Journal of Intensive Care Medicine最新文献

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Hospital Safety-Net Burden and Outcomes of COVID-19 Hospitalizations in the US: Analysis of a National Multicenter Database. 美国医院安全网负担和COVID-19住院治疗的结果:对国家多中心数据库的分析
IF 2.1 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-11 DOI: 10.1177/08850666251366167
Titilope Olanipekun, Joseph Heaton, Temidayo Abe, Abimbola Chris-Olaiya, Bekure B Siraw, Isha Shahin, Ndausung Udongwo, Iván A Huespe, Devang Sanghavi
{"title":"Hospital Safety-Net Burden and Outcomes of COVID-19 Hospitalizations in the US: Analysis of a National Multicenter Database.","authors":"Titilope Olanipekun, Joseph Heaton, Temidayo Abe, Abimbola Chris-Olaiya, Bekure B Siraw, Isha Shahin, Ndausung Udongwo, Iván A Huespe, Devang Sanghavi","doi":"10.1177/08850666251366167","DOIUrl":"https://doi.org/10.1177/08850666251366167","url":null,"abstract":"<p><p>BackgroundSafety-net hospitals (SNH) provide care to a significant proportion of low-income, uninsured, and underserved populations disproportionately affected by the COVID-19 pandemic. We evaluated the impact of safety-net burden on outcomes of COVID-19 hospitalizations.MethodsWe identified patients aged ≥ 18 years hospitalized with COVID-19 from the nationwide inpatient database using the International Classification of Diseases, Tenth Edition (ICD-10-CM) code U07.1. The primary study outcomes were inpatient mortality, respiratory failure requiring mechanical ventilation, and tracheostomy use. Secondary outcomes were total hospitalization costs (THC) and length of hospital stay (LOS). Multivariable logistic regression was used to compare the primary and secondary outcomes in HBH and medium safety-net burden (MBH) with lower-burden hospitals (LBH) (reference).ResultsAn estimated 2,608,232 COVID-19 hospitalizations met the inclusion criteria, with 68.7% occurring in HBH, 22.8% in MBH, and 8.5% in LBH. On adjusted multivariable analysis, HBH was associated with increased odds of inpatient mortality (aOR 1.19, 95% CI 1.09-1.28) compared with LBH. Both HBH (aOR 1.30, 95% CI 1.21-1.40) and MBH (aOR 1.14, 95% CI 1.06-1.24) demonstrated increased odds of mechanical ventilation compared with LBH. THC was lower in HBH and MBH compared with LBH. The LOS was similar across safety net burden categories.ConclusionAfter adjusting for patient- and hospital-level factors, COVID-19 hospitalizations at HBH had inferior inpatient outcomes compared with LBH. Targeted policy reforms are needed to address the underlying causes of these disparities and increase our health systems' readiness for future crises, particularly in underserved communities.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251366167"},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Do Sex Differences Matter in Cardiac Surgery-Associated Acute Kidney Injury? - A Narrative Review. 性别差异对心脏手术相关急性肾损伤有影响吗?-叙述评论。
IF 2.1 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-06 DOI: 10.1177/08850666251364783
Maartina J P Oosterom-Eijmael, Sarah A van Eeghen, Yugeesh R Lankadeva, Jeroen Hermanides, Abraham H Hulst, Daniel H van Raalte
{"title":"Do Sex Differences Matter in Cardiac Surgery-Associated Acute Kidney Injury? - A Narrative Review.","authors":"Maartina J P Oosterom-Eijmael, Sarah A van Eeghen, Yugeesh R Lankadeva, Jeroen Hermanides, Abraham H Hulst, Daniel H van Raalte","doi":"10.1177/08850666251364783","DOIUrl":"https://doi.org/10.1177/08850666251364783","url":null,"abstract":"<p><p>Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication following cardiac surgery. Despite growing awareness of sexual dimorphism in cardiovascular and chronic kidney disease, little is known about sexual dimorphism in CSA-AKI. In this narrative review, we will first discuss sex differences and the potential role of sex hormones in the CSA-AKI pathophysiology. Women may tolerate hypoperfusion and hypoxia better, have a different neurohumoral response and experience less inflammation and oxidative stress. Next, we discuss the conflicting evidence on the difference in incidences of CSA-AKI between sexes and suggest that female sex might not be a risk factor. Finally, we focus on sex differences in preventative treatment strategies for CSA-AKI. Analysing sex differences in interventional studies is challenging due to the relative minority of women within the cardiac surgery population. Unravelling sex differences can improve personalized medicine and improve future patients' outcomes, for both sexes.