Journal of Intensive Care Medicine最新文献

{"title":"Update on Management and Outcomes of Congenital Diaphragmatic Hernia.","authors":"K Taylor Wild, Holly L Hedrick, Anne M Ades, Maria V Fraga, Catherine M Avitabile, Juliana S Gebb, Edward R Oliver, Kristen Coletti, Erin M Kesler, K Taylor Van Hoose, Howard B Panitch, Sandy Johng, Renee P Ebbert, Lisa M Herkert, Casey Hoffman, Deanna Ruble, Sabrina Flohr, Tom Reynolds, Melissa Duran, Audrey Foster, Rebecca S Isserman, Emily A Partridge, Natalie E Rintoul","doi":"10.1177/08850666231212874","DOIUrl":"10.1177/08850666231212874","url":null,"abstract":"<p><p>Infants with congenital diaphragmatic hernia (CDH) benefit from comprehensive multidisciplinary teams that have experience in caring for the unique and complex issues associated with CDH. Despite prenatal referral to specialized high-volume centers, advanced ventilation strategies and pulmonary hypertension management, and extracorporeal membrane oxygenation, mortality and morbidity remain high. These infants have unique and complex issues that begin in fetal and infant life, but persist through adulthood. Here we will review the literature and share our clinical care pathway for neonatal care and follow up. While many advances have occurred in the past few decades, our work is just beginning to continue to improve the mortality, but also importantly the morbidity of CDH.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1175-1193"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482524","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":"Independent Risk Factors for Prolonged Tube Feeding After Endotracheal Intubation and Ventilation.","authors":"Prajwal M Pradhan, Schelomo Marmor, Christopher Tignanelli, Stephanie Misono, Jesse Hoffmeister","doi":"10.1177/08850666241258960","DOIUrl":"10.1177/08850666241258960","url":null,"abstract":"<p><strong>Purpose: </strong>Postextubation dysphagia (PED) can lead to prolonged tube feeding, but risk factors associated with prolonged tube feeding in this population are largely unknown. The purpose of this study was to identify factors independently associated with prolonged tube feeding in adult inpatients who required intubation and mechanical ventilation.</p><p><strong>Materials and methods: </strong>Retrospective observational cohort study in a dataset of 1.3 million inpatients. Extubated adults without preventilation dysphagia or tube feeding who underwent instrumental swallowing assessment were included. To characterize factors independently associated with prolonged tube feeding, we compiled a set of potential factors, completed factor selection using a random forest algorithm, and performed logistic regression.</p><p><strong>Results: </strong>In total, 206 of 987 (20.9%) patients had prolonged tube feeding. The regression model produced an area under the curve of 0.79. Factors with the greatest influence on prolonged tube feeding included dysphagia with thickened liquids, dysphagia with soft/solid foods, preadmission weight loss, number of intubations, admission for neurologic disorder, and hospital of admission.</p><p><strong>Conclusions: </strong>Several factors predicted prolonged tube feeding after extubation. The strongest were some, but not all, aspects of swallowing function and clinical practice pattern variability. Clinical decision-making should consider bolus-specific data from instrumental swallowing evaluation rather than binary presence or absence of dysphagia.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1266-1273"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288200","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":"Impact of Continuous Infusion Ketamine Compared to Continuous Infusion Benzodiazepines on Delirium in the Intensive Care Unit.","authors":"Nicholas J Vollmer, Erin D Wieruszewski, Andrea M Nei, Kristin C Mara, Alejandro A Rabinstein, Caitlin S Brown","doi":"10.1177/08850666241253541","DOIUrl":"10.1177/08850666241253541","url":null,"abstract":"<p><p><b>Purpose:</b> The purpose of this study was to evaluate rates of delirium or coma-free days between continuous infusion sedative-dose ketamine and continuous infusion benzodiazepines in critically ill patients. <b>Materials and Methods</b>: In this single-center, retrospective cohort adult patients were screened for inclusion if they received continuous infusions of either sedative-dose ketamine or benzodiazepines (lorazepam or midazolam) for at