Letter
Medicine, General & Internal
Jan O. Friedrich, Elisa Gouvea Bogossian
Summary: In a trial evaluating the efficacy of hydrocortisone in treating community-acquired pneumonia, researchers found a nearly 50% lower 28-day mortality rate in the hydrocortisone group compared to the placebo group. They also observed a higher incidence of septic shock in the placebo group. The trial did not allow the use of open-label glucocorticoids, which may have contributed to the higher mortality rate in the placebo group.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Infectious Diseases
Miriam Kesselmeier, Mathias W. Pletz, Anna Leona Blankenstein, Andre Scherag, Torsten Bauer, Santiago Ewig, Martin Kolditz
Summary: This study validated the prognostic accuracy of using qSOFA score in patients with community-acquired pneumonia (CAP), showing that qSOFA-65 was less accurate in mortality prediction compared to CRB-65. For sensitive mortality prediction, adding the age criterion >= 65 years to qSOFA is recommended. The sepsis cut-off of >= 2 in qSOFA lacked sensitivity.
CLINICAL MICROBIOLOGY AND INFECTION
(2021)
Article
Critical Care Medicine
Xanthe Brands, Floris M. C. de Vries, Fabrice Uhel, Bastiaan W. Haak, Hessel Peters-Sengers, Alex R. Schuurman, Tjitske S. R. van Engelen, Rene Lutter, Olaf L. Cremer, Marc J. Bonten, Marcus J. Schultz, Brendon P. Scicluna, Tom van der Poll
Summary: This study investigated macrophage activation-like syndrome in critically ill patients with community-acquired pneumonia, showing that the syndrome is more common in patients with hematologic malignancies and is associated with deregulation of multiple host response pathways.
CRITICAL CARE MEDICINE
(2021)
Article
Respiratory System
Yves Gillet, Anne Tristan, Jean-Philippe Rasigade, Mitra Saadatian-Elahi, Coralie Bouchiat, Michele Bes, Oana Dumitrescu, Marie Leloire, Celine Dupieux, Frederic Laurent, Gerard Lina, Jerome Etienne, Philippe Vanhems, Laurent Argaud, Francois Vandenesch
Summary: This study found that severe pneumonia caused by Staphylococcus aureus was associated with PVL toxin in toddlers and was a risk factor for mortality in older patients. Additionally, methicillin resistance and other virulence factors were also associated with mortality.
EUROPEAN RESPIRATORY JOURNAL
(2021)
Article
Immunology
Catia Cilloniz, Hector Jose Peroni, Albert Gabarrus, Carolina Garcia-Vidal, Juan M. Pericas, Jesus Bermejo-Martin, Antoni Torres
Summary: Lymphopenia was independently associated with a higher risk of ICU admission and increased in-hospital and 30-day mortality in patients with CAP and sepsis. Early identification of lymphopenia could help in identifying septic patients with CAP who require or will soon require critical care.
OPEN FORUM INFECTIOUS DISEASES
(2021)
Article
Critical Care Medicine
Kirstine K. Sogaard, Veronika Baettig, Michael Osthoff, Stephan Marsch, Karoline Leuzinger, Michael Schweitzer, Julian Meier, Stefano Bassetti, Roland Bingisser, Christian H. Nickel, Nina Khanna, Sarah Tschudin-Sutter, Maja Weisser, Manuel Battegay, Hans H. Hirsch, Hans Pargger, Martin Siegemund, Adrian Egli
Summary: This study tracked infection among COVID-19 patients at the University Hospital Basel and found that community-acquired viral and bacterial infections were rare, while hospital-acquired bacterial or fungal infections were common among ICU patients. The infection rate was higher among ICU patients.