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251364783"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep Needles and Shallow Veins. Ultrasound Estimation of Internal Jugular Mid-Vein and Posterior Wall Depth During Central Line Placement in Trendelenburg Position. 深针和浅脉。Trendelenburg位中央静脉置管时颈内内静脉及后壁深度的超声评估。
IF 2.1 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-06 DOI: 10.1177/08850666251364227
Adewale Olayode, John Oropello, Atinuke Shittu, Roopa Kohli-Seth
{"title":"Deep Needles and Shallow Veins. Ultrasound Estimation of Internal Jugular Mid-Vein and Posterior Wall Depth During Central Line Placement in Trendelenburg Position.","authors":"Adewale Olayode, John Oropello, Atinuke Shittu, Roopa Kohli-Seth","doi":"10.1177/08850666251364227","DOIUrl":"https://doi.org/10.1177/08850666251364227","url":null,"abstract":"<p><p>BackgroundCentral line placement is a very common inpatient procedure and the internal jugular (IJ) vein is the most commonly accessed site. Complications associated with this procedure include pneumothorax, hemothorax and pain which may be caused by accidental visceral injury with needle over-penetration.Research QuestionExtrapolating approximate needle length required to access sonographic mid-point of the internal jugular (IJ) vein.Study DesignRetrospective, non-randomized, non-blinded study.MethodRetrospective review of IJ vein images taken during central line placement to determine skin to mid-vein and skin to posterior wall depth in Trendelenburg position . Pooled data of IJ vein images taken with ultrasound probe perpendicular to skin during non-emergent/non-ICU central line placement from 12/01/2016 to 11/30/2019 (3years) was retrieved from a secure database. Images, biological sex and BMI were reviewed. Inclusion criteria: all IJ vein images. Exclusion criteria: Non- IJ vein images. Vein depth measurements were estimated using the depth marker grid accompanying the images.ResultsPrimary end point: average skin to mid-vein and skin to posterior wall depths. Secondary end point: compare the same dimensions based on biological sex and BMI<b>.</b> 608 images were analyzed. 375 were suitable (244 male [65%], 131 female [35%]). 233 poor quality images were discarded. Average skin to mid-vein depth for females was 1.47 cm (±0.37 SD, range 0.8-2.6 cm), for males 1.48 cm (±0.35 SD, range 0.8-2.7 cm) and for the total population 1.48 cm (±0.35 SD, range 0.8-2.7 cm). Average skin to posterior wall depth for females was 2.07 cm (±0.5 SD, range 1.2 cm-3.6 cm), for males 2.09 cm (±0.47 SD, range 1.3-3.3 cm) and for the total population 2.08 cm (+/0.48 SD, range 1.2-3.6 cm). Skin to IJ vein depths were normally distributed with similar standard deviations when compared for biological sex or total population. Adjusting for BMI, males were found to have a 0.2 cm increase in skin to mid-vein depth and a 0.12 cm increase in skin to posterior wall depth compared to females.ConclusionThe needle length required to reach the average sonographic midpoint of the IJ vein is approximately 1.48 cm with a range of 0.8 to 2.7 cm. As ultrasound does not intrinsically prevent needle over insertion, proceduralists, particularly less experienced operators, need to be mindful of needle depth to reduce complications from excessive needle tip penetration.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251364227"},"PeriodicalIF":2.1,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Antibiotic Stewardship in the Neonatal Intensive Care Unit. 新生儿重症监护室的抗生素管理。
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2024-06-05 DOI: 10.1177/08850666241258386
Dustin D Flannery, Sarah A Coggins, Alexandra K Medoro
