Article
Critical Care Medicine
Andrew J. Casamento, Ary Serpa Neto, Marcus Young, Mervin Lawrence, Christina Taplin, Glenn M. Eastwood, Angajendra Ghosh, Rinaldo Bellomo
Summary: The study compared the effects of fentanyl and morphine on ventilated patients and found that fentanyl infusion significantly increased ventilator-free days at Day 28 compared to morphine. ICU-free days were also greater and length of ICU stay shorter in the fentanyl group. Further investigation is needed to understand the clinical implications of choosing between different opioid infusion agents.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2021)
Review
Pharmacology & Pharmacy
Hua-Ze Ding, Yi-Ling Dong, Kai-Yue Zhang, Jia-Yu Bai
Summary: Dexmedetomidine administration had no significant effect on 28/30-day mortality and ventilator-free days in septic patients, but it could shorten the length of ICU stay.
FRONTIERS IN PHARMACOLOGY
(2022)
Review
Cardiac & Cardiovascular Systems
Baolu Yang, Leyi Gao, Zhaohui Tong
Summary: The use of sedative and analgesic medications during non-invasive ventilation can reduce the risk of tracheal intubation and delirium in patients with acute respiratory failure. Among the different medications, dexmedetomidine showed better clinical outcomes, especially when closely monitoring the patients' vital signs.
Article
Critical Care Medicine
Zhongheng Zhang, Jingtao Liu, Jingjing Xi, Yichun Gong, Lin Zeng, Penglin Ma
Summary: This study developed an ensemble model for predicting agitation in invasive mechanical ventilation patients under light sedation, which demonstrated good calibration and discrimination in an independent dataset.
CRITICAL CARE MEDICINE
(2021)
Review
Medicine, General & Internal
Caimu Wang, Qijiang Chen, Ping Wang, Weisheng Jin, Chao Zhong, Zisheng Ge, Kangmin Xu
Summary: Dexmedetomidine as a sedative agent for septic patients does not significantly affect all-cause mortality, length of stay in the ICU, and the incidence of delirium, but it is associated with a reduction in mechanical ventilation duration and inflammatory response.
FRONTIERS IN MEDICINE
(2021)
Review
Critical Care Medicine
Kimberley Lewis, Fayez Alshamsi, Kallirroi Laiya Carayannopoulos, Anders Granholm, Joshua Piticaru, Zainab Al Duhailib, Dipayan Chaudhuri, Laura Spatafora, Yuhong Yuan, John Centofanti, Jessica Spence, Bram Rochwerg, Dan Perri, Dale M. Needham, Anne Holbrook, John W. Devlin, Osamu Nishida, Kimia Honarmand, Begum Ergan, Eugenia Khorochkov, Pratik Pandharipande, Mohammed Alshahrani, Tim Karachi, Mark Soth, Yahya Shehabi, Morten Hylander Moller, Waleed Alhazzani
Summary: In mechanically ventilated adults, the use of dexmedetomidine compared to other sedatives, resulted in a lower risk of delirium, and a modest reduction in duration of mechanical ventilation and ICU stay, but increased the risks of bradycardia and hypotension.
INTENSIVE CARE MEDICINE
(2022)
Article
Pharmacology & Pharmacy
Y. H. Wang, Xiuming Xi
Summary: The study showed that in mechanically ventilated patients in the intensive care unit, the combination of remifentanil and dexmedetomidine can effectively achieve analgesia and sedation, improve vital signs, shorten treatment time, and have fewer adverse reactions.
INDIAN JOURNAL OF PHARMACEUTICAL SCIENCES
(2021)
Review
Critical Care Medicine
Kimberley Lewis, Joshua Piticaru, Dipayan Chaudhuri, John Basmaji, Eddy Fan, Morten Hylander Moller, John W. Devlin, Waleed Alhazzani
Summary: Dexmedetomidine usage in patients with acute respiratory failure undergoing noninvasive ventilation in the ICU can reduce the risk of intubation, delirium, and ICU length of stay, while increasing the risk of bradycardia and hypotension. However, the results are limited by uncertainty and further large randomized clinical trials are needed.
Article
Anesthesiology
Ferah Sarica, Engin Erturk, Dilek Kutanis, Ali Akdogan, Ahmet Can Senel
Summary: The study compared the effects of thoracic epidural analgesia (TEA) and traditional intravenous analgesia on postoperative respiratory mechanics in cardiac surgery, finding that TEA provided better postoperative respiratory condition through improved sedative analgesia. The TEA group had significantly lower additional sedative and analgesic drug requirements, shorter extubation time, and lower rates of respiratory complications and hospital stay compared to the intravenous group.
JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA
(2021)
Article
Medical Informatics
Longxiang Su, Chun Liu, Fengxiang Chang, Bo Tang, Lin Han, Huizhen Jiang, Weiguo Zhu, Na Hong, Xiang Zhou, Yun Long
Summary: This study used latent profile analysis and dimensionality reduction to classify patients treated with mechanical ventilation and sedation and analgesia into two categories, revealing that the depth of sedation was limited by the condition of the respiratory system.
BMC MEDICAL INFORMATICS AND DECISION MAKING
(2021)
Article
Anesthesiology
Severin Ramin, Sophie Bringuier, Orianne Martinez, Meriem Sadek, Jonathan Manzanera, Pauline Deras, Olivier Choquet, Jonathan Charbit, Xavier Capdevila
Summary: This study aimed to compare the consumption of opioids and hypnotics and patient outcomes in multiple trauma-ventilated patients with or without continuous regional analgesia (CRA). The results showed that the use of CRA did not significantly decrease the consumption of sufentanil and midazolam in the first 5 days after ICU admission. There were no significant differences in the primary and secondary endpoints between the groups.
ANAESTHESIA CRITICAL CARE & PAIN MEDICINE
(2023)
Article
Critical Care Medicine
Helene Korvenius Nedergaard, Serkan Korkmaz, Hanne Tanghus Olsen, Hanne Irene Jensen, Thomas Strom, Palle Toft
Summary: This study aimed to obtain knowledge on patients who experienced failure of non-sedation. Findings revealed that patients with non-sedation failure were more often male and predominantly received propofol as rescue sedation. Additionally, these patients had poorer outcomes in various aspects compared to those with non-sedation success.
JOURNAL OF CRITICAL CARE
(2022)
Article
Medicine, General & Internal
Yongjun Liu, Xiangyou Yu, Duming Zhu, Jun Zeng, Qinhan Lin, Bin Zang, Chuanxi Chen, Ning Liu, Xiao Liu, Wei Gao, Xiangdong Guan
Summary: This study demonstrates that Ciprofol has comparable tolerability and efficacy to propofol for sedation in mechanically ventilated patients. The plasma concentration-time curves for both drugs were similar.
CHINESE MEDICAL JOURNAL
(2022)
Article
Pharmacology & Pharmacy
Xiaobo Yang, Yun Tang, Ruofei Du, Yuan Yu, Jiqian Xu, Jiancheng Zhang, Hong Liu, Xiaojing Zou, Lehao Ren, Shiying Yuan, You Shang
Summary: This study aims to evaluate whether remimazolam besylate is not inferior to propofol in maintaining mild-to-moderate sedation in critically ill patients receiving long-term mechanical ventilation. The study design is multicenter, randomized, single-blind, non-inferiority trial. The primary outcome is the percentage of time in the target sedation range. Secondary outcomes include hours free from the invasive ventilator in 7 days, successful extubation in 7 days, weaning time, length of intensive care unit stay, length of hospital stay, and mortality in 28 days. Modified intention-to-treat and safety analysis will be performed.
FRONTIERS IN PHARMACOLOGY
(2023)
Review
Critical Care Medicine
Zhidong Qi, Sibo Yang, Jingdong Qu, Ming Li, Junbo Zheng, Rui Huang, Zhenyu Yang, Qiuyuan Han, Haibo Li
Summary: Nurse-led sedation protocols in ICUs were found to result in decreased durations of mechanical ventilation, reduced length of ICU stay, lower ICU mortality, decreased incidence of ventilator-associated pneumonia, delirium, and extubation failure.
AUSTRALIAN CRITICAL CARE
(2021)
Article
Biotechnology & Applied Microbiology
Luisa Helena Andrade da Silva, Juliana Borges Vieira, Marianna Ribeiro Cabral, Mariana Alves Antunes, Daiheon Lee, Fernanda Ferreira Cruz, Justin Hanes, Patricia Rieken Macedo Rocco, Marcelo Marcos Morales, Jung Soo Suk
Summary: Silicosis is a lung disease caused by inhalation of silica dust, and millions of industrial workers worldwide are affected. A drug called nintedanib has shown potential in treating silicosis, but its oral formulation often leads to significant side effects. Researchers have developed a nanocrystal-based suspension of nintedanib for localized treatment of silicosis via inhalation, which has shown robust anti-fibrotic effects without notable adverse effects.
