Journal of Critical & Intensive Care最新文献

{"title":"Risk Factors of 90-Day Mortality in Patients with Critical Covid-19 Infection","authors":"F. Aydemir, N. Gokmen, V. Bayrak, B. Comert, B. Ergan","doi":"10.37678/dcybd.2022.2977","DOIUrl":"https://doi.org/10.37678/dcybd.2022.2977","url":null,"abstract":"","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of PARP Inhibitör 3-Aminobenzamide on Impaired Mesenteric Blood Flow and Organ Injury in CLP-Induced Septic Shock Model","authors":"Selda Ertac Serdar, P. Atilla, A. Iskit","doi":"10.37678/dcybd.2022.2942","DOIUrl":"https://doi.org/10.37678/dcybd.2022.2942","url":null,"abstract":"Objective: In various pathophysiological conditions, including septic shock, reactive oxidants cause DNA strand breakage and subsequent activation of the nuclear enzyme poly (ADP ribose) polymerase (PARP). Activation of PARP results in cellular dysfunction. We investigated the 3-Aminobenzamide (3-AB), one of the pure PARP-1 inhibitor, on mesenteric blood flow and organ injury (lung, liver, spleen) in a murine caecal ligation and puncture (CLP) model of septic shock in both gender. Methods: Female and male Swiss albino mice received 3-AB (10 mg/kg, i.p.) or its solvent saline (0.9% NaCl, w/v) 1 hour after CLP. At 24th hour, the animals were anaesthetized with chloralhydrate (400 mg kg-1, i.p.) and the mesenteric blood flow was monitored for 15 min by using perivascular ultrasonic Doppler-flowmeter. Then the animals were exsanguinated, spleen, liver, and kidneys were isolated accordingly for histopathological examination. Thiobarbituric acid-reacting substances, glutathione and myeloperoxides activities were also determined in tissues. Results: Although the glutathione levels were decreased and thiobarbituric acid-reacting substances and myeloperoxidase activity were increased by CLP in lung and liver, 3-AB has failed to block these biochemical parameters. In CLP + saline group, the mesenteric arterial blood flow was significantly lower than that of saline group (p<0.0001). 3-AB administration, did not prevent this status. 3-AB also did not attenuate the histopathological injury inflicted by CLP. Conclusion: Poly (ADP-ribose) polymerase-1 inhibitor 3-AB, controversial to the common results of the recent literature, has no significant effect on splanchnic ischemia or multiple organ injury as histopathogically or biochemically in both gender.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasopressor Starting Dose and Association with Hemodynamic Goals, Renal Replacement Therapy, and Mortality","authors":"Jamie Micheletto, P. Belvitch, Scott T. Benken","doi":"10.37678/dcybd.2022.3132","DOIUrl":"https://doi.org/10.37678/dcybd.2022.3132","url":null,"abstract":"","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Inducible Nitric Oxide Synthase Blockers on Survival and Organ Injury in a Murine Caecal Ligation and Puncture Model of Septic Shock","authors":"N. Ulu, C. Sokmensuer, A. Iskit","doi":"10.37678/dcybd.2022.3048","DOIUrl":"https://doi.org/10.37678/dcybd.2022.3048","url":null,"abstract":"","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different Dose Corticosteroid Treatment Protocols for COVID-19 Patients Admitted to Intensive Care: Comparison of the Effects on Efficacy and Mortality","authors":"Tayfun Et, Muhammet Korkusuz, Rafet Yarımoglu","doi":"10.37678/dcybd.2022.3021","DOIUrl":"https://doi.org/10.37678/dcybd.2022.3021","url":null,"abstract":"Aim: In the present study, our purpose was to evaluate the efficacy of the pulse-steroid treatment used in COVID-19 associated severe ARDS patients, and also to identify its effects on mortality in different doses. Study design: Retrospective Study Method: Patients with severe COVID-19 associated ARDS who had not previously received steroids, but were administered 1 g methylprednisolone (group 1) or 250 mg methylprednisolone (group 2) for 3 days, then 1 mg/kg/day during their hospitalization were retrospectively analyzed. The primary end-point was the discharge rate from the ICU or death. The secondary end-point was the 15th day survival rate. Result(s): A total of 48 patients with a mean age of 70.96+/-11.04 years were included. Twenty-six (54.2%) of them were male, 22 (45.8%) were female. Group 1 included 21 patients, group 2 included 27 patients. There was no difference in terms of demographic characteristics, comorbidities present, and medical findings between the groups on admission, except for the ferritin value which was lower in group 2 (p=0.027). There was no significant difference between groups groups in the 15-day mortality (p=0.134) and length of ICU stay (p=0.329). There was no difference between the groups in terms of discharge rates (p=0.55), need for mechanical ventilation (p=0.381), and complications (p=0.784). The odds ratio regarding the mortality of the patients in the 1 g pulse-steroid group was 3.17 times more likely than the 250 mg pulse-steroid group. Conclusion(s): Our results support that pulse-steroid therapy with 250 mg methylprednisolone may be more effective in patients admitted to intensive care units with ARDS due to COVID-19. Copyright © 2022 by Society of Turkish Intensivist.