Journal of critical care最新文献_第3页

Letter to “an increase in skin blood flow after red blood cell transfusion is associated with an improvement in organ function in critically ill patients” 致“危重病人输血后皮肤血流量增加与器官功能改善有关”的信。

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-30 DOI: 10.1016/j.jcrc.2025.155280

Jianing Song, Song Peng

引用次数: 0

Letter to the Editor: “Microcirculation properties of 20 % albumin in sepsis; A randomised controlled trial” 致编辑的信：“20%白蛋白在败血症中的微循环特性；随机对照试验”。

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-30 DOI: 10.1016/j.jcrc.2025.155278

Jinzhen Huang, Nan He, Zeming Wu

引用次数: 0

Evaluation of bromocriptine for the reduction of fever in patients with acute neurologic injury: A retrospective cohort study 评价溴隐亭对急性神经损伤患者退烧的作用：一项回顾性队列研究

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-27 DOI: 10.1016/j.jcrc.2025.155276

Mikaela Rhodes PharmD , Kristen Livers PharmD, BCCCP , Michael W. Daniels MS , Emily Sieg MD , Michelle Campbell APRN , Lindsay Weitkamp PharmD, BCPS, BCCCP

{"title":"Evaluation of bromocriptine for the reduction of fever in patients with acute neurologic injury: A retrospective cohort study","authors":"Mikaela Rhodes PharmD , Kristen Livers PharmD, BCCCP , Michael W. Daniels MS , Emily Sieg MD , Michelle Campbell APRN , Lindsay Weitkamp PharmD, BCPS, BCCCP","doi":"10.1016/j.jcrc.2025.155276","DOIUrl":"10.1016/j.jcrc.2025.155276","url":null,"abstract":"<div><h3>Background/objective</h3><div>Fever is prevalent among patients with neurologic injury and has traditionally been treated with antipyretics and surface cooling modalities. Dopamine (D2) receptor agonists, such as bromocriptine, have shown a benefit for the treatment of central fever; however, there are currently no guidelines for the use of bromocriptine in this population. The purpose of this study was to evaluate the safety and efficacy of bromocriptine plus acetaminophen compared to acetaminophen alone for the treatment of fever in patients with acute neurologic injury.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study of patients admitted to the neurosciences intensive care unit (Neuro ICU) with an acute neurologic injury who received bromocriptine 5 mg every 8 h plus acetaminophen (BROMO) or acetaminophen alone (APAP) for the indication of fever. The primary outcome was reduction of temperature (°C) 72 h after initiation of bromocriptine and acetaminophen or acetaminophen alone.</div></div><div><h3>Results</h3><div>A total of 67 patients were included; 28 patients were included in the BROMO group and 39 patients in the APAP group. There was a significant reduction in temperature at 72 h in the BROMO group compared to the APAP group (−0.86 °C vs −0.39 °C, <em>p</em> = 0.017). No adverse effects were noted in either group.</div></div><div><h3>Conclusion</h3><div>This study found that bromocriptine 5 mg every 8 h is safe when used in combination with acetaminophen for fever management among patients with neurologic injury. Additional prospective, multi-center studies are needed to further elucidate the role of bromocriptine in the treatment of fever in the Neuro ICU.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155276"},"PeriodicalIF":2.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154704","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}

引用次数: 0

Recovery of motor functions and cognitive functions in patients with intensive care unit–acquired weakness 重症监护病房获得性虚弱患者运动功能和认知功能的恢复

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-27 DOI: 10.1016/j.jcrc.2025.155273

Yusuke Aoyama , Masaki Okazaki , Shogo Suzuki , Mako Umikawa , Minoru Hoshiyama

{"title":"Recovery of motor functions and cognitive functions in patients with intensive care unit–acquired weakness","authors":"Yusuke Aoyama , Masaki Okazaki , Shogo Suzuki , Mako Umikawa , Minoru Hoshiyama","doi":"10.1016/j.jcrc.2025.155273","DOIUrl":"10.1016/j.jcrc.2025.155273","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to identify factors influencing recovery of activities of daily living (ADLs) in patients with ICU-acquired weakness (ICU-AW) after ICU discharge.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted with 65 ICU-AW patients. Data were collected from ICU discharge to four weeks post-discharge. Variables analyzed included age, sex, APACHE-II score, mechanical ventilation duration, and presence of delirium. The primary outcome was ADL recovery. Multiple regression analysis was performed using data at ICU discharge, and a linear mixed model assessed changes in motor Functional Independence Measure (FIM) scores.</div></div><div><h3>Results</h3><div>Median age was 61 years (IQR: 50–70), with females comprising 44.6 %. Median APACHE-II score was 25 (IQR: 20–29), and 69.2 % were surgical ICU patients. Median mechanical ventilation duration was 19 days (IQR: 10–34), and delirium lasted a median of three days (IQR: 1–7). Multivariable analysis showed cognitive FIM score at ICU discharge (β = 19.12, <em>p</em> = 0.001) and delirium duration (β = −9.83, <em>p</em> < 0.001) were independently associated with ADL recovery. The linear mixed model revealed a significant difference in motor FIM gain between patients with preserved cognition and those with cognitive dysfunction (<em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>Cognitive function at ICU discharge and delirium duration significantly predicted ADL recovery. These factors should be considered in post-ICU rehabilitation planning.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155273"},"PeriodicalIF":2.9,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154628","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}

引用次数: 0

Letter to Editor: “External validation of eight different models to predict sepsis mortality in intensive care units” 致编辑的信：“预测重症监护病房败血症死亡率的八种不同模型的外部验证”

