Journal of critical care最新文献_第8页

Changes in left ventricular-arterial coupling during resuscitation are associated with mortality in patients with septic shock - A post-hoc analysis of a randomized trial 复苏期间左心室-动脉耦合的变化与脓毒性休克患者的死亡率有关--随机试验的事后分析

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-14 DOI: 10.1016/j.jcrc.2024.154868

Xiaoyang Zhou , Jianneng Pan , Hua Wang , Zhaojun Xu , Bixin Chen , Caibao Hu

引用次数: 0

Letter to the Editor: “Association between elevated lactate and clinical outcomes in adults with diabetic ketoacidosis” 致编辑的信："成人糖尿病酮症酸中毒患者乳酸升高与临床结果之间的关系"。

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-14 DOI: 10.1016/j.jcrc.2024.154862

Syeda Dua Azhar, Yusra Saleem, Aimen Waqar Khan

引用次数: 0

Authors response: “Association between elevated lactate and clinical outcomes in adults with diabetic ketoacidosis” 作者回复："成人糖尿病酮症酸中毒患者乳酸升高与临床结果之间的关系"。

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-14 DOI: 10.1016/j.jcrc.2024.154863

Aashish Kumar , Ra'eesa Doola , Amanda Zahumensky , Arif Shaikh , Alexis Tabah , Kevin B. Laupland , Mahesh Ramanan

引用次数: 0

One-year outcomes in COVID-19 and non-COVID-19 intensive care unit survivors COVID-19 和非 COVID-19 重症监护室幸存者的一年疗效

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-14 DOI: 10.1016/j.jcrc.2024.154858

Hidde Heesakkers , Johannes G. van der Hoeven , Stijn Corsten , Inge Janssen , Esther Ewalds , Koen S. Simons , Maaike de Blauw , Thijs C.D. Rettig , Crétien Jacobs , Susanne van Santen M.D , Arjen J.C. Slooter , Margaretha C.E. van der Woude , Marieke Zegers , Mark van den Boogaard

{"title":"One-year outcomes in COVID-19 and non-COVID-19 intensive care unit survivors","authors":"Hidde Heesakkers , Johannes G. van der Hoeven , Stijn Corsten , Inge Janssen , Esther Ewalds , Koen S. Simons , Maaike de Blauw , Thijs C.D. Rettig , Crétien Jacobs , Susanne van Santen M.D , Arjen J.C. Slooter , Margaretha C.E. van der Woude , Marieke Zegers , Mark van den Boogaard","doi":"10.1016/j.jcrc.2024.154858","DOIUrl":"https://doi.org/10.1016/j.jcrc.2024.154858","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine differences in one-year multi-domain health outcomes in COVID-19 and non-COVID-19 intensive care unit (ICU) survivors.</p></div><div><h3>Materials and methods</h3><p>Adult ICU survivors treated for COVID-19 were compared to a control group consisting of survivors admitted for respiratory distress due to other causes, i.e. non-COVID-19 ARDS or pneumonia. Occurrence of physical (frailty, fatigue, physical symptoms), mental (anxiety, depression, post-traumatic stress) and cognitive symptoms, and quality of life (QoL) scores were measured, using validated questionnaires, before and one year after ICU treatment.</p></div><div><h3>Results</h3><p>In total, 506 COVID-19 survivors could be compared to 228 non-COVID-19 survivors. At one-year follow-up, COVID-19 ICU survivors had less physical (76.2% vs. 86.9%, <em>p</em> = 0.001) and mental symptoms (32.0% vs. 47.1%, <em>p</em> < 0.001) than the control group. Cognitive symptoms were comparable (22.5% vs. 17.2%, <em>p</em> = 0.12). However, compared to pre-ICU health symptoms and scores, COVID-19 survivors experienced an increase in symptom occurrence rates in all domains and a decrease in QoL, whereas the control group only experienced an increase in mental and cognitive symptoms, with a similar QoL at one-year follow-up.</p></div><div><h3>Conclusions</h3><p>COVID-19 ICU survivors experience equal or less health problems but a greater decline in QoL one year after ICU admission compared to non-COVID-19 ARDS or pneumonia survivors.</p></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"84 ","pages":"Article 154858"},"PeriodicalIF":3.2,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0883944124003459/pdfft?md5=0e58d48e1c87dfdc53540ab74244e1f7&pid=1-s2.0-S0883944124003459-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141607775","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}

