Journal of Critical Care Medicine最新文献

{"title":"Prioritized factors of severity prognosis in patients admitted for sepsis or septic shock in a resource-limited region of central Vietnam.","authors":"Thinh Tran Xuan, Lien Truong Thuc, Minh Nguyen Van, Cao Khoa Dang, Nhan Phuc Thanh Nguyen, Thong Tran Huu, Nancy Ha, Thang Phan","doi":"10.62838/jccm-2026-0033","DOIUrl":"10.62838/jccm-2026-0033","url":null,"abstract":"<p><strong>Objectives: </strong>The early diagnosis and prognostication of severity in sepsis plays a crucial role in determining appropriate treatment strategies. This study aimed to assess the role of cheaper prognostic factors including lactate/albumin ratio and platelet count in patients with sepsis as they are correlated with the rate of multiorgan failure, and mortality rate.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 146 adult patients diagnosed with sepsis and septic shock according to the Sepsis-3 definition. All patients were admitted at either the intensive care unit of Hue University of Medicine and Pharmacy Hospital or Hue Central Hospital.</p><p><strong>Results: </strong>Average age of patients was 67 years-old, with 37.7% having sepsis and 62.3% with septic shock. The overall mortality rate in the study was 51.4% (75/146 patients). Forty six patients (32.5%) had thrombocytopenia, with mild, moderate, and severe decreases accounting for 8.9%, 21.2%, and 1.4%, respectively. The lactate/albumin ratio with a cutoff of 2.1 was the best prognostic factor for mortality with an AUROC of 0.76, sensitivity of 58.7%, and specificity of 88.7% compared to other biomarkers including lactate (AUROC = 0.71), albumin (AUROC = 0.74), platelet count (AUROC = 0.65), white blood cell count (AUROC = 0.48), procalcitonin (AUROC = 0.43), and BE (AUROC = 0.44). Multivariate regression analysis identified the L/A ratio, platelet count, SOFA score as significant predictors of mortality in sepsis.</p><p><strong>Conclusion: </strong>The lactate/albumin ratio with a cutoff of 2.1 is an available effective tool for severity prognosis of patients with sepsis/septic shock in developing countries.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"401-408"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608450","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}

{"title":"Intravenous insulin protocol reduces time to target glucose in critically ill trauma and burn patients.","authors":"Oluwafolaranmi E Sodade, Connor J English, Cindy L Austin, Charles A Lunday, Yang Wang, Brian B Draper","doi":"10.62838/jccm-2026-0027","DOIUrl":"10.62838/jccm-2026-0027","url":null,"abstract":"<p><strong>Introduction: </strong>Glycemic control is vital in the management of critically ill patients. Scientific evidence has proven that a drastic change in blood glucose levels can lead to adverse outcomes including increased hospital, ICU length of stay, morbidity, and mortality. Despite the challenges in developing standardized intravenous insulin protocols, institutions have successfully implemented protocols in various settings. Our tertiary care hospital has an established intravenous insulin protocol for the cardiac ICU. Given the complexity of managing critically ill patients, an intravenous insulin protocol for such patients was implemented in February 2022. The study aimed to evaluate the effectiveness of the newly implemented intravenous insulin protocol in glycemic control of critically ill trauma and burn patients.</p><p><strong>Methods: </strong>A single center retrospective chart review was conducted on 230 patients: 119 patients were extracted from the pre-protocol implementation and 111 patients post-protocol implementation periods. Ninety-nine patients were excluded due to on-admission diagnosis of diabetic ketoacidosis, hyperosmolar hyperglycemic state, or incomplete data. Data collection included: type of injury; body mass index, pre-existing comorbidities; insulin administration times; target glucose actualization; glycemic events; hospital and ICU length of stay, mortality rates in the ICU, hospital, and 30 days post-hospitalization.</p><p><strong>Results: </strong>In the post-implementation group, the time to reach target glucose was significantly reduced when compared to the pre-implementation group. The rates of glycemic events after achieving target glucose were similar with a slightly lower rate post-implementation. There were no differences in the length of stay or mortality rates during hospitalization or 30-days post-hospitalization between the groups. However, when comparing routes of insulin administrations, the intravenous insulin significantly showed better glucose control and reduced the rates of glycemic events than the subcutaneous route.</p><p><strong>Conclusion: </strong>Intravenous insulin protocol demonstrated a significant reduction in the time to target glucose levels for the critically ill patients.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"359-367"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608486","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}

