Journal of Intensive Care Medicine最新文献

{"title":"Spinal Cord Injury Following Extracorporeal Membrane Oxygenation: An Overlooked and Underreported Complication.","authors":"Deven C Patel, Chetan Pasrija","doi":"10.1177/08850666241287108","DOIUrl":"10.1177/08850666241287108","url":null,"abstract":"","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1282-1283"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648290","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":"Prognostic Value of Sublingual Microcirculation in Sepsis: A Systematic Review and Meta-analysis.","authors":"Aling Tang, Yi Shi, Qingqing Dong, Sihui Wang, Yao Ge, Chenyan Wang, Zhimin Gong, Weizhen Zhang, Wei Chen","doi":"10.1177/08850666241253800","DOIUrl":"10.1177/08850666241253800","url":null,"abstract":"<p><p><b>Objectives:</b> To investigate the relationship between sublingual microcirculation and the prognosis of sepsis. <b>Data sources:</b> The PubMed, Web of Science, Embase, and China National Knowledge Infrastructure (CNKI) databases were searched to identify studies published from January 2003 to November 2023. <b>Study selection:</b> Clinical studies examining sublingual microcirculation and the prognosis of sepsis were included. <b>Data extraction:</b> Sublingual microcirculation indices included the microvascular blood index (MFI), total vascular density (TVD), perfusion vascular density (PVD), perfusion vascular vessel (PPV), and heterogeneity index (HI). Prognostic outcomes included mortality and severity. Funnel plots and Egger's test were used to detect publication bias. The ability of the small vessel PPV (PPVs) to predict sepsis-related mortality was analyzed based on the summary receiver operating characteristic (SROC) curve, pooled sensitivity, and pooled specificity. <b>Data synthesis:</b> Twenty-five studies involving 1750 subjects were included. The TVD (95% CI 0.11-0.39), PVD (95% CI 0.42-0.88), PPV (95% CI 6.63-13.83), and MFI (95% CI 0.13-0.6) of the survival group were greater than those of the nonsurvival group. The HI in the survival group was lower than that in the nonsurvival group (95% CI -0.49 to -0.03). The TVD (95% CI 0.41-0.83), PVD (95% CI 0.83-1.17), PPV (95% CI 14.49-24.9), and MFI (95% CI 0.25-0.66) of the nonsevere group were greater than those of the severe group. Subgroup analysis revealed no significant difference in TVD between the survival group and the nonsurvival group in the small vessel subgroup. The area under the SROC curve (AUC) was 0.88. <b>Conclusions:</b> Sublingual microcirculation was worse among patients who died and patients with severe sepsis than among patients who survived and patients with nonsevere sepsis. PPV has a good predictive value for the mortality of sepsis patients. This study was recorded in PROSPERO (registration number: CRD42023486349).</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1221-1230"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945272","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":"The Role of the Tissue Perfusion Index in Predicting Disease Severity and Prognosis in Patients with Severe and Critical COVID-19.","authors":"Wan-Ting Lin, Yan-Jie Zhang, Ming-Kun Yan, Xiao-Tian Cai, Xin-Er Cai, Jingyuan Xu","doi":"10.1177/08850666241253162","DOIUrl":"10.1177/08850666241253162","url":null,"abstract":"<p><strong>Objectives: </strong>The study investigated whether percutaneous partial pressure of oxygen (PtcO₂), percutaneous partial pressure of carbon dioxide (PtcCO₂), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19.</p><p><strong>Design: </strong>Prospective observational study conducted from January 1, 2023 to February 10, 2023.</p><p><strong>Setting: </strong>A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China.</p><p><strong>Participants: </strong>Adults (≥18 years) with severe and critical COVID-19.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The general information and vital signs of the patients were collected. The PtcO₂ and PtcCO₂ were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO₂/fraction of inspired oxygen (FiO₂) to PtcCO₂. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined.</p><p><strong>Endpoint: </strong>Severity of the disease on the enrollment and mortality at 28.</p><p><strong>Results: </strong>A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO₂/FiO₂, PtcO₂, PtcCO₂, PtcO₂/ FiO₂, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO₂/ FiO₂, SpO₂/FiO_2, and PtcO₂ were significantly lower in critical COVID-19, while the PtcCO₂ was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001).</p><p><strong>Conclusions: </strong>The tissue perfusion index (TPI), PtcCO₂, and PtcO₂/ FiO₂ can predict the severity and outcome of severe and critical COVID-19.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1212-1220"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945278","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":"Prolonged Fatigue and Mental Health Challenges in Critical COVID-19 Survivors.","authors":"Malin Hultgren, Ingrid Didriksson, Anders Håkansson, Sara Andertun, Attila Frigyesi, Erik Mellerstedt, Maria Nelderup, Anna C Nilsson, Anton Reepalu, Martin Spångfors, Hans Friberg, Gisela Lilja","doi":"10.1177/08850666241255328","DOIUrl":"10.1177/08850666241255328","url":null,"abstract":"<p><p><b>Background:</b> The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. <b>Study Design and Methods:</b> A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5). The development between 3 and 12 months was described by changes in relation to statistical significance and suggested values for a minimally important difference (MID). Potential risk factors for long-lasting symptoms were analyzed by multivariable logistic regression. <b>Results:</b> At the 3-month follow-up, 262 survivors (87%) participated, 215 (72%) returned at 12 months. Fatigue was reported by 50% versus 40%, with a significant improvement at 12 months (MFIS; median 38 vs. 33, <i>P </i>< .001, MID ≥4). There were no significant differences in symptoms of mental illness between 3 and 12 months, with anxiety present in 33% versus 28%, depression in 30% versus 22%, and posttraumatic stress disorder in 17% versus 13%. A worse functional outcome and less sleep compared to before COVID-19 were risk factors for fatigue and mental illness at 12 months. <b>Conclusions:</b> Fatigue improved between 3 and 12 months but was still common. Symptoms of mental illness remained unchanged with anxiety being the most reported. A worse functional outcome and less sleep compared to before COVID-19 were identified as risk factors for reporting long-lasting symptoms.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1238-1249"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748359","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}

{"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}