Journal of Intensive Care Medicine最新文献

{"title":"Caring for Heart and Lung Transplant Patients.","authors":"Brigitte Hollander, Antonio Rubino, Jasvir Pamar, Florian Falter","doi":"10.1177/08850666251351592","DOIUrl":"https://doi.org/10.1177/08850666251351592","url":null,"abstract":"<p><p>Heart and lung transplantation are the definitive, and often the only, therapeutic option for patients with end stage cardiac or respiratory failure. Their journey through the intensive care unit often begins before the transplant operation when the global shortage of suitable donor organs makes bridging with mechanical circulatory support necessary. Once transplanted, recipients are vulnerable to a large number of complications ranging from issues arising from the operation to secondary organ failure and infection and to primary graft failure. Clinicians managing these patients need to be able to recognize these issues early and they need to have the tools to initiate treatment in a timely manner. There is no such discipline as a cardiothoracic transplant intensivist. Managing these complex patients requires a highly skilled team of individuals from different backgrounds - intensivists, surgeons, cardiologists and chest physicians as well as nurses, physiotherapists, ECMO specialists, pharmacists, dieticians and many more. They all contribute vital knowledge and skills. In order to put these to good use, however, they need to share the willingness and ability to efficiently communicate with each other. This review aims to give the general intensivist an overview over the peri-operative care of heart and lung transplant patients while also providing general principles should these patients need treatment outside a specialist intensive care unit.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251351592"},"PeriodicalIF":3.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637263","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":"Inflammation and Neurological Outcomes in Cardiac Arrest - a Narrative Review of Serum Biomarker Investigations.","authors":"Sergio L Angulo, Thomas W Johnson, Lilly Hutchinson, Bhagyashri Bhende, Yama Akbari, Sung-Min Cho, Imad R Khan","doi":"10.1177/08850666251357536","DOIUrl":"https://doi.org/10.1177/08850666251357536","url":null,"abstract":"<p><strong>Background: </strong>Hypoxic-ischemic brain injury (HIBI) is a significant cause of disability following cardiac arrest (CA). Activation of the inflammatory cascade is central to HIBI pathophysiology and drives post-cardiac arrest syndrome (PCAS), which can induce further secondary brain injury. Although numerous studies have described this mechanism in preclinical models, translating this knowledge to therapeutic targets and neurological outcomes in humans is variable and incomplete. The impact of inflammation on the neurovascular unit, comprising neurons, astroglia, and capillary endothelium, may play a significant role in outcomes but is poorly understood in humans.</p><p><strong>Objective: </strong>This narrative review explores studies examining PCAS, inflammation, and neurological outcomes in adult CA and classifies them into interrelated pathomechanisms.</p><p><strong>Methods: </strong>We searched multiple databases using a search string constructed from core concepts, including inflammation, CA, neurovascular unit components, and neurologic outcomes. We screened abstracts published from database conception until July 2024 and excluded animal/in-vitro studies, unrelated topics, duplicates, foreign language articles, reviews/commentaries, studies without neurological outcomes, and case studies.</p><p><strong>Results: </strong>The biomarkers studied fit into three general domains: reperfusion-induced oxidative stress, local and systemic inflammatory response, and coagulopathy associated with endothelial injury. Numerous markers were associated with neurological outcomes after CA, but few demonstrated a strong association in multivariate analysis. Few clinical trials of therapies for CA have studied impacts on the inflammatory cascade or have targeted inflammatory components. Associations between inflammation reduction and neurological outcomes are variable. However, various limitations reduce the applicability of these trials.</p><p><strong>Conclusions: </strong>Inflammatory mechanisms in PCAS may hold the key to secondary brain injury and warrant larger, more systematic studies to establish therapeutic targets to improve neurological outcomes.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251357536"},"PeriodicalIF":3.