Article
Immunology
Wandong Hong, Qin Chen, Songzan Qian, Zarrin Basharat, Vincent Zimmer, Yumin Wang, Maddalena Zippi, Jingye Pan
Summary: This study investigated clinical features and laboratory findings between critically ill and non-critically ill COVID-19 pneumonia patients. It was found that older patients with higher interleukin-6 levels were more likely to develop critical illness. Interleukin-6 was identified as a superior predictor of disease severity.
FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
(2021)
Article
Medicine, Research & Experimental
Junli Zhang, Peng Lan, Jun Yi, Changming Yang, Xiaoyan Gong, Huiqing Ge, Xiaoling Xu, Limin Liu, Jiancang Zhou, Fangfang Lv
Summary: Secondary bloodstream infection is a significant cause of death in critically ill COVID-19 patients, with risk factors including extracorporeal membrane oxygenation, central venous catheter, indwelling urethral catheter, and nasogastric tube.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2021)
Article
Immunology
Jiaxing Qiu, Alex N. Zimmet, Taison D. Bell, Shrirang Gadrey, Jackson Brandberg, Samuel Maldonado, Amanda M. Zimmet, Sarah Ratcliffe, Pavel Chernyavskiy, J. Randall Moorman, Gilles Clermont, Teague R. Henry, N. Rich Nguyen, Christopher C. Moore
Summary: This study compared the responses to bloodstream infection (BSI) in critically ill transplant and non-transplant recipients and modified the criteria for transplant recipients. The results showed that both transplant and non-transplant recipients had similar responses to BSI.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Respiratory System
Anno Saris, Tom D. Y. Reijnders, Esther J. Nossent, Alex R. Schuurman, Jan Verhoeff, Saskia van Asten, Hetty Bontkes, Siebe Blok, Janwillem Duitman, Harm-Jan Bogaard, Leo Heunks, Rene Lutter, Tom van der Poll, Juan J. Garcia Vallejo
Summary: The study reveals significant differences in immune responses between the lungs and peripheral blood in severe COVID-19 patients, with a unique local profile in pulmonary immune response. Macrophages and T cells are abundant in the lungs of critically ill patients, and T cell activation levels are associated with disease severity.
Review
Microbiology
Pedro Povoa, Patricia Moniz, Joao Goncalves Pereira, Luis Coelho
Summary: Choosing and managing antimicrobial dosing in critically ill patients is a significant challenge. The unstable pharmacokinetic status and rapidly changing clinical condition of these patients require consideration of multiple factors to maximize treatment effectiveness.
Review
Pharmacology & Pharmacy
Rachael Cusack, Alexis Garduno, Khalid Elkholy, Ignacio Martin-Loeches
Summary: The prevalence of ventilator-associated pneumonia (VAP) has been highlighted by the Covid-19 pandemic, underscoring the need for new antimicrobial approaches. This narrative review examines novel investigational drugs for VAP in the ICU setting, including monoclonal antibody treatments and phage antibiotic synthesis. The post-antibiotic era is approaching, emphasizing the importance of infection control measures and personalized medicine for severe infections.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2022)
Article
Multidisciplinary Sciences
Christopher H. Gu, Layla A. Khatib, Ayannah S. Fitzgerald, Jevon Graham-Wooten, Caroline A. Ittner, Scott Sherrill-Mix, Yuchung Chuang, Laurel J. Glaser, Nuala J. Meyer, Frederic D. Bushman, Ronald G. Collman
Summary: This study used sequencing analysis to investigate the relationship between gut microbiome and bloodstream infection in critically ill patients. The results showed that gut microbiome constituents matching the bloodstream infection species were present in half of the cases, with strain-level identity depending on the relative abundance of the species in the gut.
Article
Medicine, General & Internal
Benedikt Treml, Sasa Rajsic, Tobias Hell, Dietmar Fries, Mirjam Bachler
Summary: A study examined the changes in fibrinogen levels during tigecycline therapy in critically ill patients, finding that patients with greater fibrinogen decrease received higher dose, longer treatment, and more dose changes of tigecycline. These patients also showed higher inflammation markers and slightly reduced liver synthesis capacity.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Critical Care Medicine
Giacomo Grasselli, Emanuele Cattaneo, Gaetano Florio
Summary: This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021, with more information available at the provided links.
