{"title":"Nebulized tranexamic acid for hemoptysis in critically and non-critically ill patients: A retrospective analysis.","authors":"Nancy Bethuel, Chris Naum, Cynthia Brown","doi":"10.2478/jccm-2025-0031","DOIUrl":"10.2478/jccm-2025-0031","url":null,"abstract":"<p><strong>Introduction: </strong>Hemoptysis is a commonly encountered diagnosis caused by blood originating from the respiratory tract. Current pharmacological guideline recommendations for treatment do not exist. Tranexamic acid is a synthetic anti-fibrinolytic used in the management of various bleeding complications. Tranexamic acid has gained popularity for the treatment of hemoptysis with limited side effect knowledge. Our aim is to describe the clinical characteristics of patients receiving nebulized tranexamic acid for hemoptysis and compare clinical outcomes to those of patients receiving supportive care.</p><p><strong>Materials and methods: </strong>This is a retrospective descriptive analysis performed in medical and ICU units at three tertiary hospitals. All patients were hospitalized with hemoptysis between January 1st, 2018 - December 31st, 2021. Demographic information, severity variables, and clinical outcomes were collected from medical records. For statistical analysis, we used t-test for continuous variables, chi-square or fishers' exact test for categorical variables, and propensity analysis to adjust for disease severity and underlying medical conditions.</p><p><strong>Results: </strong>488 patients were identified; 96 received tranexamic acid. There were slightly more smokers in the no TXA group (p = 0.04) but otherwise the two groups were similar in terms of demographic characteristics. The average length of hospital and ICU stay, need for mechanical ventilation or bronchoscopy, and mortality were significantly higher in the tranexamic acid group (p<0.01). The propensity analysis showed higher odds of death with nebulized tranexamic acid use, OR 2.51 (1.56-4.02).</p><p><strong>Conclusions: </strong>There appears to be an indication bias for tranexamic acid based on disease severity without an obvious improvement in clinical outcomes. Our analysis suggests that nebulized tranexamic acid for hemoptysis may be potentially harmful, and further larger prospective research is warranted.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 3","pages":"233-239"},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790329","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}
Madeleine Brill-Edwards, W Chase Hamilton, Erika J Yoo, Jennifer Costello, George J Koenig, Murray J Cohen, Joshua A Marks
{"title":"Angioedema: Is ICU admission warranted? A single institution assessment.","authors":"Madeleine Brill-Edwards, W Chase Hamilton, Erika J Yoo, Jennifer Costello, George J Koenig, Murray J Cohen, Joshua A Marks","doi":"10.2478/jccm-2025-0023","DOIUrl":"10.2478/jccm-2025-0023","url":null,"abstract":"<p><strong>Introduction: </strong>Angioedema has potential for rapid airway decompensation requiring intervention. Patients are often admitted to an ICU for \"airway watch.\" There is a lack of evidence to support which patients require this.</p><p><strong>Aim: </strong>We aimed to characterize admission patterns and outcomes of angioedema patients at our institution to assess resource utilization and necessity of ICU use. We hypothesized that patients not requiring intubation upon presentation are safe to manage outside the ICU.</p><p><strong>Materials and methods: </strong>Retrospective chart review of patients admitted to our urban academic quaternary referral institution with angioedema ICD-10 codes between 2017 and 2020. Charts reviewed for demographics, etiology, admission location, level of care, length of stay (LOS), intubation information, discharge destination, and specific treatment administered. Statistical analysis included a t-test for continuous variables (LOS).</p><p><strong>Results: </strong>Of 135 encounters for angioedema, 117 patients were admitted. 50 were admitted to an ICU. Patients were evenly split based on sex, majority black, and the most common etiology was ACE-inhibitor use. 20 required airway intervention with intubations primarily outside the ICU setting and only 2 in the ICU. 1 surgical airway performed in the ED. The mean time from presentation to intubation was 2.7 hours (Min 0h; Max 7.5h). The average ICU LOS for non-intubated patients was 1.1 days, with hospital LOS 1.5 days compared to 0.25 days for those not admitted to an ICU (p<0.001). For intubated patients, average ICU LOS was 4.3 days, with hospital LOS 6.2 days. All intubated patients were successfully liberated from the ventilator. No deaths occurred.