Article
Anesthesiology
Tine Sylvest Meyhoff, Anders Granholm, Peter Buhl Hjortrup, Praleene Sivapalan, Theis Lange, Jon Henrik Laake, Maria Cronhjort, Stephan M. Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L. N. G. Malbrain, Morten Hylander Moller, Anders Perner
Summary: In adults with septic shock, gastrointestinal focus of infection and higher doses of norepinephrine at baseline were associated with albumin use, which also varied substantially between sites.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Anesthesiology
Tine Sylvest Meyhoff, Anders Granholm, Peter Buhl Hjortrup, Praleene Sivapalan, Theis Lange, Jon Henrik Laake, Maria Cronhjort, Stephan M. Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L. N. G. Malbrain, Morten Hylander Moller, Anders Perner
Summary: This is a protocol and statistical analysis plan for a post-hoc secondary study of septic shock patients receiving intravenous albumin. The study aims to assess the association between baseline characteristics or trial site and the administration of IV albumin during ICU stay. The results will be presented as hazard ratios and p-values for the associations.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Multidisciplinary Sciences
Tongtian Ni, Yi Wen, Yihui Wang, Weisong Jiang, Huiqiu Sheng, Erzhen Chen, Enqiang Mao, Zhixin Lan, Yaguo Huang, Yuhua Zhou
Summary: This study aimed to investigate the association between albumin/prealbumin levels and prognosis in severe acute pancreatitis (SAP) and establish a new goal-directed therapy involving these proteins. The results showed that serum albumin and prealbumin levels in the early stage of SAP are significantly relevant to prognosis, and raising these levels can improve the prognosis.
SCIENTIFIC REPORTS
(2022)
Article
Gastroenterology & Hepatology
Francois Durand, John A. Kellum, Mitra K. Nadim
Summary: Fluid resuscitation is complicated in patients with cirrhosis and hypotension due to circulatory changes and hyperdynamic state. Echocardiography shows promise for assessing fluid status. Large volumes of saline should be avoided in cirrhosis patients, and albumin may be superior for controlling inflammation. Vasopressors should be initiated early in cirrhosis patients with sepsis and hypotension, with norepinephrine as the first-line option.
JOURNAL OF HEPATOLOGY
(2023)
Article
Multidisciplinary Sciences
Timothy Coyle, Samuel M. John
Summary: The study evaluated the use of albumin in a community hospital setting over a 6-month period, finding that the most common indications for albumin administration were sepsis or septic shock, hypotension or hypovolemia, and intradialytic hypotension. Critical care, nephrology, and surgery were the departments most frequently ordering albumin.
Article
Pediatrics
Amanda Harley, Shane George, Megan King, Natalie Phillips, Gerben Keijzers, Debbie Long, Kristen Gibbons, Rinaldo Bellomo, Luregn J. Schlapbach
Summary: This study aims to investigate the feasibility of early use of inotropes in children with septic shock compared to standard fluid resuscitation. The study is an open label randomized controlled pilot study conducted at four specialized pediatric Emergency Departments. The main clinical outcome assessed will be survival free of organ dysfunction censored at 28 days.
FRONTIERS IN PEDIATRICS
(2021)
Review
Emergency Medicine
Ali Vaeli Zadeh, Alan Wong, Andrew Carl Crawford, Elias Collado, Joshua M. Larned
Summary: This study aims to examine the impact of a fluid resuscitation strategy based on guidelines versus a restrictive approach on in-hospital mortality in patients with sepsis and a history of heart failure.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2023)
Article
Medicine, General & Internal
Marie Egebjerg Jensen, Jens Aage Kolsen-Petersen, Hans Kirkegaard, Marie Kristine Jessen
Summary: Patients transported by EMS received more intravenous fluids and less oral fluids in the first 24 hours compared to non-EMS patients. The overall fluid administration was higher in EMS transported patients after adjustment for age, site, and SOFA-score.