{"title":"Effect of tactile stimulation on the level of consciousness and vital signs of patients with traumatic brain injury: a quasi- experimental study.","authors":"Richa Bhogal, Nimarta Rana, Nipin Kalal, Khina Sharma, Suryanarayanan Bhaskar","doi":"10.62838/jccm-2026-0032","DOIUrl":"10.62838/jccm-2026-0032","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with traumatic brain injury (TBI) are subjected to multiple stressors, including environmental changes, medical treatment, and surgical procedures. Hospitalization in an unfamiliar setting, especially when separated from family members, can increase anxiety and stress, which may adversely influence vital signs and levels of consciousness. Tactile stimulation, when integrated with routine medical management, may contribute to improving patient outcomes. Therefore, the present study aimed to determine the effect of tactile stimulation on the level of consciousness and vital signs among patients with traumatic brain injury.</p><p><strong>Materials and methods: </strong>A quasi-experimental study was conducted in the neurosurgery wards and intensive care units of a tertiary care hospital. A total of 40 patients with mild (Glasgow Coma Scale [GCS] score 13-15) and moderate (GCS score 9-12) traumatic brain injury were selected using a consecutive sampling technique and equally allocated into experimental and control group (n = 20 each). The experimental group received tactile stimulation in addition to conservative care daily at 8 a.m., 12 pm, and 4 p.m. for three consecutive days, with each session lasting 15-20 minutes. The control group received only conservative care. Data were collected using a sociodemographic and clinical profile, a vital sign monitoring sheet, and the Glasgow Coma Scale. Statistical analysis was performed using the Chi-square test, Fisher's exact test, Friedman test, and Mann-Whitney U test.</p><p><strong>Results: </strong>Both groups were comparable at baseline, with no statistically significant differences in socio-demographic and most clinical variables. The majority of patients had a GCS score of 9-12 at admission, and road traffic accidents were the predominant cause of injury. A statistically significant difference was observed only in the type of brain injury (p < 0.001). No statistically significant differences were found between the groups in vital signs or GCS scores across day 1, day 2, and day 3 following the intervention, indicating similar clinical outcomes.</p><p><strong>Conclusion: </strong>The findings indicate that no statistically significant differences were observed between experimental and control groups, indicating that the intervention had no significant effect on the measured clinical outcomes. The limited duration of intervention may have constrained its effectiveness.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"351-358"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608318","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}

{"title":"Technology integration in intensive care medicine through clinical engineering and convergent biotechnology.","authors":"Leonard Azamfirei","doi":"10.62838/jccm-2026-0035","DOIUrl":"10.62838/jccm-2026-0035","url":null,"abstract":"","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"309-312"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608438","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}

{"title":"Balanced crystalloids versus normal saline for initial fluid resuscitation in diabetic ketoacidosis: a systematic review and meta-analysis of randomized controlled trials.","authors":"Khaled Ahmed Reda Soliman, Ahmed Osman Hassan Ali, Farrukh Ameer, Bashaer Alharbi, Mohamed Hany Elmasry, Rawabi Mohammed Alwashmi, Bandar Saad Alshreef, Mohammad Saleh H Almabouth, Kinda Ahmed Hardan, Aymen Ali Alqurain","doi":"10.62838/jccm-2026-0022","DOIUrl":"10.62838/jccm-2026-0022","url":null,"abstract":"<p><strong>Objective: </strong>To systematically synthesize evidence from RCTs that evaluate the efficacy and safety of balanced crystalloids compared with normal saline for initial fluid resuscitation of patients with DKA.</p><p><strong>Methods: </strong>This systematic review and meta-analysis were performed considering PRISMA guidelines and was registered in PROSPERO. A comprehensive search was performed to identify RCTs comparing balanced crystalloids with normal saline in adults and children with DKA. The risk of bias was assessed by using Cochrane RoB 2 tool. A random-effects meta-analysis was performed using R software to calculate pooled Mean Differences for continuous outcomes and Odds Ratios for dichotomous outcomes with 95% Confidence Intervals.</p><p><strong>Results: </strong>Eleven RCTs were included. In the quantitative synthesis of six RCTs (n = 491) using continuous time-to-event data, balanced crystalloids were not associated with a statistically significant reduction in time to DKA resolution compared with normal saline (Mean Difference [MD] = -1.50 hours; 95% CI: -3.79 to 0.79; p=0.15), with moderate heterogeneity (I2 = 36.2%). The 95% prediction interval ranged from -5.44 to 2.44 hours. However, balanced crystalloids resulted in a significantly greater increase in serum bicarbonate at 12 hours (MD = +2.50 mmol/L; 95% CI: 1.51 to 3.48; p=0.004; I2 = 0.0%). Subgroup analyses by fluid type, DKA severity, and age group showed no significant subgroup differences.</p><p><strong>Conclusion: </strong>Initial fluid resuscitation with balanced crystalloids was not associated with a shorter time to DKA resolution compared with normal saline, and they were associated with a rapid increase in serum bicarbonate levels; however, this biochemical improvement did not translate into a shorter time to DKA resolution or other clinical benefits. The choice of crystalloids for initial DKA resuscitation remains an area of clinical equipoise because of the substantial heterogeneity and methodological limitations of the available evidence, emphasizing the need for further high-quality research.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 3","pages":"328-341"},"PeriodicalIF":1.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13403006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148606951","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}