</p><p><strong>Conclusion: </strong>Most angioedema encounters did not require airway intervention within the first hours of presentation. Airway decompensation and intervention mostly occurred prior to the ICU setting. ICU resources should be carefully allocated and may be unnecessary for patients presenting with angioedema who are not intubated on initial evaluation.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 3","pages":"240-246"},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790322","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}
Prisco Piscitelli, Vincenzo Costigliola, Leonard Azamfirei
{"title":"The challenge of antimicrobial resistance in intensive care setting.","authors":"Prisco Piscitelli, Vincenzo Costigliola, Leonard Azamfirei","doi":"10.2478/jccm-2025-0020","DOIUrl":"10.2478/jccm-2025-0020","url":null,"abstract":"","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"109-111"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095064","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}
John Harold Kanter, Adam C Glaser, Pablo Martinez-Camblor, Jakob V E Gerstl, Anna B Lebouille-Veldman, Harshit Arora, Lauren Buhl, Myles D Boone, Christopher S Ogilvy
{"title":"The effect of antiseizure medication on mortality in spontaneous aneurysmal subarachnoid hemorrhage.","authors":"John Harold Kanter, Adam C Glaser, Pablo Martinez-Camblor, Jakob V E Gerstl, Anna B Lebouille-Veldman, Harshit Arora, Lauren Buhl, Myles D Boone, Christopher S Ogilvy","doi":"10.2478/jccm-2025-0014","DOIUrl":"10.2478/jccm-2025-0014","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous aneurysmal subarachnoid hemorrhage (aSAH) is a major cause of morbidity and mortality in the United States. The efficacy of early antiseizure medication (ASM) is debated. Recent literature reports seizure rates ranging from 7.8% to 15.2% following spontaneous aSAH. Current guidelines recommend use of early ASM in patients with \"high-risk features,\" but whether early ASM use decreases the rate of death associated with aSAH remains unclear. This study assessed whether early administration of early ASM impacts mortality rates after spontaneous aSAH.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using a publicly available dataset from the Massachusetts Institute of Technology, Medical Information Mart for Intensive Care-III (MIMIC) database of all patients over the age of 18 with spontaneous aSAH resulting in an intensive care unit (ICU) admission to a major United States trauma center from 2001 to 2012. The primary exposure was receiving early ASM and primary outcome of death within 7 days. Different regression models were created to explore the association between early ASM administration within 24 hours of admission and a composite outcome of seizure and/or death within 7 days of admission. Secondary outcomes included 30-day and one-year mortality.</p><p><strong>Results: </strong>Of 253 patients with spontaneous aSAH, 148 received early ASM within 24 hours. Patients who did receive early ASM were less likely to die within 7 days of admission (adjusted odd ratio, [aOR]: 0.26 95% CI 0.10 to 0.68; P=0.006) but were more likely to have a seizure (aOR: 7.63 95% CI 2.07 to 28.17; P=0.002).</p><p><strong>Conclusion: </strong>Early ASM administration was associated with lower rates of death and composite death/seizure within 7 days of admission among patients who presented to an ICU with spontaneous aSAH. These findings suggest broader use of early ASM in patients who present with spontaneous aSAH may improve early mortality.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"173-182"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095067","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}
Sonia Luka, Adela Golea, Raluca Mihaela Tat, Eugenia Maria Lupan Mureșan, George Teo Voicescu, Ștefan Cristian Vesa, Maria Adriana Albu, Daniela Ionescu