FRONTIERS IN MEDICINE
(2022)
Review
Medicine, General & Internal
Rachael Cusack, Susan O'Neill, Ignacio Martin-Loeches
Summary: Sepsis is a common and deadly syndrome in intensive care settings, and fluid therapy is often used as an intervention. However, the effects of fluid bolus on microcirculation in sepsis have not been fully addressed. This systematic review aims to analyze studies examining the microcirculatory outcomes after a fluid bolus in sepsis patients. The review found no clear effects of fluid bolus on microcirculation parameters, but the heterogeneity between studies and methodologies prevented meta-analysis. Further research is needed to understand the effects of different resuscitation fluids on microcirculation.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Penglin Ma, Jingtao Liu, Feng Shen, Xuelian Liao, Ming Xiu, Heling Zhao, Mingyan Zhao, Jing Xie, Peng Wang, Man Huang, Tong Li, Meili Duan, Kejian Qian, Yue Peng, Feihu Zhou, Xin Xin, Xianyao Wan, ZongYu Wang, Shusheng Li, Jianwei Han, Zhenliang Li, Guolei Ding, Qun Deng, Jicheng Zhang, Yue Zhu, Wenjing Ma, Jingwen Wang, Yan Kang, Zhongheng Zhang
Summary: Septic shock can be classified into five phenotypes based on clinical variables, each requiring tailored resuscitation strategies for optimal outcomes.
Article
Computer Science, Artificial Intelligence
Akash Gupta, Michael T. Lash, Senthil K. Nachimuthu
Summary: A data-driven optimization solution was developed in this study to determine the optimal quantity of IV fluids for septic patients, resulting in an average reduction of 22% in mortality.
EXPERT SYSTEMS WITH APPLICATIONS
(2021)
Article
Cardiac & Cardiovascular Systems
Zhiyuan Ma, Mahesh Krishnamurthy, Vivek Modi, David Allen, Jamshid Shirani
Summary: This retrospective study found a significant association between cardiac troponin release on admission and higher in-hospital mortality and 1-year mortality among septic patients. Further analysis revealed that adequate fluid resuscitation can lower in-hospital mortality in septic patients without cardiac troponin release, but not in those with it.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Article
Medicine, Research & Experimental
Yu-Ming Wang, Ying Chen, Yan-Jun Zheng, Yun-Chuan Huang, Wei-Wei Chen, Ran Ji, Li-Li Xu, Zhi-Tao Yang, Hui-Qiu Sheng, Hong-Ping Qu, En-Qiang Mao, Er-Zhen Chen
Summary: For patients with sepsis and septic shock, a low fluid intake volume during the first 24 h and a persistent negative fluid balance from the second day were found to be associated with favorable outcomes. The mean daily fluid balance was also identified as an independent prognostic factor for these patients.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2021)
Article
Critical Care Medicine
Ishaq Lat, Craig M. Coopersmith, Daniel De Backer
Summary: This study builds upon the research priorities related to fluid resuscitation and vasopressor therapy identified by a group of experts, providing important insights and directions for future studies.
CRITICAL CARE MEDICINE
(2021)
Article
Medicine, General & Internal
Tiffany Patterson, Gavin Perkins, Alexander Perkins, Tim Clayton, Richard Evans, Matthew Dodd, Steven Robertson, Karen Wilson, Adam Mellett-Smith, Rachael Fothergill, Paul Mccrone, Miles Dalby, Philip Maccarthy, Sam Firoozi, Iqbal Malik, Roby Rakhit, Ajay Jain, Jerry P. Nolan, ARREST Trial Collaborators
Summary: This study assessed whether expedited delivery to a cardiac arrest center compared with current standard of care reduces deaths in patients with resuscitated cardiac arrest. The results showed that expedited delivery to a cardiac arrest center did not reduce mortality in adult patients without ST elevation.
