Critical Care Medicine最新文献

{"title":"When Ethics Meet Socrates in Critical Care.","authors":"Cesar Pedreros, Angel Saenz, Andres Ferre, Andres Giglio","doi":"10.1097/CCM.0000000000006634","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006634","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1340-e1341"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Society of Critical Care Medicine Presidential Address-54th Annual Congress, February 2025.","authors":"Jose L Pascual","doi":"10.1097/CCM.0000000000006722","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006722","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1177-e1180"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The authors reply.","authors":"Yuki Kotani, Vincenzo Russotto","doi":"10.1097/CCM.0000000000006659","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006659","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1334-e1335"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The authors reply.","authors":"Mohammad I H Hirzallah, Lochner Piergiorgio, Christos Krogias, Chiara Robba, Jurgita Valaikiene, Aarti Sarwal, Felix Schlachetzki, Jakob Pansell","doi":"10.1097/CCM.0000000000006658","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006658","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1328-e1330"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diarrhea in Mechanically Ventilated Patients: A Nested Multicenter Substudy.","authors":"Joanna C Dionne, Jennie Johnstone, Diane Heels-Ansdell, Parsa Tahvildar Khazaneh, Nicole Zytaruk, France Clarke, Lori Hand, Tina Millen, William Dechert, Rebecca Porteous, Fiona Auld, Miranda Hunt, Eileen Campbell, Tracey Bentall, Tracy Campbell, Orla Smith, Louise Rose, Yaseen M Arabi, Erick Duan, M Elizabeth Wilcox, Lauralyn McIntyre, Bram Rochwerg, Tim Karachi, Neill K Adhikari, Emmanuel Charbonney, Charles St-Arnaud, Arnold Kristof, Kosar Khwaja, François Marquis, Ryan Zarychanski, Eyal Golan, Deborah Cook","doi":"10.1097/CCM.0000000000006667","DOIUrl":"10.1097/CCM.0000000000006667","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine the prevalence and incidence of diarrhea, diarrhea risk factors, processes of care, and clinical outcomes associated with diarrhea in invasively ventilated patients in the ICU.</p><p><strong>Design: </strong>Bedside nurses prospectively documented each patient's bowel movement (BM) using the Bristol Stool Chart type and number. Research Coordinators collected baseline and daily data evaluating risk factors for diarrhea and patient outcomes. The diarrhea definition was the World Health Organization definition of ≥3 loose or watery BMs (Bristol type 6 or 7) per day. We used Cox proportional hazards regression to evaluate risk factors and the association with the risk of death in the ICU.</p><p><strong>Setting: </strong>Forty-four ICUs in Canada, the United States, and Saudi Arabia.</p><p><strong>Patients: </strong>All 2,650 invasively ventilated critically ill patients were enrolled in this preplanned secondary analysis of a randomized trial that evaluated the probiotic Lactobacillus rhamnosus GG on infectious outcomes.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Among 2,650 patients, the mean age (sd) was 59.8 (16.5) years, with an Acute Physiology and Chronic Health Evaluation II Score of 22.0 (7.8); 61.2% received inotropes/vasopressors on study day 1. Diarrhea occurred among 60.4% of patients and on 18.2% of ICU study days. Independent risk factors for diarrhea were a history of Clostridioides difficile infection, laxatives, and antibiotic use. Adjusted for these factors, enteral nutrition, particularly with moderate-high-protein content, also increased the risk of diarrhea. Univariable analysis suggested that diarrhea was associated with C. difficile testing, fecal management device insertion, and increased length of ICU and hospital stay. After adjusting for illness severity, mechanical ventilation, inotropes/vasopressors, renal replacement therapy, and severe infections, diarrhea was not associated with an increased risk of death.</p><p><strong>Conclusions: </strong>Diarrhea is common among invasively ventilated patients. Risk factors include a history of C. difficile, use of antibiotics, laxatives, and enteral nutrition, particularly moderate-high-protein composition feeds.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1247-e1256"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Prevalence and Characteristics of Oropharyngeal Dysphagia in Critically Ill Patients During the Acute and Postacute Recovery Phase.","authors":"Cara Donohue, Kaitlynn Raye, Pratik Pandharipande, Robert S Dittus, E Wesley Ely","doi":"10.1097/CCM.0000000000006669","DOIUrl":"10.1097/CCM.0000000000006669","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence and characteristics of oropharyngeal dysphagia in critically ill adults during acute and postacute care settings.</p><p><strong>Data sources: </strong>This systematic review was registered on PROSPERO and used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched (PubMed, Scopus, Cochrane Library, CINAHL, and Embase) from the time of inception to September 2024 using search terms: dysphagia, deglutition disorders, swallowing disorders, sepsis, postintensive care syndrome, COVID-19, critical illness.</p><p><strong>Study selection: </strong>Independent review of articles was conducted by two raters using four inclusion criteria: 1) adults older than 18 years; 2) diagnosis of COVID-19, sepsis, critical illness, or ostintensive care syndrome and dysphagia; 3) underwent clinical swallow evaluation; and 4) in acute or postacute care setting.</p><p><strong>Data extraction: </strong>Two raters independently assessed levels of research evidence and risk of bias using the Oxford center for Evidence-based Medicine Levels of Evidence and the Modified Downs and Black Checklist and extracted demographics, study design, dysphagia assessment methods, outcomes, and comorbidities.</p><p><strong>Data synthesis: </strong>After removing duplicates, 5058 articles were identified and 4844 screened out based on title/abstract. Full-text review was completed for 214 articles, and 51 met inclusion. Prevalence of dysphagia ranged from 15% to 100%. Dysphagia persisted in up to 74% of individuals at hospital discharge and up to 22% of patients 10 to 17 months posthospital discharge.</p><p><strong>Conclusions: </strong>Due to study design limitations, high risk of bias, and heterogeneity in methods/outcomes, firm conclusions cannot be drawn. However, current data suggest a high prevalence of dysphagia in critically ill adults who persists greater than or equal to 12 months posthospital discharge. Given the high rates of silent aspiration, prospective, longitudinal research is needed to further understand the prevalence and impact of chronic dysphagia on health and quality of life in critically ill adults.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"e1292-e1302"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Transfusion During Critical Illness, Not Just a Reflex Response to Low Hemoglobin Concentration.","authors":"Nicholas A Bosch","doi":"10.1097/CCM.0000000000006671","DOIUrl":"10.1097/CCM.0000000000006671","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":"e1317-e1319"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hit By a Bus: Erratum.","authors":"Uttara Koul","doi":"10.1097/CCM.0000000000006687","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006687","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1353"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction Agents for Tracheal Intubation in Critically Ill Patients.","authors":"Carlos Chamorro-Falero, Julia Macías-Clemente, Juan J Morales-Domene","doi":"10.1097/CCM.0000000000006631","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006631","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1331-e1332"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer Review: Present and Future for Critical Care Medicine.","authors":"Jonathan Sevransky, Sheila Alexander, Lama Nazer, Aarti Sarwal, Tamas Szakmany, Robert Tasker","doi":"10.1097/CCM.0000000000006689","DOIUrl":"https://doi.org/10.1097/CCM.0000000000006689","url":null,"abstract":"","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":"53 6","pages":"e1174-e1176"},"PeriodicalIF":7.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}