Journal of critical care最新文献

{"title":"Letter to the Editor: “Effect of music intervention on anxiety in critically ill patients, a meta-analysis of randomized controlled trials”","authors":"Chenlei Sun , Ke Meng","doi":"10.1016/j.jcrc.2025.155199","DOIUrl":"10.1016/j.jcrc.2025.155199","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155199"},"PeriodicalIF":3.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144687188","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":"Fluid management in sepsis associated acute kidney injury","authors":"Nurul Zaynah Nordin ,&nbsp;Waqas Akhtar ,&nbsp;Marlies Ostermann","doi":"10.1016/j.jcrc.2025.155188","DOIUrl":"10.1016/j.jcrc.2025.155188","url":null,"abstract":"<div><div>Sepsis-associated acute kidney injury (SA-AKI) significantly contributes to morbidity and mortality in critically ill patients, necessitating an evidence-based approach to fluid management. Understanding the pathophysiology of SA-AKI and appreciation of the delicate balance between adequate fluid resuscitation and prevention of fluid overload, are essential to deliver optimal management of these patients.</div><div>This review highlights the phases of fluid therapy, the strategies for fluid management in SA-AKI, the types of preferred fluids in different phases, and both, pharmacologic and mechanical methods of fluid removal. The application of individualised strategies tailored to specific patient subsets, including those with septic cardiomyopathy or chronic kidney disease remains challenging. A major limitation is that most fluid studies were conducted in critically ill patients in general, rather than patients with SA-AKI. Future research is imperative to study fluid management specifically in SA-AKI, refine therapeutic protocols and guide management to improve patient outcomes.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155188"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679459","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":"An increase in skin blood flow after red blood cell transfusion is associated with an improvement in organ function in critically ill patients","authors":"Elaine Cavalcante dos Santos,&nbsp;Péter Bakos,&nbsp;Diego Orbegozo,&nbsp;Hassane Njimi,&nbsp;Zoé Demailly,&nbsp;Jacques Creteur,&nbsp;Jean-Louis Vincent,&nbsp;Fabio Silvio Taccone","doi":"10.1016/j.jcrc.2025.155204","DOIUrl":"10.1016/j.jcrc.2025.155204","url":null,"abstract":"<div><h3>Introduction</h3><div>Red blood cell transfusions (RBCTs) are administered to critically ill patients to enhance tissue oxygen delivery. We investigated whether an increase in skin blood flow (SBF), a proxy for tissue perfusion, after RBCT was associated with improved organ function in non-bleeding intensive care unit (ICU) patients.</div></div><div><h3>Methods</h3><div>This secondary analysis of a prospective cohort included 175 adult ICU patients without acute bleeding who received a RBCT. Finger SBF was measured at basal temperature (SBF_BT) using skin laser Doppler before and one hour post-RBCT: patients with a ≥ 20 % increase in SBF_BT were classified as SBF responders. Patients were also classified as having high (&gt;73 PU) or low (≤73 PU) baseline SBF_BT, based on the optimal pre-transfusion SBF_BT threshold for predicting SBF response. Patients with a ≥ 1 point reduction in Sequential Organ Failure Assessment (SOFA) score within 24 h post-RBCT were classified as “SOFA responders”. The primary outcome was the association between SBF responder status and SOFA responder status.</div></div><div><h3>Results</h3><div>Of 175 patients, 103 (58.9 %) improved SOFA. There was a trend of more SBF responders in the SOFA responders than in the SOFA non-responders group (51/103 [49.5 %] vs. 26/72 [36.1 %]); <em>p</em> = 0.08), respectively. SBF responder status (<em>n</em> = 77, 44 %) independently predicted a decreased SOFA score post-RBCT (OR 2.64, 95 %CI 1.25–5.41, <em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>An increase in SBF_BT after RBCT was independently associated with a reduction of 1 point in SOFA score within 24 h after RBCT. These findings highlight the potential role of RBCT in improving tissue perfusion and organ function in acute illness.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155204"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679458","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":"Response to letter to the Editor regarding “Cumulative impact of hypotension during intermittent hemodialysis on kidney recovery in critically ill patients with AKI-D”","authors":"Jae Ho Kim ,&nbsp;Joonhee Yoon ,&nbsp;Ji-Eun Kim ,&nbsp;Seongho Jo ,&nbsp;Yuri Lee ,&nbsp;Ji Won Kim ,&nbsp;Seun Deuk Hwang ,&nbsp;Seoung Woo Lee ,&nbsp;Joon Ho Song ,&nbsp;Kipyo Kim","doi":"10.1016/j.jcrc.2025.155198","DOIUrl":"10.1016/j.jcrc.2025.155198","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155198"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679622","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":"Continuous venovenous hemodialysis does not mean a fixed continuous vancomycin clearance","authors":"Tim J.L. Smeets ,&nbsp;Chantal A. Boly ,&nbsp;Jan H. Elderman ,&nbsp;Nicole G.M. Hunfeld ,&nbsp;Henrik Endeman","doi":"10.1016/j.jcrc.2025.155190","DOIUrl":"10.1016/j.jcrc.2025.155190","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155190"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679621","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":"Melatonin for all? Concerns about recent guidelines","authors":"Lars W. Andersen ,&nbsp;Mathias J. Holmberg ,&nbsp;Asger Granfeldt","doi":"10.1016/j.jcrc.2025.155193","DOIUrl":"10.1016/j.jcrc.2025.155193","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155193"},"PeriodicalIF":3.2,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679623","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":"Anti-infective management in brain-dead organ donors – A retrospective analysis at two centers reveals need for improvement","authors":"Jan Sönke Englbrecht ,&nbsp;Hendrik Bracht ,&nbsp;Julian Philip Gehrenkemper ,&nbsp;Rainer Borgstedt ,&nbsp;Dominic Witzke ,&nbsp;Antje Gottschalk ,&nbsp;Christian Lanckohr","doi":"10.1016/j.jcrc.2025.155196","DOIUrl":"10.1016/j.jcrc.2025.155196","url":null,"abstract":"<div><h3>Background</h3><div>Adequate donor management is essential to increase the number of transplantable organs. No specific recommendations about anti-infective management for organ donors are available and the sparse literature indicates that antimicrobials are used too liberally. We analyzed anti-infective management of brain-dead donors to add to the limited evidence.