Intensive Care Medicine最新文献

{"title":"End-of-life care awareness in a low-middle-income country: a plea for improvement.","authors":"Radhouane Toumi, Mohamed Boussarsar","doi":"10.1007/s00134-024-07715-x","DOIUrl":"https://doi.org/10.1007/s00134-024-07715-x","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619761","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":"Landiolol in patients with septic shock.","authors":"Vassilios Vazgiourakis, Konstantinos Mantzarlis, Demosthenes Makris","doi":"10.1007/s00134-024-07706-y","DOIUrl":"https://doi.org/10.1007/s00134-024-07706-y","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619764","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":"Heart rate control in septic shock-\"every journey begins with a first step\" (Confucius).","authors":"Sebastian Rehberg, Frantisek Duska","doi":"10.1007/s00134-024-07721-z","DOIUrl":"https://doi.org/10.1007/s00134-024-07721-z","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619763","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":"Personalized positive end-expiratory pressure in spontaneously breathing patients with acute respiratory distress syndrome by simultaneous electrical impedance tomography and transpulmonary pressure monitoring: a randomized crossover trial","authors":"Tommaso Mauri, Domenico L. Grieco, Elena Spinelli, Marco Leali, Joaquin Perez, Valentina Chiavieri, Tommaso Rosà, Pierluigi Ferrara, Gaetano Scaramuzzo, Massimo Antonelli, Savino Spadaro, Giacomo Grasselli","doi":"10.1007/s00134-024-07695-y","DOIUrl":"https://doi.org/10.1007/s00134-024-07695-y","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Personalized positive end-expiratory pressure (PEEP) might foster lung and diaphragm protection in patients with acute respiratory distress syndrome (ARDS) who are undergoing pressure support ventilation (PSV). We aimed to compare the physiologic effects of personalized PEEP set according to synchronized electrical impedance tomography (EIT) and driving transpulmonary pressure (∆PL) monitoring against a classical lower PEEP/FiO₂ table in intubated ARDS patients undergoing PSV.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A cross-over randomized multicenter study was conducted in 30 ARDS patients with simultaneous recording of the airway, esophageal and transpulmonary pressure, together with EIT during PSV. Following a decremental PEEP trial (18 cmH₂O to 4 cmH₂O), PEEP_EIT-∆PL was identified as the level with the smallest difference between lung overdistension and collapse. A low PEEP/FiO₂ table was used to select PEEP_TABLE. Each PEEP strategy was applied for 20 min, and physiologic data were collected at the end of each step.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The PEEP trial was well tolerated. Median PEEP_EIT-∆PL was higher than PEEP_TABLE (10 [8–12] vs. 8 [5–10] cmH₂O; <i>P</i> = 0.021) and, at the individual patient level, PEEP_EIT-∆PL level differed from PEEP_TABLE in all patients. Overall, PEEP_EIT-∆PL was associated with lower dynamic ∆PL (<i>P</i> &lt; 0.001) and pressure–time product (<i>P</i> &lt; 0.001), but there was variability among patients. PEEP_EIT-∆PL also decreased respiratory drive and effort (<i>P</i> &lt; 0.001), improved regional lung mechanics (<i>P</i> &lt; 0.05) and reversed lung collapse (<i>P</i> = 0.007) without increasing overdistension (<i>P</i> = 0.695).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Personalized PEEP selected using synchronized EIT and transpulmonary pressure monitoring could be associated with reduced dynamic lung stress and metabolic work of breathing in ARDS patients undergoing PSV.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":"245 1","pages":""},"PeriodicalIF":38.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142598507","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":"Comment on: European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.","authors":"Michael J O'Leary","doi":"10.1007/s00134-024-07702-2","DOIUrl":"https://doi.org/10.1007/s00134-024-07702-2","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581386","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":"Identifying and treating hypoactive delirium: back to square one?","authors":"Julia Tavares-Pereira, Luísa Pereira Novaes, Mariana Luz, Bruna Brandao Barreto, Dimitri Gusmao-Flores","doi":"10.1007/s00134-024-07703-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07703-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581490","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":"Non-synchronized unassisted spontaneous ventilation may minimize the risk of high global tidal volume and transpulmonary pressure, but it is not free from pendelluft.","authors":"Rodrigo A Cornejo, Roberto Brito, Daniel H Arellano, Caio C A Morais","doi":"10.1007/s00134-024-07707-x","DOIUrl":"https://doi.org/10.1007/s00134-024-07707-x","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568375","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":"Reflections on awake prone positioning in COVID-19: considerations on body inclination, respiratory support, and patient variability.","authors":"Yuxian Wang, Shengyu Hao, Jieqiong Song, Ming Zhong","doi":"10.1007/s00134-024-07710-2","DOIUrl":"https://doi.org/10.1007/s00134-024-07710-2","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568381","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":"Central venous catheter insertion site and infection prevention in 2024. Author's reply.","authors":"Nicolas Massart, Vincent Cosme, Florian Reizine, Arnaud Friggeri, Alain Lepape","doi":"10.1007/s00134-024-07705-z","DOIUrl":"https://doi.org/10.1007/s00134-024-07705-z","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568374","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 nature of clinical research: even a clear answer gives rise to many other questions.","authors":"Michael C Reade, David Liu","doi":"10.1007/s00134-024-07711-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07711-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":" ","pages":""},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568384","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}