{"title":"Antibiotic Stewardship in the Neonatal Intensive Care Unit.","authors":"Dustin D Flannery, Sarah A Coggins, Alexandra K Medoro","doi":"10.1177/08850666241258386","DOIUrl":"10.1177/08850666241258386","url":null,"abstract":"<p><p>Antibiotic stewardship is a multidisciplinary, evidence-based approach to optimize antibiotic use and mitigate development of antibiotic resistance. Neonates have high rates of antibiotic exposure, particularly those born preterm and admitted to the NICU, and mounting evidence describes the adverse consequences of such exposures in the absence of infection. Here, we review the general principles of antibiotic stewardship and how they can be applied in NICUs. The unique characteristics of NICUs and patients cared for in this setting, which warrant unique implementation strategies and special considerations are discussed. We summarize current antibiotic use metrics for assessment of responses to stewardship interventions and changes over time, and review evidence-based infection prevention practices in the NICU. Current recommendations for empiric antibiotic use in the NICU and the utility of infection biomarkers are summarized. Lastly, given the growing global threat of increasing antibiotic resistance, specific threats in the NICU are highlighted.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"862-875"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In-hospital Mortality is Lower in Brain-Injured Patients After Admission to a Neuroscience Intensive Care Unit: A Multi-Center Cohort Study. 神经科学重症监护病房收治的脑损伤患者住院死亡率较低:一项多中心队列研究
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2025-04-13 DOI: 10.1177/08850666251325778
Angel J Cadena-Tejada, Shaista Alam, Varoon Thavapalan, Sara Habib, Fred Rincon
{"title":"In-hospital Mortality is Lower in Brain-Injured Patients After Admission to a Neuroscience Intensive Care Unit: A Multi-Center Cohort Study.","authors":"Angel J Cadena-Tejada, Shaista Alam, Varoon Thavapalan, Sara Habib, Fred Rincon","doi":"10.1177/08850666251325778","DOIUrl":"10.1177/08850666251325778","url":null,"abstract":"<p><p>ObjectiveTo study the impact of dedicated Neuroscience Intensive Care Units (NSU) on clinical outcomes in patients with acute brain injury.DesignRetrospective, multicenter cohort study.Setting172 intensive care units within the United States.PatientsProspectively compiled and maintained a registry of a total of 32,047 brain-injured patients (stroke = AIS, aneurysmal-bleed = SAH, intra-cerebral-hemorrhage = ICH, and traumatic brain injury = TBI) from 2008-2013.MeasurementsExposure of interest was the type of intensive care unit (ICU), divided into NSU and non-NSU (medical = MICU, non-neurosurgical = SICU, trauma = TICU, cardiac = CCU, or mixed). Outcomes of interest were the actual and predicted in-hospital mortality, ICU mortality, ICU length of stay, and ventilator-free days. We calculated the actual and predicted in-hospital mortality using the Cerner Corporation Acute Physiology and Chronic Health Evaluation IV (APACHE Clinical Information System, CIS). We then compared the actual in-hospital mortality against the mortality prediction of the APACHE-IV model based on ICU designation (NSU v. non-NSU). The multivariable model was adjusted for within-hospital effects and known predictors of poor outcomes after brain injury.Main ResultsNational APACHE-IV predicted that in-hospital mortality was higher for NSU admissions than non-NSU admissions (21% v. 19%, p < .0001). However, the actual ICU mortality (10% vs 11%, p < 0.01) and in-hospital mortality (15% vs 16%, p = 0.06) were lower in patients admitted to a NSU as compared to non-NSU. We observed lower ventilator-free days (22 vs 24, p < 0.001) in NSU v. non-NSU. In the multivariable regression analysis adjusted for within-hospital effects, known variables of poor outcome, and the severity of illness APACHE-III score, the in-hospital mortality was lower for NSU admissions (OR, 0.8; 95%CI, 0.7-0.9, p = 0.02) as compared to non-NSU.ConclusionAdmission of critically ill brain-injured patients to dedicated NSUs is associated with lower actual in-hospital mortality. Future iterations of APACHE-IV modeling may need to incorporate NSU designations for calculations of expected mortality among brain-injured patients.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"902-906"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022475","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
Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic. 伊朗儿科和成人重症监护病房的医源性感染:全面回顾 COVID-19 大流行期间的风险因素、病因学、分子流行病学、抗菌药敏感性和预防策略。
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2024-05-06 DOI: 10.1177/08850666241249162
Mehdi Safarabadi, Tahereh Motallebirad, Davood Azadi, Ali Jadidi
{"title":"Healthcare-associated infections in Iranian pediatric and adult intensive care units: A comprehensive review of risk factors, etiology, molecular epidemiology, antimicrobial sensitivity, and prevention strategies during the COVID-19 pandemic.","authors":"Mehdi Safarabadi, Tahereh Motallebirad, Davood Azadi, Ali Jadidi","doi":"10.1177/08850666241249162","DOIUrl":"10.1177/08850666241249162","url":null,"abstract":"<p><p>The current review article provides a comprehensive analysis of nosocomial infections in pediatric and adult intensive care units (ICUs) in Iran. We examine the risk factors and etiology of nosocomial infections, with a particular focus on molecular epidemiology and antimicrobial sensitivity. In this article, we explore a range of prevention strategies, including hand hygiene, personal protective equipment, environmental cleaning, antibiotic stewardship, education, and training. Moreover, we discuss the impact of the COVID-19 pandemic on infection control measures in ICUs and provide valuable insights for healthcare professionals and policymakers seeking to address this critical public health issue. In conclusion, this review article can serve as a valuable resource for those interested in understanding and improving infection control in ICUs and beyond.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"839-848"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sepsis as a Potential Risk Factor for Upper Gastrointestinal Bleeding in Critically Ill Patients: A Systematic Review and Meta-analysis. 脓毒症是危重病人上消化道出血的潜在风险因素:系统回顾与元分析》。
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2024-05-30 DOI: 10.1177/08850666241252048
Yanfen Yao, Tejin Ba, Bagenna Bao, Shuanglin Zhang, Li Kong
{"title":"Sepsis as a Potential Risk Factor for Upper Gastrointestinal Bleeding in Critically Ill Patients: A Systematic Review and Meta-analysis.","authors":"Yanfen Yao, Tejin Ba, Bagenna Bao, Shuanglin Zhang, Li Kong","doi":"10.1177/08850666241252048","DOIUrl":"10.1177/08850666241252048","url":null,"abstract":"<p><p><b>Purpose:</b> Sepsis is a common and critical condition in intensive care units (ICUs) known to complicate patient outcomes. Previous studies have indicated an association between sepsis and various ICU morbidities, including upper gastrointestinal bleeding (UGIB). However, the extent of this relationship and its implications in ICU settings remain inadequately quantified. This study aims to elucidate the association between sepsis and the risk of UGIB in ICU patients. <b>Methods:</b> A comprehensive meta-analysis was conducted, encompassing nine studies with a total of nearly 9000 participants. These studies reported events for both sepsis and nonsepsis patients separately. Pooled odds ratios (ORs) were calculated to assess the risk of UGIB in septic versus nonseptic ICU patients. Subgroup analyses were conducted based on age and study design, and both unadjusted and adjusted ORs were examined. <b>Results:</b> The pooled OR indicated a significant association between sepsis and UGIB (OR = 3.276, 95% CI: 1.931 to 5.557). Moderate heterogeneity was observed (I² = 43.9%). The association was significant in adults (pooled OR = 4.083) but not in children. No difference in association was found based on the study design. Unadjusted and adjusted ORs differed slightly, indicating the influence of confounding factors. <b>Conclusion:</b> This meta-analysis reveals a significant association between sepsis and an increased risk of UGIB in ICU patients, particularly in adults. These findings highlight the need for vigilant monitoring and proactive management of septic ICU patients to mitigate the risk of UGIB. Future research should focus on understanding the underlying mechanisms and developing tailored preventive strategies.