JOURNAL OF INTENSIVE CARE
(2021)
Article
Immunology
Xanthe Brands, Tjitske S. R. van Engelen, Floris M. C. de Vries, Bastiaan W. Haak, Augustijn M. Klarenbeek, Maadrika M. N. P. Kanglie, Inge A. H. van den Berk, Alex R. Schuurman, Hessel Peters-Sengers, Natasja A. Otto, Daniel R. Faber, Rene Lutter, Brendon P. Scicluna, Jaap Stoker, Jan M. Prins, W. Joost Wiersinga, Tom van der Poll
Summary: Hyperferritinemia in patients hospitalized for community-acquired pneumonia is associated with disturbances in key host response pathways, indicating a broad deregulation of various mechanisms involved in sepsis pathogenesis.
JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Pediatrics
Caizhi Huang, Cong Zhang, Jie Zhang, Lin Zhang, Yi Mo, Liya Mo
Summary: This study investigated the association between Heparin-binding protein (HBP) levels and the development of respiratory failure (RF) and sepsis in critically ill children with severe community-acquired pneumonia (CAP). The results showed that HBP, IL-6, and D-dimer were significant predictors of RF development, with HBP independently associated with RF development. Additionally, HBP was found to be the best indicator for progression to severe sepsis compared to other biomarkers.
FRONTIERS IN PEDIATRICS
(2021)
Article
Immunology
Leigh M. Howard, Kathryn M. Edwards, Yuwei Zhu, Carlos G. Grijalva, Wesley H. Self, Seema Jain, Krow Ampofo, Andrew T. Pavia, Sandra R. Arnold, Jonathan A. McCullers, Evan J. Anderson, Richard G. Wunderink, Derek J. Williams
Summary: Clinical features did not reliably distinguish HMPV-associated pneumonia from other pathogens. HMPV-associated pneumonia was less severe than bacterial and adult RSV pneumonia, but was otherwise as or more severe than other common pathogens.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Medicine, General & Internal
Sedat Ozbay, Mustafa Ayan, Orhan Ozsoy, Canan Akman, Ozgur Karcioglu
Summary: Community-acquired pneumonia (CAP) is a common cause of death and a major healthcare concern globally. Procalcitonin (PCT) and C-reactive protein (CRP) are reliable biomarkers for diagnosing severe infections, including pneumonia and sepsis. PCT is superior to other acute phase reactants in predicting pneumonia, bacteremia, sepsis, and poor outcome. This manuscript provides an overview of CAP, sepsis, and the importance of PCT and other markers for diagnosis and management.
Review
Respiratory System
Ignacio Martin-Loeches, Antoni Torres
Summary: This article highlights recent advances in treatment guidelines for patients with sCAP, emphasizing important points in the diagnosis and treatment of sCAP, as well as the challenges in management and the need for clearer recommendations.
CURRENT OPINION IN PULMONARY MEDICINE
(2021)
Article
Respiratory System
Hannah Lawrence, Tricia M. McKeever, Wei Shen Lim, British Thoracic Soc
Summary: The readmission rates for community-acquired pneumonia (CAP) in the UK have increased over the past decade. This study aimed to describe the cohort of patients who were readmitted within 30 days after hospitalisation for CAP in England and explore the reasons for this. A retrospective analysis was performed using data from the British Thoracic Society audit, and it was found that pneumonia was the most common condition treated on readmission and had a higher mortality rate than other diagnoses.
Review
Infectious Diseases
Catia Cilloniz, Juan Manuel Pericas, Walter H. Curioso
Summary: This article reviews the factors related to CAP-associated outcomes, including host, microorganism, therapeutic approach, and health system organization. The aim is to discuss controversial points and provide recommendations for further research and patient management to improve CAP outcomes, beyond mortality.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Article
Infectious Diseases
Catia Cilloniz, Cristina Dominedo, Albert Gabarrus, Carolina Garcia-Vidal, Jose Becerril, Diego Tovar, Estela Moreno, Juan M. Pericas, Carmen Rosa Vargas, Antoni Torres
Summary: This study aimed to describe the prevalence, risk factors, and outcomes of MSSA community-acquired pneumonia and found that MSSA CAP patients had higher 30-day mortality than pneumococcal CAP patients, with MSSA being an independent factor of mortality.
