Letter
Medicine, General & Internal
Jan O. Friedrich, Elisa Gouvea Bogossian
Summary: In a trial evaluating the efficacy of hydrocortisone in treating community-acquired pneumonia, researchers found a nearly 50% lower 28-day mortality rate in the hydrocortisone group compared to the placebo group. They also observed a higher incidence of septic shock in the placebo group. The trial did not allow the use of open-label glucocorticoids, which may have contributed to the higher mortality rate in the placebo group.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Review
Medicine, General & Internal
G. Klefti, A. T. Hill
Summary: This study, through a meta-analysis, found that non-invasive ventilation (NIV) significantly reduced the rate of endotracheal intubation and the proportion of patients meeting the criteria for intubation, as well as ICU mortality rate, compared to standard medical care for severe community-acquired pneumonia in adults. However, no significant effect on hospital mortality rate was found. The quality of evidence for the outcomes related to intubation and proportion of patients meeting intubation criteria was rated as 'Moderate', while the quality of evidence for ICU and hospital mortality rate was rated as 'Low'.
QJM-AN INTERNATIONAL JOURNAL OF MEDICINE
(2022)
Article
Infectious Diseases
Keita Imanishi, Kazuhiro Yasuo
Summary: Respiratory failure due to muscle spasms is a common consequence of tetanus. Noninvasive positive pressure ventilation (NPPV) can effectively manage respiratory failure in tetanus patients who decline intubation, reducing the risk of complications and shortening the duration of ventilatory support.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2022)
Article
Respiratory System
Hannah Lawrence, Tricia M. McKeever, Wei Shen Lim, British Thoracic Soc
Summary: The readmission rates for community-acquired pneumonia (CAP) in the UK have increased over the past decade. This study aimed to describe the cohort of patients who were readmitted within 30 days after hospitalisation for CAP in England and explore the reasons for this. A retrospective analysis was performed using data from the British Thoracic Society audit, and it was found that pneumonia was the most common condition treated on readmission and had a higher mortality rate than other diagnoses.
Article
Pediatrics
Vinod H. Ratageri, Puspha Panigatti, Aparna Mukherjee, Rashmi R. Das, Jagdish Prasad Goyal, Javeed Iqbal Bhat, Bhadresh Vyas, Rakesh Lodha, Deepak Singhal, Prawin Kumar, Kuldeep Singh, Samarendra Mahapatro, Bashir Ahmad Charoo, S. K. Kabra, K. R. Jat
Summary: The role of serum procalcitonin in diagnosing pediatric community-acquired pneumonia remains controversial. This study aimed to investigate the utility of serum procalcitonin in differentiating bacterial and non-bacterial respiratory infections in children and to assess its usefulness in diagnosing pneumonia. The study found that elevated procalcitonin was significantly associated with radiographic pneumonia, but not with pneumonia based on WHO criteria. However, it can act as a surrogate marker for severe pneumonia.
Review
Public, Environmental & Occupational Health
Istvan Ruzsics, Peter Matrai, Peter Hegyi, David Nemeth, Judit Tenk, Alexandra Csenkey, Balint Eross, Gabor Varga, Marta Balasko, Erika Petervari, Gabor Veres, Robert Sepp, Rakonczay Zoltan, Aron Vincze, Andras Garami, Zoltan Rumbus
Summary: Noninvasive ventilation (NIV) decreases mortality and reduces the need for intubation in pneumonia-associated respiratory failure, particularly in populations that include patients with COPD.