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"849-859"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Cleveland Clinic Post-ICU Recovery Clinic: Early Experience During the COVID-19 Pandemic. 克利夫兰诊所icu后康复诊所:COVID-19大流行期间的早期经验。
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2025-03-23 DOI: 10.1177/08850666251326551
Kavya Kommaraju, Heather Torbic, Joshua Veith, Xiaofeng Wang, Michelle Biehl
{"title":"The Cleveland Clinic Post-ICU Recovery Clinic: Early Experience During the COVID-19 Pandemic.","authors":"Kavya Kommaraju, Heather Torbic, Joshua Veith, Xiaofeng Wang, Michelle Biehl","doi":"10.1177/08850666251326551","DOIUrl":"10.1177/08850666251326551","url":null,"abstract":"<p><p>BackgroundOver half of ICU survivors experience post intensive care syndrome (PICS). Few PICS clinics were operational in the United States at the onset of the COVID-19 pandemic. Here we describe early experience of such a clinic at a large academic medical center. Our objective was to describe the (a) model of care (b) clinic interventions (c) short-term cognitive, psychiatric, and functional outcomes (d) one-year outcomes of COVID-19 ICU survivors at the Cleveland Clinic post-ICU recovery clinic (PIRC).MethodsWe conducted a retrospective cohort study through a chart review of all patients seen in PIRC from April 2020 - December 2020. A total of 59 patients completed the visit with 49% being virtual, and 51% being in-person. The cohort was predominantly white (50.8%), and male (57.6%) with a median age of 58.2 years. We screened for cognitive and psychiatric impairments using several different validated questionnaires. Functional impairments were self-reported and detected after assessment by a physical therapist. Quantifiable clinic interventions were referrals, pharmacy medication reconciliation, and vaccine administration. One-year outcomes were health care utilization, and death.ResultsIn our cohort, 36%, 39.6%, and 17% of patients screened positive for cognitive impairment, anxiety and/or depression, and PTSD respectively. 42.3% of patients had lower extremity mobility impairment. 57.6% of patients required at least one referral after clinic. Of the 67.9% of patients who were working and 93.9% driving prior to hospitalization, only 24.6% and 73.2% had returned to those activities, respectively. The most common pharmacy intervention was discontinuation of a medication no longer in use. By one year, 34% of patients had hospital re-admissions with 5% requiring the ICU. There were no deaths.ConclusionsAdult survivors of COVID-19 critical illness have impairments in all PICS domains as well as high health care utilization in the first year after hospital discharge.MeSH TermsPost intensive care syndrome, COVID-19Key Points/SummaryAdult survivors of COVID-19 critical illness have impairments in all PICS domains as well as high health care utilization in the first year after hospital discharge. Post-ICU recovery clinics can help survivors with recovery.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"893-901"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Methylene Blue and Cyanocobalamin for Vasoplegic Syndrome in Liver Transplantation. 亚甲基蓝和氰钴胺素在肝移植血管截瘫综合征中的作用。
IF 2.1 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2025-06-05 DOI: 10.1177/08850666251347951
Yaroslava Longhitano, Ezeldeen Albuelkasem, Antonio Voza, Luigi La Via, Christian Zanza, Raymond M Planinsic