JOURNAL OF INFECTION
(2021)
Article
Multidisciplinary Sciences
Robert F. J. Kullberg, Xanthe Brands, Augustijn M. Klarenbeek, Joe M. Butler, Natasja A. Otto, Daniel R. Faber, Brendon P. Scicluna, Tom van der Poll, W. Joost Wiersinga, Bastiaan W. Haak
Summary: The study found a correlation between intestinal microbiota and immune responses in patients with community-acquired pneumonia. The composition of rectal microbiota one month after hospitalization was related to cytokine responses, potentially explaining the increased risk of recurrent infections after hospitalization.
Article
Anesthesiology
Denise Battaglini, Lavienraj Premraj, Samuel Huth, Jonathon Fanning, Glenn Whitman, Rakesh C. Arora, Judith Bellapart, Diego Bastos Porto, Fabio S. Taccone, Jacky Y. Suen, Gianluigi Li Bassi, John F. Fraser, Sung-Min Cho, Chiara Robba
Summary: This systematic review investigates the use of noninvasive multimodal neuromonitoring in critically ill adult patients with COVID-19. The findings suggest that alterations in cerebral hemodynamics, brain compliance, brain oxygenation, pupillary response, and brain electrophysiological activity are common in these patients, but they are not clearly associated with worse outcome or the development of new neurological complications.
JOURNAL OF NEUROSURGICAL ANESTHESIOLOGY
(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)
Review
Anesthesiology
Chiara Robba, Denise Battaglini, Francesco Rasulo, Francisco A. Lobo, Basil Matta
Summary: Non-invasive neuromonitoring has seen increased use in non-brain injured patients due to the recognition of the risk of brain injury in various clinical scenarios. Cerebral oximetry using Near infrared Spectroscopy has shown efficacy in preventing cerebral hypoxemia and is a simple, continuous measure of cerebral oxygenation. However, current recommendations for standard monitoring do not include specific indications for brain oximetry. This manuscript provides an overview of the pathophysiology and applications of cerebral oxygenation in non brain injured patients for the early identification and treatment of neurological complications.
JOURNAL OF CLINICAL MONITORING AND COMPUTING
(2023)
Editorial Material
Respiratory System
Sarah Wahlster, James A. Town, Denise Battaglini, Chiara Robba
Summary: Recent studies have focused on the interplay between the brain and lungs in critically ill patients. Further research is needed to understand the pathophysiological interactions, develop neuroprotective ventilation strategies, address treatment conflicts in patients with both brain and lung injuries, and improve prognostic models for extubation and tracheostomy decisions. To facilitate this research, BMC Pulmonary Medicine invites submissions to its new Collection on 'Brain-lung crosstalk'.
BMC PULMONARY MEDICINE
(2023)
Article
Respiratory System
Jorge Luis Velez-Paez, Santiago Xavier Aguayo-Moscoso, Christian Castro-Bustamante, Mario Montalvo-Villagomez, Fernando Jara-Gonzalez, Lucy Baldeon-Rojas, Natalia Zubieta-DeUrioste, Denise Battaglini, Gustavo R. Zubieta-Calleja
Summary: This study aimed to compare the survival rate of obese patients with COVID-19 at high altitude with overweight and normal patients. The results showed that obese patients had a lower mortality rate, but it was not statistically significant compared to overweight and normal patients. Age was an independent risk factor for mortality. In high-altitude areas, obese patients had higher pulmonary artery pressure and mechanical power, but a lower extubation failure rate.
BMC PULMONARY MEDICINE
(2023)
Article
Physiology
Alberto Giardina, Danilo Cardim, Pietro Ciliberti, Denise Battaglini, Lorenzo Ball, Magdalena Kasprowicz, Erta Beqiri, Peter Smielewski, Marek Czosnyka, Shirin Frisvold, Matjaz Groznik, Paolo Pelosi, Chiara Robba
Summary: This study aims to assess the effect of increasing positive end-expiratory pressure (PEEP) on cerebral autoregulation in brain injured patients. The results showed that increasing PEEP did not worsen cerebral autoregulation and did not require clinical intervention.