{"title":"Effect of premorbid beta-blockers on cardiac function and clinical outcomes in septic patients: a retrospective study.","authors":"Siyu Yang, Rongyao Feng, Xiangzhou Fang, Chaojie Wei","doi":"10.62838/jccm-2026-0014","DOIUrl":"10.62838/jccm-2026-0014","url":null,"abstract":"<p><strong>Background: </strong>Beta-blockers have been reported to exert potential beneficial effects in sepsis in recent years. However, their clinical application in sepsis remains limited due to concerns regarding hemodynamic impacts. This study aims to explore whether premorbid use of beta-blockers is associated with improvements in cardiac function and favorable clinical outcomes among patients with sepsis.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study was conducted in the Intensive Care Unit (ICU) of a university-affiliated hospital. All patients diagnosed with sepsis admitted between August 2022 and March 2024 were enrolled. Exclusion criteria included age < 18 years, hospitalization duration < 48 hours, a history of severe underlying cardiac conditions, and incomplete clinical records. Primary outcomes included myocardial injury markers, echocardiographic parameters, and electrocardiographic indices to assess cardiac function. Secondary outcome was mortality.</p><p><strong>Results: </strong>Among 1005 septic patients, 228 had received premorbid beta-blockers. No significant difference in baseline disease severity was observed between the two groups. Patients with premorbid beta-blocker exposure had lower levels of cardiac troponin I (TnI, 87.9 [IQR, 23.4-306.0] vs 142.0 [IQR, 37.8-481.2]), lactic dehydrogenase (LDH, 274.0 [IQR, 175.0-496.0] vs 319.0 [IQR, 229.0-456.8]), and B-type natriuretic peptide (BNP, 267.9 [IQR, 118.1-1065.1] vs 509.3 [IQR, 184.8-1203.0]). Echocardiographic assessments revealed that premorbid beta-blockers were associated with a higher left ventricular ejection fraction (LVEF, 58% [IQR 52-60] vs 55% [IQR 50-60]). Additionally, premorbid beta-blockers were linked to lower 14-day (13.6% [IQR 9.1-18.1] vs 21.5% [IQR 18.6-24.4]), 28-day (17.5% [IQR 12.6-22.5] vs 27.4% [IQR 24.3-30.6]), and in-hospital (18.9% [IQR 13.7-24.0] vs 28.8% [IQR 25.6-32.0]) mortality rates.</p><p><strong>Conclusions: </strong>Among septic patients, premorbid beta-blockers are associated with preserved cardiac function and improved clinical outcomes. These findings highlight the need for prospective or randomized controlled trials to further explore the potential cardioprotective role of beta-blockers in sepsis.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 2","pages":"271-280"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976253","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}