least 24 h, were mechanically ventilated for at least 48 h and admitted to the intensive care unit of a large quaternary academic center between 5/5/2018 and 12/1/2021. <b>Results:</b> A total of 165 patients were included with 64 patients in the ketamine group and 101 patients in the benzodiazepine group (lorazepam n = 35, midazolam n = 78). The primary outcome of median (IQR) delirium or coma-free days within the first 28 days of hospitalization was 1.2 (0.0, 3.7) for ketamine and 1.8 (0.7, 4.6) for benzodiazepines (p = 0.13). Patients in the ketamine arm spent a significantly lower proportion of time with RASS -3 to +4, received significantly higher doses and longer durations of propofol and fentanyl infusions, and had a significantly longer intensive care unit length of stay. <b>Conclusions:</b> The use of sedative-dose ketamine had no difference in delirium or coma-free days compared to benzodiazepines.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1204-1211"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141081297","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":"Exploring Rapid Response Team Activation Impact in Patients with Cirrhosis with Acute Decompensation.","authors":"Joelle N Friesen, Mackenzie Maberry, Jody C Olson, Alice Gallo de Moraes","doi":"10.1177/08850666241302024","DOIUrl":"https://doi.org/10.1177/08850666241302024","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis is associated with significant healthcare utilization, yet data about in-hospital decompensations remain sparse. Additionally, the impact of liver transplant candidacy status on resuscitation and outcomes is largely unknown.</p><p><strong>Aims: </strong>We aimed to evaluate the characteristics of resuscitation events for patients with cirrhosis with acute decompensation, analyzing liver transplant candidacy and intensive care unit (ICU) transfer parameters.</p><p><strong>Methods: </strong>Retrospective single-center review of adult patients with liver cirrhosis who had a rapid response team (RRT) activation during hospitalization and no prior liver transplantation.</p><p><strong>Results: </strong>Patients with cirrhosis who were liver transplant candidates were more likely to be younger (<i>p</i> = .003), have a higher serum total bilirubin (<i>p</i> = .015), higher INR (<i>p</i> < .001), and higher MELD 3.0 (<i>p</i> = .006). There was no significant difference in ICU transfer (<i>p</i> = .170) after RRT activation. Liver transplant candidates had a lower 30- and 60-day mortality (<i>p</i> = .008, <i>p</i> = .014) and were less likely to have a code status discussion after decompensation (<i>p</i> = .001). Lower serum albumin was associated with ICU transfer (<i>p</i> = .001). Patients who transferred to the ICU were more likely to have a code status discussion within 24 h after RRT (<i>p</i> = .011) without significant difference in 30- or 60-day mortality (<i>p</i> = .059, <i>p</i> = .277).</p><p><strong>Conclusions: </strong>Liver transplant candidacy in patients with cirrhosis with acute decompensation is not clearly correlated with ICU transfer. Liver transplant candidates are more likely to be younger, have higher MELD 3.0 scores, less likely to have code status discussed after RRT, and have lower 30- and 60-day mortality rates. Patients who transfer to the ICU are more likely to have a code status discussion without any significant difference in 30- or 60-day mortality.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241302024"},"PeriodicalIF":3.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710408","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":"Methylene Blue for Septic Shock: A Systematic Review and Meta-analysis of Randomized and Prospective Observational Studies.","authors":"Afrah Alkazemi, Sayed Abdulmotaleb Almoosawy, Anwar Murad, Abdulrahman Alfares","doi":"10.1177/08850666241300312","DOIUrl":"https://doi.org/10.1177/08850666241300312","url":null,"abstract":"<p><strong>Background: </strong>The impact of methylene blue (MB) on critical patient outcomes, including overall mortality, hemodynamic stability, and organ function has been inconsistently described across studies. This study aims to evaluate the efficacy of MB therapy in adult patients with septic shock in the intensive care unit (ICU).