FRONTIERS IN PHYSIOLOGY
(2023)
Article
Respiratory System
C. Cilloniz, A. Motos, J. M. Pericas, T. G. Castaneda, A. Gabarrus, R. Ferrere, D. Garcia-Gasulla, O. Penuelas, D. de Gonzalo-Calvo, L. Fernandez-Barat, F. Barbe, A. Torres
Review
Respiratory System
Antoni Torres, Alona Kuraieva, Gregory G. Stone, Catia Cilloniz
Summary: Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for a variety of problematic infections in the community and healthcare settings, including pneumonia, with severe disease and high mortality rates. Ceftaroline fosamil has been shown to be a possible alternative treatment for MRSA pneumonia.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Critical Care Medicine
Enric Barbeta, Marta Arrieta, Ana Motos, Joaquim Bobi, Hua Yang, Minlan Yang, Giacomo Tanzella, Pierluigi Di Ginnatale, Stefano Nogas, Carmen Rosa Vargas, Roberto Cabrera, Denise Battaglini, Andrea Meli, Kasra Kiarostami, Nil Vazquez, Laia Fernandez-Barat, Montserrat Rigol, Ricard Mellado-Artigas, Gerard Frigola, Marta Camprubi-Rimblas, Pau Ferrer, Daniel Martinez, Antonio Artigas, Carlos Ferrando, Miquel Ferrer, Antoni Torres
Summary: This study successfully established an accurate animal model of ARDS induced by pulmonary sepsis. The model was created in pigs by inducing ARDS through pneumonia, the most common risk factor in humans, and analyzed the additional effect of ventilator-induced lung injury.
Article
Critical Care Medicine
Elisa Gouvea Bogossian, Chahnez Taleb, Raffaele Aspide, Rafael Badenes, Denise Battaglini, Federico Bilotta, Aaron Blandino Ortiz, Anselmo Caricato, Carlo Alberto Castioni, Giuseppe Citerio, Gioconda Ferraro, Costanza Martino, Isabella Melchionda, Federica Montanaro, Berta Monleon Lopez, Consolato Gianluca Nato, Michael Piagnerelli, Edoardo Picetti, Chiara Robba, Olivier Simonet, Aurelie Thooft, Fabio Silvio Taccone
Summary: This study aimed to assess the changes in cerebrospinal fluid glucose-to-lactate ratio (CGLR) related to therapies aimed at reducing intracranial pressure. The results showed that CGLR significantly changed over time, regardless of the study group, with a more significant effect in patients receiving interventions to reduce intracranial pressure.
Article
Critical Care Medicine
Ana Motos, Hua Yang, Gianluigi Li Bassi, Minlan Yang, Andrea Meli, Denise Battaglini, Roberto Cabrera, Joaquim Bobi, Francesco Pagliara, Gerard Frigola, Marta Camprubi-Rimblas, Laia Fernandez-Barat, Montserrat Rigol, Antoni Ferrer-Segarra, Kasra Kiarostami, Daniel Martinez, David P. Nicolau, Antonio Artigas, Paolo Pelosi, Jordi Vila, Antoni Torres
Summary: Inhaled amikacin combined with intravenous meropenem improves bactericidal efficacy for monolateral multidrug resistant P. aeruginosa pneumonia in a swine model. However, it does not have a significant effect on preventing pathogen dissemination. Inhaled amikacin enhances bacterial eradication in tracheal secretions and prevents antibiotic resistance.
Letter
Clinical Neurology
Denise Battaglini, Nicole M. White, Lavienraj Premraj, Barbara Wanjiru Citarella, Laura Merson, Chiara Robba, David Thomson, Sung-Min Cho
JOURNAL OF NEUROLOGY
(2023)