Article
Microbiology
Ioannis Andrianopoulos, Theodora Maniatopoulou, Nikolaos Lagos, Nikolaos Kazakos, Athanasios Papathanasiou, Georgios Papathanakos, Despoina Koulenti, Christos Kittas, Vasilios Koulouras
Summary: COVID-19 patients with A. baumannii BSI have similar clinical characteristics and outcomes compared to non-COVID-19 patients, but COVID-19 patients are more likely to develop severe infections and septic shock, with ventilator-associated pneumonia as the main source of their BSI.
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
Biochemistry & Molecular Biology
Pablo Amend, Patricia Mester, Stephan Schmid, Martina Mueller, Christa Buechler, Vlad Pavel
Summary: This study aimed to investigate the association between plasma chemerin levels and underlying diseases as well as causes of severe illness. The results showed that plasma chemerin levels were related to inflammation in patients with liver cirrhosis but not to severe infections and other diseases. This suggests that plasma chemerin may serve as an early biomarker for the diagnosis of Gram-positive infections in patients with liver cirrhosis.
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.
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
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)
Review
Biology
Carmelo Biondo, Elena Ponzo, Angelina Midiri, Giuseppe Bernardo Ostone, Giuseppe Mancuso
Summary: Coronavirus disease 2019 (COVID-19) is a potentially serious acute respiratory infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This review aims to assess the incidence of bacterial co-infections and superinfections in patients with COVID-19, highlight the importance of rational antibiotic use, and discuss alternative antimicrobial agents to counter multidrug-resistant bacteria.
Article
Medicine, General & Internal
Christoph J. Leitl, Sandra E. Stoll, Wolfgang A. Wetsch, Tobias Kammerer, Alexander Mathes, Bernd W. Boettiger, Harald Seifert, Fabian Dusse
Summary: This study evaluated the diagnostic performance and potential therapeutic benefit of additional next-generation sequencing (NGS) of microbial DNA from plasma in critically ill COVID-19 patients with bloodstream infections (BSIs). The NGS positivity rate was 52%, higher than the blood culture (BC) positivity rate of 28%. NGS results led to diagnostic procedures and the commencement of antimicrobial therapy, providing new therapeutic approaches.
JOURNAL OF CLINICAL MEDICINE
(2023)
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
Public, Environmental & Occupational Health
Vassiliki Pitiriga, John Bakalis, Kalliopi Theodoridou, Petros Kanellopoulos, George Saroglou, Athanasios Tsakris
Summary: The study compares the rates of CLABSI related to CVC and PICC in critically ill patients and evaluates the microbiological distribution. The results show that PICC lines have significantly lower CLABSI rates compared to CVC, despite being in place for a longer duration. The high prevalence of CLABSI-MDROs highlights the importance of public health awareness.
ANTIMICROBIAL RESISTANCE AND INFECTION CONTROL
(2022)
Review
Critical Care Medicine
Pierluigi Viale, Christian E. Sandrock, Paula Ramirez, Gian Maria Rossolini, Thomas P. Lodise
Summary: Appropriate antibiotic treatment is crucial for critically ill patients with serious Gram-negative infections. Cefiderocol is an effective antibiotic with activity against drug-resistant Gram-negative pathogens. Clinical studies have shown its efficacy in treating various types of infections caused by resistant bacteria.
ANNALS OF INTENSIVE CARE
(2023)
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
Medicine, Research & Experimental
Gary Duclos, Ines Lakbar, Mohamed Boucekine, Georges Lolo, Nadim Cassir, Marc Leone
Summary: This study aimed to assess the impact of MDRB-related infection and colonization on the 60-day mortality rate of ICU patients. The results showed that MDRB-related infection did not increase the mortality rate after 60 days. Other factors, such as comorbidities, may contribute to a higher mortality rate.
ADVANCES IN THERAPY
(2023)
Article
Infectious Diseases
Jean-Francois Timsit, Paul-Henri Wicky, Etienne de Montmollin
Summary: Metallo-beta-lactamases-producing (MBL) Enterobacterales is a growing problem worldwide. The optimization of antibiotic therapy is challenging, with combination therapy being the main option. Prior to antibiotic susceptibility testing, combination therapy should be used. Optimization of the pharmacokinetic/pharmacodynamic properties of antimicrobials is crucial in severe infections. The treatment of MBL infections requires close collaboration among clinicians, microbiologists, pharmacists, and infection control practitioners.