Article
Critical Care Medicine
John A. Clark, Andrew Conway Morris, Martin D. Curran, Deborah White, Esther Daubney, Iain R. L. Kean, Vilas Navapurkar, Josefin Bartholdson Scott, Mailis Maes, Rachel Bousfield, M. Estee Torok, David Inwald, Zhenguang Zhang, Shruti Agrawal, Constantinos Kanaris, Fahad Khokhar, Theodore Gouliouris, Stephen Baker, Nazima Pathan
Summary: This study evaluated a molecular diagnostic test for lower respiratory tract infection and found that it had high sensitivity and specificity compared to routine microbiology testing. The test also provided faster results, which could aid in the better use of antimicrobial therapy.
Article
Pharmacology & Pharmacy
Noel Zahr, Saik Urien, Benoit Llopis, Gaelle Noe, Nadine Tissot, Kevin Bihan, Helga Junot, Clemence Marin, Bochra Mansour, Charles-Edouard Luyt, Alexandre Bleibtreu, Christian Funck-Brentano
Summary: This retrospective study investigated the pharmacokinetics of cefiderocol in adult patients and found that albumin binding and renal function were significant predictors of cefiderocol concentrations. The results suggest that individual adjustment of cefiderocol based on unbound drug concentration can optimize therapeutic efficacy.
Article
Pediatrics
Ilker Devrim, Ozlem Sarac Sandal, Miray Yilmaz celebi, Pinar Hepduman, Ahmet Gonullu, Gulhan Atakul, Aybuke Akaslan Kara, Yeliz Oruc, Gamze Guelfidan, Nuri Bayram, Hasan Agin
Summary: This study suggests that the use of central line bundles not only reduces the incidence of CLABSI but also delays the time to onset of infection in CLABSI patients. Additionally, as a direct consequence of the CLB, the number of CLABSIs caused by gram-positive cocci did not increase, while the proportion of CLABSIs caused by C. parapsilosis decreased.
EUROPEAN JOURNAL OF PEDIATRICS
(2023)
Article
Public, Environmental & Occupational Health
Luciana Rodrigues Pires de Campos, Marina Farrel Cortes, Beatriz Deo, Camila Rizek, Sania Santos, Lauro Perdigao, Silvia Figueiredo Costa
Summary: Mechanical ventilation, surgery, and hemodialysis are independent risk factors for multidrug-resistant bloodstream infections in critically ill trauma patients. Carbapenemase (KPC) is the main mechanism of resistance, and cross-transmission may contribute to its spread.
AMERICAN JOURNAL OF INFECTION CONTROL
(2022)
Editorial Material
Microbiology
Savino Spadaro
Summary: This Special Issue of Microorganisms examines the epidemiology, diagnostic innovations, and strategies applied in the context of infections in critically ill patients with MDR infections, emphasizing the importance of optimizing antimicrobial drug dosing in intensive care units.
Review
Critical Care Medicine
Lewis Winning, Fionnuala T. Lundy, Bronagh Blackwood, Daniel F. McAuley, Ikhlas El Karim
Summary: The link between oral health and respiratory infections, especially in intubated patients, is crucial. There is currently a lack of consensus on the best oral care practices, highlighting the need for standardized research to provide personalized oral care.
Editorial Material
Respiratory System
Enric Contreras-Barbeta, Anna Millan, Jordi Rello
EUROPEAN RESPIRATORY JOURNAL
(2022)
Article
Immunology
Joachim Klein, Jordi Rello, George Dimopoulos, Pierre Bulpa, Koen Blot, Dirk Vogelaers, Stijn Blot
Summary: Solid-organ transplantation (SOT) is a well-known risk factor for invasive pulmonary aspergillosis (IPA) in ICU patients. The study revealed that IPA in SOT patients in the ICU often presents with nonspecific medical imaging findings, leading to a high mortality rate of 68%. Lung transplantation was associated with better survival outcomes.
TRANSPLANT INFECTIOUS DISEASE
(2022)
Article
Medicine, General & Internal
Yaroslava Longhitano, Christian Zanza, Tatsiana Romenskaya, Angela Saviano, Tonia Persiano, Mirco Leo, Andrea Piccioni, Marta Betti, Antonio Maconi, Ivano Pindinello, Riccardo Boverio, Jordi Rello, Francesco Franceschi, Fabrizio Racca
Summary: The aim of this study was to determine whether a simple bedside test, the single-breath counting test (SBCT), can predict the need for non-invasive respiratory strategies (NIRS) in COVID-19 patients within 24 hours of accessing the Emergency Department (ED). The study found that SBCT was an accurate predictor of NIRS requirement, even in patients without respiratory symptoms.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Infectious Diseases
Sofia Tejada, Sergio Ramirez-Estrada, Carlos G. Forero, Miguel Gallego, Joan B. Soriano, Pablo A. Cardinal-Fernandez, Stephan Ehrmann, Jordi Rello
Summary: This network meta-analysis aimed to evaluate the effectiveness and safety of different types of aerosol generating devices in adult patients with non-cystic fibrosis bronchiectasis (NCFB). The results showed that administering antibiotics via dry powder inhaler (DPI) significantly improved time to first exacerbation and quality of life compared to nebulizers, while no significant differences were observed in other clinical efficacy and microbiologic response measures between the devices.