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626517","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":"Early Rehabilitation for Patients with Septic Shock Associated with Mobilization During Their Intensive Care Unit Stay Without Worsening Mortality: A Multicenter, Prospective, Cohort Study.","authors":"Tasuku Hanajima, Yu Kawazoe, Takeshi Morimoto, Hitoshi Yamamura, Kyohei Miyamoto, Noriko Miyagawa, Yoshinori Ohta, Hideki Kanai, Tetsuya Kobayashi, Yoshiaki Tanabe, Tomonari Masuda, Yuichi Kataoka, Yasushi Asari","doi":"10.1177/08850666251355211","DOIUrl":"https://doi.org/10.1177/08850666251355211","url":null,"abstract":"<p><strong>Objectives: </strong>Early rehabilitation of critically ill patients has been reported to have benefits such as recovery of physical function at the time of discharge and increasing ventilator-free days, but there is also a risk of increasing the mortality rate. Whether early rehabilitation for patients with septic shock is associated with mobilization during their intensive care unit (ICU) stay without worsening the survival rate was investigated.</p><p><strong>Design: </strong>The Best Available Treatment for septic SHOCK (BEAT-SHOCK) registry was a multicenter, prospective, cohort study.</p><p><strong>Setting: </strong>Twenty ICUs in Japan.</p><p><strong>Patients: </strong>Patients with septic shock requiring high-dose norepinephrine (≥0.2 µg/kg/min) who were admitted to participating ICUs for more than 5 days from 2020 to 2022.</p><p><strong>Interventions: </strong>Early rehabilitation within 48 h after ICU admission for patients with septic shock.</p><p><strong>Measurements: </strong>The primary outcomes were sitting on the edge of the bed and standing within 14 days during the ICU stay, with secondary outcomes including 28-day mortality and 90-day mortality.</p><p><strong>Main results: </strong>Of 268 patients, 156 underwent early rehabilitation. The early rehabilitation and no early rehabilitation groups had similar median ages (72 vs 73 years) and Acute Physiology And Chronic Health Evaluation II scores (28 vs 26). Early rehabilitation had a significant effect on sitting on the edge of the bed within 14 days after ICU admission (adjusted hazard ratio [aHR] 1.66; 95% confidence interval [CI] 1.15-2.39). It also had a significant effect on standing within 14 days after ICU admission (aHR 2.20; 95%CI 1.29-3.77). The 90-day mortality rate was similar between the groups (early rehabilitation group: 28%, no early rehabilitation group: 23%, <i>P</i>=0.51), with an aHR of 1.27 (95%CI 0.78-2.08).</p><p><strong>Conclusion: </strong>Early rehabilitation for patients with septic shock was associated with mobilization during their ICU stay without worsening the survival rate.<b>[</b>Trial registration: UMIN clinical trial registry, UMIN000038302. Registered November 1, 2019, https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000043641<b>]</b>.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251355211"},"PeriodicalIF":3.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560396","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":"Effectiveness of Corticosteroids on Persistent Inflammation, Immunosuppression, and Catabolism Syndrome in Patients with Septic Shock: A Retrospective Claims Database Study.","authors":"Hayabusa Takano, Naoki Kanda, Hiroyuki Ohbe, Minoru Yoshida, Kensuke Nakamura","doi":"10.1177/08850666251353723","DOIUrl":"https://doi.org/10.1177/08850666251353723","url":null,"abstract":"<p><p>BackgroundPersistent inflammation, immunosuppression, and catabolism syndrome (PICS) that develops following critical illness is one of the most challenging issues in critical care medicine. While corticosteroids are widely used in septic shock, their impact on PICS remains unclear. While corticosteroids may reduce inflammation, they potentially increase infection risk and affect muscle function.MethodsThis retrospective cohort study analyzed 3186 patients with septic shock from a Japanese administrative claims database, which was supplied by Medical Data Vision Co., Ltd (Tokyo, Japan). Using propensity score matching, we compared outcomes between patients who received corticosteroids within the first two days of admission (steroid group) and those who did not (control group). The primary outcome was the incidence of PICS on day 28, defined as meeting at least two of the following criteria: C-reactive protein >2.0 mg/dL, albumin <3.0 g/dL, and lymphocyte count <800/μL.ResultsA total of 4054 patients were enrolled in this retrospective cohort study. After the exclusion of 868 patients, 3186 eligible patients (906 in the steroid group and 2280 in the control group) were included in the propensity score analysis. After matching, there was no significant difference in the incidence of PICS on day 28 between the steroid and control groups (16.7% vs 13.6%; risk difference, 2.22%; 95% CI, -1.89% to 6.34%; P = 0.095). Additionally, no significant differences were observed in 28-day mortality (15.2% vs 15.2%), in-hospital mortality, PICS on day 14, the Barthel Index at discharge or the percentage of patients meeting PICS criteria for each component on day 14 and day 28.ConclusionsThe administration of corticosteroids in patients with septic shock was not associated with the incidence of PICS.