{"title":"Admission biomarkers and COVID-19 mortality: A retrospective study during Vietnam's pandemic peak.","authors":"Uyen Thi Bich Nguyen, Hau Phuc Le, Vu Hoang Anh Nguyen, Ai-Thanh Tran-Nguyen","doi":"10.62838/jccm-2026-0003","DOIUrl":"10.62838/jccm-2026-0003","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the prognostic value of key admission biomarkers in predicting mortality among hospitalized COVID-19 patients and to establish optimal cut-off thresholds for clinical decision-making.</p><p><strong>Methods: </strong>Retrospective cohort study included 269 COVID-19 patients treated at Thu Duc City Hospital, Vietnam, during the peak of the fourth pandemic wave in 2021. Logistic regression identified independent predictors of mortality, and receiver operating characteristic (ROC) curve analysis assessed the diagnostic performance of biomarkers. The area under the ROC curve (AUROC), Sensitivity, Specificity and Accuracy Index were used to determine optimal cut-off values.</p><p><strong>Results: </strong>Among the 269 patients, 53 (19.7%) died and 216 (80.3%) survived. Non-survivors exhibited elevated D-dimer (4.48 μg/mL vs 0.93 μg/mL, p < 0.0001), neutrophil counts (6.8 × 10⁹/L vs 3.5 × 10⁹/L, p < 0.0001) and white blood cell counts (11.68 × 10⁹/L vs. 7.87 × 10⁹/L, p < 0.0001). Lymphocyte counts and fibrinogen levels were significantly lower in non-survivors (p < 0.05). Logistic regression identified D-dimer (OR = 1.05, 95% CI: 1.02-1.09, p = 0.001), neutrophil counts (OR = 1.32, 95% CI: 1.10-1.63, p = 0.005) and lymphocyte counts (OR = 0.51, 95% CI: 0.26-0.92, p = 0.033) as significant predictors of mortality. ROC analysis revealed that D-dimer (AUROC = 0.809) and neutrophil counts (AUROC = 0.726) demonstrated strong discriminatory power, with cut-off values of ≥1.126 μg/mL (sensitivity = 90.57%, specificity = 60.19%) and ≥6.715 × 10⁹/L (sensitivity = 52.83%, specificity = 82.87%), respectively.</p><p><strong>Conclusion: </strong>These findings support the use of admission biomarkers to guide early interventions and improve patient outcomes in severe COVID-19 cases. Further studies are warranted to validate these results and explore their applicability in other settings.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 2","pages":"158-166"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976281","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}

{"title":"Influence of different short peripheral cannula materials on the incidence of phlebitis in intensive care units: A post-hoc analysis of the AMOR-VENUS study.","authors":"Yutaro Shinzato, Hideto Yasuda, Haruka Taira, Yuki Kishihara, Masahiro Kashiura, Takashi Moriya, Yuki Kotani, Natsuki Kondo, Kosuke Sekine, Nobuaki Shime, Keita Morikane","doi":"10.62838/jccm-2026-0012","DOIUrl":"10.62838/jccm-2026-0012","url":null,"abstract":"<p><strong>Aim of the study: </strong>Short peripheral cannula (SPC)-related phlebitis occurs in 7.5% of critically ill patients, and mechanical irritation from cannula materials is a risk factor. Softer polyurethane cannulas reportedly reduce phlebitis, but the incidence of phlebitis may vary depending on the type of polyurethane. Differences in cannula stiffness may also affect the incidence of phlebitis; however, this relationship is not well understood. This study analyzed intensive care unit (ICU) patient data to compare the incidence of phlebitis across different cannula products, focusing on polyurethane.</p><p><strong>Material and methods: </strong>This is a post-hoc analysis of the AMOR-VENUS study that involved 23 ICUs in Japan. We included patients aged ≥ 18 years, who were admitted to the ICU with SPCs. The primary outcome was phlebitis, evaluated using hazard ratios (HRs) and 95% confidence intervals (CIs). Based on the market share and differences in synthesis, polyurethanes were categorized into PEU-Vialon^® (BD, USA), SuperCath^® (Medikit, Japan), and other polyurethanes; non-polyurethane materials were also analyzed. Multivariable marginal Cox regression analysis was performed using other polyurethanes as a reference.</p><p><strong>Results: </strong>In total, 1,355 patients and 3,429 SPCs were evaluated. Among polyurethane cannulas, 1,087 (33.5%) were PEU-Vialon^®, 702 (21.6%) were SuperCath^®, and 276 (8.5%) were other polyurethanes. Among non-polyurethane cannulas, 1,292 (39.8%) were ethylene tetrafluoroethylene (ETFE) cannulas, and 72 (2.2%) used other materials. The highest incidence of phlebitis was observed with SuperCath^® (13.1%). Multivariate analysis revealed an HR of 1.45 (95% CI 0.75-2.8, p = 0.21) for PEU-Vialon^®, 2.60 (95% CI 1.35-5.00, p < 0.01) for SuperCath^®, 2.29 (95% CI 1.19-4.42, p = 0.01) for ETFE, and 2.2 (95% CI 0.46-10.59, p = 0.32) for others.</p><p><strong>Conclusions: </strong>The incidence of phlebitis varied among polyurethane cannulas. Further research is warranted to determine the causes of these differences.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 2","pages":"252-261"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976200","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}