Article
Health Care Sciences & Services
Blanca Valenzuela-Mendez, Francisco Valenzuela-Sanchez, Juan Francisco Rodriguez-Gutierrez, Rafael Bohollo-de-Austria, Angel Estella, Pilar Martinez-Garcia, Maria Angela Gonzalez-Garcia, Jordi Rello
Summary: This study evaluated the usefulness of MR-proadrenomedullin in the prognosis of influenza A pneumonia and compared it with other biomarkers. The results showed that MR-proadrenomedullin is effective in determining adverse outcomes and risk of ICU admission and mortality in patients with influenza virus pneumonia.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Review
Medicine, General & Internal
Sofia Tejada, Raquel Martinez-Reviejo, Taisa A. Nogueira, Aroa Gomez, Teresa Pont, Xuelian Liao, Zheng Zhang, Oriol Manuel, Jordi Rello
Summary: Sex disparities may have a significant impact on patient and allograft outcomes after solid organ transplantation. Females have higher survival rates than males, especially in liver and kidney transplantation. Male sex is a protective factor against hospital readmission. Further research is needed to explore the impact on graft dysfunction and overall infections. Consideration of sex should be given in SOT management decisions.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Editorial Material
Medicine, General & Internal
Jordi Rello, Jose Artur Paiva
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Critical Care Medicine
Jordi Rello, Adrien Bougle, Jean-Jacques Rouby
INTENSIVE CARE MEDICINE
(2023)
Review
Microbiology
Joana Alves, Betania Abreu, Pedro Palma, Emine Alp, Tarsila Vieceli, Jordi Rello
Summary: The emergence of antibiotic resistance is a global health threat, especially for high-risk patients like those with neutropenia. Antimicrobial stewardship (AMS) programs should focus on optimizing antibiotic use and improving patient outcomes. This narrative review updates the current advances in AMS strategies for bacterial infections in high-risk neutropenic patients, emphasizing the core variables of diagnosis, drug, dose, duration, and de-escalation (5D). Collaboration between intensivists and AMS programs, as well as the formation of multidisciplinary teams, is crucial for improving patient care.
Article
Infectious Diseases
Dalia Adukauskiene, Ausra Ciginskiene, Agne Adukauskaite, Despoina Koulenti, Jordi Rello
Summary: This study compared the clinical features and 60-day ICU all-cause mortality between monobacterial and polybacterial MDR Klebsiella spp. VAP episodes. The results showed that polybacterial episodes had higher mortality rates and were associated with factors such as less-severe disease and extended drug-resistant Klebsiella spp. Monobacterial episodes were associated with prior hospitalization, diabetes mellitus, obesity, prior antibiotic therapy, prior treatment with cephalosporins, and specific symptoms at VAP onset. Patients with polybacterial VAP were more likely to be comatose and had higher SAPS II scores at VAP onset.
Article
Infectious Diseases
Susana Nunez-Pereira, Eva Benavent, Marta Ulldemolins, Beatriz Sobrino-Diaz, Jose A. Iribarren, Rosa Escudero-Sanchez, Maria Dolores Del Toro, Andres Nodar, Luisa Sorli, Alberto H. Bahamonde, Helem H. Vilchez, Oriol Gasch, Elena Munez, David Rodriguez-Montserrat, Maria Jose Garcia-Pais, Sleiman Haddad, Julia Sellares-Nadal, Oscar Murillo, Dolors Rodriguez-Pardo
Summary: Infection after spinal instrumentation (IASI) caused by Cutibacterium spp. is becoming more common, especially in younger patients within the first month post-surgery. These infections often result in implant removal, although the antibiotic regimen is generally shorter. Rifampin use did not impact the treatment outcome in our study.
