Article
Critical Care Medicine
Luis Morales-Quinteros, Ary Serpa Neto, Antonio Artigas, Lluis Blanch, Michela Botta, David A. Kaufman, Marcus J. Schultz, Anissa M. Tsonas, Frederique Paulus, Lieuwe D. Bos
Summary: Estimates of wasted ventilation, such as the dead space fraction and ventilatory ratio, were significantly higher in non-survivors compared to survivors among COVID-19-related ARDS patients. However, quantifying this impairment of ventilation did not add prognostic information beyond baseline risk factors in this study.
Article
Anesthesiology
Roberta Maj, Paola Palermo, Simone Gattarello, Serena Brusatori, Rosanna D'Albo, Carmelo Zinnato, Mara Velati, Federica Romitti, Mattia Busana, Johannes Wieditz, Peter Herrmann, Onnen Moerer, Micheal Quintel, Konrad Meissner, Barnaby Sanderson, Davide Chiumello, John J. Marini, Luigi Camporota, Luciano Gattinoni
Summary: Ventilatory ratio (VR) is a useful measure associated with outcome, but its absolute value is influenced by venous admixture and CO2 volume expired per minute (VCO2), which are not directly related to ventilation. Adjusting for VD/VTphys, VCO2, and PaO2/FiO2, VR is not independently associated with mortality.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Review
Medicine, General & Internal
Adnan Liaqat, Matthew Mason, Brian J. J. Foster, Sagar Kulkarni, Aisha Barlas, Awais M. M. Farooq, Pooja Patak, Hamza Liaqat, Rafaela G. G. Basso, Mohammed S. S. Zaman, Dhaval Pau
Summary: Mechanical ventilatory strategies, such as using low tidal volumes and optimizing positive end expiratory pressure (PEEP), are crucial for managing ARDS and reducing morbidity and mortality. The role of other ventilatory strategies is still unclear.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Critical Care Medicine
Manuel Tisminetzky, Bruno L. Ferreyro, Fernando Frutos-Vivar, Andres Esteban, Fernando Rios, Arnaud W. Thille, Konstantinos Raymondos, Lorenzo Del Sorbo, Oscar Penuelas, Eddy Fan
Summary: This study found that a relative decline in the ventilatory ratio within 24 hours of prone positioning in ARDS patients was associated with lower ICU mortality, while relative changes in other physiological parameters were not associated with ICU mortality.
Article
Public, Environmental & Occupational Health
Zhu Zhan, Xin Yang, Hu Du, Chuanlai Zhang, Yuyan Song, Xiaoyun Ran, An Zhang, Mei Yang
Summary: This study in Chongqing, China, analyzed the clinical features, outcomes, and ARDS characteristics of COVID-19 patients in ICU. Most patients developed ARDS during ICU stay, with over half having moderate ARDS. Nearly one-third of ARDS patients showed early improvement, with higher survival rates and shorter ICU stays. Age (<55 years) was independently associated with early improvement, suggesting stratified management based on eiARDS or age is recommended.
JMIR PUBLIC HEALTH AND SURVEILLANCE
(2021)
Article
Medicine, Research & Experimental
Qiaoyi Xu, Shuya Mei, Fang Nie, Zhiyun Zhang, Junqi Feng, Jinyuan Zhang, Xiaoqing Qian, Yuan Gao, Zhengyu He, Shunpeng Xing
Summary: The study demonstrates that lipopolysaccharide induces activation of the JNK signaling pathway and TNF-alpha secretion in pulmonary macrophages, leading to interaction between inflammation and metabolism that promotes lung fibroblast glycolysis. This interaction plays a crucial role in lipopolysaccharide-induced pulmonary fibrosis.
LABORATORY INVESTIGATION
(2022)
Article
Critical Care Medicine
Francois Beloncle, Antoine Studer, Valerie Seegers, Jean-Christophe Richard, Christophe Desprez, Nicolas Fage, Hamid Merdji, Bertrand Pavlovsky, Julie Helms, Sibylle Cunat, Satar Mortaza, Julien Demiselle, Laurent Brochard, Alain Mercat, Ferhat Meziani
Summary: Differences in physiology were found between COVID-19 and non-COVID-19 patients with ARDS, with higher C-RS in COVID-19 patients initially. The relationship between C-RS and oxygenation was only seen in non-COVID-19 patients on day 1. Both COVID-19 and non-COVID-19 patients showed similar C-RS and VR at day 7.
