Journal of critical care最新文献

{"title":"Relationship between echocardiography-estimated right ventricular-pulmonary artery coupling and mortality in septic shock","authors":"Yusuke Hirao , Joshua Hu , Brent Matsuda , Ryota Sato","doi":"10.1016/j.jcrc.2025.155072","DOIUrl":"10.1016/j.jcrc.2025.155072","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155072"},"PeriodicalIF":3.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715015","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: “Understanding ventilator-induced lung injury: The role of mechanical power”","authors":"R. Santa Cruz , A.M. Esquinas","doi":"10.1016/j.jcrc.2025.155068","DOIUrl":"10.1016/j.jcrc.2025.155068","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155068"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697845","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":"Establishment and validation of a critical care echocardiography-based predictive model for sepsis-induced cardiomyopathy: A prospective cohort study","authors":"Xiaojuan Yang ,&nbsp;Wanqi Sun ,&nbsp;Kai Chen ,&nbsp;Xiaohong Wang","doi":"10.1016/j.jcrc.2025.155066","DOIUrl":"10.1016/j.jcrc.2025.155066","url":null,"abstract":"<div><h3>Background</h3><div>Integrating echocardiographic parameters for a comprehensive and precise evaluation of sepsis-induced cardiomyopathy (SIC) presents a significant challenge.</div></div><div><h3>Research question</h3><div>To develop a nomogram for the echocardiographic diagnosis of SIC.</div></div><div><h3>Study design and methods</h3><div>A cohort of 181 septic patients was prospectively enrolled for critical care echocardiography assessments. The cohort was randomly divided into a training dataset (70 %, <em>n</em> = 126) and a validation dataset (30 %, <em>n</em> = 55). The LASSO regression analysis was used to identify key echocardiographic predictors, which were then analyzed using multivariate logistic regression to determine the final diagnostic predictors and establish an echocardiographic model for SIC. A nomogram was developed based on the model, which was evaluated and verified for discrimination, calibration, and clinical utility.</div></div><div><h3>Results</h3><div>Three key predictors, including left ventricular global longitudinal strain (GLS), early diastolic mitral flow velocity (E), and tricuspid annular plane systolic motion amplitude (TAPSE), were selected from 14 variables to develop a SIC echocardiographic predictive model. The model exhibited a strong discrimination with an area under the curve (AUC) value of 0.879 in the training dataset and 0.888 in the validation dataset. The results of the Hosmer-Lemeshow test further validated the consistency between predicted probabilities and actual outcomes in both datasets. Decision curve analysis (DCA) indicated a substantial net clinical benefit within risk threshold ranges of 5–100 % in the training dataset and 21–100 % in the validation dataset.</div></div><div><h3>Conclusion</h3><div>The nomogram, incorporating GLS, E, and TAPSE, emerged as a reliable non-invasive tool for assessing the risk of SIC.</div></div><div><h3>Clinical trial registration</h3><div>The study protocol was registered in the ChiCTR database (Registration No. ChiCTR2200066966; Date of Registration: December 22, 2022).</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155066"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680630","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: “Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications”","authors":"Mohammad O. Abdelhafez ,&nbsp;Abdurrahman M. Hamadah ,&nbsp;Kamel A. Gharaibeh","doi":"10.1016/j.jcrc.2025.155070","DOIUrl":"10.1016/j.jcrc.2025.155070","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155070"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680632","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":"Accuracy between ICU admission and discharge diagnoses in non-survivors: A retrospective cohort study","authors":"Hannah H.M. Hulsewe ,&nbsp;Thom Wilbers ,&nbsp;Frank van Rosmalen ,&nbsp;Jasper van Bommel ,&nbsp;Sylvia Brinkman ,&nbsp;Bas C.T. van Bussel ,&nbsp;Iwan C.C. van der Horst ,&nbsp;Ronny M. Schnabel","doi":"10.1016/j.jcrc.2025.155065","DOIUrl":"10.1016/j.jcrc.2025.155065","url":null,"abstract":"<div><h3>Introduction</h3><div>Models predicting in-hospital mortality for intensive care unit (ICU) patients, like Acute Physiologic and Chronic Health Evaluation (APACHE) IV, depend on correct data about admission diagnoses. Incorrectly recording diagnoses or changes in diagnoses during admission may impact estimating mortality.