引用次数: 0

Letter to the editor: “How a positive fluid balance develops in acute kidney injury: A binational, observational study” 致编辑的信：急性肾损伤患者的体液正平衡是如何形成的？一项两国观察性研究。

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-14 DOI: 10.1016/j.jcrc.2024.154855

Alejandro Úbeda-Iglesias , Dra. Irene Fernández-Burgos

引用次数: 0

High PEEP/low FiO2 ventilation is associated with lower mortality in COVID–19 高 PEEP/低 FiO2 通气与 COVID-19 死亡率降低有关

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-11 DOI: 10.1016/j.jcrc.2024.154854

Robin L. Goossen , Relin van Vliet , Lieuwe D.J. Bos , Laura A. Buiteman-Kruizinga , Markus W. Hollman , Sheila N. Myatra , Ary Serpa Neto , Peter E. Spronk , Meta C.E. van der Woude , David M.P. van Meenen , Frederique Paulus , Marcus J. Schultz

{"title":"High PEEP/low FiO2 ventilation is associated with lower mortality in COVID–19","authors":"Robin L. Goossen , Relin van Vliet , Lieuwe D.J. Bos , Laura A. Buiteman-Kruizinga , Markus W. Hollman , Sheila N. Myatra , Ary Serpa Neto , Peter E. Spronk , Meta C.E. van der Woude , David M.P. van Meenen , Frederique Paulus , Marcus J. Schultz","doi":"10.1016/j.jcrc.2024.154854","DOIUrl":"https://doi.org/10.1016/j.jcrc.2024.154854","url":null,"abstract":"<div><h3>Rationale</h3><p>The positive end–expiratory pressure (PEEP) strategy in patients with coronavirus 2019 (COVID–19) acute respiratory distress syndrome (ARDS) remains debated. Most studies originate from the initial waves of the pandemic. Here we aimed to assess the impact of high PEEP/low FiO<sub>2</sub> ventilation on outcomes during the second wave in the Netherlands.</p></div><div><h3>Methods</h3><p>Retrospective observational study of invasively ventilated COVID–19 patients during the second wave. Patients were categorized based on whether they received high PEEP or low PEEP ventilation according to the ARDS Network tables. The primary outcome was ICU mortality, and secondary outcomes included hospital and 90–day mortality, duration of ventilation and length of stay, and the occurrence of kidney injury. Propensity matching was performed to correct for factors with a known relationship to ICU mortality.</p></div><div><h3>Results</h3><p>This analysis included 790 COVID–ARDS patients. At ICU discharge, 32 (22.5%) out of 142 high PEEP patients and 254 (39.2%) out of 848 low PEEP patients had died (HR 0.66 [0.46–0.96]; <em>P</em> = 0.03). High PEEP was linked to improved secondary outcomes. Matched analysis did not change findings.</p></div><div><h3>Conclusions</h3><p>High PEEP ventilation was associated with improved ICU survival in patients with COVID–ARDS.</p></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"83 ","pages":"Article 154854"},"PeriodicalIF":3.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0883944124003411/pdfft?md5=647cc3b637300249f6faaa9478fb304b&pid=1-s2.0-S0883944124003411-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595083","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}

引用次数: 0

Enhancing Sepsis prognosis: Integrating social determinants and demographic variables into a comprehensive model for critically ill patients 加强败血症预后：将社会决定因素和人口统计学变量纳入重症患者综合模型

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-11 DOI: 10.1016/j.jcrc.2024.154857

