Journal of Intensive Care最新文献

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AN ANALYSIS OF STUDENTS’ NEEDS AND PREFERENCES TO DEVELOP ENGLISH TEXTBOOK FOR THE SEVENTH GRADERS 七年级英语教材的学生需求与偏好分析
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-28 DOI: 10.31602/intensive.v6i1.10037
Rino Thesaloga
{"title":"AN ANALYSIS OF STUDENTS’ NEEDS AND PREFERENCES TO DEVELOP ENGLISH TEXTBOOK FOR THE SEVENTH GRADERS","authors":"Rino Thesaloga","doi":"10.31602/intensive.v6i1.10037","DOIUrl":"https://doi.org/10.31602/intensive.v6i1.10037","url":null,"abstract":"This paper is compiled to address the students’ needs regarding topics and material preferences in learning English also their present difficulties. The incompatibility of the current textbook is indicated by the students’ scores on multiple academic assessments. One of the main factors is that most students did not learn English in Elementary School; hence they only know a few isolated English words. As a result, they struggle to comprehend the full English content. This descriptive-quantitative research extracted the students’ bilingual status, opinions, purposes, and topic preferences from 55 students to develop a more compatible English textbook. As a result, the questionnaire and the interview show that the students want elementary-level material, accessible pronunciation examples, involvement of Bahasa Indonesia, and topics based on local content.","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91063260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
TRANSLATION TECHNIQUES OF CULTURAL WORDS APPLIED IN THE NOVEL THE HUNGER GAMES 小说《饥饿游戏》中文化词汇的翻译技巧
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-28 DOI: 10.31602/intensive.v6i1.10251
Yasminda Dilisayana, Fatchul Mu’in, N. Nasrullah
{"title":"TRANSLATION TECHNIQUES OF CULTURAL WORDS APPLIED IN THE NOVEL THE HUNGER GAMES","authors":"Yasminda Dilisayana, Fatchul Mu’in, N. Nasrullah","doi":"10.31602/intensive.v6i1.10251","DOIUrl":"https://doi.org/10.31602/intensive.v6i1.10251","url":null,"abstract":"To translate a book into other languages requires sufficient knowledge. It cannot just randomly  be translated, because readers may have difficulty understanding the content. It is important to know and understand the techniques of translation before translating to avoid making mistakes. Before translating a book, translator should know and understand some translation techniques. The researcher conducted this study to find translation techniques which were applied by the translator in translating cultural words in the novel The Hunger Games by Suzanne Collins. This research used descriptive qualitative research. The source of the data is The Hunger Games novel written by Suzanne Collins and its Indonesian version that is translated by Hetih Rusli. The research instrument in this study is the researcher herself with the help of table list. The researcher considered to focus on cultural words in the novel as a necessary data and analyzed the translation techniques based on the theory by Molina and Albir. The result of this research showed that there are twelve translation techniques which were applied by the translator in translating 84 cultural words found in the novel. There are 29 calque, 19 Borrowing, 13 Amplification, 6 Linguistic compression, 2 Description, 5 Discursive creation, 3 Linguistic amplification , 2 Literal translation, 2 Particularization, 1 Established equivalent, 1 Generalization, and 1 Reduction. The researcher offers that the reason why the translator mostly used calque technique is because most of the cultural words in The Hunger Games novel have the equivalent in Indonesian.","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73160541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
INCREASING STUDENTS’ VOCABULARY USING JUMBLED SENTENCES: ACTION STUDY RESEARCH 用混乱的句子增加学生的词汇量:行动学习研究
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-28 DOI: 10.31602/intensive.v6i1.9606
Melisa Octaviana, Hafizhatu Nadia, Tenny Murtiningsih