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Kidney Injury Incidence, Risk Factors and Effects on Mortality in Critically ill COVID-19 Patients: A Retrospective Cohort Study","authors":"L. Ferliçolak, Irem Alkan Tekes, N. D. Altıntaş","doi":"10.37678/dcybd.2022.3251","DOIUrl":"https://doi.org/10.37678/dcybd.2022.3251","url":null,"abstract":"Objective: Acute kidney injury (AKI) is a common condition in critically ill patients, especially those with severe infections, and associated with increased morbidity and mortality. While the main features associated with COVID-19 are extensive alveolar damage and acute respiratory failure, another common complication in patients infected with SARS-CoV-2 is AKI. There is increasing evidence that it affects the kidneys in particular. It was aimed to investigate the frequency and risk factors of AKI development in critically ill COVID-19 patients. Material(s) and Method(s): Between March 15th, 2020 and June 1st, 2021, patients with COVID-19 who were admitted to the intensive care unit(ICU) for more than 24 hours were included in the study and analysed, retrospectively. Patients were grouped according to whether they developed AKI according to KDIGO criteria during the first week of their ICU stay and compared for risk factors. Result(s): There were 206 patients who met the inclusion criteria, of whom 120 had developed AKI during the first week of admission. Patients in AKI group were older with a median age of 70.5 years (p<0.001). The median APACHEII and SOFA scores were higher in the AKI group (20 and 5, respectively, p<0.001). Hypertension was the most common comorbidity and was more frequent in AKI patients (69%, p<0.001), invasive mechanical ventilation (IMV) and vasopressor requirements were more common in AKI patients (78%, p<0.001 and 66%, p<0.001, respectively). In 31 (26%) patients with AKI, renal replacement therapy was required. Mortality rate was higher in AKI patients (68%, p<0.001). Logistic regression analyses revealed hypertension (OR=2.71, %95CI=1.23-5.95, p=0.013) and IMV (OR= 8.15, %95 CI= 3.35-19.83, p< 0.001) as risk factors for AKI. Conclusion(s): AKI is a poor prognostic condition commonly seen in critically ill COVID-19 patients. The rate of AKI development is higher in patients with hypertension and those who need invasive mechanical ventilation. The development of AKI has been associated with high mortality in critically ill COVID-19 patients. Copyright © 2022 by Society of Turkish Intensivist-Available online at www.dcyogunbakim.org.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Hypoalbuminemia and Mortality in Geriatric Patients with Sepsis","authors":"M. Erdoğan, H. A. Fındıklı","doi":"10.37678/dcybd.2021.2824","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2824","url":null,"abstract":"Aim: Albumin can be used as prognostic markers for various clinical results including critical care patients. In our study, we aimed to examine the relationship between albumin and mortality in geriatric patients with sepsis. Design: Retrospective Study Materials and Methods: This study included geriatric patients with sepsis treated in the medical intensive care unit of Adana City Training and Research Hospital between January 2018 and December 2020. Two hundred and fifty-two patients were enrolled in the study. Results: The median acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment, and Charlson Comorbidity Index score were significantly higher in the non-survivors group. According to the laboratory parameters the serum levels of creatinine and, C-reactive protein were significantly higher in the non-survivor group. The serum level of platelets and albumin was significantly higher in the survivor group. In the multivariate analysis, age, APACHE II, platelets, and albumin were determined as significant independent determinants after the correction of the other variables. The lower albumin levels were associated with an increased risk of mortality in geriatric patients with sepsis. In the receiver operating characteristic curve analysis, albumin values of 2.85 and below were predictive for mortality. Conclusion: Albumin levels can be used as a predictor of mortality in geriatric patients with sepsis. In addition, studies should be planned to evaluate whether the APACHE-2 score and albumin level together can better predict mortality in geriatric patients with sepsis.