{"title":"The Role of Methylene Blue and Cyanocobalamin for Vasoplegic Syndrome in Liver Transplantation.","authors":"Yaroslava Longhitano, Ezeldeen Albuelkasem, Antonio Voza, Luigi La Via, Christian Zanza, Raymond M Planinsic","doi":"10.1177/08850666251347951","DOIUrl":"10.1177/08850666251347951","url":null,"abstract":"<p><p>Vasoplegic syndrome is a complication that may occur during liver transplantation, most often after donor graft reperfusion. Multiple factors in end-stage liver disease (ESLD) may contribute to this vasodilation which may be exacerbated during reperfusion in liver transplantation. Two cases of vasoplegia during living donor liver transplantation are reported along with a systematic review of current literature. These patients were successfully treated with methylene blue and cyanocobalamin. All publications between January 1992 to september 2024 that assessed the use of methylene blue and/or cyanocobalamin in vasoplegia during liver transplantation in humans were included. Seven case reports and one case series were found and reviewed. These consisted of 4 case reports of vasoplegic syndrome during liver transplantation treated with methylene blue and other four describing the use of cyanocobalamin. A total of twenty-four patients were treated with methylene blue and eight patients with cyanocobalamin in the reviewed articles and all patients had a beneficial impact on blood pressure after administration of the medications. Patients affected by vasoplegia during liver transplantation show encouraging results when treated with methylene blue and cyanocobalamin, but these data have to be confirmed by additional studies.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"907-914"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Retrospective Cohort Study of the Role of Palliative Care Consultation for Patients on Extracorporeal Membrane Oxygenation. 体外膜氧合患者姑息治疗咨询作用的回顾性队列研究。
IF 3 3区 医学
Journal of Intensive Care Medicine Pub Date : 2025-08-01 Epub Date: 2025-03-23 DOI: 10.1177/08850666251327105
Samira Teeri, Pooja Singh, Ritika Gadodia, Shikha Kapil, Maxwell Hockstein, Keki Balsara, Akram M Zaaqoq, Anirudh Rao
{"title":"A Retrospective Cohort Study of the Role of Palliative Care Consultation for Patients on Extracorporeal Membrane Oxygenation.","authors":"Samira Teeri, Pooja Singh, Ritika Gadodia, Shikha Kapil, Maxwell Hockstein, Keki Balsara, Akram M Zaaqoq, Anirudh Rao","doi":"10.1177/08850666251327105","DOIUrl":"10.1177/08850666251327105","url":null,"abstract":"<p><p>BackgroundExtracorporeal membrane oxygenation (ECMO) serves as a critical intervention for patients with severe cardiac and pulmonary dysfunction. Given the high rates of mortality and morbidity, as well as the impact on families, palliative care (PC) integration is recommended. We aimed to examine the indications and outcomes of ECMO patients at a tertiary care hospital and evaluate the impact of PC consultation on patient outcomes.MethodsWe conducted a retrospective cohort study of 306 patients cannulated for venovenous (VV) or venoarterial (VA) ECMO from January 2020 to December 2022. We analyzed demographics, ECMO indications, and outcomes, comparing those who received PC consultations with those who did not.ResultsOf the 306 patients analyzed, 220 were on VA-ECMO and 86 on VV-ECMO. The overall in-hospital mortality rate was 49%. Patients on VV-ECMO had longer ECMO durations (8 vs 4 days) and hospital stays (31 vs 16 days, P < 0.001) than patients on VA-ECMO. PC consultations were associated with increased ECMO duration and hospital stay in both groups (P < 0.001). Mortality among patients who received PC consultations was not statistically different from those who did not (P = 0.68). Notably, patients with obesity on VA-ECMO had 2.3 times higher odds of in-hospital death (P = 0.027).ConclusionPC consultation is integral in managing patients on ECMO, focusing on holistic support for patients and their families. Further prospective studies are warranted to explore the psychosocial benefits of PC for patients on ECMO and their family members.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"885-892"},"PeriodicalIF":3.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692438","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}
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