Review
Anesthesiology
Vera Crone, Morten Hylander Moller, Anders Perner, Waleed Alhazzani, Mette Krag
Summary: This study aims to systematically describe and explore the evidence on the use of prokinetic agents in hospitalised adults. The study will assess study design, population, agents, indications and outcomes, provide descriptive analyses, and characterize knowledge gaps.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Article
Anesthesiology
Carl Thomas Anthon, Frederic Pene, Anders Perner, Elie Azoulay, Kathryn Puxty, Andry Van de Louw, Andreas Barratt-Due, Sanjay Chawla, Pedro Castro, Pedro Povoa, Luis Coelho, Victoria Metaxa, Laveena Munshi, Matthias Kochanek, Tobias Liebregts, Thomas Kander, Johanna Hastbacka, Morten Hylander Moller, Lene Russell
Summary: The international cohort study aims to provide contemporary epidemiological data on thrombocytopenia and platelet transfusion practices in adult ICU patients. The study will collect data from at least 1000 acutely admitted adult ICU patients and focus on the occurrence and mortality rate of thrombocytopenia, as well as indications for platelet transfusion.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Article
Anesthesiology
Nicolai Haase, Ronni Plovsing, Steffen Christensen, Lone M. Poulsen, Anne C. Brochner, Bodil S. Rasmussen, Marie Helleberg, Jens U. S. Jensen, Lars P. K. Andersen, Hanna Siegel, Michael Ibsen, Vibeke L. Jorgensen, Robert Winding, Susanne Iversen, Henrik P. Pedersen, Jacob Madsen, Christoffer Solling, Ricardo S. Garcia, Jens Michelsen, Thomas Mohr, George Michagin, Ulrick S. Espelund, Helle Bundgaard, Lynge Kirkegaard, Margit Smitt, David L. Buck, Niels-Erik Ribergaard, Helle S. Pedersen, Birgitte V. Christensen, Lone P. Nielsen, Esben Clapp, Trine B. Jonassen, Sarah Weihe, Kirstine la Cour, Frederik M. Nielsen, Emilie K. Madsen, Trine N. Haberlandt, Nick Meier, Anders Perner
Summary: After the first wave of COVID-19 in Denmark, a lower proportion of hospitalized patients with COVID-19 were admitted to ICU. Among ICU patients, use of organ support was lower and length of stay was reduced, but mortality rates remained relatively high.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Article
Anesthesiology
Sarah Weihe, Camilla B. Mortensen, Nicolai Haase, Lars P. K. Andersen, Thomas Mohr, Hanna Siegel, Michael Ibsen, Vibeke R. L. Jorgensen, David L. Buck, Helle B. S. Pedersen, Henrik P. Pedersen, Susanne Iversen, Niels Ribergaard, Bodil S. Rasmussen, Robert Winding, Ulrick S. Espelund, Helle Bundgaard, Christoffer G. Solling, Steffen Christensen, Ricardo S. Garcia, Anne C. Brochner, Jens Michelsen, George Michagin, Lynge Kirkegaard, Anders Perner, Ole Mathiesen, Lone M. Poulsen
Summary: ICU admission due to COVID-19 may result in long-term cognitive and physical impairment, including cognitive and functional impairment and fatigue.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Review
Critical Care Medicine
Anders Granholm, Carl T. Anthon, Maj-Brit N. Kjaer, Mathias Maagaard, Benjamin S. Kaas-Hansen, Praleene Sivapalan, Olav L. Schjorring, Lars W. Andersen, Ole Mathiesen, Thomas Strom, Aksel K. G. Jensen, Anders Perner, Morten H. Moller
Summary: This scoping review aims to examine how recent clinical trials handle challenges such as outcome selection, deceased patients, and missing data in analyses.
CRITICAL CARE MEDICINE
(2022)
Article
Anesthesiology
Lars Hyldborg Lundstrom, Anders K. Norskov, Line D. Kjeldgaard, Jorn Wetterslev, Charlotte Rosenstock
Summary: From 2008 to 2016, there was a significant increase in the use of video laryngoscopy, becoming the first-choice device for airway management. The data also showed a noticeable reduction in failed intubation over the time of observation.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Anesthesiology
Mark Borthwick, Anders Granholm, Soren Marker, Mette Krag, Theis Lange, Matt P. Wise, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Joerg C. Schefold, Jorn Wetterslev, Anders Perner, Morten Hylander Moller
Summary: Critically ill patients are at risk of gastrointestinal bleeding, and pharmacological stress ulcer prophylaxis (SUP) is commonly used to minimize this risk. The effect of enteral nutrition as SUP on GI bleeding rates is uncertain, with conflicting data and variable practice. This study aims to explore the association between enteral nutrition and GI bleeding rates in ICU patients and evaluate any interactions with pharmacologic SUP. The results may provide important insights for guiding practice and designing future clinical trials on the effect of enteral nutrition on GI bleeding.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Review
Anesthesiology
Mathias Maagaard, Marija Barbateskovic, Nina C. Andersen-Ranberg, Jonas R. Kronborg, Ya-Xin Chen, Huan-Huan Xi, Anders Perner, Jorn Wetterslev
Summary: This systematic review of randomized clinical trials found that dexmedetomidine may reduce the occurrence of serious adverse events and delirium in intensive care or post-operative care units. However, there was no conclusive evidence for its effects on all-cause mortality. The certainty of evidence ranged from very low for delirium to low for the remaining outcomes.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Review
Anesthesiology
Marie Warrer Munch, Anders Granholm, Andreas Bender Jonsson, Fredrik Sjovall, Marie Helleberg, Frederik Botius Hertz, Jakob Steen Andersen, Morten Steensen, Michael Patrick Achiam, Anders Perner, Morten Hylander Moller
Summary: This study aimed to compare the desirable and undesirable effects of piperacillin/tazobactam versus carbapenems in patients with severe bacterial infections. The results suggest that piperacillin/tazobactam may be associated with less favorable outcomes in patients with severe bacterial infections compared to carbapenems.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Article
Anesthesiology
Gitte K. Vesterlund, Hans-Christian Thorsen-Meyer, Morten H. Moller, Soren Brunak, Thomas Strom, Anders Perner, Benjamin S. Kaas-Hansen
Summary: This study aimed to describe abnormal serum levels of magnesium, phosphate, and zinc in Danish ICU patients and assess their associations with outcomes. The results showed that most ICU patients had low serum levels of magnesium, phosphate, or zinc, and some received supplementation. However, the associations between serum levels and clinical outcomes were inconclusive due to insufficient data.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
Review
Critical Care Medicine
Praleene Sivapalan, Karen L. Ellekjaer, Marie K. Jessen, Tine S. Meyhoff, Maria Cronhjort, Peter B. Hjortrup, Jorn Wetterslev, Anders Granholm, Morten H. Moller, Anders Perner
Summary: Among adult patients with sepsis, lower IV fluid volumes probably result in little to no difference in all-cause mortality compared with higher IV fluid volumes, but the interpretation is limited by imprecision in the estimate.
