces, and a correlation analysis reveals their impact on the anomalies and couplings. The density models and p-v(SV) couplings help identify significant geological features in the Antarctic region.
Review
Medicine, Research & Experimental
Miranda J. Melis, Muska Miller, Vera B. M. Peters, Mervyn Singer
Summary: Sepsis is a life-threatening condition caused by an uncontrolled host response to infection, leading to organ dysfunction. It affects various body systems with fluctuations in gene transcription and downstream pathways. However, the complex nature of sepsis pathophysiology has hindered the development of new therapeutic approaches. This review highlights the impact of altered endocrine system on mitochondrial dysfunction and immune suppression, important aspects of sepsis pathophysiology.
Article
Multidisciplinary Sciences
Nishkantha Arulkumaran, Mervyn Singer, Stefan Howorka, Jonathan R. R. Burns
Summary: In this study, the authors assemble DNA subunits into structural frameworks to support the formation of membrane-based protocells and prototissues, harnessing simplicity to create complexity.
NATURE COMMUNICATIONS
(2023)
Article
Geography, Physical
Glenn A. Jones, Bernd Kulessa, Ana M. G. Ferreira, Martin Schimmel, Andrea Berbellini, Andrea Morelli
Summary: Seismic Rayleigh wave ellipticity measurements are used to determine subsurface structure and are increasingly applied in glaciological research. Using the DOP-E method, we identify and extract Rayleigh waves in Greenland to study sea ice processes and upper crust geology. We suggest future applications of the DOP-E method for studying seasonal and long-term variability of sea ice and monitoring ice sheet thickness and subglacial environment in the polar regions.
ANNALS OF GLACIOLOGY
(2023)
Article
Critical Care Medicine
Stephen Huang, Antoine Vieillard-Baron, Bruno Evrard, Gwenael Prat, Michelle Chew, Martin Balik, Fernando Clau-Terre, Daniel De Backer, Armand Mekontso Dessap, Sam Orde, Andrea Morelli, Filippo Sanfilippo, Cyril Charron, Philippe Vignon, ECHO COVID Study Grp
Summary: This study aimed to evaluate the association between different phenotypes of right ventricular (RV) involvement and mortality in the intensive care unit (ICU) in patients with acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). Post-hoc analysis of longitudinal data from the ECHO-COVID observational study showed that RV involvement is prevalent in patients ventilated for COVID-19 ARDS and different phenotypes of RV involvement may lead to different ICU mortality, with acute cor pulmonale (ACP) having the worst outcome.
INTENSIVE CARE MEDICINE
(2023)
Article
Pharmacology & Pharmacy
Rebekah A. Eadie, Cathrine A. McKenzie, Daniel J. Hadfield, Nicola J. Kalk, Scott Bolesta, Martin F. Dempster, Daniel F. McAuley, Bronagh Blackwood
Summary: This study investigated the use of opioid, sedative, and preadmission medications in critically ill adults in UK ICUs, and found a high prevalence of medication with potential for iatrogenic withdrawal syndrome. Most ICUs lacked sedation/analgesia policies and did not screen for iatrogenic withdrawal.
INTERNATIONAL JOURNAL OF CLINICAL PHARMACY
(2023)
Review
Anesthesiology
Filippo Sanfilippo, Antonio Messina, Sabino Scolletta, Elena Bignami, Andrea Morelli, Maurizio Cecconi, Giovanni Landoni, Stefano Romagnoli
Summary: The impact of left ventricular diastolic dysfunction on critically ill patients admitted to the intensive care unit has gained recent interest. Treatment options for diastolic dysfunction are limited, making a proactive approach crucial in improving outcomes. The CHEOPS bundle, combining chest ultrasound, hemodynamics assessment, optimization of mechanical ventilation and pulmonary circulation, and stabilization, provides a potentially useful acronym for optimizing the management of critically ill patients with left ventricular diastolic dysfunction.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)