Journal of the Intensive Care Society最新文献

Association of appropriate empiric antimicrobial therapy with acute kidney injury in gram-negative sepsis. 适当的经验性抗菌药物治疗与革兰氏阴性败血症急性肾损伤的关系。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-10-09 DOI: 10.1177/17511437251377990

Tetsu Ohnuma, Shreya Khandelwal, Shingo Chihara, Miriam Treggiari, Jamie R Privratsky, Pattrapun Wongsripuemtet, Julia A Messina, Karthik Raghunathan, Vijay Krishnamoorthy

{"title":"Association of appropriate empiric antimicrobial therapy with acute kidney injury in gram-negative sepsis.","authors":"Tetsu Ohnuma, Shreya Khandelwal, Shingo Chihara, Miriam Treggiari, Jamie R Privratsky, Pattrapun Wongsripuemtet, Julia A Messina, Karthik Raghunathan, Vijay Krishnamoorthy","doi":"10.1177/17511437251377990","DOIUrl":"10.1177/17511437251377990","url":null,"abstract":"Background: Despite advances in sepsis management, the relationship between appropriate empiric antibiotic therapy and acute kidney injury (AKI) in sepsis remains unclear. This study aimed to examine the association of appropriate empiric antimicrobial therapy with AKI in early onset sepsis caused by gram-negative bloodstream infections.Methods: We conducted a retrospective study of gram-negative bloodstream infection episodes in adult patients with early onset sepsis, using the Premier Healthcare Database from 2016 to 2020. The exposure was appropriate empiric antibiotic therapy determined by antibiotic regiments and antimicrobial susceptibilities of pathogens. The primary outcome was development of AKI or death by day 7 after the onset of sepsis. AKI was defined using the Kidney Disease Improving Global Outcome criteria based on serum creatinine levels, as urine output data were not available. The multivariable regression analysis was used to examine the association between appropriate empiric antibiotic therapy and the outcomes.Results: We identified 8565 patients with gram negative sepsis. In the total sample, the proportion of appropriate empiric antibiotic therapy was 93.2%, and the prevalence of AKI was 85.3%. Appropriate empiric antibiotic therapy was associated with decreased risk of AKI or death (adjusted odds ratio 0.70, 95% CI 0.52-0.94). For secondary outcomes, appropriate empiric antibiotic therapy was associated with lower AKI, shorter hospital LOS, lower C. difficile infections. However, it was not associated with in-hospital mortality.Conclusion: Appropriate empiric antibiotic therapy was associated with lower AKI in gram-negative sepsis. Early administration of appropriate antibiotics may prevent development of AKI.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251377990"},"PeriodicalIF":1.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12510998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum to "Guidance for: The acute management of status epilepticus in adult patients". “成人患者癫痫持续状态的急性管理指南”的勘误。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-10-08 eCollection Date: 2025-08-01 DOI: 10.1177/17511437251347396

引用次数: 0

Do-not-attempt-cardiopulmonary resuscitation decisions in critical care: The gap between theory and practice. 不尝试心肺复苏在重症监护中的决定：理论与实践之间的差距。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-10-07 DOI: 10.1177/17511437251369306

Prashanth Nandhabalan, Thearina de Beer, Robert Tobin, Dan Harvey, Richard Innes, Aaron D'Sa, Victoria Metaxa

引用次数: 0

The role of corticosteroids in the management of non-COVID-19 severe community-acquired pneumonia in the intensive care unit: A narrative review. 皮质类固醇在重症监护病房非covid -19重症社区获得性肺炎管理中的作用：一项叙述性综述

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-27 DOI: 10.1177/17511437251374816

Isis Terrington, Olivia Cox, Patrick Copley, Benjamin Eastwood, Elizabeth Webb, Cathrine McKenzie, Kordo Saeed, Andrew Conway-Morris, Michael P W Grocott, Ahilanandan Dushianthan