</p><p><strong>Methods: </strong>The systematic search of PubMed/MEDLINE, EMBASE and Cochrane Library databases up to February 2024 included randomized controlled trials and prospective observational studies involving adult septic shock patients who received intravenous MB therapy. The primary outcome was all-cause mortality, with secondary outcomes on hemodynamics and ICU length of stay.</p><p><strong>Results: </strong>Fifteen studies (5 randomized, 10 non-randomized) involving a total of 441 patients, met the inclusion criteria. The meta-analysis showed statistically significant reduction in mortality rates among septic shock patients treated with MB (mortality rate 0.52; 95% CI 0.38 to 0.66; <i>P</i> < .001). In a sub-analysis of only randomized trials, the results remained statistically significant (risk ratio 0.66; 95% CI 0.47 to 0.94; <i>P</i> = .023). A significant increase in mean arterial pressure post-infusion was observed in three studies. Two studies showed no substantial difference in heart rate and two studies showed no difference in cardiac index following MB administration. Only one study showed a reduction in the length of ICU stay with MB use, while another observed a decrease in overall hospital length of stay.</p><p><strong>Conclusions: </strong>The review and meta-analysis suggest that MB may be associated with a significant reduction in mortality in septic shock patients though findings are limited by sample size and heterogeneity. Further robust studies are needed to validate these results.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241300312"},"PeriodicalIF":3.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687238","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":"High-dose Intravenous N-Acetylcysteine in Mechanically Ventilated Patients with COVID-19 Pneumonia: A Propensity-Score Matched Cohort Study.","authors":"Ka Man Fong, George Wing Yiu Ng, Anne Kit Hung Leung, Kang Yiu Lai","doi":"10.1177/08850666241299391","DOIUrl":"https://doi.org/10.1177/08850666241299391","url":null,"abstract":"<p><strong>Background: </strong>Current therapies for severe COVID-19, such as steroids and immunomodulators are associated with various side effects. N-acetylcysteine (NAC) has emerged as a potential adjunctive therapy with minimal side effects for patients with cytokine storm due to COVID-19. However, evidence supporting high-dose intravenous NAC in severe COVID-19 pneumonia requiring mechanical ventilation is limited.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of consecutive patients aged ≥ 18 who were admitted for acute respiratory failure (PaO2/FiO2 ratio <300) with SARS-CoV-2 infection to the Intensive Care Unit (ICU) of Queen Elizabeth Hospital from fifth July 2020 to 31^st October 2022. Inclusion was limited to patients who required mechanical ventilation. High-dose NAC refers to a dosage of 10 g per day. The primary outcome was all-cause mortality within 28 days. Propensity-score matched analysis using logistic regression was performed.</p><p><strong>Results: </strong>Among the 136 patients analyzed, 42 (40.3%) patients received NAC. The unmatched NAC patients displayed a higher day-28 mortality (12 (28.6%) versus 4 (6.5%), p = 0.005) and fewer ventilator-free days (18.5 (0-23.0) versus 22.0 (18.3-24.0), p = 0.015). No significant differences were observed in ICU and hospital length of stays among survivors. In patients who were not treated with tocilizumab, those receiving NAC exhibited a trend toward a quicker reduction in C-reactive protein compared to those who did not receive NAC.After propensity score matching which included 64 patients with 33 (51.6%) receiving NAC, no significant differences were found in 28-day mortality, ventilator-free days, or ICU and hospital length of stay. After adjusting for potential confounders, logistic regression of the propensity score-matched population did not demonstrate that the use of NAC independently affected 28-day mortality.</p><p><strong>Conclusions: </strong>In patients with COVID-19 pneumonia requiring mechanical ventilation and receiving standard COVID-19 treatment, the addition of high-dose NAC did not lead to improved clinical outcomes.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241299391"},"PeriodicalIF":3.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687160","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":"Assessing the Role of Blood Gas Analysis in COVID-19 Patients for Early Warning and Clinical Guidance.","authors":"Youji Wang, Tielian Liu, Hualongyue Du, Yongliang Wang, Gang Xiao, Xiaoming Lyu","doi":"10.1177/08850666241297081","DOIUrl":"https://doi.org/10.1177/08850666241297081","url":null,"abstract":"<p><strong>Objective: </strong>To assess the role of blood gas analysis as an auxiliary tool for detecting and predicting the progression of COVID-19 in patients.