Journal of critical care最新文献

{"title":"Authors reply: “Is ketamine safe for traumatic brain injury? A systematic review and meta-analysis”","authors":"João Vitor Sciorilli , Yohanna Idsabella Rossi , Rodrigo dos Reis Schevz , Davi Barbosa Pereira da Silva , Josué Lee , Flávio Gallani , Marc Maegele","doi":"10.1016/j.jcrc.2026.155452","DOIUrl":"10.1016/j.jcrc.2026.155452","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155452"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic impact of dexmedetomidine in critically ill patients with and without cirrhosis: A retrospective cohort study","authors":"Grace M. Conroy ,&nbsp;Jason R. Yerke ,&nbsp;Michael A. Rudoni ,&nbsp;Aanchal Kapoor ,&nbsp;Stephanie N. Bass","doi":"10.1016/j.jcrc.2026.155424","DOIUrl":"10.1016/j.jcrc.2026.155424","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to compare adverse hemodynamic effects of dexmedetomidine in critically ill patients with and without cirrhosis.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective, observational cohort study of adult patients who received at least 2 h of a dexmedetomidine infusion while admitted to a medical or surgical intensive care unit between November 2018 and December 2021 at multiple hospitals within the Cleveland Clinic. Patients were divided into cohorts with and without cirrhosis. The primary objective was to compare the incidence of adverse hemodynamic events between groups, defined as incidence of bradycardia during dexmedetomidine infusion. Secondary outcomes included incidence of severe bradycardia and hypotension within 24 h of dexmedetomidine initiation. A multivariable logistic regression was performed for bradycardia and hypotension during drug infusion.</div></div><div><h3>Results</h3><div>In total, 157 patients were included; 37 patients with and 120 without cirrhosis. Patients with cirrhosis had similar baseline heart rate but higher cardiac SOFA (0 [0,3] vs. 0 [0,0]; <em>p</em> = 0.01). Patients with cirrhosis demonstrated a higher incidence of bradycardia (40.5% vs. 22.5%; RR 1.9 [95% CI 1.1–3.2]). After adjustment, the odds of developing bradycardia during dexmedetomidine infusion were greater in the cirrhosis group (adjusted OR 2.24 [95% CI 0.96–5.21]). The cirrhosis group had increased odds of developing hypotension in the first 24 h (adjusted OR 2.36 [95% CI 0.99–5.63]).</div></div><div><h3>Conclusions</h3><div>Dexmedetomidine use was associated with higher rates of bradycardia, severe bradycardia, and hypotension in patients with cirrhosis. Future research is needed on dexmedetomidine use based on severity of liver disease.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155424"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: “The clinical outcome of Montelukast versus co-enzyme Q10 in adult patients with sepsis: A randomized controlled clinical trial”","authors":"Ghada Hussein ELadly ,&nbsp;Salwa Omar Elkhattab Amin ,&nbsp;Nagwa Ali Sabri ,&nbsp;May Ahmed Shawki","doi":"10.1016/j.jcrc.2026.155447","DOIUrl":"10.1016/j.jcrc.2026.155447","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155447"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and internal validation of machine learning in predicting prognosis of acute kidney injury patients in resource-limited setting","authors":"Tanat Lertussavavivat ,&nbsp;Sira Sriswasdi ,&nbsp;Surasak Faisatjatham ,&nbsp;Theerapon Sukmark ,&nbsp;Sadudee Peerapornratana ,&nbsp;Nuttha Lumlertgul ,&nbsp;Nobphathorn Mahamitra ,&nbsp;Thanachai Panaput ,&nbsp;Konlawij Trongtrakul ,&nbsp;Rangsun Bhurayanontachai ,&nbsp;Kamol Khositrangsikun ,&nbsp;Karjbundid Surasit ,&nbsp;Jonny Jonny ,&nbsp;Noot Sengthavisouk ,&nbsp;Kriang Tungsanga ,&nbsp;Nattachai Srisawat","doi":"10.1016/j.jcrc.2026.155479","DOIUrl":"10.1016/j.jcrc.2026.155479","url":null,"abstract":"<div><h3>Background</h3><div>Machine learning models for predicting acute kidney injury (AKI) prognosis have primarily been developed in resource-rich settings, with limited validation in resource-limited environments. This study applied machine learning techniques to predict in-hospital mortality and major adverse kidney events within 28 days (MAKE-28) among critically ill patients with AKI in Southeast Asia.