JOURNAL OF INFECTION AND PUBLIC HEALTH
(2022)
Article
Immunology
Leigh M. Howard, Kathryn M. Edwards, Yuwei Zhu, Carlos G. Grijalva, Wesley H. Self, Seema Jain, Krow Ampofo, Andrew T. Pavia, Sandra R. Arnold, Jonathan A. McCullers, Evan J. Anderson, Richard G. Wunderink, Derek J. Williams
Summary: Clinical features did not reliably distinguish HMPV-associated pneumonia from other pathogens. HMPV-associated pneumonia was less severe than bacterial and adult RSV pneumonia, but was otherwise as or more severe than other common pathogens.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Infectious Diseases
Jamila Nambafu, Mary Achakolong, Fridah Mwendwa, Jumaa Bwika, Felix Riunga, Samuel Gitau, Hanika Patel, Rodney D. Adam
Summary: Lower respiratory tract infections are a major cause of morbidity and mortality globally. A study in Kenya found that viruses, especially Influenza A, were commonly identified as etiologic agents in patients with community acquired pneumonia. The study also highlighted the presence of underlying conditions such as cardiovascular disease and diabetes, pointing to the increasing burden of infectious and noncommunicable diseases in the region.
BMC INFECTIOUS DISEASES
(2021)
Review
Infectious Diseases
Catia Cilloniz, Juan Manuel Pericas, Walter H. Curioso
Summary: This article reviews the factors related to CAP-associated outcomes, including host, microorganism, therapeutic approach, and health system organization. The aim is to discuss controversial points and provide recommendations for further research and patient management to improve CAP outcomes, beyond mortality.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2023)
Article
Infectious Diseases
Catia Cilloniz, Cristina Dominedo, Albert Gabarrus, Carolina Garcia-Vidal, Jose Becerril, Diego Tovar, Estela Moreno, Juan M. Pericas, Carmen Rosa Vargas, Antoni Torres
Summary: This study aimed to describe the prevalence, risk factors, and outcomes of MSSA community-acquired pneumonia and found that MSSA CAP patients had higher 30-day mortality than pneumococcal CAP patients, with MSSA being an independent factor of mortality.
JOURNAL OF INFECTION
(2021)
Review
Medicine, Research & Experimental
Juan Wang, Shuang Bian, Xiaomiao Tang, Sheng Ye, Shen Meng, Wei Lei
Summary: Serum albumin levels and duration of NPPV treatment were identified as independent risk factors for the efficacy of NPPV treatment in respiratory failure.
EUROPEAN JOURNAL OF MEDICAL RESEARCH
(2021)
Review
Infectious Diseases
Alexander Rombauts, Gabriela Abelenda-Alonso, Guillermo Cuervo, Carlota Gudiol, Jordi Carratala
Summary: Despite ongoing efforts to identify biomarkers and effective treatment strategies for modulating the inflammatory response in CAP, ideal solutions have yet to be found. The contradictory results in studies concerning the role of immunomodulatory agents further complicates the task of adequately identifying the population who may benefit most.
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
(2022)
Article
Medicine, General & Internal
Alex R. Schuurman, Tom D. Y. Reijnders, Tjitske S. R. van Engelen, Valentine Leopold, Justin de Brabander, Christine van Linge, Michiel Schinkel, Liza Pereverzeva, Bastiaan W. Haak, Xanthe Brands, Maadrika M. N. P. Kanglie, Inge A. H. van den Berk, Renee A. Douma, Daniel R. Faber, Prabath W. B. Nanayakkara, Jaap Stoker, Jan M. Prins, Brendon P. Scicluna, W. Joost Wiersinga, Tom van der Poll
Summary: This study identifies shared and distinct pathophysiological mechanisms in different aetiologies of community-acquired pneumonia (CAP), which may guide new pathogen-specific therapeutic strategies.
Article
Pediatrics
Meryl Vedrenne-Cloquet, Sonia Khirani, Lucie Griffon, Charlotte Collignon, Sylvain Renolleau, Brigitte Fauroux
Summary: NIPPV is more effective than CPAP in reducing respiratory effort in infants with severe acute bronchiolitis. Both clinically and physiologically, NIPPV can significantly reduce respiratory effort and improve other indicators compared to CPAP.
PEDIATRIC PULMONOLOGY
(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.