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666251353723"},"PeriodicalIF":3.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553759","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":"A Case Series Study of Airway Pressure Release Ventilation in Patients with Intracranial Pathologies and Acute Respiratory Failure.","authors":"Leon Schmidt, Keith Lamb, Dragan Jankovic, Darius Kalasauskas, Michael Kosterhon, Florian Ringel, Thomas Kerz","doi":"10.1177/08850666251320550","DOIUrl":"10.1177/08850666251320550","url":null,"abstract":"<p><p><b>Background:</b> Airway Pressure Release Ventilation (APRV) is an alternate mode of ventilation in acute respiratory failure (ARF), but there is inconsistent data to support its use over other modes of ventilation. Because of increased intrathoracic pressure for most of the respiratory cycle, a negative impact of APRV on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) has been hypothesized. We evaluated the effects of APRV ventilation, with particular attention to ICP, CPP and ICP-directed therapy, in a real-world cohort of neuro-ICU patients. <b>Methods:</b> Retrospective single-center analysis from January 2021 to December 2023 of neurosurgical ICU patients with ICP monitoring. APRV was used as a rescue mode at the physician's discretion when the Horovitz index (PaO₂/FIO₂ ratio) fell below 150 despite optimized conventional ventilation. <b>Results:</b> Between 2021 and 2023, APRV was utilized in 29 patients undergoing a total of 60 episodes. Forty patients (66.7%) were female, median age was 49.5 (Q1 34; Q3 61.25) years.After transition to APRV, mean FiO2 decreased by 4.3% (t = 3.5, p < .001) and mean PaO2 increased by 22.7 mm Hg (t = 4.2, p < .001). The Horovitz index improved by 44.6 mm Hg (t = 4.9, p < .001). Mean compliance did not differ after transition to APRV (-1.5 ml/mbar, t = -0.9, p = .4).During the APRV episode, mean ICP was 1.2 mm Hg lower (t = 2.6, p = .01), while mean CPP was 1.6 mm Hg higher (t = -0.9, p = .4) and the intensity of ICP-directed therapy (TIL) was significantly lower (X²= 92.771, p < .001). <b>Conclusion:</b> APRV was hemodynamically tolerated in 29 out of 33 patients, and was safe with regard to ICP, CPP, and the intensity of ICP-directed therapy. Oxygenation was increased by APRV. 4 out of 33 patients would not tolerate APRV for hemodynamic reasons, APRV therefore was stopped immediately.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"789-797"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523111","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":"\"Unlocking Airway Predictability: The Role of Ultrasound in Assessing Cormack-Lehane Grade Through Anterior Neck Soft Tissue Thickness at the Level of Vocal Cords and Hyoid Bone\".","authors":"D G S R Krishnamoorthy, K J Devendra Prasad, K Rajesh, Y Nikhil Reddy, S R Aravind","doi":"10.1177/08850666251323257","DOIUrl":"10.1177/08850666251323257","url":null,"abstract":"<p><p><b>Introduction:</b> Endotracheal intubation in the emergency department can be challenging due to difficult airways. The Cormack-Lehane score helps assess intubation difficulty based on laryngoscopic views, with higher scores indicating poorer visibility. This study examines whether point-of-care ultrasound measurements of anterior neck soft tissue thickness at the vocal cords and hyoid bone can predict difficult intubations with Macintosh blade. <b>Methodology:</b> Prospective observational study included 100 patients over 18 years old who required rapid sequence intubation in emergency department at a tertiary care hospital in India, from March to December 2023. Patients with cervical spine pathology and pregnant women were excluded. Ultrasound measurements of anterior neck soft tissue thickness were taken at the vocal cords and hyoid bone. Direct laryngoscopy with a Macintosh blade was then performed, and the CL grade was recorded. Intubation difficulty was categorized based on CL grades 1-2 (easy) and 3-4 (difficult). Diagnostic performance metrics, including sensitivity, specificity, and Area under the Receiver Operating Characteristic Curve (AUROC), were calculated. <b>Results:</b> The study found that increased anterior neck soft tissue thickness at both the