Article
Anesthesiology
Lohith H. N. Kumar, Swagata Tripathy, Prasanta Kumar Das
Summary: The study found that goal-directed therapy guided by DCO2 did not improve organ function, but it did reduce ICU stay. More evidence is needed to determine the routine use of DCO2 in sicker patients.
ANESTHESIA AND ANALGESIA
(2022)
Review
Medicine, General & Internal
Stephen Macdonald, Sandra L. Peake, Alasdair R. Corfield, Anthony Delaney
Summary: Intravenous fluid resuscitation is recommended as the first-line treatment for sepsis-associated hypotension and/or hypoperfusion, but there is limited high-level evidence to support this practice. Recent studies have found potential harms associated with large volume fluid resuscitation, leading to recommendations for a more conservative approach and earlier use of vasopressors. However, there is currently uncertainty and variation in practice regarding the choice between fluids or vasopressors for initial resuscitation in septic shock.
FRONTIERS IN MEDICINE
(2022)
Article
Critical Care Medicine
Amjad N. Kanj, Lucrezia Rovati, Claudia Castillo Zambrano, Alberto Marquez, Kellie Robbins, Gustavo Cortes Puentes, Alice Gallo De Moraes, Ognjen Gajic
Summary: This study aimed to assess the occurrence of low ScvO(2) in patients with severe hypoxemia and its association with clinical management and patient outcomes. The results showed that 56% of mechanically ventilated patients with severe hypoxemia had ScvO(2) <70%. Patients with low ScvO(2) had worse systemic oxygenation and hemodynamic parameters, and were more likely to undergo blood transfusions and receive medications.
Article
Critical Care Medicine
Chang Liu, Heyi Li, Zhiyong Peng, Bo Hu, Yue Dong, Xiaolan Gao, Ryan D. Frank, Rahul Kashyap, Ognjen Gajic, Kianoush B. Kashani
Summary: The study demonstrates that the use of albumin during the initial 6 hours of resuscitation in septic patients does not provide benefits in clinical outcomes.
Article
Medicine, General & Internal
Maximilian Dietrich, Tobias Hoelle, Lazar Detelinov Lalev, Martin Loos, Felix Carl Fabian Schmitt, Mascha Onida Fiedler, Thilo Hackert, Daniel Christoph Richter, Markus Alexander Weigand, Dania Fischer
Summary: This study analyzed the indication for and effect of fresh frozen plasma (FFP) transfusion in patients with septic shock. The results showed that early FFP administration did not have significant harm or associated benefit in septic shock, and plasma should only be used in patients with a strong indication according to current recommendations.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Emergency Medicine
Hua-ling Wang, Jun Shao, Wei-li Liu, Fei Wu, Han-bing Chen, Rui-Qiang Zheng, Qi-hong Chen
Summary: A multicenter prospective observational study found that an initial fluid resuscitation rate of 20-30 ml/kg may be associated with reduced 28-day mortality in patients with septic shock, highlighting the need for further high-quality randomized controlled clinical trials to confirm these findings.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Anesthesiology
Anne A. Aaen, Anders W. Voldby, Nicolas Storm, Jeppe Kildsig, Egon G. Hansen, Erik Zimmermann-Nielsen, Kenneth M. Jensen, Pernille Tibaek, Anette Mortensen, Ann M. Moller, Birgitte Brandstrup
Summary: The study suggests that goal-directed fluid therapy does not reduce the risk of major complications or death in patients undergoing emergency gastrointestinal surgery, but may prolong hospital stay.
BRITISH JOURNAL OF ANAESTHESIA
(2021)
Review
Medicine, General & Internal
Gianluca Tullo, Marcello Candelli, Irene Gasparrini, Sara Micci, Francesco Franceschi
Summary: Sepsis and septic shock are leading causes of in-hospital mortality worldwide, with significant burden on healthcare systems. Ultrasound has been used as an adjunctive tool for the diagnosis and treatment of these conditions, providing valuable information for clinicians. Further research is needed to determine the impact of ultrasound on patient survival.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Multidisciplinary Sciences
Boulos Nassar, Mohamed Badr, Nicolas Van Grunderbeeck, Johanna Temime, Florent Pepy, Gaelle Gasan, Laurent Tronchon, Didier Thevenin, Jihad Mallat
Summary: This study aimed to investigate the reliability of Delta-Delta PCO2 and Delta ScvO(2) in defining fluid responsiveness in septic patients undergoing volume expansion (VE). The results showed that these parameters were significantly correlated with changes in CI after VE and could predict fluid responsiveness effectively.