</div></div><div><h3>Methods</h3><div>All deceased patients admitted to the ICU between Jan 1, 2018 and Dec 31, 2020 were included. Up to two discharge diagnoses were assigned using APACHE IV diagnostic codes. These were compared to the up to two diagnoses documented at admission. When differences occurred, these were classified as registration errors or diagnostic change. The APACHE IV predicted mortality was calculated using either admission or discharge diagnoses. The agreement between both methods was expressed as the mean difference and the intra-class correlation coefficient (ICC).</div></div><div><h3>Results</h3><div>886 (16 %) of 5633 patients died. In 363 (41 %) patients, there was no difference between admission and discharge diagnoses. Registration errors occurred in 138 (16 %) patients. 416 (47 %) patients had diagnostic change. The mean difference between predictions was 0.019 (95 % CI: 0.015–0.024). The ICC was 0.97 (95 % CI: 0.97–0.98).</div></div><div><h3>Discussion</h3><div>Differences between ICU admission and discharge diagnoses occur frequently, this leads to only a small discrepancy in the overall predicted mortality of deceased ICU patients.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155065"},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: “Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications”","authors":"Yalcin Golcuk","doi":"10.1016/j.jcrc.2025.155069","DOIUrl":"10.1016/j.jcrc.2025.155069","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155069"},"PeriodicalIF":3.2,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143680633","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":"Erythropoietin in ICU patients receiving early red blood cell transfusions: A retrospective study of the impact on transfusion requirements","authors":"Thomas Carpentier ,&nbsp;Anthony Merlin ,&nbsp;Arnaud Cappe ,&nbsp;Matthieu Metzelard ,&nbsp;Léonie Villeret ,&nbsp;Patrick Jeanjean ,&nbsp;Yazine Mahjoub ,&nbsp;Julien Maizel ,&nbsp;Hervé Dupont ,&nbsp;Stéphanie Malaquin ,&nbsp;Aurélien Mary","doi":"10.1016/j.jcrc.2025.155052","DOIUrl":"10.1016/j.jcrc.2025.155052","url":null,"abstract":"<div><h3>Purpose</h3><div>Anemia correlates with increased ICU mortality; but the use of erythropoietin (EPO) as a treatment remains debated. We sought to assess EPO use in ICU severe anemia.</div></div><div><h3>Methods</h3><div>A retrospective single-center study was conducted in four adult ICUs. Inclusion criteria were ICU stay ≥10 days (to limit immortality bias) and RBC transfusion within the first 48 h (an indication of severe anemia likely to justify EPO). EPO contraindication was an exclusion criterion. Univariate tests were followed by a multivariable analysis.</div></div><div><h3>Results</h3><div>Over a 28-month period, 190 patients (69 with EPO) were included. EPO subgroups displayed had a higher prevalence of hemorrhagic shock and surgical ICU admissions. EPO administration was significantly associated with a lower requirement for late RBC transfusions in trauma and non-trauma subgroups, with odds ratios [95 % confidence interval] of 0.29 [0.10–0.85] and 0.03 [0.004–0.18], respectively. In the EPO subgroup, the median hemoglobin level rose by 1.2 g/dL. Cox model showed a significant association with mortality at day 28 and 365.</div></div><div><h3>Conclusion</h3><div>Our study supports the hypothesis whereby EPO administration in severely anemic ICU patients reduces late transfusion needs, with a potentially higher survival rate. Systematic EPO use post-RBC transfusion in ICU patients warrants further investigation.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155052"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644842","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":"Implementation of quality-controlled in-house dialysis solution for continuous renal replacement therapy: A solution for resource-limited settings","authors":"Khanittha Yimsangyad ,&nbsp;Tanat Lertussavavivat ,&nbsp;Akarathep Leewongworasingh ,&nbsp;Nattira Sorose ,&nbsp;Nattachai Srisawat","doi":"10.1016/j.jcrc.2025.155064","DOIUrl":"10.1016/j.jcrc.2025.155064","url":null,"abstract":"","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155064"},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669961","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":"Failure to reintroduce home medication in critically ill patients","authors":"Florens N. Polderman ,&nbsp;Hieronymus J. Derijks ,&nbsp;Maaike A. Sikma ,&nbsp;Rob J. van Marum","doi":"10.1016/j.jcrc.2025.155051","DOIUrl":"10.1016/j.jcrc.2025.155051","url":null,"abstract":"<div><h3>Purpose</h3><div>Home medication is often discontinued or adjusted during hospital admission. This study aims to investigate discrepancies between home medication before admission and at ICU discharge.