Elie Sarraf , Alireza Vafaei Sadr , Vida Abedi , Anthony S. Bonavia

{"title":"Enhancing Sepsis prognosis: Integrating social determinants and demographic variables into a comprehensive model for critically ill patients","authors":"Elie Sarraf , Alireza Vafaei Sadr , Vida Abedi , Anthony S. Bonavia","doi":"10.1016/j.jcrc.2024.154857","DOIUrl":"https://doi.org/10.1016/j.jcrc.2024.154857","url":null,"abstract":"<div><h3>Background</h3><p>The Sequential Organ Failure Assessment (SOFA) score monitors organ failure and defines sepsis but may not fully capture factors influencing sepsis mortality. Socioeconomic and demographic impacts on sepsis outcomes have been highlighted recently.</p></div><div><h3>Objective</h3><p>To evaluate the prognostic value of SOFA scores against demographic and social health determinants for predicting sepsis mortality in critically ill patients, and to assess if a combined model increases predictive accuracy.</p></div><div><h3>Methods</h3><p>The study utilized retrospective data from the MIMIC-IV database and prospective external validation from the Penn State Health cohort. A Random Forest model incorporating SOFA scores, demographic/social data, and the Charlson Comorbidity Index was trained and validated.</p></div><div><h3>Findings</h3><p>In the MIMIC-IV dataset of 32,970 sepsis patients, 6,824 (20.7%) died within 30 days. A model including demographic, socioeconomic, and comorbidity data with SOFA scores improved predictive accuracy beyond SOFA scores alone. Day 2 SOFA, age, weight, and comorbidities were significant predictors. External validation showed consistent performance, highlighting the importance of delta SOFA between days 1 and 3.</p></div><div><h3>Conclusion</h3><p>Adding patient-specific demographic and socioeconomic information to clinical metrics significantly improves sepsis mortality prediction. This suggests a more comprehensive, multidimensional prognostic approach is needed for accurate sepsis outcome predictions.</p></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"83 ","pages":"Article 154857"},"PeriodicalIF":3.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0883944124003447/pdfft?md5=36b45867a08adfca3877080e37534580&pid=1-s2.0-S0883944124003447-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595084","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}

引用次数: 0

Authors reply: “How a positive fluid balance develops in acute kidney injury: A binational, observational study” 作者回复："急性肾损伤患者的体液正平衡是如何形成的？一项两国观察性研究"。

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-04 DOI: 10.1016/j.jcrc.2024.154856

引用次数: 0

The effect of high-dose selenium on mortality and postoperative organ dysfunction in post-cardiotomy cardiogenic shock patients supported with mechanical circulatory support – A post-hoc analysis of the SUSTAIN CSX trial 大剂量硒对接受机械循环支持的心肌梗死术后心源性休克患者死亡率和术后器官功能障碍的影响--SUSTAIN CSX 试验的事后分析

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-07-02 DOI: 10.1016/j.jcrc.2024.154853

Sascha Ott , Ellen Dresen , Zheng Yii Lee , Lukas M. Müller-Wirtz , Livia Procopiuc , Elyad Ekrami , Leonard Pitts , Nicolas Hellner , Daniel Catena , Georg Daniel Duerr , Maria Wittmann , Reiner M. Waeschle , Gunnar Elke , Benjamin O'Brien , Daren K. Heyland , Christian Stoppe

{"title":"The effect of high-dose selenium on mortality and postoperative organ dysfunction in post-cardiotomy cardiogenic shock patients supported with mechanical circulatory support – A post-hoc analysis of the SUSTAIN CSX trial","authors":"Sascha Ott , Ellen Dresen , Zheng Yii Lee , Lukas M. Müller-Wirtz , Livia Procopiuc , Elyad Ekrami , Leonard Pitts , Nicolas Hellner , Daniel Catena , Georg Daniel Duerr , Maria Wittmann , Reiner M. Waeschle , Gunnar Elke , Benjamin O'Brien , Daren K. Heyland , Christian Stoppe","doi":"10.1016/j.jcrc.2024.154853","DOIUrl":"https://doi.org/10.1016/j.jcrc.2024.154853","url":null,"abstract":"<div><h3>Purpose</h3><p>Cardiac surgery, post-cardiotomy cardiogenic shock (PCCS), and temporary mechanical circulatory support (tMCS) provoke substantial inflammation. We therefore investigated whether a selenium-based, anti-inflammatory strategy would benefit PCCS patients treated with tMCS in a post-hoc analysis of the sustain CSX trial.</p></div><div><h3>Methods</h3><p>Post-hoc analysis of patients receiving tMCS for PCCS in the Sustain CSX trial, which investigated the effects of high-dose selenium on postoperative organ dysfunction in cardiac surgery patients. Primary outcome: duration of tMCS therapy. Secondary outcomes: postoperative organ dysfunction and 30-day mortality.</p></div><div><h3>Results</h3><p>Thirty-nine patients were treated with tMCS for PCCS. There was no difference in the median duration of tMCS between the selenium and the placebo group (3 days [IQR: 1–6] vs. 2 days [IQR: 1–7], <em>p</em> = 0.52). Median dialysis duration was longer in the selenium group (1.5 days [0–21.8] vs. 0 days [0–1.8], <em>p</em> = 0.048). There was no difference in 30-day mortality (53% vs. 41%, OR 1.44, 95% CI 0.32–6.47, <em>p</em> = 0.62).</p></div><div><h3>Conclusion</h3><p>In this explorative study, a perioperative high-dose selenium-supplementation did not show beneficial effects on organ dysfunctions and mortality rates in patients with PCCS receiving tMCS.</p></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"83 ","pages":"Article 154853"},"PeriodicalIF":3.2,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S088394412400340X/pdfft?md5=7c1dd9cded0d7e5b0e67775f00ca10b6&pid=1-s2.0-S088394412400340X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141485005","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}