SCIENTIFIC REPORTS
(2021)
Review
Medicine, General & Internal
Shuaiyu Jiang, Mengmeng Wu, Xiaoguang Lu, Yilong Zhong, Xin Kang, Yi Song, Zhiwei Fan
Summary: This study indicates that limited fluid resuscitation (LFR) is more beneficial than harmful in patients with hemorrhagic shock or septic shock, reducing mortality, multiple organ dysfunction syndrome (MODS), acute respiratory distress syndrome (ARDS), and disseminated intravascular coagulation (DIC) rates.
Article
Health Care Sciences & Services
Daun Jeong, Gun Tak Lee, Jong Eun Park, Tae Gun Shin, Kyunga Kim, Doeun Jang, Won Young Kim, You Hwan Jo, Sung Phil Chung, Jin Ho Beom, Sung-Hyuk Choi, Woon Yong Kwon, Gil Joon Suh, Byuk Sung Ko, Kap Su Han, Jong Hwan Shin, Hanjin Cho, Sung Yeon Hwang
Summary: This study investigated the impact of changes in emergency department practices due to the COVID-19 pandemic on the clinical outcomes and management of patients with septic shock. Although there were delays in sepsis-related interventions during the pandemic, there was no significant difference in in-hospital mortality between the pre- and post-COVID-19 groups.
JOURNAL OF PERSONALIZED MEDICINE
(2022)
Article
Emergency Medicine
Gun Tak Lee, Sung Yeon Hwang, Jong Eun Park, Ik Joon Jo, Won Young Kim, Sung Phil Chung, You Hwan Jo, Gil Joon Suh, Sung-Hyuk Choi, Tae Gun Shin
Summary: The study aimed to investigate the diagnostic accuracy of post-fluid resuscitation lactate levels in predicting 28-day mortality in suspected septic shock patients. The results showed that post-fluid resuscitation lactate levels were more accurate than initial lactate levels in predicting mortality.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Multidisciplinary Sciences
Ole Broch, Lars Hummitzsch, Jochen Renner, Patrick Meybohm, Martin Albrecht, Peter Rosenthal, Ann-Christine Rosenthal, Markus Steinfath, Berthold Bein, Matthias Gruenewald
Summary: This study investigated the feasibility and impact of EGDT on myocardial damage and function after cardiac resuscitation in a translational pig model. The EGDT group showed a significant decrease in lactate levels and improved systolic myocardial function, indicating the potential benefits of implementing EGDT algorithms in post cardiac arrest care. Further investigation is needed to fully understand the impact and implementation of EGDT after cardiac arrest.
SCIENTIFIC REPORTS
(2021)
Article
Critical Care Medicine
Patrice Rosengrave, Emma Spencer, Jonathan Williman, Jan Mehrtens, Stacey Morgan, Tara Doyle, Kymbalee van der Heyden, Anna Morris, Geoff Shaw, Anitra C. Carr
Summary: This study investigated the effect of intravenous vitamin C administration on vasopressor requirements and outcomes in patients with septic shock. The results showed that intravenous vitamin C did not significantly decrease vasopressor dosage or duration. There were also no significant differences in SOFA scores, length of stay, and mortality between the intervention and placebo groups. Further research is needed to consider factors such as intervention timing, dosage, duration, and trial location to provide more definitive evidence.
Article
Critical Care Medicine
Heekyung Lee, Sung-Hyuk Choi, Kyuseok Kim, Tae Gun Shin, Yoo Seok Park, Seung Mok Ryoo, Gil Joon Suh, Woon Yong Kwon, Tae Ho Lim, Donghee Son, Won Young Kim, Byuk Sung Ko
Summary: Initial fluid resuscitation of 30 mL/kg within 3 or 6 h was not significantly associated with in-hospital mortality in septic shock patients with isolated hyperlactatemia. However, administration of 30 mL/kg crystalloid within 6 h was associated with higher ICU admission and RRT.