</p><p><strong>Research methodology/design: </strong>A consecutive cohort study was conducted of 106 patients diagnosed with the novel coronavirus. Patients were divided into two groups based on age and the course of the disease (mild to moderate and severe). Blood gas analysis parameters were measured for all participants and results were compared between groups.</p><p><strong>Setting: </strong>This study was conducted in the Department of Laboratory Medicine, The Third Affiliated Hospital, Southern Medical University, Guangzhou, China.</p><p><strong>Main outcome measures: </strong>Arterial/alveolar oxygen partial pressure ratio, reduced hemoglobin fraction, sodium ion, lactic acid, oxygen saturation, oxygen partial pressure, and oxyhemoglobin fraction.</p><p><strong>Results: </strong>Findings indicated statistically significant differences between the two groups in the measured parameters.</p><p><strong>Conclusion: </strong>Blood gas analysis has the potential to more accurately assess the progression of COVID-19 in elderly patients, specifically related to respiratory and acid-base balance issues.</p><p><strong>Implications for clinical practice: </strong>This study underscores the importance for bedside nurses to pay close attention to acid-base balance, lung ventilation/ventilation function, and hypoxia status in elderly critically ill patients with COVID-19, in order to more effectively diagnose and predict the progression of the disease.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241297081"},"PeriodicalIF":3.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622290","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":"Bacterial Superinfections in Critically Ill Patients With SARS-CoV-2 Infection: A Retrospective Cohort Study.","authors":"Anfal Y Al-Ali, Abdul Salam, Osama Almuslim, Maha Alayouny, Mohammed Alhabib, Nada AlQadheeb","doi":"10.1177/08850666241298229","DOIUrl":"https://doi.org/10.1177/08850666241298229","url":null,"abstract":"<p><strong>Background: </strong>There is a considerable gap in the current evidence concerning the prevalence of superinfections among critically ill patients with SARS-CoV-2 infection in Saudi Arabia.</p><p><strong>Objectives: </strong>We sought to determine the prevalence of bacterial superinfections following the initiation of antibiotic therapy in critically ill patients with SARS-CoV-2 infection.</p><p><strong>Methods: </strong>A retrospective observational study that included patients with SARS-CoV-2 infection admitted to the intensive care unit (ICU) for at least 24 hours and received empirical antibiotic therapy. The primary outcome was the rate of bacterial superinfections occurring at least 48 hours after the initiation of antibiotics. ICU-related outcomes and complications were compared between subgroups with and without superinfections and amongst the two most frequently used antibiotic regimens.</p><p><strong>Results: </strong>A total of 230 patients were included in our study. Superinfections developed in 40 (17.4%) patients, with the median time from the first dose of antibiotic to the emergence of superinfection of 17.6 days (IQR 9.8-29.2). Patients with superinfections had longer median ICU stays [ 27.1 days(IQR 15.2-43.3) versus 7.1 days(IQR 3.8-11.8); <i>P</i> < 0.001], developed more complications [92.5% versus 52.6%; <i>P</i> < 0.001], and had higher ICU mortality [45.0% versus 22.1%; <i>P</i> = 0.0034] compared to patients without superinfections. The two most frequently prescribed antibiotic regimens were piperacillin/tazobactam plus levofloxacin (53.9%) and meropenem plus levofloxacin (19.7%). Although there was no significant difference in the rate of superinfections [15.3% versus 26.7%; <i>P</i> = 0.09] between the two groups, patients in the superinfections group who received piperacillin/tazobactam plus levofloxacin developed more complications [94.7% versus 91.7%; <i>P</i> < 0.001] and had a higher ICU mortality [57.9% versus 50%; <i>P</i> < 0.001].</p><p><strong>Conclusion: </strong>Superinfections occurred at a higher rate in critically ill patients with SARS-CoV-2 infection post empirical antibiotics initiation. The use of piperacillin/tazobactam plus levofloxacin was associated with an increase in the rate of complications and higher ICU mortality. Larger multicenter studies are needed to confirm these results.