BIOENGINEERING & TRANSLATIONAL MEDICINE
(2023)
Article
Medicine, General & Internal
Rosa M. R. Pereira, Marilia A. Dagostin, Valeria F. Caparbo, Lucas P. Sales, Sandra G. Pasoto, Clovis A. Silva, Emily F. N. Yuki, Carla G. S. Saad, Ana C. Medeiros-Ribeiro, Leonard V. K. Kupa, Solange R. G. Fusco, Victor A. O. Martins, Carolina C. M. F. Martins, Carmen Valente Barbas, Samuel K. Shinjo, Nadia E. Aikawa, Eloisa Bonfa
Summary: This study evaluates the immunogenicity, antibody decay, booster dose, and safety of inactivated CoronaVac vaccination in patients with ANCA-associated vasculitis. The results show that CoronaVac vaccine exhibits good safety and moderate immunogenicity in AAV patients, with a mild decline in antibodies after six months but a good response to the booster dose. Overall, the vaccine has minimal adverse effects.
Editorial Material
Critical Care Medicine
Carmen Silvia Valente Barbas, Alexandre Marini Isola, Sergio Baldisserotto
CRITICAL CARE MEDICINE
(2023)
Editorial Material
Anesthesiology
Marcelo Gama de Abreu, Marcus J. Schultz, Ary Serpa Neto
Summary: Spin and fragility are common in randomised controlled trials published in anaesthesia journals. Staying with the facts and addressing only the primary endpoint in the conclusion of clinical research reports might help reduce spin. Routinely reporting the fragility index, in turn, could deliver information about robustness, enhancing the transparency of positive dichotomous results. It is in the best interest of clinical research that authors, reviewers, and journals come together to reduce spin and address the fragility of randomised controlled trials.
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Cell & Tissue Engineering
Soraia Abreu, Leonardo Alves, Luiza Carvalho, Debora Xisto, Natalia Blanco, Ligia Castro, Priscilla Olsen, Jose Roberto Lapa e Silva, Marcelo Marcos Morales, Miqueias Lopes-Pacheco, Daniel Weiss, Patricia Rieken Macedo Rocco
Summary: This study aims to evaluate the therapeutic effect of serum preconditioning on human mesenchymal stromal cells (hMSCs) in patients with asthma. The results show that serum preconditioning increases the apoptosis rate of hMSCs and the expression of transforming growth factor-β, interleukin-10, tumor necrosis factor-α-stimulated gene 6 protein, and indoleamine 2,3-dioxygenase-1. Serum preconditioning also promotes M2 polarization of macrophages and enhances their phagocytic activity, thereby reducing inflammation and remodeling.
Letter
Respiratory System
Claudia C. dos Santos, Chirag M. Vaswani, Shirley H. J. Mei, Patricia R. M. Rocco, Daniel J. Weiss, Duncan J. Stewart, W. Conrad Liles
EUROPEAN RESPIRATORY JOURNAL
(2023)
Article
Critical Care Medicine
Aranka Akkermans, Sanne Prins, Amber S. Spijkers, Jean Wagemans, Nanon H. M. Labrie, Dick L. Willems, Marcus J. Schultz, Thomas G. V. Cherpanath, Job B. M. van Woensel, Marc van Heerde, Anton H. van Kaam, Moniek van de Loo, Anne Stiggelbout, Ellen M. A. Smets, Mirjam A. de Vos
Summary: This study examines the argumentative practices of doctors and families in making decisions about life-sustaining treatment in ICUs. The research identifies the arguments used by both parties and explores how they structure their arguments during conversations. The study reveals that there is limited and brief exchange of arguments, although the types of arguments presented by doctors and families largely overlap.
INTENSIVE CARE MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Natalia G. Blanco, Natalia M. Machado, Ligia L. L. Castro, Mariana A. A. Antunes, Christina M. M. Takiya, Monique R. O. Trugilho, Luana R. R. Silva, Adriana F. Paes F. Leme, Romenia R. Domingues, Bianca A. A. Pauletti, Beatriz T. T. Miranda, Johnatas D. D. Silva, Claudia C. C. dos Santos, Pedro L. L. Silva, Patricia R. M. Rocco, Fernanda F. F. Cruz
Summary: The effects of different sources of MSC-derived extracellular vesicles (EVs), including those obtained from bone marrow (BM), adipose (AD), or lung (L) tissues, on sepsis were investigated. The proteome analysis of EVs revealed that BM-EVs were associated with less organ damage compared with AD-EVs and L-EVs.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Medicine, General & Internal
Denise Battaglini, Brigitta Fazzini, Pedro Leme Silva, Fernanda Ferreira Cruz, Lorenzo Ball, Chiara Robba, Patricia R. M. Rocco, Paolo Pelosi
Summary: Over the last decade, management of acute respiratory distress syndrome (ARDS) has advanced significantly in terms of supportive and pharmacologic therapies. Lung protective mechanical ventilation is crucial for ARDS management, with recommendations including low tidal volume, plateau pressure, and driving pressure. Other therapies such as recruitment maneuvers and prone positioning are considered for severe ARDS cases. Despite extensive research, effective pharmacotherapies for ARDS are yet to be found, but sub-phenotypes of ARDS have shown potential for personalized pharmacologic treatments.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Lucas Rodrigues de Moraes, Chiara Robba, Denise Battaglini, Paolo Pelosi, Patricia R. M. Rocco, Pedro Leme Silva
Summary: Coronavirus disease (COVID-19) is caused by the SARS-CoV-2 virus and can lead to severe respiratory failure requiring mechanical ventilation (MV). Noninvasive respiratory support (NRS), MV, and ECMO are used as treatment strategies. Lung imaging advances have improved understanding of COVID-19 and ventilatory strategies. This review aims to discuss evidence on NRS devices and strategies, personalized MV management based on COVID-19 pathophysiology, and the use of rescue strategies like ECMO in critically ill COVID-19 patients.