{"title":"The use of biomarkers testing in Emergency Department.","authors":"Sonia Luka, Adela Golea, Raluca Mihaela Tat, Eugenia Maria Lupan Mureșan, George Teo Voicescu, Ștefan Cristian Vesa, Maria Adriana Albu, Daniela Ionescu","doi":"10.2478/jccm-2024-0041","DOIUrl":"10.2478/jccm-2024-0041","url":null,"abstract":"<p><strong>Introduction: </strong>In the fast-paced environment of Emergency Departments (EDs), biomarkers are essential for the rapid diagnosis and management of critical conditions.</p><p><strong>Aim of the study: </strong>This study evaluates the current clinical practice on key biomarkers in Romanian EDs, addressing the needs of emergency medicine physicians, and the challenges associated with biomarker testing.</p><p><strong>Material and methods: </strong>An online survey was sent to physicians working in ED to explore their perceptions, needs, and barriers regarding biomarkers, including Point-of-care (POC). Data was collected anonymously through an online platform and subsequently analyzed.</p><p><strong>Results: </strong>This survey analyzed data from 168 completed responses, with 95.2% of respondents being specialists in emergency medicine. Procalcitonin and presepsin were most preferred for PoCT, while troponin and D-dimer were highly rated regardless of the testing method, reflecting their utility in sepsis and cardiovascular emergencies. Neuron-specific enolase, interleukin-6, and procalcitonin were the biomarkers considered needed.</p><p><strong>Conclusions: </strong>The most frequently used biomarkers in ED were troponin, D-dimer, BNP/NT-proBNP, and procalcitonin. NSE, IL-6, and procalcitonin were the most recommended for future integration. High costs, limited availability, and false-positive concerns remain significant challenges in biomarker use.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"164-172"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095074","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}
Razvan Marian Melinte, Matei Florin Negrut, Daniel Oltean-Dan, Adrian Dumitru Ivanescu, Tudor-Mihai Magdas, Oana Antal, Adela Hilda Onutu, Marian Andrei Melinte, Robert Bolcas
{"title":"A brief report on the association of preoperative hematological indices and acute deep vein thrombosis following total hip arthroplasty for osteoarthritis.","authors":"Razvan Marian Melinte, Matei Florin Negrut, Daniel Oltean-Dan, Adrian Dumitru Ivanescu, Tudor-Mihai Magdas, Oana Antal, Adela Hilda Onutu, Marian Andrei Melinte, Robert Bolcas","doi":"10.2478/jccm-2025-0018","DOIUrl":"10.2478/jccm-2025-0018","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty (THA) is a standard orthopedic procedure. Deep vein thrombosis (DVT) and pulmonary embolism are potential life-threatening postoperative complications.</p><p><strong>Aim of the study: </strong>This study aimed to assess the prognostic value of systemic inflammatory indices [monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI)] and their potential association with acute postoperative DVT.</p><p><strong>Materials and methods: </strong>We designed a multicentric, retrospective, observational cohort study, including adult patients undergoing elective HTA. Patients were divided into two groups, the DVT and non-DVT groups. We investigated the development of acute DVT early, and at 4 weeks after surgery and also registered length of hospital stay and mortality. All demographic data and laboratory data, hematological indices were extracted from patients files.</p><p><strong>Results: </strong>199 patients were included. Of those, 12 (6.03%) developed DVT and 187 (93.97%) did not. There was no statistically significant difference between patient age, gender, BMI, smoking status or comorbidities. No difference was founds between the two groups regarding median values of MLR (0.31 vs 0.27, p=0.12), NLR (3.16 vs 2.42, p=0.27), PLR (163.39 vs 123.01, p=0.27), SII (660.26 vs 568.52, p=0.33), SIRI (67.5 vs 65.26, p=0.89) and AISI (302.35 vs 290.48, p=0.85). Length of hospital stay was not significantly different (median 9 days in the DVT group vs 7 days in the non-DVT group, p=0.38), but mortality was significantly higher in the DVT group (3 deaths vs none in the non-DVT group, p<0.001).</p><p><strong>Conclusion: </strong>MLR, NLR, PRL, SII, SIRI and AISI were not associated with the development of acute DVT following HTA in our study population.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"192-197"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094250","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":"Characteristics and temporality of the ventilatory techniques in the management of acute respiratory distress syndrome: A scoping review.","authors":"Théo Battalian, Raúl Escudero Romero, Arianne Barzaga Molina","doi":"10.2478/jccm-2025-0019","DOIUrl":"10.2478/jccm-2025-0019","url":null,"abstract":"<p><strong>Introduction: </strong>Acute Respiratory Distress Syndrome (ARDS) is a critical condition characterised by acute respiratory failure due to increased alveolar-capillary membrane permeability. This leads to non-cardiogenic pulmonary oedema, hypoxemia, and impaired respiratory compliance, significantly impacting patients' survival and quality of life. The management of ARDS involves various ventilatory and non-ventilatory therapies. Understanding the optimal timing and application of these therapies is crucial for improving patient outcomes.