hyoid bone and vocal cords was significantly associated with higher CL grades (<i>P</i> < .001). The AUROC values were 0.961 for hyoid bone measurements and 0.970 for vocal cords measurements, indicating high diagnostic accuracy. The sensitivity and specificity of these measurements suggest they are effective predictors of difficult intubation. Notably, higher ANS measurements correlated with a higher likelihood of requiring multiple intubation attempts. <b>Conclusion:</b> This study supports the use of ultrasound-measured anterior neck soft tissue thickness at the hyoid bone and vocal cords as effective predictors of difficult intubation. The high accuracy and statistical significance of these measurements suggest they can improve pre-intubation assessments and guide clinical decisions. Using these ultrasound measurements in routine practice could help better predict intubation challenges and improve patient outcome.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"798-806"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700474","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":"Systematic Ultrasound Screening for Lower Extremity Deep Vein Thrombosis in ICU Patients with Severe COVID-19: A Randomized Clinical Trial.","authors":"Carlos Ernesto Marrero Eligio De La Puente, David Flota Ruiz, Lluis Sánchez Besalduch, Xavier Faner Capó, Daniel Gil Sala, Clara Palmada Ibars, Ivan Bajaña Mindiolaza, Luis Silvestre Chiscano Camon, Adolfo Ruiz Sanmartin, Juan Carlos Ruiz-Rodríguez, Ricard Ferrer, Sergi Bellmunt Montoya","doi":"10.1177/08850666251313774","DOIUrl":"10.1177/08850666251313774","url":null,"abstract":"<p><p>BackgroundVenous thromboembolism (VTE), whether pulmonary embolism (PE) or deep vein thrombosis (DVT), is common in patients with COVID-19. Recommendations on systematic screening in the intensive care unit (ICU) are lacking.Research questionIs there any clinical benefit of systematic screening for DVT in critically ill patients with severe COVID-19?Study design and methodsSingle-center randomized clinical trial (RCT) of COVID-19 cases admitted to the ICU. Patients were randomized into two groups: a study group that underwent ultrasound (US) screening for DVT Mondays and Thursdays, and a control group that was treated according to the unit protocol. The primary outcome was the presence of DVT. Secondary outcomes were ICU total stay, death within 21-day follow-up and bleeding complications (minor or major). A composite outcome of poor prognosis variables was analyzed. We tested a superiority hypothesis with a confidence level of 95% and an equivalence limit of 20%.Results163 patients (84 screening group, 79 control group) were enrolled between April and July 2021. There were 90 men (55.2%) with a mean ± SD age of 49.8 ± 13.58 years. In screening group 16.7% developed DVT versus 3.8% in control group (p = .007), and 3.6% versus 5.1% developed PE, respectively (p = 0.7). Poor outcome variables were male sex, age, COVID-19 vaccination status, Fibrinogen, Urea, Creatinine and Interleukin 6 (IL6) levels; Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scales. The superiority comparison, with a power of 95%, showed no statistically significant differences for a composite endpoint (p = .123). After adjusting by group, the OR for poor outcome is 1.966 (0.761-5.081) p = 0.163InterpretationAmong these patients, a strategy of systematic US screening for DVT was not associated with any significant improvements to clinical outcomes compared with usual care.Clinical Trial RegistrationClinicaltrials.org registration number: NCT05028244.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"739-748"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Number of Oral bacteria with Ventilator-Associated Pneumonia and Delirium in Patients in the Intensive Care Unit.","authors":"Chika Arimizu, Tomohiko Akahoshi, Teppei Jinno, Michiko Furuta, Ayako Ohashi, Shinnosuke Takamori, Naohisa Wada","doi":"10.1177/08850666251320924","DOIUrl":"10.1177/08850666251320924","url":null,"abstract":"<p><p>ObjectivesVentilator-associated pneumonia (VAP) and delirium are major complications among patients in the intensive care unit (ICU). The impact of oral bacterial count on these conditions is not well understood. This study aimed to explore the association between oral bacterial load and the incidence of VAP and delirium in ICU patients.MethodsIn this single-center longitudinal study, 130 patients admitted to the ICU from September 2022 to May 2023 were included. Oral bacteria counts on the tongue were quantified, and assessments of oral health using the Oral Health Assessment Tool (OHAT) and oral moisture levels were also conducted. We examined the