FRONTIERS IN MEDICINE
(2023)
Article
Medicine, General & Internal
Pedro L. Silva, Fernanda F. Cruz, Camila M. Martins, Jacob Herrmann, Sarah E. Gerard, Yi Xin, Maurizio Cereda, Lorenzo Ball, Paolo Pelosi, Patricia R. M. Rocco
Summary: Lung weight can be measured with quantitative chest CT to evaluate the severity of pulmonary edema and prognosis in patients with COVID-19. Certain laboratory markers, such as leukocytes, neutrophils, D-dimer, and LDH, are found to be higher in patients with overweight lungs.
FRONTIERS IN MEDICINE
(2023)
Article
Medicine, General & Internal
Liselotte J. Hol, Marcus Schultz, Ignacio Martin-Loeches, David M. P. van Meenen, Ary Serpa Neto, Frederique Paulus
Summary: The aim of this analysis was to compare ventilation management and outcomes in invasively ventilated patients with acute hypoxemic respiratory failure due to COVID-19 between the first and second wave in the Netherlands. The study found that patients in the second wave were sicker, had more comorbidities, and had worse oxygenation parameters. Changes in ventilation management were observed, such as lower positive end-expiratory pressure and higher fraction inspired oxygen. Duration of ventilation was shorter, but mortality rates were similar.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Taina B. Oliveira, Cassia L. Braga, Denise Battaglini, Paolo Pelosi, Patricia R. M. Rocco, Pedro L. Silva, Fernanda F. Cruz
Summary: This study compared the effects of sevoflurane and propofol on immune responses and cytokine expression in rats with sepsis. The results showed that sevoflurane increased the expression of anti-inflammatory biomarkers in monocytes, enhanced their phagocytic capacity, and increased neutrophil migration. Sevoflurane also protected lung epithelial and endothelial cells. in contrast, propofol had less significant effects.
FRONTIERS IN MEDICINE
(2023)
Article
Medicine, General & Internal
Thiago Domingos Correa, Thais Dias Midega, Ricardo Luiz Cordioli, Carmen Silvia Valente Barbas, Roberto Rabello Filho, Bruno Caldin da Silva, Moacyr Silva Junior, Ricardo Kenji Nawa, Fabricio Rodrigues Torres de Carvalho, Gustavo Faissol Janot de Matos, Neide Marcela Lucinio, Rodrigo Dias Rodrigues, Raquel Afonso Caserta Eid, Bruno de Arruda Bravim, Adriano Jose Pereira, Bento Fortunato Cardoso dos Santos, Joao Renato Rebello Pinho, Andreia Pardini, Vanessa Damazio Teich, Claudia Regina Laselva, Miguel Cendoroglo Neto, Sidney Klajner, Leonardo Jose Rolim Ferraz
Summary: This retrospective study compared the clinical characteristics and outcomes of patients admitted to intensive care units during the first and second waves of the COVID-19 pandemic. The results showed similar mortality rates and need for invasive organ support between the two waves, despite the second wave patients being younger and less severely ill at the time of admission to the intensive care unit.
EINSTEIN-SAO PAULO
(2023)
Article
Critical Care Medicine
Christoph Boesing, Laura Schaefer, Peter T. Graf, Paolo Pelosi, Patricia R. M. Rocco, Thomas Luecke, Joerg Krebs
Summary: In ARDS patients treated with VV ECMO, adjusting PEEP to 10 cmH(2)O can reduce MP, improve hemodynamic parameters, and increase oxygen delivery.
JOURNAL OF CRITICAL CARE
(2024)