</div></div><div><h3>Materials and methods</h3><div>In this retrospective cohort study, electronic health records of 200 patients admitted to the ICU of a large teaching hospital in the Netherlands between August 1, 2021, and September 30, 2022, were analyzed for (dis) continuation of home medication. Inclusion criteria: first-time ICU admission during hospital stay, a length of stay ≥48 h, survival at ICU discharge, and use of home medication at hospital admission. Exclusion criteria: transfer from/to another hospital, discharge with palliative care, or chronic ventilation with an elective admission.</div></div><div><h3>Results</h3><div>The mean patient age was 63.5 (±12.8) years, and 63.0 % were male. Most ICU admissions were non-surgical (76.0 %). Mean APACHE4 scores were 68.4 (±22.9). At ICU discharge, 46.7 % (535/1003) of home medications were not reintroduced, with 22.4 % incorrectly not reintroduced, while at hospital discharge, these rates were 12.1 % (106/876) and 14.2 %, respectively.</div></div><div><h3>Conclusions</h3><div>Nearly half of home medications were discontinued at ICU discharge, with nearly a quarter not properly reintroduced on ward transfer, posing unnecessary risks. However, at hospital discharge, most home medications were correctly reintroduced or appropriately discontinued.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155051"},"PeriodicalIF":3.2,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576955","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":"Association of opioid utilization in the intensive care unit and opioid prescriptions at hospital discharge in opioid-naïve non-surgical patients who received enhanced oxygen therapy","authors":"Lan N. Bui PharmD, MPH ,&nbsp;Qian Ding BPharm, MS, PhD ,&nbsp;Rowan Rosewarne PharmD, MPH ,&nbsp;Tilyn Digiacomo PharmD, MSHIA ,&nbsp;Jacob Jarboe PharmD ,&nbsp;Whitney Seals BS ,&nbsp;Emem Etukinoh PharmD, MSN ,&nbsp;Denise H. Rhoney PharmD","doi":"10.1016/j.jcrc.2025.155048","DOIUrl":"10.1016/j.jcrc.2025.155048","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the association between opioid utilization in community-based intensive care units and the continuation of opioid prescriptions at hospital discharge for non-surgical, opioid-naïve patients.</div></div><div><h3>Materials and methods</h3><div>This nested case-control study included adults without opioid prescriptions 45 days before hospital admission who had intensive care unit stays of 48 h or longer and received enhanced oxygen therapy. Patients were excluded if they had opioid allergies, cancer, in-hospital death, palliative care, major surgery, or substance use disorders. Opioid utilization was measured using cumulative oral morphine equivalents and average daily morphine equivalents during the intensive care unit stay. Multivariable regression models examined the association between opioid utilization and opioid prescription at discharge.</div></div><div><h3>Results</h3><div>Among 260 patients, 33 patients (12.7 %) received opioid prescriptions at discharge. These patients had significantly higher cumulative morphine equivalents during their intensive care unit stay (cases: 3362.4, standard error 1102.5; controls: 1024.9, standard error 240.0; <em>p</em> = 0.002) and higher average daily morphine equivalents during their stay (cases: 129.8, standard error 36.9; controls: 61.2, standard error 10.7; <em>p</em> = 0.03). Patients who received more than 90 cumulative morphine equivalents during their intensive care unit stay had 6.63 times higher odds of receiving an opioid prescription at discharge (<em>p</em> &lt; 0.001). Each additional 10 daily morphine equivalents increased the odds of discharge continuation by 3 % (<em>p</em> = 0.011).</div></div><div><h3>Conclusions</h3><div>Increased opioid utilization during intensive care unit stays was associated with higher odds of opioid prescriptions at discharge in opioid-naïve, non-surgical patients.</div></div><div><h3>Abstract key points</h3><div><strong>Question:</strong> Does opioid use in community-based ICUs correlate with continued opioid prescriptions at discharge for opioid-naïve, non-surgical patients?</div><div><strong>Findings:</strong> This nested case-control study found that patients who received opioids during their ICU stay had a higher likelihood of being prescribed opioids at discharge. Specifically, those with cumulative opioid use &gt;90 MME had 6.63 times higher odds of opioid continuation at discharge.</div><div><strong>Meaning:</strong> The study concludes that higher opioid use during ICU stays significantly increases the likelihood of opioid prescription continuation at hospital discharge for opioid-naïve, non-surgical patients.</div></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"88 ","pages":"Article 155048"},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563568","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}