Article
Infectious Diseases
Antoine Piantoni, Marion Houard, Gaetan Piga, Ghadi Zebian, Sarah Ruffier des Aimes, Berenice Holik, Frederic Wallet, Anahita Rouze, Louis Kreitmann, Caroline Loiez, Julien Labreuche, Saad Nseir
Summary: This study aimed to evaluate the relationship between COVID-19 and ICU-acquired bloodstream infections (BSI) caused by multidrug-resistant bacteria (MDRB). The results showed that COVID-19 was significantly associated with an increased risk of MDRB-related ICU-acquired BSI, especially after 15 days of ICU admission.
Editorial Material
Critical Care Medicine
Lene Russell, Frederic Pene, Ignacio Martin-Loeches
INTENSIVE CARE MEDICINE
(2023)
Article
Infectious Diseases
Sharon Einav, Marc Leone, Ignacio Martin-Loeches
Summary: Guidelines recommend early administration of antimicrobial therapy in sepsis and septic shock, based on observational studies suggesting improved outcomes. However, front-line physicians face pressure to quickly decide on antibiotic use in uncertain sepsis cases. Overuse of antibiotics contributes to the emergence of multidrug-resistant bacteria, and this article discusses the situation of physicians criticized for unnecessary or delayed antibiotic use and offers options to assist bedside decision-making.
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
(2023)
Article
Infectious Diseases
Bianca B. P. Antunes, Amanda A. B. Silva, Patricia H. C. Nunes, Ignacio Martin-Loeches, Pedro Kurtz, Silvio Hamacher, Fernando A. Bozza
Summary: The objective of this study was to compare the differences in antimicrobial use between COVID-19 and non-COVID-19 patients, and to compare two commonly used metrics for antimicrobial use: Defined Daily Dose (DDD) and Days of Therapy (DOT). The study found that COVID-19 patients had a higher use of broad-spectrum antimicrobials in the ICU, and overall, the DDD metric overestimated antimicrobial use compared with the DOT metric.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Letter
Critical Care Medicine
S. Blot, M. Deschepper
MEDICINA INTENSIVA
(2023)
Article
Critical Care Medicine
Tai Pham, Leo Heunks, Giacomo Bellani, Fabiana Madotto, Irene Aragao, Gaetan Beduneau, Ewan C. Goligher, Giacomo Grasselli, Jon Henrik Laake, Jordi Mancebo, Oscar Penuelas, Lise Piquilloud, Antonio Pesenti, Hannah Wunsch, Frank van Haren, Laurent Brochard, John G. Laffey
Summary: This study investigated the management and outcomes of weaning from invasive mechanical ventilation in patients requiring at least 2 days of ventilation. The results showed that only 65% of patients were successfully weaned at 90 days. Factors such as delayed initiation of weaning and excessive sedation levels were associated with weaning failure. Understanding these factors could improve the success rate of weaning.
LANCET RESPIRATORY MEDICINE
(2023)
Review
Infectious Diseases
Raquel Carbonell, Gerard Moreno, Ignacio Martin-Loeches, Maria Bodi, Alejandro Rodriguez
Summary: Pneumonia is a significant global problem, with viruses being a common cause and mixed viral and bacterial pneumonia posing a risk for severe disease. Biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP), can provide valuable information for early diagnosis and prognosis. This review analyzes the available evidence and provides recommendations for the use of biomarkers in influenza and SARS-CoV-2 pneumonia. The authors propose a practical PCT algorithm for guiding antibiotic initiation in these cases.
Review
Critical Care Medicine
Elio Antonucci, Tania Polo, Manuela Giovini, Massimo Girardis, Ignacio Martin-Loeches, Nathan D. Nielsen, Francisco Jose Chacon Lozsan, Ricard Ferrer, Ines Lakbar, Marc Leone
Summary: Background: This study reviews different studies on refractory septic shock and/or catecholamine resistance and/or high dose norepinephrine, highlighting the heterogeneity in the definitions used by authors. Method: A systematic review of papers reporting data on refractory septic shock was conducted. Results: Out of 276 papers reviewed initially, 8 studies were included, comprising of 3 randomized controlled trials, 3 prospective studies, and 2 retrospective studies, with a total of 562 patients with septic shock. Catecholamine resistance was generally defined as decreased vascular responsiveness to catecholamine regardless of the administered norepinephrine dose. Refractory septic shock was broadly defined as a clinical condition characterized by persistent hyperdynamic shock despite adequate fluid resuscitation (individualized doses) and high doses of norepinephrine (>= 1 mu g/kg/min). Reported high doses of norepinephrine were often >= 1 mu g/kg/min. However, there was significant variability in the usage of these terms throughout the literature. Discussion: The usage of terms for refractory septic shock showed marked inconsistencies. Consensus definitions are urgently needed to establish a common language in the medical literature and to harmonize future studies.