</p><p><strong>Aim of the study: </strong>This scoping review aims to identify and synthesise the ventilatory techniques used in managing ARDS, focusing on their temporality and the interplay between different therapies. The study seeks to synthesize the available evidence and summarize current management strategies, highlighting areas for further research and improvement in ARDS care.</p><p><strong>Material and methods: </strong>A systematic search of PubMed, EBSCO, and ScienceDirect databases was conducted, following the Joanna Briggs Institute guidelines (2015), for articles published between 2013 and 2023. Studies involving adult patients (18 years or older) diagnosed with ARDS and receiving ventilatory support in the ICU were included. Exclusion criteria included other acute respiratory pathologies, clinically extreme obese patients, and patients with tracheostomy.</p><p><strong>Results: </strong>437 articles were identified through the database search, of which 23 met the inclusion criteria and were included in the final review. Most articles were published between 2015-2019 (43.5%), originated from the USA (34.78%), and employed observational study designs (73.91%). The included studies reported on patients aged between 23 and 79 years, with intrapulmonary causes being the most common aetiology for ARDS. Various ventilatory strategies were identified, including conventional oxygen therapy, high-flow nasal cannula (HFNC), non-invasive ventilation (NIV), invasive ventilation (IMV), and combined approaches. Temporality was reported in 35% of the articles, but none of them as their primary focus.</p><p><strong>Conclusions: </strong>The review highlights the diversity of ventilatory techniques employed in ARDS management and the importance of individualizing treatment strategies based on patient response and disease severity. The temporality of these interventions remains a crucial aspect, requiring further investigation to establish clearer guidelines for optimizing the timing and sequence of ventilatory support in ARDS. The findings underscore the need for future research to focus on patient-centred outcomes and the long-term implications of ARDS management, including quality of life and functional status.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"122-131"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095114","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":"Use of prone position in spontaneous breathing in patients with COVID-19.","authors":"Rodrigo Cerqueira Borges, Isadora Salvador Rocco, Camila Botana Alves Ferreira, Mauricio Kenzo Tobara, Cristiane Helena Papacidero, Vanessa Chaves Barreto Ferreira, Andrey Wirgues Sousa","doi":"10.2478/jccm-2025-0015","DOIUrl":"10.2478/jccm-2025-0015","url":null,"abstract":"<p><strong>Objective: </strong>To investigate if awake prone position (PP) reduces the rate of endotracheal intubation and mortality in patients with COVID-19 admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This was a retrospective cohort study of 726 patients who were admitted to the ICU with acute hypoxic respiratory failure secondary to COVID-19. The protocol of the institution recommended the use of awake PP in patients with nasal catheter with an oxygen flow ≥ 5 L/min and SpO<sub>2</sub> ≤ 90% or a high-flow nasal catheter (HFNC) with FiO<sub>2</sub> ≥ 50% and SpO<sub>2</sub> ≤ 90%. The following data were collected: age, comorbidities, SAPS-3 score, onset of symptoms, the degree of pulmonary involvement, duration of invasive and noninvasive MV, HFNC therapy, nitric oxide therapy, hemodialysis and PP while spontaneously breathing.</p><p><strong>Results: </strong>There was a higher mortality rate in the supine position group (27.1%) than in the awake PP group (13.9%). There was no significant difference in the time on MV or number of patients on MV (p>0.05). The variables with p < 0.05 in the bivariate analysis were entered into the Cox regression model. The model was adjusted for awake PP, sex, age, SAPS-3 score, onset of symptoms, the degree of pulmonary involvement, chronic arterial disease, and noninvasive ventilation. The only variable associated with lower mortality over time was awake PP (hazard ratio: 0.55; 95% confidence interval: 0.33-0.92).