Article
Anesthesiology
Jonathan H. Chow, Ashish K. Khanna, Shravan Kethireddy, David Yamane, Andrea Levine, Amanda M. Jackson, Michael T. McCurdy, Ali Tabatabai, Gagan Kumar, Paul Park, Ivy Benjenk, Jay Menaker, Nayab Ahmed, Evan Glidewell, Elizabeth Presutto, Shannon Cain, Naeha Haridasa, Wesley Field, Jacob G. Fowler, Duy Trinh, Kathleen N. Johnson, Aman Kaur, Amanda Lee, Kyle Sebastian, Allison Ulrich, Salvador Pena, Ross Carpenter, Shruti Sudhakar, Pushpinder Uppal, Benjamin T. Fedeles, Aaron Sachs, Layth Dahbour, William Teeter, Kenichi Tanaka, Samuel M. Galvagno, Daniel L. Herr, Thomas M. Scalea, Michael A. Mazzeffi
Summary: A retrospective cohort study in multiple hospitals in the United States showed that aspirin use in COVID-19 patients may be associated with reduced risk of mechanical ventilation, ICU admission, and in-hospital mortality. Further studies are needed to confirm a causal relationship.
ANESTHESIA AND ANALGESIA
(2021)
Review
Critical Care Medicine
Mingjia Zheng
Summary: Cumulative evidence shows that the ventilatory ratio is closely related to mortality in acute respiratory distress syndrome (ARDS), and increased dead space is a primary feature in COVID-19-ARDS. Therefore, attention has been focused on dead space ventilation-related indices such as physiological dead space fraction, ventilatory ratio, and end-tidal-to-arterial PCO2 ratio. These indices have been used in PEEP titration, prediction of prone position response, and extracorporeal life support for ARDS patients. Although there are limitations, these indices can help in stratifying and identifying subphenotypes for individualized therapy.
Review
Medicine, Research & Experimental
Michelle M. Schafer, Michael Baram, Gregory C. Kane
Summary: Studying the physiological anomaly of giraffes can provide insights into clinically relevant processes. The unique trachea design of giraffes offers a solution to the problem of excessive dead space and can be applicable in managing COVID-19 patients with acute respiratory distress syndrome.
INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
(2022)
Review
Critical Care Medicine
Dilip Jayasimhan, Jennifer Chieng, John Kolbe, David A. Sidebotham
Summary: This systematic review and meta-analysis evaluated the ability of dead-space ventilation measures to predict mortality in patients with ARDS. The results showed that high dead-space ventilation was associated with increased mortality in these patients.
CRITICAL CARE MEDICINE
(2023)
Article
Medicine, General & Internal
Rajarajan Ganesan, Varun Mahajan, Karan Singla, Sushant Konar, Tanvir Samra, Senthil K. Sundaram, Vikas Suri, Mandeep Garg, Naveen Kalra, Goverdhan D. Puri
Summary: This study found that age, Charlson comorbidity index, sequential organ failure assessment score, D-dimer, lactate dehydrogenase, and neutrophil to lymphocyte ratio are independently associated with mortality in COVID-19 ICU patients. A model incorporating these parameters at admission can predict ICU mortality with good accuracy.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Medicine, General & Internal
Yoann Zerbib, Nelly Guilain, Sebastien Eymieux, Rustem Uzbekov, Sandrine Castelain, Emmanuelle Blanchard, Catherine Francois, Denis Chatelain, Clement Brault, Julien Maizel, Philippe Roingeard, Michel Slama
Summary: This study provides a detailed histopathological description of fatal COVID-19 and compares the lesions in ICU and non-ICU patients. It reveals that lung injury differs between ICU and non-ICU patients, and extrapulmonary damage, such as kidney and myocardial injury, is more frequent in ICU patients. The study also presents the first description of SARS-CoV-2-induced double-membrane vesicles in kidney biopsy samples, indicating intense viral replication in this organ.