Article
Infectious Diseases
Eva Benavent, Marta Ulldemolins, Cristina El Haj, Raul Rigo-Bonnin, Heidi Yu, Lynn Wang, Hasini Wickremasinghe, Javier Ariza, Oscar Murillo
Summary: This study aimed to analyze the PK/PD indices of meropenem predicting anti-biofilm efficacy against meropenem-susceptible and meropenem-resistant strains of Pseudomonas aeruginosa. The results showed that f%T >MIC was the PK/PD index that best correlated with the anti-biofilm efficacy of meropenem. Using the extended infusion regimen of meropenem can better recover bactericidal activity in monotherapy, including activity against meropenem-resistant P. aeruginosa.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Review
Infectious Diseases
J. Laporte-Amargos, M. Ulldemolins, M. Puig-Asensio, C. Tebe, S. Castro, J. Carratala, C. Gudiol
Summary: A systematic review and meta-analysis evaluated the efficacy of prolonged infusion of beta-lactam antibiotics (BLA) in onco-haematological patients with febrile neutropenia (FN). The study found no significant reduction in all-cause mortality or other secondary outcomes with prolonged BLA infusion compared to short-term infusion. High-quality randomized controlled trials are needed to identify subgroups of FN patients who may benefit from prolonged BLA infusion.
JOURNAL OF INFECTION
(2023)
Editorial Material
Anesthesiology
Xuelian Liao, Jordi Rello
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)
Article
Respiratory System
Luis Felipe Reyes, Srinivas Murthy, Esteban Garcia-Gallo, Mike Irvine, Laura Merson, Ignacio Martin-Loeches, Jordi Rello, Fabio S. Taccone, Robert A. Fowler, Annemarie B. Docherty, Christiana Kartsonaki, Irene Aragao, Peter W. Barrett, Abigail Beane, Aidan Burrell, Matthew Pellan Cheng, Michael D. Christian, Jose Pedro Cidade, Barbara Wanjiru Citarella, Christl A. Donnelly, Susana M. Fernandes, Craig French, Rashan Haniffa, Ewen M. Harrison, Antonia Ying Wai Ho, Mark Joseph, Irfan Khan, Michelle E. Kho, Anders Benjamin Kildal, Demetrios Kutsogiannis, Francois Lamontagne, Todd C. Lee, Gianluigi Li Bassi, Jose Wagner Lopez Revilla, Catherine Marquis, Jonathan Millar, Raul Neto, Alistair Nichol, Rachael Parke, Rui Pereira, Sergio Poli, Pedro Povoa, Kollengode Ramanathan, Oleksa Rewa, Jordi Riera, Sally Shrapnel, Maria Joao Silva, Andrew Udy, Timothy Uyeki, Steve A. Webb, Evert-Jan Wils, Amanda Rojek, Piero L. Olliaro
Summary: This study investigated the clinical outcomes of severe COVID-19 patients treated outside the ICU, compared to those treated in the ICU. It found that patients admitted to an ICU had a longer hospital stay and a lower 28-day fatality ratio.
Article
Critical Care Medicine
Dhruv Sarma, Jacob C. Jentzer
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Gurleen Kaur, David D. Berg
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Leon Zhou, Brandon M. Wiley
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Emily K. Zern, Rachel C. Frank, Evin Yucel
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Damien Smith, Benjamin B. Kenigsberg
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Gozde Demiralp, Robert T. Arrigo, Christopher Cassara, Maryl R. Johnson
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Katie P. Truong, James N. Kirkpatrick
Summary: The increasing use of MCS in advanced heart failure patients has led to a greater need for end-of-life management, including MCS device withdrawal and advance care planning. Preparedness planning and palliative care services are important in ensuring a smooth transition to the end of life. Ethical dilemmas can complicate end-of-life care, and withdrawal/deactivation should follow a set protocol that addresses psychosocial/spiritual needs and patient comfort.
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Brent Klinkhammer, Taya V. Glotzer
CRITICAL CARE CLINICS
(2024)
Article
Critical Care Medicine
Jacob B. Pierce, Willard N. Applefeld, Balimkiz Senman, Daniel B. Loriaux, Patrick R. Lawler, Jason N. Katz
Summary: Due to the increasing medical complexity of patients, heterogeneity of treatment effects in broad clinical syndromes, and significant competing risks for morbidity and mortality, future clinical trials in the CICU are likely to benefit from innovative approaches to trial design, analysis, and execution, such as incorporating novel trial endpoints, Bayesian analysis strategies, trial networks and clinical registries, adaptive platform trials, and comprehensive research programs. It will be crucial for the authors as a field to articulate priorities for future research and embrace these novel techniques that will ultimately help take better care of patients in the contemporary CICU.
CRITICAL CARE CLINICS
(2024)