associations between oral bacterial count, OHAT scores, and oral moisture with the incidence of VAP and delirium.ResultsThe incidence rates of VAP and delirium were 31.4% and 35.4%, respectively. Patients with a high oral bacterial load (≥5.0 × 10⁷ CFU/mL) at ICU admission had a higher likelihood of developing VAP (odds ratio [OR] 7.43, 95% confidence interval [CI] 1.68-32.87) and delirium (OR 3.30, 95% CI 1.04-10.44) compared with those with lower bacterial counts (<1.0 × 10⁷ CFU/mL). No significant associations were found between OHAT scores and oral moisture and the occurrence of VAP or delirium.ConclusionA higher oral bacterial count at ICU admission was associated with increased incidences of VAP and delirium.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"779-788"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523265","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":"When Our Best Friend Becomes Our Worst Enemy: The Mitochondrion in Trauma, Surgery, and Critical Illness.","authors":"May-Kristin Torp, Kåre-Olav Stensløkken, Jarle Vaage","doi":"10.1177/08850666241237715","DOIUrl":"10.1177/08850666241237715","url":null,"abstract":"<p><p>Common for major surgery, multitrauma, sepsis, and critical illness, is a whole-body inflammation. Tissue injury is able to trigger a generalized inflammatory reaction. Cell death causes release of endogenous structures termed damage associated molecular patterns (DAMPs) that initiate a sterile inflammation. Mitochondria are evolutionary endosymbionts originating from bacteria, containing molecular patterns similar to bacteria. These molecular patterns are termed mitochondrial DAMPs (mDAMPs). Mitochondrial debris released into the extracellular space or into the circulation is immunogenic and damaging secondary to activation of the innate immune system. In the circulation, released mDAMPS are either free or exist in extracellular vesicles, being able to act on every organ and cell in the body. However, the role of mDAMPs in trauma and critical care is not fully clarified. There is a complete lack of knowledge how they may be counteracted in patients. Among mDAMPs are mitochondrial DNA, cardiolipin, <i>N</i>-formyl peptides, cytochrome C, adenosine triphosphate, reactive oxygen species, succinate, and mitochondrial transcription factor A. In this overview, we present the different mDAMPs, their function, release, targets, and inflammatory potential. In light of present knowledge, the role of mDAMPs in the pathophysiology of major surgery and trauma as well as sepsis, and critical care is discussed.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"695-714"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174983","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":"Relationship Between the Prognostic Nutritional index and Short-Term Prognosis among Patients with Community-Acquired Bacterial Pneumonia: A Retrospective Analysis of the MIMIC-IV.","authors":"Qingsong Wu, Lianyi Liao, Qingjun Deng","doi":"10.1177/08850666251315718","DOIUrl":"10.1177/08850666251315718","url":null,"abstract":"<p><p>ObjectivesThe objective of this study was to investigate the association between the prognostic nutritional index (PNI) and the short-term outcomes in patients with community-acquired bacterial pneumonia (CABP).DesignThis study employed a retrospective design, utilizing data from the Medical Information Mart for Intensive Care (MIMIC)-IV database.Participants371 individuals from the MIMIC-IV database who were diagnosed with CABP.Primary and secondary outcomesThe primary endpoint was 28-day all-cause mortality. The secondary endpoint was the length of stay (LOS) in the intensive care unit (ICU) and in hospital.ResultsThe area under the curve of PNI for predicting 28-day all-cause mortality is 0.702 (95% CI 0.630 to 0.775; <i>p</i> < 0.001). Patients were divided into two groups based on their PNI at admission: the low PNI (<35.75) group and the high PNI group (≥35.75). CABP patients with higher PNI presented a lower 28-day all-cause mortality rate (adjusted HR: 0.53, 95% CI 0.28-0.98, <i>p</i> = 0.044). Moreover, a negative linear correlation was found between the PNI and short-term mortality rates via restricted cubic splines. Eventually, there was no difference in the LOS in the ICU or hospital between the two groups.ConclusionThese findings suggest a negative correlation between the PNI at admission and the short-term mortality rate of CABP. PNI is helpful for early identification of high-risk patients.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"769-778"},"PeriodicalIF":3.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189268","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}