{"title":"The effect of oral protein and carbohydrate solution administration on NLR, IL-6 and CRP levels in patients undergoing surgery.","authors":"Mahendratama P Adhi, Oscar Febriano, Alfi Yasmina, Iwan Nuryawan, Agung Ary Wibowo, Kenanga Marwan Sikumbang","doi":"10.62838/jccm-2026-0011","DOIUrl":"10.62838/jccm-2026-0011","url":null,"abstract":"<p><strong>Aims: </strong>To determine the effect of administering oral protein and carbohydrate solutions the C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Neutrophil-Lymphocyte Ratio (NLR) in patients planned any surgery.</p><p><strong>Methods: </strong>A double-blind, randomized clinical study, at Ulin Regional Hospital, Banjarmasin with patients planned any surgery. This research had 80 patients in total (40 subjects in the control group and 40 subjects in the intervention group). Before surgery, 200 mL of a protein and carbohydrate solution per oral was given to the intervention group, while a placebo was given to the control group. Twenty-four hours after surgery, each subject's levels of CRP, IL-6 and NLR were measured. Statistical Package for the Social Sciences Version 29 was used to analyze the data.</p><p><strong>Results: </strong>NLR at 24 hours postoperatively in the intervention group was lower than in the control group, but not statistically different (8.65±4.33 vs. 7.86±4.65, p=0.308). The IL-6 level at 24 hours postoperatively in the intervention group was significantly lower than in the control group (9.49 (6.03-22.65) vs. 20.08 (11.64-50.11), p=0.011). Although not statistically different, the CRP level at 24 hours postoperatively in the intervention group was lower than in the control group (15.10 (7.20-41.60) vs. 34.70 (11.87-71.55), p=0.056). There was no difference in postoperative nausea or vomiting between the two groups.</p><p><strong>Conclusion: </strong>Postoperative interleukin-6 levels have been demonstrated to decrease when oral protein and carbohydrate solutions are given to patients undergoing surgery; however, NLR and CRP levels have not been seen to decrease.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 2","pages":"243-251"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976282","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}

{"title":"Positive fluid balance is associated with earlier acute kidney injury in COVID-19 patients.","authors":"Rezwan Munshi, Sandra Gomez-Paz, Salman Bhutta, Joshua Fogel, James Pellegrini, Narois Nehru, Eric Lam, Sofia Rubinstein","doi":"10.62838/jccm-2026-0006","DOIUrl":"10.62838/jccm-2026-0006","url":null,"abstract":"<p><strong>Introduction: </strong>Managing fluid balance in COVID-19 patients can be challenging, particularly if acute kidney injury (AKI) develops.</p><p><strong>Aim of the study: </strong>We study the relationship between fluid net input and output (FNIO) in COVID-19 patients with development of AKI, time to development of AKI, in-hospital length of stay (LOS), and in-hospital mortality.</p><p><strong>Material and methods: </strong>Retrospective study of 403 patients with COVID-19. Data for FNIO were from day 1 through day 10 or earlier if AKI occurred.</p><p><strong>Results: </strong>AKI occurred in 22.8%, in-hospital mortality occurred in 26.3%, mean days to AKI were 7.7 (SD=6.3), and mean LOS was 11.5 (SD=13.2) days. In the multivariate logistic regression analyses, increased FNIO mean was significantly associated with slightly increased odds for mortality (OR=1.001, 95% CI:1.0001, 1.0011, p=0.02) but was not significantly associated with AKI. In the multivariate linear regression analyses, increased FNIO mean was significantly associated with lesser days to AKI (B=-6.63*10^-5, SE=<0.001, p=0.003) in the whole sample, greater days to AKI in the subset of those with ICU treatment (B=<0.001, SE=<0.001, p<0.001), while FNIO mean was not significantly associated with LOS.</p><p><strong>Conclusions: </strong>Positive fluid balance was associated with faster onset of AKI and increased mortality. Fluid administration in patients with COVID-19 should be guided by routinely measuring FNIO. A restrictive fluid management regimen rather than usual care should be practiced.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"12 2","pages":"186-198"},"PeriodicalIF":1.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976210","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}