</div></div><div><h3>Method</h3><div>Data were derived from the Southeast Asia AKI cohort, a prospective multicenter study of critically ill patients. Demographic, clinical, and laboratory variables collected at ICU admission were analyzed. Logistic regression, random forest, and extreme gradient boosting (XGBoost) were used to develop prediction models, with recursive feature elimination applied for feature selection.</div></div><div><h3>Results</h3><div>Of 6993 ICU patients, 1650 individuals with AKI were included for analysis. Of these, 778 (47.1%) died during hospitalization and 1204 (73.9%) experienced MAKE-28. The three models demonstrated comparable performance in predicting MAKE-28 and hospital mortality (AUC 0.73–0.76 for MAKE-28 outcome and AUC 0.71–0.75 for hospital mortality). Discrimination ability was moderate, and all machine learning approaches outperformed conventional clinical scores. No difference in performance was observed between logistic regression and more complex machine learning models.</div></div><div><h3>Conclusion</h3><div>Machine learning models using routinely available clinical variables may offer useful prognostic information for AKI outcomes in resource-limited settings and outperform traditional scoring systems. External validation is required to confirm generalizability and support clinical implementation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155479"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of abnormal global longitudinal left ventricular strain during sepsis: A retrospective cohort study","authors":"Ivan Huespe ,&nbsp;Fernando A. Sosa ,&nbsp;Anek Jena ,&nbsp;Aayushi Pareek ,&nbsp;Faiz Saleem ,&nbsp;Said Bateh ,&nbsp;Lucia Bertorello Andrade ,&nbsp;Barbara Tort Oribe ,&nbsp;Federico Daldoss ,&nbsp;Jose Soto Soto ,&nbsp;Jose Delgado ,&nbsp;Lekhya Raavi ,&nbsp;Sadhana Jonna ,&nbsp;Belen Garcia ,&nbsp;Daniel Ivulich ,&nbsp;Jorge Mendez ,&nbsp;Veronica Monzon ,&nbsp;Eduardo Prado ,&nbsp;Shahin Isha ,&nbsp;Swetha Reddy ,&nbsp;Devang K. Sanghavi","doi":"10.1016/j.jcrc.2026.155442","DOIUrl":"10.1016/j.jcrc.2026.155442","url":null,"abstract":"<div><h3>Background</h3><div>Sepsis survivors often face long-term cardiovascular complications, including major adverse cardiovascular events (MACE), potentially linked to septic cardiomyopathy. Left ventricular global longitudinal strain (LV GLS) is a sensitive marker of cardiac dysfunction and a predictor of adverse outcomes. This study aimed to evaluate whether cardiac dysfunction measured by LV GLS is an independent predictor of MACE in septic patients.</div></div><div><h3>Methods</h3><div>This multicenter retrospective open cohort study included 439 patients hospitalized with sepsis or septic shock between 2018 and 2022. LV systolic function was assessed using LV GLS and Left Ventricular Ejection Fraction (LVEF) within seven days of admission. Patients were followed until July 2024. Restricted cubic spline Cox regression models examined non-linear associations between LV GLS, LVEF, and MACE. Additionally, Cox regression models adjusted for demographics, comorbidities, laboratory values, and sepsis severity markers evaluated whether LV systolic dysfunction, defined as high LV GLS (&gt; −16) or low LVEF, were predictors of MACE.</div></div><div><h3>Results</h3><div>During the study period, 439 septic patients were included, totaling 595 patient-years of follow-up. Among them, 254 experienced MACE. LV GLS exhibited a non-linear association with MACE, with values between −23 and − 16 associated with the lowest risk. High LV GLS was independently associated with MACE (unadjusted HR: 1.4 [95% CI: 1.07, 1.8; <em>p</em> = 0.01]; adjusted HR 1.38 [95% CI: 1.01, 1.9; <em>p</em> = 0.04]). In contrast, low LVEF was not associated with MACE (unadjusted HR 1.2 [95% CI: 0.9, 1.5; <em>p</em> = 0.2]; adjusted HR 1.03 [95% CI: 0.73, 1.45; <em>p</em> = 0.8]).</div></div><div><h3>Conclusions</h3><div>LV GLS was an independent predictor of MACE in septic patients, whereas LVEF did not show a significant association. These findings suggest that LV GLS may be a valuable biomarker for long-term cardiovascular risk stratification in this population.