{"title":"INCREASING STUDENTS’ VOCABULARY USING JUMBLED SENTENCES: ACTION STUDY RESEARCH","authors":"Melisa Octaviana, Hafizhatu Nadia, Tenny Murtiningsih","doi":"10.31602/intensive.v6i1.9606","DOIUrl":"https://doi.org/10.31602/intensive.v6i1.9606","url":null,"abstract":"This study aims to increase students' English vocabulary by using Jumbled Sentences in a small classroom. The subjects of this study were composed of seven students. This study used Classroom Action Research (CAR) as the method and was conducted by collaboration between teacher and researcher. The data were gathered through observation, interviews, field notes, and tests. The result of the study showed there was an improvement in student abilities. Student scores have increased significantly. In the first cycle post-test, only one out of seven students got good grades, with the Kriteria Ketuntasan Minimum (KKM) of English lessons being (75). Meanwhile, the student's scores in the second cycle post-test showed that seven of seven students scored above 75. In addition, there was a positive response from the English teacher and students about this study. In conclusion, jumbled sentences could increase students' abilities, especially in their vocabulary","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78723618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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: 1
THE EFFECT OF THREE STEP INTERVIEW TECHNIQUE TO IMPROVE STUDENTS’ SPEAKING ABILITY 三步访谈技巧对提高学生口语能力的效果
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-28 DOI: 10.31602/intensive.v6i1.10751
Syaifudin Latif Darmawan, Aulia Hanifah Qomar, Nandita Rosalina
{"title":"THE EFFECT OF THREE STEP INTERVIEW TECHNIQUE TO IMPROVE STUDENTS’ SPEAKING ABILITY","authors":"Syaifudin Latif Darmawan, Aulia Hanifah Qomar, Nandita Rosalina","doi":"10.31602/intensive.v6i1.10751","DOIUrl":"https://doi.org/10.31602/intensive.v6i1.10751","url":null,"abstract":"Speaking is considered as an important skill to be accomplished by students. Speaking is related to the pronunciation of words that aim to convey what is to be conveyed both of feelings or ideas. However, there were some problems that make human could not express their ideas. They are such as difficult to pronounce the words, low vocabulary, and misunderstanding. The main purpose of this research is to know whether Three-Step Interview Technique effective towards students’ Speaking Ability at eleventh grade of MA Darul A’mal Metro. The population of the research was the students on the eleventh grade in MA Darul A’mal Metro. The sampling technique was random sampling technique. The researcherschose social and science class as the sampling. Based on the result of data analysis, the mean score of post-test in experimental class was13.26 and the mean score of post-test in control class was 12.00. It showed that the students’ post- test score in experimental class was higher than students’ post-test score in control class. The result can be seen from sig. (2-tailed) of the equal variance assumed in the independent sample test table which the sig. (2-tailed) is 0.043. It is lower than α = 0.05 and it means that Ho is rejected and Ha is accepted. It showed that there was significant influence of using three-step interview towards students’ speaking ability at the first semester of the eleventh grade of MA Darul A’mal. Speaking is considered as an important skill to be accomplished by students. Speaking is related to the pronunciation of words that aim to convey what is to be conveyed both of feelings or ideas. However, there were some problems that make human could not express their ideas. They are such as difficult to pronounce the words, low vocabulary, and misunderstanding. The main purpose of this research is to know whether Three-Step Interview Technique effective towards students’ Speaking Ability at eleventh grade of MA Darul A’mal Metro. The population of the research was the students on the eleventh grade in MA Darul A’mal Metro. The sampling technique was random sampling technique. The researcherschose social and science class as the sampling. Based on the result of data analysis, the mean score of post-test in experimental class was13.26 and the mean score of post-test in control class was 12.00. It showed that the students’ post- test score in experimental class was higher than students’ post-test score in control class. The result can be seen from sig. (2-tailed) of the equal variance assumed in the independent sample test table which the sig. (2-tailed) is 0.043. It is lower than α = 0.05 and it means that Ho is rejected and Ha is accepted. It showed that there was significant influence of using three-step interview towards students’ speaking ability at the first semester of the eleventh grade of MA Darul A’mal.","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84858187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study. 住院败血症患者ICU入院时间与死亡率之间的关系:一项全国性前瞻性队列研究
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-21 DOI: 10.1186/s40560-023-00663-6
Yoon Hae Ahn, Jinwoo Lee, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-Man Lim, Sang-Min Lee, Hong Yeul Lee