JOURNAL OF CRITICAL CARE
(2023)
Editorial Material
Nursing
Goncalo Guerreiro, Pedro Povoa
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Article
Medicine, General & Internal
Jose Pedro Cidade, Vicente Ces de Souza Dantas, Alessandra de Figueiredo Thompson, Renata Carnevale Carneiro Chermont de Miranda, Rafaela Mamfrim, Henrique Caroli, Gabriela Escudini, Natalia Oliveira, Taiza Castro, Pedro Povoa
Summary: This study conducted a multicenter prospective cohort study in five hospitals in Portugal and Brazil for one year, and identified three distinct clinical phenotypes of severe COVID-19 patients with different characteristics and outcomes. Identifying and differentiating these phenotypes can help physicians develop different treatment strategies.
JOURNAL OF CLINICAL MEDICINE
(2023)
Review
Medicine, General & Internal
Rachael Cusack, Lieuwe D. Bos, Pedro Povoa, Ignacio Martin-Loeches
Summary: Acute respiratory distress syndrome (ARDS) is a severe organ failure mainly occurring in critically ill patients due to various insults such as sepsis, trauma, or aspiration. Sepsis is the leading cause of ARDS, resulting in high mortality and resource consumption. ARDS is characterized by acute respiratory failure with severe and often refractory hypoxemia. Endothelial damage plays a crucial role in the development of ARDS. Understanding the mechanisms of ARDS provides opportunities for novel diagnostic and therapeutic approaches. Biochemical signals can be utilized to identify and classify patients into ARDS phenotypes, enabling earlier personalized treatment.
FRONTIERS IN MEDICINE
(2023)
Review
Infectious Diseases
Marios Karvouniaris, Maria Panagiota Almyroudi, Mohd Hafiz Abdul-Aziz, Stijn Blot, Elisabeth Paramythiotou, Evdoxia Tsigou, Despoina Koulenti
Summary: Gram-negative bacterial resistance to antimicrobials has been increasing globally in recent decades, posing a daily challenge for hospital practice. Researchers and industry have made efforts to develop novel antimicrobials resilient to bacterial resistance mechanisms. Several new antimicrobials, including cefiderocol, imipenem-cilastatin-relebactam, eravacycline, omadacycline, and plazomicin, have become commercially available in the past five years. Other agents, such as aztreonam-avibactam, cefepime-enmetazobactam, cefepime-taniborbactam, cefepime-zidebactam, sulopenem, tebipenem, and benapenem, are in advanced development and have reached phase 3 clinical trials. This review critically discusses the characteristics, pharmacokinetic/pharmacodynamic properties, and current clinical data of these antimicrobials.
Article
Biochemistry & Molecular Biology
Alexis Garduno, Gustavo Sganzerla Martinez, Ali Toloue Ostadgavahi, David Kelvin, Rachael Cusack, Ignacio Martin-Loeches
Summary: Abnormal activation of innate and adaptive immunity may contribute to the dysregulated immune response seen in severe cases of COVID-19 and bacterial sepsis. While mild cases show differences in gene expression related to the specific infection, severe cases tend to share similar immune profiles. These findings suggest the need for co-adjuvant therapies and interventions to prevent the development of severe disease.
Editorial Material
Nursing
Stijn Blot, Jean-Francois Timsit, Jean-Ralph Zahar
INTENSIVE AND CRITICAL CARE NURSING
(2023)
Review
Microbiology
Georgios Papathanakos, Ioannis Andrianopoulos, Menelaos Xenikakis, Athanasios Papathanasiou, Despoina Koulenti, Stijn Blot, Vasilios Koulouras
Summary: Sepsis, a life-threatening infection-induced disorder of organ function, is a major cause of mortality worldwide, particularly in intensive care units. With an incomplete understanding of its complex pathophysiology, sepsis exhibits great heterogeneity in clinical expression, patient response to treatment, and outcomes. This heterogeneity poses a significant challenge for improving treatment in critical care. However, artificial intelligence and machine learning techniques offer promise for identifying clinical phenotypes and distinguishing individuals based on various factors such as temperature, hemodynamics, organ dysfunction, fluid status, ICU trajectories, and outcome. Ultimately, this approach may allow for targeted therapeutic interventions and optimal timing in septic patients.