JOURNAL OF CRITICAL CARE
(2021)
Review
Immunology
Sang Ho Choi, Antoni Cesar, Timothy Arthur Chandos Snow, Naveed Saleem, Nishkantha Arulkumaran, Mervyn Singer
Summary: This study found that the efficacy of doxycycline is comparable to macrolides or fluoroquinolones in adult patients with mild-to-moderate community-acquired pneumonia (CAP), suggesting that it is a viable treatment option. However, larger trials are needed to confirm these findings due to the lack of recent studies.
CLINICAL INFECTIOUS DISEASES
(2023)
Article
Critical Care Medicine
Bruno A. M. P. Besen, Otavio T. Ranzani, Mervyn Singer
INTENSIVE CARE MEDICINE
(2023)
Article
Critical Care Medicine
Jan O. Friedrich, Michael O. Harhay, Derek C. Angus, Karen E. A. Burns, Deborah J. Cook, Dean A. Fergusson, Simon Finfer, Paul Hebert, Kathy Rowan, Gordon Rubenfeld, John C. Marshall
Summary: This study evaluated the performance characteristics of mortality as an outcome measure in clinical trials, finding that the differential effects on mortality persist for 60 to 90 days following recruitment and the adoption rate of mortality reduction measures in clinical practice is low. The findings provide a conceptual framework for choosing a time horizon and interpreting mortality outcome in trials of acute illness.
CRITICAL CARE MEDICINE
(2023)
Letter
Medicine, General & Internal
John A. Myburgh, Ian M. Seppelt, Simon R. Finfer
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Review
Clinical Neurology
Simon Chadwick, Lachlan Donaldson, Pierre Janin, Archie Darbar, Rosie Sutherland, Oliver Flower, Naomi Hammond, Jonathan Parkinson, Anthony Delaney
Summary: This study conducted a systematic review and meta-analysis to investigate the association between VRI (ventriculostomy-related infection) and clinical outcomes and resource use in patients with EVD. The results showed that VRI was not associated with increased mortality or poor neurological outcome, but it was associated with prolonged duration of EVD placement, ICU and hospital admission, and increased rate of internal ventricular shunt placement.
JOURNAL OF CLINICAL NEUROSCIENCE
(2023)
Article
Multidisciplinary Sciences
Erola Pairo-Castineira, Konrad Rawlik, Andrew D. Bretherick, Ting Qi, Yang Wu, Isar Nassiri, Glenn A. McConkey, Marie Zechner, Lucija Klaric, Fiona Griffiths, Wilna Oosthuyzen, Athanasios Kousathanas, Anne Richmond, Jonathan Millar, Clark D. Russell, Tomas Malinauskas, Ryan Thwaites, Kirstie Morrice, Sean Keating, David Maslove, Alistair Nichol, Malcolm G. Semple, Julian Knight, Manu Shankar-Hari, Charlotte Summers, Charles Hinds, Peter Horby, Lowell Ling, Danny McAuley, Hugh Montgomery, Peter J. M. Openshaw, Colin Begg, Timothy Walsh, Albert Tenesa, Carlos Flores, Jose A. Riancho, Augusto Rojas-Martinez, Pablo Lapunzina, Jian Yang, Chris P. Ponting, James F. Wilson, Veronique Vitart, Malak Abedalthagafi, Andre D. Luchessi, Esteban J. Parra, Raquel Cruz, Angel Carracedo, Angie Fawkes, Lee Murphy, Kathy Rowan, Alexandre C. Pereira, Andy Law, Benjamin Fairfax, Sara Clohisey Hendry, J. Kenneth Baillie
Summary: This study analyzed genetic data from 24,202 severe COVID-19 cases and identified potentially druggable targets, including inflammatory signaling, monocyte-macrophage activation and endothelial permeability, immunometabolism, and host factors required for viral entry and replication.
Article
Clinical Neurology
Naomi Niznick, Victoria Saigle, Maria Luisa Marti, Josephine Laframboise, Xiaohui Zha, Chris Andersen, Justin Presseau, Michael Chasse, Lauralyn McIntyre, Dean F. Fergusson, Alexis Turgeon, Francois A. Lauzier, Stephan Mayer, Shouri Lahiri, Tim Ramsay, Shane English
Summary: This study aimed to assess the clinical relevance of the modified Rankin scale (mRS) as a research outcome measure for aneurysmal subarachnoid hemorrhage (aSAH) survivors. Through an international cross-sectional survey of 355 aSAH survivors, family members, and caregivers, it was found that there was poor agreement between self-assessed outcome, actual mRS score, and dichotomization of the mRS score into good/poor outcomes. Approximately 30% of respondents believed that the mRS should not be used as an outcome measure in future aSAH trials.