{"title":"Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study.","authors":"Yoon Hae Ahn,&nbsp;Jinwoo Lee,&nbsp;Dong Kyu Oh,&nbsp;Su Yeon Lee,&nbsp;Mi Hyeon Park,&nbsp;Haein Lee,&nbsp;Chae-Man Lim,&nbsp;Sang-Min Lee,&nbsp;Hong Yeul Lee","doi":"10.1186/s40560-023-00663-6","DOIUrl":"https://doi.org/10.1186/s40560-023-00663-6","url":null,"abstract":"<p><strong>Background: </strong>Based on sparse evidence, the current Surviving Sepsis Campaign guideline suggests that critically ill patients with sepsis be admitted to the intensive care unit (ICU) within 6 h. However, limited ICU bed availability often makes immediate transfer difficult, and it is unclear whether all patients will benefit from early admission to the ICU. Therefore, the purpose of this study was to determine the association between the timing of ICU admission and mortality in patients with hospital-onset sepsis.</p><p><strong>Methods: </strong>This nationwide prospective cohort study analyzed patients with hospital-onset sepsis admitted to the ICUs of 19 tertiary hospitals between September 2019 and December 2020. ICU admission was classified as either early (within 6 h) or delayed (beyond 6 h). The primary outcome of in-hospital mortality was compared using logistic regression adjusted for key prognostic factors in the unmatched and 1:1 propensity-score-matched cohorts. Subgroup and interaction analyses assessed whether in-hospital mortality varied according to baseline characteristics.</p><p><strong>Results: </strong>A total of 470 and 286 patients were included in the early and delayed admission groups, respectively. Early admission to the ICU did not significantly result in lower in-hospital mortality in both the unmatched (adjusted odds ratio [aOR], 1.35; 95% confidence interval [CI], 0.99-1.85) and matched cohorts (aOR, 1.38; 95% CI, 0.94-2.02). Subgroup analyses showed that patients with increasing lactate levels (aOR, 2.10; 95% CI, 1.37-3.23; P for interaction = 0.003), septic shock (aOR, 2.06; 95% CI, 1.31-3.22; P for interaction = 0.019), and those who needed mechanical ventilation (aOR, 1.92; 95% CI, 1.24-2.96; P for interaction = 0.027) or vasopressor support (aOR, 1.69; 95% CI, 1.17-2.44; P for interaction = 0.042) on the day of ICU admission had a higher risk of mortality with delayed admission.</p><p><strong>Conclusions: </strong>Among patients with hospital-onset sepsis, in-hospital mortality did not differ significantly between those with early and delayed ICU admission. However, as early intensive care may benefit those with increasing lactate levels, septic shock, and those who require vasopressors or ventilatory support, admission to the ICU within 6 h should be considered for these subsets of patients.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10120484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9791532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous ECMO. 无细胞血红蛋白和触珠蛋白作为急性呼吸窘迫综合征(ARDS)患者预后指标和静脉-静脉ECMO治疗的潜力。
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-20 DOI: 10.1186/s40560-023-00664-5
Victoria Bünger, Oliver Hunsicker, Alexander Krannich, Felix Balzer, Claudia D Spies, Wolfgang M Kuebler, Steffen Weber-Carstens, Mario Menk, Jan A Graw
{"title":"Potential of cell-free hemoglobin and haptoglobin as prognostic markers in patients with ARDS and treatment with veno-venous ECMO.","authors":"Victoria Bünger,&nbsp;Oliver Hunsicker,&nbsp;Alexander Krannich,&nbsp;Felix Balzer,&nbsp;Claudia D Spies,&nbsp;Wolfgang M Kuebler,&nbsp;Steffen Weber-Carstens,&nbsp;Mario Menk,&nbsp;Jan A Graw","doi":"10.1186/s40560-023-00664-5","DOIUrl":"https://doi.org/10.1186/s40560-023-00664-5","url":null,"abstract":"<p><strong>Background: </strong>Hemolysis is associated with increased mortality in patients with sepsis, ARDS, or therapy with extracorporeal membrane oxygenation (ECMO). To quantify a critical threshold of hemolysis in patients with ARDS and treatment with veno-venous ECMO, we aimed to identify cutoff values for cell-free hemoglobin (CFH) and haptoglobin (Hp) plasma concentrations associated with a significant increase in ICU mortality.</p><p><strong>Methods: </strong>Patients with ARDS admitted to a tertiary ARDS referral center between 01/2007 and 12/2018 and treatment with veno-venous ECMO were included. Cutoff values for mean CFH (mCFH) and mean Hp (mHp) plasma concentrations dividing the cohort into groups with significantly different ICU mortalities were calculated and patient characteristics were compared. A multiple logistic regression model with stepwise backward variable selection was included. In addition, cutoff values for vulnerable relative timespans for the respective CFH and Hp concentrations were calculated.