</div></div><div><h3>Methods</h3><div>All brain-dead donors at the University Hospitals Münster (2010–2024) and Bielefeld Bethel (2020–2024) were retrospectively included. The use and indication of antimicrobials, microbiological diagnostics and inflammatory markers were assessed during intensive care unit stay and organ retrieval.</div></div><div><h3>Results</h3><div>149 donors were included, 76.5 % received antimicrobials in the intensive care unit and 21.5 % during organ retrieval. Antimicrobial exposure did not correlate between both periods. Indication for antimicrobials was documented in 61 % of donors, with aspiration pneumonia (33 %) and ventilator-associated pneumonia (33 %) being the most common diagnoses. Positive microbiological cultures were found in 36 % of donors but without correlation to antimicrobial exposure or length of exposure. The proportion of donors with out of normal range values for C-reactive protein (67–100 %), white blood cell count (53–88 %) and procalcitonin (22–43 %) was high, but only C-reactive protein differed between the day before and the day of brain death diagnosis and between infected and non-infected donors.</div></div><div><h3>Conclusion</h3><div>Antimicrobial use was high during intensive care unit stay, low during organ retrieval and inconsistent between both periods. Inflammatory markers were insufficient to indicate infection. Aggravated by a lack of evidence-based recommendations, this indicates inadequate anti-infective management of DBD donors, which may have a negative impact on the organ recipient.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155196"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671089","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: “Effect of music intervention on anxiety in critically ill patients, a meta-analysis of randomized controlled trials.”","authors":"Muhammad Saqib MBBS, MD, FCPS-I ,&nbsp;Asia Batool MBBS ,&nbsp;Qurat Ul Ain Iftikhar MBBS ,&nbsp;Makhzan Ali Akbar MBBS ,&nbsp;Faiza Hayat Qadri MBBS ,&nbsp;Kanz Ul Eman Maryam MBBS ,&nbsp;Syeda Alishba Zahra Naqvi MBBS ,&nbsp;Asiya Najam Ul Haq MBBS ,&nbsp;Fareeha Hasan MBBS","doi":"10.1016/j.jcrc.2025.155200","DOIUrl":"10.1016/j.jcrc.2025.155200","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155200"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671088","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":"Current practices of depletive fluid strategies in intensive care units– A National French Survey","authors":"Benoit Chivet ,&nbsp;Coutrot Maxime ,&nbsp;Dépret François ,&nbsp;Louis Boutin","doi":"10.1016/j.jcrc.2025.155189","DOIUrl":"10.1016/j.jcrc.2025.155189","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155189"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671091","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":"Sepsis-associated liver dysfunction confounds the association between circulating PCSK9 concentration and mortality in septic patients: A single-center retrospective cohort study","authors":"Kai-Lee Chen ,&nbsp;Ruey-Hsing Chou ,&nbsp;Chun-Chin Chang ,&nbsp;Chin-Sung Kuo ,&nbsp;Jih-Hua Wei ,&nbsp;Ya-Wen Lu ,&nbsp;Hsin-I Teng ,&nbsp;Po-Hsun Huang ,&nbsp;Shing-Jong Lin","doi":"10.1016/j.jcrc.2025.155197","DOIUrl":"10.1016/j.jcrc.2025.155197","url":null,"abstract":"<div><h3>Background</h3><div>Pro-protein convertase subtilisin/kexin 9 (PCSK9) is a potential therapeutic target in sepsis. However, its role as a prognostic biomarker remains unclear. This study investigated the relationship between plasma PCSK9 concentration and mortality in septic patients, focusing on the impact of sepsis-associated liver dysfunction (SALD).</div></div><div><h3>Methods</h3><div>Patients meeting the Sepsis-3 criteria were enrolled. Plasma samples were collected within 24 h of admission. Patients were grouped into tertiles based on PCSK9 concentration and followed up for survival analysis. Further analyses were performed using Cox proportional hazard models and restricted cubic spline curves.</div></div><div><h3>Results</h3><div>A total 415 of patients were enrolled. Low PCSK9 group exhibited higher 28-day mortality. Among patients with liver sequential organ failure score (SOFA) ≥ 1, PCSK9 concentration displayed an inverse linear correlation with mortality, in contrast to a U-shaped pattern among those with liver SOFA = 0. Adjustment for international normalized ratio and liver SOFA diminished the significance of the association between PCSK9 concentration and mortality in the entire cohort.</div></div><div><h3>Conclusion</h3><div>The association between low plasma PCSK9 concentration and mortality in sepsis may be influenced by SALD. Further investigations into the role of PCSK9 in sepsis should consider the impact of liver dysfunction on PCSK9 synthesis and prognosis.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"90 ","pages":"Article 155197"},"PeriodicalIF":3.2,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144671090","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}