Review
Anesthesiology
Jessica X. L. Li, Xia Wang, Amanda Henry, Craig S. Anderson, Naomi Hammond, Katie Harris, Hueiming Liu, Kelly Loffler, John Myburgh, Jeyaraj Pandian, Brendan Smyth, Balasubramanian Venkatesh, Cheryl Carcel, Mark Woodward
Summary: This study aimed to determine sex differences in pain prevalence and intensity reported by participants with diverse disease states. The study found that females were more likely to report pain and experienced higher levels of pain compared to males. This study reinforces the importance of reporting sex-disaggregated analysis to identify similarities and differences between females and males that may affect disease profiles and management.
Article
Critical Care Medicine
Peter J. McGuigan, Julia Edwards, Bronagh Blackwood, Paul Dark, James C. Doidge, David A. Harrison, Gareth Kitchen, Izabella Lawson, Alistair D. Nichol, Kathryn M. Rowan, Manu Shankar-Hari, Danny F. McAuley
Summary: This study aimed to report the variation in incidence and outcome of in hospital cardiac arrest (IHCA) based on the hour of occurrence. It was found that IHCA occurred more frequently and had poorer outcomes at night. However, this variation was not present in patients admitted to the intensive care unit (ICU).
Article
Medicine, General & Internal
Carl Marincowitz, Omar Bouamra, Tim Coats, Dhushy Kumar, David Lockey, Lyndon Mason, Virginia Newcombe, Julian Thompson, Antoinette Edwards, Fiona Lecky
Summary: This study used national registry data in England to assess the impact of successive COVID lockdowns on major trauma patients. They found large reductions in major trauma during both lockdowns, particularly related to road traffic collisions. Likelihood of survival following major trauma fell when the lockdown measures were first introduced but returned to pre-lockdown levels over the first lockdown.
Article
Clinical Neurology
Tessa Garside, Ralph Stanford, Oliver Flower, Trent Li, Edward Dababneh, Naomi Hammond, Frances Bass, James Middleton, Jonathan Tang, Jonathan Ball, Anthony Delaney
Summary: Interventions provided in the early phases after spinal cord injury may improve neurological recovery, but it is unclear if early documentation of neurological status is practiced in NSW. Lack of documentation may hinder evaluation of treatment response and prognostication.
JOURNAL OF SPINAL CORD MEDICINE
(2023)
Article
Hematology
Benjamin Sansom, Brooke Riley, Andrew Udy, Shyamala Sriram, Jeffrey Presneill, Rinaldo Bellomo
Summary: This study compared the use of CRRT during ECMO with non-ECMO-CRRT and found that CRRT used in conjunction with ECMO has a longer circuit life despite higher circuit pressures. However, significantly elevated access pressures may predict early CRRT circuit failure during ECMO, possibly due to progressive membrane thrombosis.
BLOOD PURIFICATION
(2023)
Article
Hematology
Kyle Christopher White, Kevin B. Laupland, Emily See, Ary Serpa-Neto, Rinaldo Bellomo
Summary: The effect of CRRT commencement on urine output was investigated in a retrospective cohort study. It was found that starting CRRT was associated with a significant decrease in urine output that continued over the first 24 hours.
BLOOD PURIFICATION
(2023)
Meeting Abstract
Urology & Nephrology
Y. Diana Kwong, Kathleen Liu, Chi-Yuan Hsu, Bruce Cooper, Paul Palevsky, John Kellum, Kirsten Johansen, Christine Miaskowski
AMERICAN JOURNAL OF KIDNEY DISEASES
(2023)
Article
Critical Care Medicine
Marcus Young, Natasha E. Holmes, Kartik Kishore, Sobia Amjad, Michele Gaca, Ary Serpa Neto, Michael C. Reade, Rinaldo Bellomo
Summary: The use of natural language processing (NLP) can help identify behavioral disturbance phenotypes with different characteristics, prevalence, trajectory, treatment, and outcomes. In critically ill patients, those with an agitated phenotype are more likely to receive antipsychotic medications and have a higher risk of mortality compared to patients with a non-agitated or combined phenotype.