{"title":"The role of corticosteroids in the management of non-COVID-19 severe community-acquired pneumonia in the intensive care unit: A narrative review.","authors":"Isis Terrington, Olivia Cox, Patrick Copley, Benjamin Eastwood, Elizabeth Webb, Cathrine McKenzie, Kordo Saeed, Andrew Conway-Morris, Michael P W Grocott, Ahilanandan Dushianthan","doi":"10.1177/17511437251374816","DOIUrl":"10.1177/17511437251374816","url":null,"abstract":"Severe community-acquired pneumonia (sCAP) is associated with a significant health burden, both in the UK and globally, with intensive care support needed for many patients. The high morbidity and mortality associated with sCAP has led to the exploration of adjunctive therapies that may help reduce disease burden and improve clinical outcomes. One such proposed treatment is corticosteroids, aiming to moderate the disproportionate inflammation caused by sCAP. Despite several studies suggesting potential benefits, the use of corticosteroids in patients with sCAP remains contentious, with recent large trials producing conflicting results. These variations in trial outcomes have resulted in conflicting national and international guidelines. Such discrepancies align with findings from a recent national survey that indicated ongoing clinical uncertainty regarding the use of corticosteroids for sCAP in UK intensive care units. Several factors contribute to these conflicting outcomes, including patient population, the severity classification utilised, the type and duration of interventions provided, and, perhaps most importantly, the lack of pre-phenotyping to identify patients who may benefit most from the treatment. This narrative review aims to examine the recent literature, current guidelines, and evidence for using corticosteroids in sCAP, while exploring the candidate phenotypes of relevance in the design of clinical trials.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251374816"},"PeriodicalIF":1.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Critical illness and recovery-learning from the shared experience of survivors and their families: A qualitative study. 危重疾病与康复——从幸存者及其家人的共同经验中学习：一项定性研究。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-27 DOI: 10.1177/17511437251372020

Ceri Lynch, Cheney J G Drew, Sarah Gill, Ceri Battle, Kim Smallman

{"title":"Critical illness and recovery-learning from the shared experience of survivors and their families: A qualitative study.","authors":"Ceri Lynch, Cheney J G Drew, Sarah Gill, Ceri Battle, Kim Smallman","doi":"10.1177/17511437251372020","DOIUrl":"10.1177/17511437251372020","url":null,"abstract":"Background: Improved survival from critical illness in recent years has led to an increase in patients with Post Intensive Care Syndrome (PICS). Routine, dedicated, specific and individualised assessment, rehabilitation and follow-up after critical care discharge is recommended but is currently inadequate in the UK. The aim of this study was to explore patients' and family members' experiences of a critical care admission, focussing on recovery and rehabilitation.Methods: As part of an intervention development programme, a series of iterative focus groups with survivors of critical illness and their family members was held. Parallel groups with staff involved in the care and rehabilitation of critically ill patients were also conducted. Participants mapped out their recovery journey identifying key moments and challenges and shared their recommendations for recovery and rehabilitation. Brokered dialogue was used to enable patient and staff groups to ask and answer questions of each other. Data analysis was completed using reflexive thematic coding.Results: Thirty-four participants attended the focus groups, with 28 attending the first two groups discussed in this paper. Using the experiences described by the participants, three overarching themes were identified; fear, helplessness and frustration. Participants also reported both short and longer-term consequences of ICU admission and shared their priorities and advice for recovery and rehabilitation.Conclusion: Critical care admission is a traumatic experience for patients and family members. Our data highlights patients' needs for ongoing, holistic support during a stay in critical care and beyond.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251372020"},"PeriodicalIF":1.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The evolution of mortality from sepsis in patients with cancer: A systematic review and meta-analysis. 癌症患者败血症死亡率的演变：一项系统回顾和荟萃分析。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-27 DOI: 10.1177/17511437251363762

Luke Edwards, Elizabeth Nelmes, Maddalena Ardissino, Helen Lin Jia Qi, Shaman Jhanji, David B Antcliffe, Kate C Tatham