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241298229"},"PeriodicalIF":3.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622310","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":"Adult Code Sepsis: A Narrative Review of its Implementation and Impact.","authors":"Andrés Giglio, María Aranda, Andres Ferre, Marcio Borges","doi":"10.1177/08850666241293034","DOIUrl":"https://doi.org/10.1177/08850666241293034","url":null,"abstract":"<p><p>This narrative review explores the implementation and impact of sepsis code protocols, an urgent intervention strategy designed to improve clinical outcomes in patients with sepsis. We examined the degree of implementation, activation criteria, areas of implementation, personnel involved, responses after activation, goals and targets, impact on clinical indicators, and challenges in implementation. The reviewed evidence suggests that sepsis codes can significantly reduce sepsis-related mortality and enhance early administration of treatments. However, variability in activation criteria and inconsistent application present ongoing challenges. The review considers the incorporation of newer scoring systems, such as NEWS and MEWS, and the potential integration of machine learning tools for early sepsis detection. It highlights the importance of tailoring implementation to specific healthcare contexts and the value of ongoing training to optimize sepsis response. Limitations include the ongoing controversy surrounding sepsis definitions and the need for standardized, feasible quality indicators. Future research should focus on standardizing activation criteria, improving protocol adherence, and exploring emerging technologies to enhance early sepsis detection and management. Despite challenges, sepsis codes show promise in improving patient outcomes when implemented thoughtfully and consistently across healthcare settings.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241293034"},"PeriodicalIF":3.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568939","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":"Ferritin Levels on Hospital Admission Predict Hypoxic-Ischemic Encephalopathy in Patients After Out-of-Hospital Cardiac Arrest: A Prospective Observational Single-Center Study.","authors":"Swantje Nickelsen, Eleonore Grosse Darrelmann, Lea Seidlmayer, Katrin Fink, Simone Britsch, Daniel Duerschmied, Ruediger E Scharf, Albrecht Elsaesser, Thomas Helbing","doi":"10.1177/08850666241252602","DOIUrl":"10.1177/08850666241252602","url":null,"abstract":"<p><strong>Aim: </strong>Out-of-hospital cardiac arrest (OHCA) is a major health concern in Western societies. Poor outcome after OHCA is determined by the extent of hypoxic-ischemic encephalopathy (HIE). Dysregulation of iron metabolism has prognostic relevance in patients with ischemic stroke and sepsis. The aim of this study was to determine whether serum iron parameters help to estimate outcomes after OHCA.</p><p><strong>Methods: </strong>In this prospective single-center study, 70 adult OHCA patients were analyzed. Serum ferritin, iron, transferrin (TRF), and TRF saturation (TRFS) were measured in blood samples drawn on day 0 (admission), day 2, day 4, and 6 months after the return of spontaneous circulation (ROSC). The association of 4 iron parameters with in-hospital mortality, neurological outcome (cerebral performance category [CPC]), and HIE was investigated by receiver operating characteristics and multivariate regression analyses.</p><p><strong>Results: </strong>OHCA subjects displayed significantly increased serum ferritin levels on day 0 and lowered iron, TRF, and TRFS on days 2 and 4 after ROSC, as compared to concentrations measured at a 6-month follow-up. Iron parameters were not associated with in-hospital mortality or neurological outcomes according to the CPC. Ferritin on admission was an independent predictor of features of HIE on cranial computed tomography and death due to HIE.</p><p><strong>Conclusion: </strong>OHCA is associated with alterations in iron metabolism that persist for several days after ROSC. Ferritin on admission can help to predict HIE.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1120-1130"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945270","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}