</p><p><strong>Results: </strong>A quantitative cutoff value of 11 mg/dl for mCFH separated the cohort (n = 442) regarding ICU mortality (mCFH ≤ 11 mg/dl: 38%, [95%-CI: 32.22-43.93] (n = 277) vs. mCFH > 11 mg/dl: 70%, [61.99-76.47] (n = 165), p < 0.001). Analogously, a mHp cutoff value ≤ 0.39 g/l was associated with a significant increase in ICU mortality (mHp ≤ 0.39 g/l: 68.7%, [60.91-75.61] (n = 163) vs. mHp > 0.39 g/l: 38.7%, [33.01-44.72] (n = 279), p < 0.001). The independent association of ICU mortality with CFH and Hp cutoff values was confirmed by logistic regression adjusting for confounders (CFH Grouping: OR 3.77, [2.51-5.72], p < 0.001; Hp Grouping: OR 0.29, [0.19-0.43], p < 0.001). A significant increase in ICU mortality was observed when CFH plasma concentration exceeded the limit of 11 mg/dl on 13.3% of therapy days (≤ 13.3% of days with CFH > 11 mg/dl: 33%; [26.81-40.54] (n = 192) vs. > 13.3% of days with CFH > 11 mg/dl: 62%; [56.05-68.36] (n = 250), p < 0.001). Analogously, a mortality increase was detected when Hp plasma concentration remained ≤ 0.39 g/l for > 18.2% of therapy days (≤ 18.2% days with Hp ≤ 0.39 g/l: 27%; [19.80-35.14] (n = 138) vs. > 18.2% days with Hp ≤ 0.39 g/l: 60%; [54.43-65.70] (n = 304), p < 0.001).</p><p><strong>Conclusions: </strong>Moderate hemolysis with mCFH-levels as low as 11 mg/dl impacts mortality in patients with ARDS and therapy with veno-venous ECMO. Furthermore, a cumulative dose effect should be considered indicated by the relative therapy days with CFH-concentrations > 11 mg/dl. In addition, also Hp plasma concentrations need consideration when the injurious effect of elevated CFH is evaluated.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9426861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Mechanical power and 30-day mortality in mechanically ventilated, critically ill patients with and without Coronavirus Disease-2019: a hospital registry study. 2019年冠状病毒病和非冠状病毒病机械通气危重患者的机械功率和30天死亡率:一项医院登记研究
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-04-06 DOI: 10.1186/s40560-023-00662-7
Basit A Azizi, Ricardo Munoz-Acuna, Aiman Suleiman, Elena Ahrens, Simone Redaelli, Tim M Tartler, Guanqing Chen, Boris Jung, Daniel Talmor, Elias N Baedorf-Kassis, Maximilian S Schaefer
{"title":"Mechanical power and 30-day mortality in mechanically ventilated, critically ill patients with and without Coronavirus Disease-2019: a hospital registry study.","authors":"Basit A Azizi,&nbsp;Ricardo Munoz-Acuna,&nbsp;Aiman Suleiman,&nbsp;Elena Ahrens,&nbsp;Simone Redaelli,&nbsp;Tim M Tartler,&nbsp;Guanqing Chen,&nbsp;Boris Jung,&nbsp;Daniel Talmor,&nbsp;Elias N Baedorf-Kassis,&nbsp;Maximilian S Schaefer","doi":"10.1186/s40560-023-00662-7","DOIUrl":"https://doi.org/10.1186/s40560-023-00662-7","url":null,"abstract":"<p><strong>Background: </strong>Previous studies linked a high intensity of ventilation, measured as mechanical power, to mortality in patients suffering from \"classic\" ARDS. By contrast, mechanically ventilated patients with a diagnosis of COVID-19 may present with intact pulmonary mechanics while undergoing mechanical ventilation for longer periods of time. We investigated whether an association between higher mechanical power and mortality is modified by a diagnosis of COVID-19.</p><p><strong>Methods: </strong>This retrospective study included critically ill, adult patients who were mechanically ventilated for at least 24 h between March 2020 and December 2021 at a tertiary healthcare facility in Boston, Massachusetts. The primary exposure was median mechanical power during the first 24 h of mechanical ventilation, calculated using a previously validated formula. The primary outcome was 30-day mortality. As co-primary analysis, we investigated whether a diagnosis of COVID-19 modified the primary association. We further investigated the association between mechanical power and days being alive and ventilator free and effect modification of this by a diagnosis of COVID-19. Multivariable logistic regression, effect modification and negative binomial regression analyses adjusted for baseline patient characteristics, severity of disease and in-hospital factors, were applied.</p><p><strong>Results: </strong>1,737 mechanically ventilated patients were included, 411 (23.7%) suffered from COVID-19. 