FRONTIERS IN MEDICINE
(2022)
Article
Medicine, General & Internal
Elizabeth M. Parker, Edward A. Bittner, Lorenzo Berra, Richard M. Pino
Summary: This study examined the effects of prolonged, repeated, early versus later prone positioning (PP) for 20 patients with COVID-19 respiratory failure. The results showed that a single turn prone for more than 39 hours effectively improved lung oxygenation, saved the burden of multiple prone turns, and there was no significant advantage to initiating PP when the initial PaO2/FiO2 ratio was more than 150 compared to when it was less than or equal to 150.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Physiology
Sayed Metwaly, Andreanne Cote, Sarah J. Donnelly, Mohammad M. Banoei, Chel H. Lee, Graciela Andonegui, Bryan G. Yipp, Hans J. Vogel, Oliver Fiehn, Brent W. Winston
Summary: This study aimed to identify metabolic fingerprints of ARDS, comparing them with ICU controls. The subphenotypes and clinical subgroups of ARDS were found to have distinct metabolic profiles, with involvement of serine-glycine metabolism. These identified metabolic fingerprints are not diagnostic biomarkers for ARDS, and further research is needed for generalizability.
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY
(2021)
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
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
Public, Environmental & Occupational Health
Christiana Kartsonaki, J. Kenneth Baillie, Noelia Garcia Barrio, Joaquin Baruch, Abigail Beane, Lucille Blumberg, Fernando Bozza, Tessa Broadley, Aidan Burrell, Gail Carson, Barbara Wanjiru Citarella, Andrew Dagens, Emmanuelle A. Dankwa, Christl A. Donnelly, Jake Dunning, Loubna Elotmani, Martina Escher, Nataly Farshait, Jean-Christophe Goffard, Bronner P. Goncalves, Matthew Hall, Madiha Hashmi, Benedict Sim Lim Heng, Antonia Ho, Waasila Jassat, Miguel Pedrera Jimenez, Cedric Laouenan, Samantha Lissauer, Ignacio Martin-Loeches, France Mentre, Laura Merson, Ben Morton, Daniel Munblit, Nikita A. Nekliudov, Alistair D. Nichol, Budha Charan Singh Oinam, David Ong, Prasan Kumar Panda, Michele Petrovic, Mark G. Pritchard, Nagarajan Ramakrishnan, Grazielle Viana Ramos, Claire Roger, Oana Sandulescu, Malcolm G. Semple, Pratima Sharma, Louise Sigfrid, Emily C. Somers, Anca Streinu-Cercel, Fabio Taccone, Pavan Kumar Vecham, Bharath Kumar Tirupakuzhi Vijayaraghavan, Jia Wei, Evert-Jan Wils, Xin Ci Wong, Peter Horby, Amanda Rojek, Piero L. Olliaro, Ali Abbas
Summary: This study analyzed demographic features, treatments, and clinical outcomes of hospitalized COVID-19 patients in 52 countries from January 2020 to January 2022. Age and male sex were associated with a higher risk of death. Symptoms, co-morbidities, and treatments were associated with clinical outcomes. This comprehensive international study provides valuable information for prioritizing treatment for COVID-19 patients at higher risk of death.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2023)
Article
Virology
David S. Y. Ong, Peter de Man, Tim Verhagen, Gerda Doejaaren, Marloes A. Dallinga, Esmee Alibux, Matthijs L. Janssen, Evert-Jan Wils
Summary: Airborne transmission is an important route for the spread of SARS-CoV-2. A study comparing virus detection in air samples from patients infected with different variants found a higher positivity rate in samples from Omicron variant patients compared to Delta variant patients.
JOURNAL OF MEDICAL VIROLOGY
(2023)
Article
Medicine, General & Internal
L. Robin Goossen, Marielle Verboom, Marielle Blacha, Illaa Smesseim, Ludo F. M. Beenen, David M. P. van Meenen, Frederique Paulus, J. Marcus Schultz
Summary: In this single-center cohort study in the Netherlands, the incidence of air leaks, including subcutaneous emphysema, pneumothorax, and pneumomediastinum, was found to be 8.4% in patients with COVID-19, which was comparable to previous reports in patients with acute hypoxemic respiratory failure.
Article
Physiology
Thijs A. Lilien, David M. P. Van Meenen, Marcus J. Schultz, Lieuwe D. J. Bos, Reinout A. Bem
Summary: The interest in oxygen toxicity has led to numerous studies, but there is still no consensus on the clinical impact of hyperoxia and hyperoxemia. This article explores the importance of hyperoxia-induced lung injury in current critical care practice, suggesting that it may be less important than other ventilator-related factors in patients with acute respiratory distress syndrome.
AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY
(2023)
Editorial Material
Critical Care Medicine
Pedro D. Wendel-Garcia, Lieuwe D. J. Bos
Article
Critical Care Medicine
Ignacio Martin-Loeches, Luis Felipe Reyes, Saad Nseir, Otavio Ranzani, Pedro Povoa, Emili Diaz, Marcus J. Schultz, Alejandro H. Rodriguez, Cristian C. Serrano-Mayorga, Gennaro De Pascale, Paolo Navalesi, Mauro Panigada, Luis Miguel Coelho, Szymon Skoczynski, Mariano Esperatti, Andrea Cortegiani, Stefano Aliberti, Anselmo Caricato, Helmut J. F. Salzer, Adrian Ceccato, Rok Civljak, Paolo Maurizio Soave, Charles-Edouard Luyt, Pervin Korkmaz Ekren, Fernando Rios, Joan Ramon Masclans, Judith Marin, Silvia Iglesias-Moles, Stefano Nava, Davide Chiumello, Lieuwe D. Bos, Antoni Artigas, Filipe Froes, David Grimaldi, Fabio Silvio Taccone, Massimo Antonelli, Antoni Torres
Summary: This study aimed to report the clinical characteristics, microbiology, and clinical outcomes of ICU-admitted patients with nosocomial lower respiratory tract infections (LRTI). The study found that patients with ventilator-associated hospital-acquired pneumonia (VHAP) had the highest mortality rates, and multidrug-resistant pathogens were frequently the cause of the nosocomial LRTI in this multinational cohort study.
INTENSIVE CARE MEDICINE
(2023)
Article
Critical Care Medicine
Rombout B. E. van Amstel, Jason N. Kennedy, Brendon P. Scicluna, Lieuwe D. J. Bos, Hessel Peters-Sengers, Joe M. Butler, Eddie Cano-Gamez, Julian C. Knight, Alexander P. J. Vlaar, Olaf L. Cremer, Derek C. Angus, Tom van der Poll, Christopher W. Seymour, Lonneke A. van Vught
Summary: Among critically ill patients with sepsis, subtype strategies using clinical, biomarker, and transcriptomic data do not identify comparable patient populations and are likely to reflect disparate clinical characteristics and underlying biology.
INTENSIVE CARE MEDICINE
(2023)
Article
Virology
Willem A. Mak, Wendy Visser, Marijke van der Vliet, Hilde Y. Markus, Johannes G. M. Koeleman, David S. Y. Ong
Summary: COVID-19 bivalent ancestral/Omicron mRNA booster vaccinations enhance immunity and induce neutralizing antibody and T-cell responses against Omicron infections. Previous infection and bivalent booster vaccination increase immune responses. Hybrid immunity is associated with improved T-cell immunity preservation.
JOURNAL OF MEDICAL VIROLOGY
(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
Athiwat Tripipitsiriwat, Orawan Suppapueng, David M. P. van Meenen, Frederique Paulus, Markus W. Hollmann, Chaisith Sivakorn, Marcus J. Schultz, PRoVENT COVID Investigators
Summary: This study found that patients with chronic obstructive pulmonary disease (COPD) have a higher mortality rate in COVID-19 and higher 28-day mortality compared to non-COPD patients. The ventilation management and the use of prone positioning differed slightly between COPD and non-COPD patients.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Critical Care Medicine
Jean-Marc Cavaillon, Antonio Artigas, Andreas Barratt-Due, Evangelos J. Giamarellos-Bourboulis, Hernando Gomez, Gilles Hayem, Alexander P. J. Vlaar, W. Joost Wiersinga
Summary: The COVID-19 pandemic has posed challenges in developing effective therapies. The infection leads to viral sepsis and immunological autoinflammatory response, prompting the exploration of both bacterial sepsis-inspired therapies and specific antiviral strategies. This article summarizes the current understanding of utilizing SARS-CoV-2 antivirals, corticosteroids, anti-IL-1, anti-IL-6, anti-C5a, and stem cell therapy in severe cases, emphasizing the importance of patient stratification and treatment timing for successful outcomes.
Letter
Critical Care Medicine
Bernhard Wernly, Hans Flaatten, Susannah Leaver, Bertrand Guidet, Christian Jung
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.