Article
Critical Care Medicine
Christina Boncyk, Kimberly Rengel, Joanna Stollings, Matt Marshall, Xiaoke Feng, Matthew Shotwell, Pratik P. Pandharipande, Christopher G. Hughes
Summary: This study describes the incidence and factors associated with recurrent delirium in the intensive care unit (ICU). The researchers found that over 10% of delirious ICU patients experienced recurrent symptoms, and factors such as age, duration of mechanical ventilation, and medication exposure were associated with recurrence.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Thomas C. Rollinson, Luke A. McDonald, Joleen Rose, Glenn Eastwood, Rahul Costa-Pinto, Lucy Modra, Akinori Maeda, Zoe Bacolas, James Anstey, Samantha Bates, Scott Bradley, Jodi Dumbrell, Craig French, Angaj Ghosh, Kimberley Haines, Tim Haydon, Carol L. Hodgson, Jennifer Holmes, Nina Leggett, Forbes McGain, Cara Moore, Kathleen Nelson, Jeffrey Presneill, Hannah Rotherham, Simone Said, Meredith Young, Peinan Zhao, Andrew Udy, Ary Serpa Neto, Anis Chaba, Rinaldo Bellomo
Summary: Neuromuscular blockers (NMBs) used during prone positioning in COVID-19 ARDS patients can improve oxygenation and have a sustained effect upon returning to supine position.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Kyung Hun Nam, Jason Phua, Bin Du, Shinichiro Ohshimo, Hwa Jung Kim, Chae-Man Lim, Sheila Nainan Myatra, Nik Azman Bin Nik Adib, Yaseen M. Arabi, Ming-Cheng Chan, Mohammad Omar Faruq, Ike Sri Redjeki, Do Ngoc Son, Khalid Mahmood Khan Nafees, Dilshan Priyankara, Boonsong Patjanasoontorn, Jose Emmanuel Palo, Aidos Konkayev, Gentle Sunder Shrestha, Younsuck Koh
Summary: This study investigated the current practices of mechanical ventilation in Asian intensive care units. The results showed that low tidal volume ventilation and sufficient PEEP were underused in patients with ARDS, while intermediate tidal volumes were commonly used in patients without ARDS. Country income, age, and severity of illness were associated with mortality.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Rudolf Likar, Ilia Aroyo, Katrin Bangert, Bjorn Degen, Rainer Dziewas, Oliver Galvan, Michaela Trapl Grundschober, Markus Kostenberger, Paul Muhle, Joerg C. Schefold, Patrick Zuercher
Summary: This article presents expert opinions on the diagnosis and management of dysphagia in ICU patients. The panel suggests adopting clinical algorithms to promote standardized and high-quality care, and proposes two clinical management algorithms to improve early detection and effective treatment of dysphagia in ICU patients.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Pawel Pasieka, Anna Surowka, Jakub Fronczek, Evan Skwara, Miroslaw Czuczwar, Michal Borys, Pawel Krawczyk, Miroslaw Zietkiewicz, Lukasz R. Nowak, Maciej Zukowski, Katarzyna Kotfis, Katarzyna Cwyl, Jacek Skowronek, Joanna Solek-Pastuszka, Jowita Biernawska, Pawel Grudzien, Pawel Nasilowski, Natalia Popek, Waldemar Cyrankiewicz, Katarzyna Sierakowska, Wojciech Mudyna, Szymon Bialka, Dorota Studzinska, Szymon Bernas, Mariusz Piechota, Waldemar Machala, Lukasz Sadowski, Jan Stefaniak, Radoslaw Owczuk, Malgorzata Szymkowiak, Ryszard Gawda, Natalia Kozera, Barbara Adamik, Waldemar Gozdzik, Agnieszka Wieczorek, Jaroslaw Janc, Anna Kluzik, Janusz Trzebicki, Pawel Zatorski, Wojciech Gola, Hubert Hymczak, Lukasz J. Krzych, Szymon Czajka, Urszula Kosciuczuk, Bartosz Kudlinski, Hans Flaatten, Wojciech Szczeklik
Summary: The study aims to evaluate whether there is an increased propensity to limit life-sustaining treatment (LST) among elderly patients in Poland from 2018-2019 compared to 2016-2017. The results show that clinicians in Poland have become more proactive in limiting LST in critically ill patients aged 80 and above during the studied period, although the prevalence of LST limitations in Poland remains low.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jihad Mallat, Malcolm Lemyze, Marc-Olivier Fischer
Summary: In mechanically ventilated patients with acute circulatory failure, changes in PVI induced by PLR accurately predict fluid responsiveness.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jingyuan Xu, Yanjie Zhang, Jie Jiang, Yi Yang, Fengmei Guo