509 (29.3%) died within 30 days. The median mechanical power during the first 24 h of ventilation was 19.3 [14.6-24.0] J/min in patients with and 13.2 [10.2-18.0] J/min in patients without COVID-19. A higher mechanical power was associated with 30-day mortality (OR<sub>adj</sub> 1.26 per 1-SD, 7.1J/min increase; 95% CI 1.09-1.46; p = 0.002). Effect modification and interaction analysis did not support that this association was modified by a diagnosis of COVID-19 (95% CI, 0.81-1.38; p-for-interaction = 0.68). A higher mechanical power was associated with a lower number of days alive and ventilator free until day 28 (IRR<sub>adj</sub> 0.83 per 7.1 J/min increase; 95% CI 0.75-0.91; p < 0.001, adjusted risk difference - 2.7 days per 7.1J/min increase; 95% CI - 4.1 to - 1.3).</p><p><strong>Conclusion: </strong>A higher mechanical power is associated with elevated 30-day mortality. While patients with COVID-19 received mechanical ventilation with higher mechanical power, this association was independent of a concomitant diagnosis of COVID-19.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10077655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9271367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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: 1
Onset timing and duration of augmented renal clearance in a mixed intensive care unit. 混合重症监护病房中增强肾清除率的发病时间和持续时间。
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-03-23 DOI: 10.1186/s40560-023-00660-9
Ryusei Mikami, Mineji Hayakawa, Shungo Imai, Mitsuru Sugawara, Yoh Takekuma
{"title":"Onset timing and duration of augmented renal clearance in a mixed intensive care unit.","authors":"Ryusei Mikami,&nbsp;Mineji Hayakawa,&nbsp;Shungo Imai,&nbsp;Mitsuru Sugawara,&nbsp;Yoh Takekuma","doi":"10.1186/s40560-023-00660-9","DOIUrl":"https://doi.org/10.1186/s40560-023-00660-9","url":null,"abstract":"<p><strong>Background: </strong>Augmented renal clearance (ARC) is associated with lower blood plasma concentrations of renally excreted drugs; however, its time course is unknown. The current study aimed to determine the onset timing/duration of ARC, its risk factors, and its association with clinical outcomes by continuous monitoring of urinary creatinine clearance (CrCl) in critically ill patients.</p><p><strong>Methods: </strong>Data were retrospectively obtained from the medical records of 2592 critically ill patients admitted to the intensive care unit (ICU) from January 2019 to June 2022 at a tertiary emergency hospital. Among these, patients with continuously measured urinary CrCl were selected and observed over time. We evaluated the onset timing and duration of ARC by plotting Kaplan-Meier curves. Furthermore, by multivariate analyses, factors associated with the onset and persistence of ARC were analyzed, and the association between the ARC time course and clinical outcomes was evaluated.</p><p><strong>Results: </strong>The prevalence of ARC was 33.4% (245/734). ARC onset was within 3 days of admission in approximately half of the cases, and within 1 week in most of the other cases. In contrast, the persistence duration of ARC varied widely (median, 5 days), and lasted for more than a month in some cases. Multivariate analysis identified younger age, male sex, lower serum creatinine at admission, admission with central nervous system disease, no medical history, use of mechanically assisted ventilation, and vasopressor use as onset factors for ARC. Furthermore, factors associated with ARC persistence such as younger age and higher urinary CrCl on ARC day 1 were detected. The onset of ARC was significantly associated with reduced mortality, but persistent of ARC was significantly associated with fewer ICU-free days.</p><p><strong>Conclusions: </strong>Despite the early onset of ARC, its duration varied widely and ARC persisted longer in younger patients with higher urinary CrCl. Since the duration of ARC was associated with fewer ICU-free days, it may be necessary to consider a long-term increased-dose regimen of renally excreted drugs beginning early in patients who are predicted to have a persistent ARC.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9182298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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: 3
Prehospital tranexamic acid for trauma victims. 为创伤患者提供院前氨甲环酸。
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-03-22 DOI: 10.1186/s40560-023-00661-8
Kazuhiko Omori, Ian Roberts