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Modified Barrow Oral Care Protocol in Patients Receiving Mechanical Ventilation","authors":"Robab Javanmard, N. Mozaffari, S. Iranpour, M. Shamshiri","doi":"10.37678/dcybd.2021.2619","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2619","url":null,"abstract":"Objective: Adoption of an effective and feasible oral care protocol is vital for patients receiving mechanical ventilation (MV). This study aimed to examine the effectiveness of the modified Barrow Oral Care Protocol (MBOCP) in patients receiving invasive mechanical ventilation in ICU. Methods: A double-blind clinical trial design was used to evaluate the effectiveness of MBOCP. A convenience sample of 90 patients admitted to two ICUs of a referral hospital from August 2019 to February 2020 were randomly assigned to intervention (n=45) and control (n=45) groups. Intervention group received oral care through MBOCP for 6 days and the control group received routine care. Repeated-measures ANOVA was used to compare the oral health between two groups. Results: The bedside oral health score showed significant difference between the two groups from the third day and continued until to the last day of study, indicating oral health improvement in the intervention group (P<0.001). Conclusion: The present study showed that the application of accessible oral care supplies such as toothbrush, non-foaming toothpaste, chlorhexidine and oral moisturizer through an evidence-based and protocolized care format is effective than a disorganized and routine oral care. It is recommended that nurses to apply available supplies in the form of established and evidence-based protocols for oral care in ICU.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficiencies of Laboratory Parameters in Covid-19 Patients Follow up","authors":"A. Orçun, Ozlem Cakir Madenci, I. Onem, Z. Yildiz, A. Batırel, K. Saraçoğlu","doi":"10.37678/dcybd.2021.2771","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2771","url":null,"abstract":"Introduction: Diagnostic efficiencies of laboratory parameters used in COVID-19 patients and their association with disease severity were evaluated. Materials and Methods: Laboratory parameters of COVID-19 patients hospitalized in Dr. Lutfi Kirdar Kartal City Hospital between March and August 2020 were evaluated. The patients were grouped as non-severe and severe according to the interim guidance of the World Health Organization (WHO). The diagnostic performances of NLR, D-dieter, CRP, procalcitonin, IL-6, LDH, and ferritin in discrimination of severe cases were evaluated by Receiver operator's characteristics (ROC) analysis. Generalized lineer model Analysis (GLM) was performed with mortality as a dependent variable and age, gender, NLR, D-dimer, CRP, Procalcitonin, IL-6, LDH, and ferritin as an independent variables. Results: A total of 257 patients were evaluated and there was a significant difference between non-severe and severe cases in terms of NLR, D-dimer, CRP, Procalcitonin, IL-6, LDH, and Ferritin values. All the parameters showed comparable perfoluiances in discriminating severe disease;D-dimer with the least (AUC 73.5%), and NLR with the highest (AUC 80.7%) efficiency. Values above 4.5 for NLR, 930 ug/L for D-dimer, 64 mg/L for CRP, 0.136 ug/L for procalcitonin, 44.3 pg/mL for IL-6, 304 IU for LDH, and 312 ug/L for ferritin were associated with severe disease. Contribution of age, NLR, D-dimer, and CRP were found significant on the model. Conclusions: NLR, D-dimer, CRP, procalcitonin, IL-6, LDH, and ferritin showed comparable performances in discriminating severe cases with predefined cut-offs. Age, NLR, D-dimer, and CRP may be considered as predictors of mortality in COVID-19 patients.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Basic Parameters for Prediction of ICU Mortality","authors":"Nilgün Tabakoğlu, V. Inal","doi":"10.37678/dcybd.2021.2590","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2590","url":null,"abstract":"","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"4571 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}