Article
Biochemistry & Molecular Biology
Adrian Ceccato, Marta Camprubi-Rimblas, Lieuwe D. J. Bos, Pedro Povoa, Ignacio Martin-Loeches, Carles Forne, Aina Areny-Balaguero, Elena Campana-Duel, Luis Morales-Quinteros, Sara Quero, Paula Ramirez, Mariano Esperatti, Antoni Torres, Lluis Blanch, Antonio Artigas
Summary: The measurement and dynamics of Pancreatic Stone Protein (PSP) do not contribute to the early diagnosis of Ventilator-associated pneumonia (VAP).
Review
Nursing
Guanjie Chen, Xiaoqing Li, Xuezhu Li, Songqiao Liu, Jianfeng Xie
Summary: This study aimed to describe the current situation of mucosal membrane pressure injury in patients in the intensive care unit. The included studies showed that the incidence and prevalence of mucosal membrane pressure injury vary widely, and specific risk assessment tools and standardized staging criteria need further development. The risk factors for mucosal membrane pressure injury involve multiple aspects and require further verification.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Letter
Nursing
[Anonymous]
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Yen-Ching Chuang, Tao Miao, Fengmin Cheng, Yanjiao Wang, Ching-Wen Chien, Ping Tao, Linlin Kang
Summary: This study developed an interpretive model using the rough set approach to assess the risk level of pressure injuries in adult inpatients and identified critical risk factors associated with these injuries. The prediction model established demonstrated reliable predictive capabilities and can help nurses improve work efficiency by focusing on high-risk and severe-risk rules.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Jin Zhang, Wanjun Liu, Wenyan Xiao, Yu Liu, Tianfeng Hua, Min Yang
Summary: This study developed a data-driven blood culture classification model using machine learning and cluster analysis to optimize the management and treatment of ICU patients. The results showed that different blood culture clusters had different prognoses, blood culture outcomes, and suggested different durations of antibiotic treatment.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Letter
Nursing
Ezinne O. Igwe, Pauline Ding, Jessica Nealon, Karen Charlton, Victoria Traynor
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Laura Allum, Ella Terblanche, Natalie Pattison, Bronwen Connolly, Louise Rose
Summary: This study identified 36 actionable processes of care from interviews with intensive care staff, with an emphasis on enhancing patient autonomy through optimizing communication and involvement in decision-making, participation of family, and continuity of staff and care plans.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Fatma Azizoglu, Banu Terzi
Summary: This study identifies and visualizes global trends in the research on pressure injuries, prevention, and measurement tools in intensive care units. Through bibliometric analysis, the study reveals that the most commonly used keywords are pressure injury, pressure ulcer, critical care, pressure ulcers, intensive care unit, and pressure injuries.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Adrianna Lorraine Watson
Summary: This study explored the meaning behind professional identity in intensive care nurses who cared for patients with COVID-19. The findings suggest that professional identity is evolving for nurses as they care for patients in the intensive care and that evolution affects nursing professionals' quality of life. The implications for clinical practice include enhancing nurse retention and fulfillment by recognizing and nurturing nurses' strong professional identity.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Review
Nursing
Donghui Jia, Hengyang Wang, Qian Wang, Wenrui Li, Xuhong Lan, Hongfang Zhou, Zhigang Zhang
Summary: This meta-analysis assessed the predictive value of the rapid shallow breathing index (RSBI) for extubation outcomes. The results showed moderate accuracy, but poor sensitivity and specificity for RSBI in predicting successful extubation. Future studies should explore the combination of RSBI with other indicators and clinical experience to improve the success rate of extubation.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Melissa J. Bloomer, Eva Yuen, Ruth Williams, Alison M. Hutchinson
Summary: The COVID-19 pandemic led to strict restrictions on hospital visitation, which had a profound impact on family relationships during critical illness at the end of life in the intensive care unit. A family-centred approach to care, prioritizing and protecting family connections, is crucial in this context.
INTENSIVE AND CRITICAL CARE NURSING
(2024)
Article
Nursing
Frances Fengzhi Lin, Niki Murphy, Angelly Martinez, Andrea P. Marshall
Summary: This study investigated the facilitators and barriers to evidence-based central venous access device care in the adult intensive care setting. The results identified work structures, processes to optimize care quality, and factors influencing staff behavior as the key factors. Facilitators to optimal care included explicit language use, work system integration, research evidence dissemination, audit, and feedback. However, there was inconsistency in practices such as audit, feedback, and patient participation.
INTENSIVE AND CRITICAL CARE NURSING
(2024)