Article
Critical Care Medicine
Maj-Brit Norregaard Kjaer, Tine Sylvest Meyhoff, Praleene Sivapalan, Anders Granholm, Peter Buhl Hjortrup, Martin Bruun Madsen, Morten Hylander Moller, Ingrid Egerod, Jorn Wetterslev, Theis Lange, Maria Cronhjort, Jon Henrik Laake, Stephan M. Jakob, Marek Nalos, Marlies Ostermann, Doug Gould, Maurizio Cecconi, Manu L. N. G. Malbrain, Christian Ahlstedt, Louise Bendix Kiel, Morten H. Bestle, Lars Nebrich, Thomas Hildebrandt, Lene Russell, Marianne Vang, Michael Lindhart Rasmussen, Christoffer Solling, Anne Craveiro Brochner, Mette Krag, Carmen Pfortmueller, Miroslav Kriz, Martin Siegemund, Giovanni Albano, Soren Rosborg Aagaard, Helle Bundgaard, Vera Crone, Sine Wichmann, Bror Johnstad, Yvonne Karin Martin, Philipp Seidel, Johan Martensson, Jacob Hollenberg, Mats Wistrand, Abele Donati, Enrico Barbara, Thomas Karvunidis, Alexa Hollinger, Andrea Carsetti, Nuttha Lumlertgul, Eva Joelsson-Alm, Nikolas Lambiris, Tayyba Naz Aslam, Fredrik Femtehjell Friberg, Gitte Kingo Vesterlund, Camilla Bekker Mortensen, Stine Rom Vestergaard, Sidsel Fjordbak Caspersen, Diana Bertelsen Jensen, Morten Borup, Bodil Steen Rasmussen, Anders Perner
Summary: This study compared the long-term outcomes of restrictive versus standard IV fluid therapy in adult ICU patients with septic shock. The results showed that there were no significant differences in survival, HRQoL, and cognitive function at 1 year between the two groups, but clinically important differences could not be ruled out.
INTENSIVE CARE MEDICINE
(2023)
Article
Surgery
Martijn S. Marsman, Jarn Wetterslev, Patrick W. H. E. Vriens, Ronald L. A. W. Bleys, Abdelkarime Kh. Jahrome, Frans L. Moll, Frederik Keus, Michel M. P. J. Reijnen, Giel G. Koning
Summary: This study compared the eversion technique and carotid endarterectomy with patch angioplasty in patients with symptomatic carotid artery stenosis through randomized controlled trials. The results showed that the eversion technique may reduce the occurrence of serious adverse events, but there was no difference in other outcomes. According to GRADE rating, all patient-relevant outcomes had low certainty of evidence.
SURGERY OPEN SCIENCE
(2023)
Review
Critical Care Medicine
Nina Christine Andersen-Ranberg, Marija Barbateskovic, Anders Perner, Marie Oxenboll Collet, Lone Musaeus Poulsen, Mathieu van der Jagt, Lisa Smit, Jorn Wetterslev, Ole Mathiesen, Mathias Maagaard
Summary: By reviewing recent trials, we found that haloperidol may reduce mortality and have minimal impact on serious adverse events in critically ill patients with delirium. However, further trial data is needed to confirm the effects of haloperidol in these patients.