{"title":"Prehospital tranexamic acid for trauma victims.","authors":"Kazuhiko Omori, Ian Roberts","doi":"10.1186/s40560-023-00661-8","DOIUrl":"10.1186/s40560-023-00661-8","url":null,"abstract":"<p><p>The public enquiry into the mass casualty incident at the Manchester Arena in the UK in which 23 people died and over 1000 were injured, identified the need for timely intramuscular administration of tranexamic acid to trauma patients. Since then, a number of studies and trials have been carried out and UK paramedics are now authorized to give intramuscular tranexamic acid in the pre-hospital setting. In Japan, pre-hospital administration by emergency life-saving technicians is not yet authorized, despite the fact that tranexamic acid was invented by Japanese scientists. In Japan, the need for the pre-hospital administration of tranexamic acid has been raised on several occasions, where a patient died from traumatic bleeding prior to hospital admission. This paper summarizes the evidence on the use of tranexamic acid in patients with traumatic bleeding, including new evidence on the intramuscular route.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10035187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9539067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Analysis of urinary C-C motif chemokine ligand 14 (CCL14) and first-generation urinary biomarkers for predicting renal recovery from acute kidney injury: a prospective exploratory study. 分析尿C-C基序趋化因子配体14 (CCL14)和第一代尿生物标志物预测急性肾损伤后肾脏恢复:一项前瞻性探索性研究。
IF 7.1 2区 医学
Journal of Intensive Care Pub Date : 2023-03-20 DOI: 10.1186/s40560-023-00659-2
Ben-Shu Qian, Hui-Miao Jia, Yi-Bing Weng, Xin-Cheng Li, Chao-Dong Chen, Fang-Xing Guo, Yu-Zhen Han, Li-Feng Huang, Yue Zheng, Wen-Xiong Li
{"title":"Analysis of urinary C-C motif chemokine ligand 14 (CCL14) and first-generation urinary biomarkers for predicting renal recovery from acute kidney injury: a prospective exploratory study.","authors":"Ben-Shu Qian,&nbsp;Hui-Miao Jia,&nbsp;Yi-Bing Weng,&nbsp;Xin-Cheng Li,&nbsp;Chao-Dong Chen,&nbsp;Fang-Xing Guo,&nbsp;Yu-Zhen Han,&nbsp;Li-Feng Huang,&nbsp;Yue Zheng,&nbsp;Wen-Xiong Li","doi":"10.1186/s40560-023-00659-2","DOIUrl":"https://doi.org/10.1186/s40560-023-00659-2","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a frequent syndrome in the intensive care unit (ICU). AKI patients with kidney function recovery have better short-term and long-term prognoses compared with those with non-recovery. Numerous studies focus on biomarkers to distinguish them. To better understand the predictive performance of urinary biomarkers of renal recovery in patients with AKI, we evaluated C-C motif chemokine ligand 14 (CCL14) and two first-generation biomarkers (cell cycle arrest biomarkers and neutrophil gelatinase-associated lipocalin) in two ICU settings.</p><p><strong>Methods: </strong>We performed a prospective study to analyze urinary biomarkers for predicting renal recovery from AKI. Patients who developed AKI after ICU admission were enrolled and urinary biomarkers including tissue inhibitor of metalloproteinase-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7), CCL14, and neutrophil gelatinase-associated lipocalin (NGAL) were detected on the day of AKI diagnosis. The primary endpoint was non-recovery from AKI within 7 days. The individual discriminative ability of CCL14, [TIMP-2] × [IGFBP7] and NGAL to predict renal non-recovery were evaluated by the area under receiver operating characteristics curve (AUC).</p><p><strong>Results: </strong>Of 164 AKI patients, 64 (39.0%) failed to recover from AKI onset. CCL14 showed a fair prediction ability for renal non-recovery with an AUC of 0.71 (95% CI 0.63-0.77, p < 0.001). [TIMP-2] × [IGFBP7] showed the best prediction for renal non-recovery with an AUC of 0.78 (95% CI 0.71-0.84, p < 0.001). However, NGAL had no use in predicting non-recovery with an AUC of 0.53 (95% CI 0.45-0.60, p = 0.562). A two-parameter model (non-renal SOFA score and AKI stage) predicted renal non-recovery with an AUC of 0.77 (95% CI 0.77-0.83, p = 0.004). When [TIMP-2] × [IGFBP7] was combined with the clinical factors, the AUC was significantly improved to 0.82 (95% CI 0.74-0.87, p = 0.049).</p><p><strong>Conclusions: </strong>Urinary CCL14 and [TIMP-2] × [IGFBP7] were fair predictors of renal non-recovery from AKI. Combing urinary [TIMP-2] × [IGFBP7] with a clinical model consisting of non-renal SOFA score and AKI stage enhanced the predictive power for renal non-recovery. Urinary CCL14 showed no significant advantage in predicting renal non-recovery compared to [TIMP-2] × [IGFBP7].</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10026399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9529508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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: 2
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