Summary: This meta-analysis examined the effect of milrinone on prognosis in adult critically ill patients and found a significant decrease in the incidence of ventricular arrhythmia in patients with cardiac surgery. However, there was no significant reduction in all-cause mortality or the incidence of myocardial infarction. More research is needed to determine the reliable and conclusive evidence for the effects of milrinone.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Zhi-Tao Li, Da-Bing Huang, Jian-Feng Zhao, Hui Li, Shui-Qiao Fu, Wei Wang
Summary: Venous congestion is associated with AKI after cardiac surgery, but not necessarily with CRRT. Among the markers tested, IRVF exhibits the strongest correlation with AKI.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Sarah E. Nelson, Spyridoula Tsetsou, John Liang
Summary: This article discusses a range of issues associated with tracking CLABSI and CAUTI metrics, including lack of evidence, moral distress, and definition problems. It recommends forming a task force consisting of key stakeholders to improve the use of these metrics.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Ross Prager, Eric Walser, Kaan Y. Balta, Anton Nikouline, William R. Leeper, Kelly Vogt, Neil Parry, Robert Arntfield
Summary: Resuscitative TEE has been shown to be a valuable diagnostic tool in trauma care, with the potential to impact treatment strategies and diagnostic approaches for patients in the trauma bay.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Jaeyun Sung, Sanu S. Rajendraprasad, Kemuel L. Philbrick, Brent A. Bauer, Ognjen Gajic, Aditya Shah, Krzysztof Laudanski, Johan S. Bakken, Joseph Skalski, Lioudmila V. Karnatovskaia
Summary: With a large number of cells and genes, the human gut microbiome is crucial for health and disease. Modern living disrupts the balance between the host and its microbiome, leading to adverse impacts on critical illness and patient outcomes. Restoring the gut microbiome shows promise for preventing and treating critical illnesses.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Claire Chaignat, Laurent Lagrost, Karena Moretto, Jean-Paul Pais de Barros, Hadrien Winiszewski, Jacques Grober, Philippe Saas, Gael Piton
Summary: The aim of this study was to investigate the correlation between plasma citrulline levels and plasma lipopolysaccharide (LPS) concentration, as well as the impact of sepsis on gut function in critically ill patients. The results showed no correlation between plasma citrulline concentration and plasma LPS concentration or activity. However, septic patients had significantly lower plasma citrulline levels. Additionally, abdominal sepsis was associated with higher plasma LPS activity compared to extra-abdominal sepsis.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Pyoung Jik Lee, Thomas Hampton
Summary: This study found that smartphone applications with low-cost external microphones can reliably measure average noise levels in both laboratory and field settings, but show significant differences compared to professional equipment when measuring maximum noise levels.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Greg Roberts, James S. Krinsley, Jean-Charles Preiser, Stephen Quinn, Peter R. Rule, Michael Brownlee, Guillermo E. Umpierrez, Irl B. Hirsch
Summary: Relative hypoglycemia was commonly seen in patients with HbA1c ≥ 8% and was independently associated with mortality. Absolute hypoglycemia was associated with mortality regardless of HbA1c.
JOURNAL OF CRITICAL CARE
(2024)
Article
Critical Care Medicine
Katsura Hayakawa, Shigehiko Uchino, Hideki Endo, Kazuki Hasegawa, Kazuya Kiyota
Summary: This study assessed the performance of the APACHE III and JROD models under different conditions of missing variables and found that a higher number of missing physiological variables led to underestimated predicted mortality rates and higher standardized mortality ratios.
JOURNAL OF CRITICAL CARE
(2024)