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-27 DOI: 10.1016/j.jcrc.2025.155266

Leela Kumaran , Sheifali Gupta

引用次数: 0

Authors reply: "Response to furosemide and the receipt of kidney replacement therapy in critically ill patients” 作者回复：“危重患者对速尿的反应和接受肾脏替代治疗”

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-25 DOI: 10.1016/j.jcrc.2025.155272

Amir Gal Oz , Ron Wald , Dekel Stavi , Yael Lichter , Yoel Angel , Oded Sold , Roy Rafael Dayan , Nardeen Khoury , Nimrod Adi , Noam Goder

引用次数: 0

Letter to the Editor: “Response to furosemide and the receipt of kidney replacement therapy in critically ill patients” 致编辑的信：“危重患者对速尿的反应和接受肾脏替代治疗”

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-24 DOI: 10.1016/j.jcrc.2025.155271

Cunzi Yan

引用次数: 0

Beyond the usual: A focus on infrequent complications of CRRT 超越常规：关注CRRT的罕见并发症

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-23 DOI: 10.1016/j.jcrc.2025.155270

Gonzalo Ramírez-Guerrero , Cristian Pedreros-Rosales , David Ballesteros , Mitchell Rosner , Claudio Ronco

{"title":"Beyond the usual: A focus on infrequent complications of CRRT","authors":"Gonzalo Ramírez-Guerrero , Cristian Pedreros-Rosales , David Ballesteros , Mitchell Rosner , Claudio Ronco","doi":"10.1016/j.jcrc.2025.155270","DOIUrl":"10.1016/j.jcrc.2025.155270","url":null,"abstract":"<div><div>Continuous renal replacement therapy (CRRT) is a cornerstone in the management of critically ill patients with acute kidney injury and fluid-electrolyte disturbances. While widely adopted and considered safe, CRRT is not exempt from complications—some of which, though infrequent, can have serious consequences for patient outcomes and circuit performance. In this review, we present a focused analysis of underrecognized but clinically relevant complications associated with CRRT, including hypertriglyceridemia-related circuit failure, euglycemic ketoacidosis, cold agglutinin-mediated filter clotting, hypophosphatemia-induced weaning failure, hypothermia, and citrate-induced magnesium depletion. Each section highlights the pathophysiology, risk factors, clinical implications, and preventive strategies for these events. Notably, we emphasize the importance of early recognition and targeted monitoring, as many of these complications may develop silently or mimic more common issues. Practical recommendations are provided to guide clinicians in optimizing CRRT delivery and minimizing the risk of adverse events. By shedding light on these rare complications, we aim to improve awareness, encourage proactive surveillance, and ultimately enhance the safety and effectiveness of extracorporeal therapy in critical care settings.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155270"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117700","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}

引用次数: 0

AI in critical care: A roadmap to the future 重症监护中的人工智能：未来的路线图

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-23 DOI: 10.1016/j.jcrc.2025.155262

J.D. Workum , G. Meyfroidt , J. Bakker , C. Jung , J.M. Tobin , D. Gommers , P.W.G. Elbers , J.G. van der Hoeven , M.E. Van Genderen

{"title":"AI in critical care: A roadmap to the future","authors":"J.D. Workum , G. Meyfroidt , J. Bakker , C. Jung , J.M. Tobin , D. Gommers , P.W.G. Elbers , J.G. van der Hoeven , M.E. Van Genderen","doi":"10.1016/j.jcrc.2025.155262","DOIUrl":"10.1016/j.jcrc.2025.155262","url":null,"abstract":"<div><div>Artificial intelligence (AI) has the potential to revolutionize critical care medicine by enhancing patient care, improving resource allocation and reducing clinician workload. Despite this promise, many AI applications remain confined to scientific research rather than being integrated into everyday clinical practice. This manuscript aims to help intensivists prepare themselves and their intensive care units (ICUs) for AI implementation. It provides a comprehensive yet practical roadmap, detailing AI methods, applications, responsible AI principles, common roadblocks and implementation strategies.</div><div>We propose a three-tiered risk-based approach to AI implementation, starting with low-risk low-complexity administrative AI, progressing to logistical AI, and finally integrating medical AI as clinical decision support systems. This ensures a gradual build-up of AI skills, technical AI readiness of the ICU, incremental value demonstration and alignment with evolving regulatory standards. For each AI project, responsible AI principles should be incorporated and adequately addressed throughout the entire AI lifecycle, from development to validation to implementation and scaling. Common roadblocks for AI implementation including technical issues (such as data quality and interoperability issues), organizational challenges (such as lack of a clear vision and strategy), and clinical concerns (such as limited AI literacy among staff), should be addressed proactively.</div><div>By following this roadmap, ICUs can achieve sustainable AI integration, ultimately improving patient outcomes and clinician experience. The future of critical care lies in the responsible and strategic adoption of AI, with intensivists playing a central role in shaping its implementation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"91 ","pages":"Article 155262"},"PeriodicalIF":2.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117702","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}

引用次数: 0

Authors reply: "The external validation of eight different models to predict sepsis mortality in intensive care units is still valid" 作者回答说：“预测重症监护病房败血症死亡率的八种不同模型的外部验证仍然有效。”

IF 2.9 3区医学

Journal of critical care Pub Date : 2025-09-22 DOI: 10.1016/j.jcrc.2025.155268

Satyen Hargovan , Charlotte Simpson , Sayonne Sivalingam , Angus Carter , Ronny Gunnarsson

引用次数: 0