引用次数: 0

Impact of AKI on metabolic compensation for respiratory acidosis in ICU patients with AECOPD AKI 对重症监护病房 AECOPD 患者呼吸性酸中毒代谢补偿的影响。

IF 3.2 3区医学

Journal of critical care Pub Date : 2024-06-26 DOI: 10.1016/j.jcrc.2024.154846

Florian Marcy MD , Katharina Goettfried , Philipp Enghard MD, PhD , Sophie K. Piper PhD , Julius Valentin Kunz MD , Tim Schroeder MD

{"title":"Impact of AKI on metabolic compensation for respiratory acidosis in ICU patients with AECOPD","authors":"Florian Marcy MD , Katharina Goettfried , Philipp Enghard MD, PhD , Sophie K. Piper PhD , Julius Valentin Kunz MD , Tim Schroeder MD","doi":"10.1016/j.jcrc.2024.154846","DOIUrl":"10.1016/j.jcrc.2024.154846","url":null,"abstract":"<div><h3>Purpose</h3><p>Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) can result in severe respiratory acidosis. Metabolic compensation is primarily achieved by renal retention of bicarbonate. The extent to which acute kidney injury (AKI) impairs the kidney's capacity to compensate for respiratory acidosis remains unclear.</p></div><div><h3>Materials and methods</h3><p>This retrospective analysis covers clinical data between January 2009 and December 2021 for 498 ICU patients with AECOPD and need for respiratory support.</p></div><div><h3>Results</h3><p>278 patients (55.8%) presented with or developed AKI. Patients with AKI exhibited higher 30-day-mortality rates (14.5% vs. 4.5% <em>p</em> = 0.001), longer duration of mechanical ventilation (median 90 h vs. 14 h; p = 0.001) and more severe hypercapnic acidosis (pH 7.23 vs. 7.28; pCO<sub>2</sub> 68.5 mmHg vs. 61.8 mmHg). Patients with higher AKI stages exhibited lower HCO<sub>3</sub><sup>−</sup>/pCO<sub>2</sub> ratios and did not reach expected HCO<sub>3</sub><sup>−</sup> levels. In a mixed model analysis with random intercept per patient we analyzed the association of pCO<sub>2</sub> (independent) and HCO<sub>3</sub><sup>−</sup> (dependent variable). Lower estimates for averaged change in HCO<sub>3</sub><sup>−</sup> were observed in patients with more severe AKI.</p></div><div><h3>Conclusion</h3><p>AKI leads to poor outcomes and compromises metabolic compensation of respiratory acidosis in ICU patients with AECOPD. While buffering agents may aid compensation for severe AKI, their use should be approached with caution.</p></div>","PeriodicalId":15451,"journal":{"name":"Journal of critical care","volume":"83 ","pages":"Article 154846"},"PeriodicalIF":3.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0883944124003332/pdfft?md5=a8841a8e8611c65de8cd30e2a6074d0b&pid=1-s2.0-S0883944124003332-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468393","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}

引用次数: 0