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155442"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INTELLiVENT-ASV: Bayesian mortality meta-analysis and Chilean cost-effectiveness evaluation","authors":"Aurio Fajardo-Campoverdi ,&nbsp;Paulina Vivanco-Aravena","doi":"10.1016/j.jcrc.2026.155469","DOIUrl":"10.1016/j.jcrc.2026.155469","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155469"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: “Associations of positive end-expiratory pressure (PEEP) with extubation failure and clinical outcomes in invasively ventilated patients with acute brain injury: A secondary analysis of the ENIO study”","authors":"Denise Battaglini ,&nbsp;Raphael Cinotti ,&nbsp;Karim Asehnoune ,&nbsp;Andrea Loggini ,&nbsp;Luca Montagnani ,&nbsp;Lorenzo Ball ,&nbsp;Francesca Gualdi ,&nbsp;Patricia R.M. Rocco ,&nbsp;Marcus J. Schultz ,&nbsp;Nicolò Antonino Patroniti ,&nbsp;Chiara Robba","doi":"10.1016/j.jcrc.2026.155448","DOIUrl":"10.1016/j.jcrc.2026.155448","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155448"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “A risk-adjusted length of stay to evaluate severe community-acquired pneumonia (sCAP) outcomes: a machine learning analysis of 16,985 ICU admissions”","authors":"Xian Zhang ,&nbsp;Min Zhang","doi":"10.1016/j.jcrc.2026.155461","DOIUrl":"10.1016/j.jcrc.2026.155461","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155461"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: “Associations of positive end-expiratory pressure (PEEP) with extubation failure and clinical outcomes in invasively ventilated patients with acute brain injury: A secondary analysis of the ENIO study”","authors":"Denise Battaglini ,&nbsp;Raphael Cinotti ,&nbsp;Karim Asehnoune ,&nbsp;Andrea Loggini ,&nbsp;Luca Montagnani ,&nbsp;Lorenzo Ball ,&nbsp;Francesca Gualdi ,&nbsp;Patricia R.M. Rocco ,&nbsp;Marcus J. Schultz ,&nbsp;Nicolò Antonino Patroniti ,&nbsp;Chiara Robba","doi":"10.1016/j.jcrc.2026.155449","DOIUrl":"10.1016/j.jcrc.2026.155449","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155449"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute respiratory distress syndrome and acute kidney injury in critically ill patients: A scoping review on this lung-kidney crosstalk","authors":"Francisco Z. Mattedi ,&nbsp;Heitor S. Ribeiro ,&nbsp;Geraldo F. Busatto ,&nbsp;Carlos R.R. Carvalho ,&nbsp;Dirce Maria Trevisan Zanetta ,&nbsp;Emmanuel A. Burdmann ,&nbsp;on behalf of the HCFMUSP COVID-19 Study Group","doi":"10.1016/j.jcrc.2026.155445","DOIUrl":"10.1016/j.jcrc.2026.155445","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS) is high; nonetheless, the lung-kidney crosstalk remains unclear.</div></div><div><h3>Objective</h3><div>Describe the association between ARDS and AKI in critically ill patients.</div></div><div><h3>Methods</h3><div>This scoping review was conducted according to the JBI and PRISM-ScR and included studies that investigated critically ill patients with ARDS (Participants), described AKI-related outcomes (Concept), and were conducted in hospitals (Context). MEDLINE, Embase, and LILACS databases were searched for articles published up to January 2024. Only observational studies were considered. Data on the diagnosis of ARDS-AKI and other kidney-related outcomes were extracted.</div></div><div><h3>Results</h3><div>A total of 2943 studies were screened, of which 28 were included in this review. Most studies were prospective and the majority originated from Europe. AKI was diagnosed using the KDIGO criteria in most studies and the pooled overall rate of AKI development across the studies was 46.8% (95% CI: 40.8–52.8). Two reports identified ARDS as an independent risk factor for AKI. Kidney replacement therapy was described in 17 studies. AKI recovery was described in only three studies. Seventeen studies evaluated hospital mortality, specifically in patients with ARDS-AKI, and found a greater mortality risk as compared to only ARDS.</div></div><div><h3>Conclusions</h3><div>This scoping review emphasizes the variability of the evidence, which hinders definitive conclusions about the association between ARDS and AKI, despite their common occurrence in critically ill patients. Therefore, a significant gap remains in our understanding of this lung-kidney interaction.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"93 ","pages":"Article 155445"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}