{"title":"The evolution of mortality from sepsis in patients with cancer: A systematic review and meta-analysis.","authors":"Luke Edwards, Elizabeth Nelmes, Maddalena Ardissino, Helen Lin Jia Qi, Shaman Jhanji, David B Antcliffe, Kate C Tatham","doi":"10.1177/17511437251363762","DOIUrl":"10.1177/17511437251363762","url":null,"abstract":"Background: Increasing numbers of patients with cancer are being admitted to intensive care units (ICU) with sepsis. The mortality from sepsis and septic shock in these patients is unclear. This study aimed to establish mortality from sepsis and septic shock in patients with cancer admitted to ICU and assess mortality trends over time.Methods: We conducted a literature search using MEDLINE and EMBASE. Included studies enrolled adult patients with cancer admitted to ICU with sepsis or septic shock and reported outcomes of interest. Studies were assessed using the Newcastle-Ottawa Scale for risk of bias and the quality assessment tool for observational cohort and cross-sectional studies. We performed a meta-analysis to estimate pooled ICU, hospital and 30-day mortality from sepsis and septic shock and a multivariate meta-regression to assess mortality trends over time. The study was registered on PROSPERO (CRD42022341277).Results: Twenty-five articles were included. The pooled ICU, hospital and 30-day mortality for sepsis was 44% (95% CI 38%-50%), 54% (95% CI 49%-60%) and 49% (95% CI 44%-55%) respectively. The pooled ICU, hospital and 30-day mortality for septic shock was 51% (95% CI 45%-57%), 62.6% (95% CI 56%-69%) and 54% (95% CI 46%-61%) respectively. There was significant heterogeneity between studies. The meta-regression identified decreasing ICU and hospital mortality from sepsis, and decreasing ICU mortality from septic shock.Conclusion: Patients with cancer admitted to ICU with sepsis face a significant mortality risk greater than that of the general population, despite decreasing mortality over time. Further research is required to improve outcomes.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251363762"},"PeriodicalIF":1.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Critical care and the law - pertinent cases from 2024. 从2024年开始的重症监护和法律相关案件。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-25 DOI: 10.1177/17511437251367221

Aaron D'Sa, Robert Tobin, Luigi Camporota, Thearina de Beer, Dan Harvey, Richard Innes, Prashanth Nandhabalan, Victoria Metaxa

引用次数: 0

Right ventricular injury during VV-ECMO for severe ARDS: Does time matter? VV-ECMO治疗严重ARDS时右室损伤：时间重要吗？

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-24 DOI: 10.1177/17511437251374821

Robert McDonald, Jo-Anne Fowles, Robert Gatherer, Francisca Caetano

引用次数: 0

Barriers to accreditation in point-of-care echocardiography for critical care: A Scottish perspective. 危重症护理点超声心动图鉴定的障碍：苏格兰视角。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-23 DOI: 10.1177/17511437251365176

Helen French, Christopher Leddy, Philip McCall

{"title":"Barriers to accreditation in point-of-care echocardiography for critical care: A Scottish perspective.","authors":"Helen French, Christopher Leddy, Philip McCall","doi":"10.1177/17511437251365176","DOIUrl":"10.1177/17511437251365176","url":null,"abstract":"Point-of-care echocardiography accreditation is not mandated within the Faculty of Intensive Care Medicine (FICM) training curriculum, yet it is commonly utilised to aid clinical decision making in the intensive care unit. We designed a survey to assess barriers to accreditation in point-of-care echocardiography across Scottish critical care units. The majority (70.1%) of respondents were unaccredited, with the most common barrier (n = 102) being 'lack of time with a mentor for supervised scanning'. This was amplified by the fact that only 25% of mentors received job planned time for scanning. Men were over-represented in those with accreditation, accounting for 61.4% of accredited clinicians, despite making up 51.0% of all respondents. In contrast, women represented 62.5% of unaccredited individuals who had undertaken at least one attempt at the process. We did not find a difference with other protected characteristics. This survey suggests that targeted support locally for those struggling to complete the process could address some of these concerns, and that further work needs to be taken to identify and address gender inequity in point of care echocardiography accreditation.","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251365176"},"PeriodicalIF":1.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lower non-invasive estimated P_mus predicts extubation failure in mechanically ventilated ICU patients. 低无创Pmus可预测机械通气ICU患者拔管失败。

IF 1.4

Journal of the Intensive Care Society Pub Date : 2025-09-16 DOI: 10.1177/17511437251377989

Graziela Müller, Manoela Bonato Zocoli, Jéssica Magnante, Geovana Teo Zamprogna, Silvano Altair do Nascimento, Gustavo Bruno Rático, Ewan C Goligher, Antuani Rafael Baptistella

引用次数: 0