</p><p><strong>Conclusion: </strong>Awake prone position has been shown to be a safe and effective therapy that reduced mortality but not the risk of intubation in patients with COVID-19.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"149-156"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095123","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":"Management strategies and outcomes predictors of interstitial lung disease exacerbation admitted to an intensive care setting: A narrative review.","authors":"Ans Alamami","doi":"10.2478/jccm-2025-0013","DOIUrl":"10.2478/jccm-2025-0013","url":null,"abstract":"<p><strong>Background: </strong>Interstitial lung disease (ILD) is a cluster of diseases that affect the lungs, characterized by different degrees of inflammation and fibrosis within the parenchyma. In the intensive care unit (ICU), ILD poses substantial challenges because of its complicated nature and high morbidity and mortality rates in severe cases. ILD pathophysiology frequently entails persistent inflammation that results in fibrosis, disrupting the typical structure and function of the lung. Patients with ILD frequently experience dyspnea, non-productive cough, and tiredness. In the ICU setting, these symptoms may worsen and lead to signs of acute respiratory failure with significantly impaired gas physiology.</p><p><strong>Methodology: </strong>A systematic search was conducted in reputable databases, including PubMed, Google Scholar, and Embase. To ensure a comprehensive search, a combination of keywords such as \"interstitial lung disease,\" \"intensive care,\" and \"outcomes\" was used. Studies published within the last ten years reporting on the outcomes of ILD patients admitted to intensive care included.</p><p><strong>Result: </strong>Effective management of ILD in an ICU setting is challenging and requires a comprehensive approach to address the triggering factor and providing respiratory support, Hypoxemia severity is a critical predictor of mortality, with lower PaO<sub>2</sub>/FiO<sub>2</sub> ratios during the first three days of ICU admission associated with increased mortality rates. The need for mechanical ventilation, particularly invasive mechanical ventilation (IMV), is a significant predictor of poor outcomes in ILD patients. Additionally, higher positive end-expiratory pressure (PEEP) settings, and severity of illness scores, such as the Acute Physiology and Chronic Health Evaluation (APACHE) score, are also linked to increased mortality. Other poor prognostic factors include the presence of shock and pulmonary fibrosis on computed tomography (CT) images. Among the various types of ILDs, idiopathic pulmonary fibrosis (IPF) is associated with the highest mortality rate. Furthermore, a high ventilatory ratio (VR) within 24 hours after intubation independently predicts ICU mortality.</p><p><strong>Conclusion: </strong>This literature review points out outcome predictors of interstitial lung disease in intensive care units, which are mainly hypoxemia, the severity of the illness, invasive ventilation, the presence of shock, and the extent of fibrosis on CT Images.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"112-121"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095137","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 use of intraventricular vancomycin in subacute brain abscess in an adolescent male: A case report.","authors":"Tomas Leng, Ibrahim Serhat Karakus","doi":"10.2478/jccm-2024-0046","DOIUrl":"10.2478/jccm-2024-0046","url":null,"abstract":"<p><strong>Introduction: </strong>Brain abscess is a serious condition in children, leading to rapid deterioration, and permanent neurological damage associated with significant morbidity and mortality. Current management protocols for brain abscesses focus on intravenous antibiotics and surgical excision and drainage.</p><p><strong>Case presentation: </strong>A 12-year-old adolescent male who had headache and photophobia and was diagnosed with multiple brain abscesses and was refractory to conventional medical and neurosurgical intervention. A single dose of 10 mg vancomycin was administered through endo-ventricular drain, resulting in resolution of abscesses and alleviation of symptoms.</p><p><strong>Conclusion: </strong>We describe the first instance of intraventricular vancomycin use in the pediatric age group for the treatment of multiple brain abscesses. Given the variability in dosing reported in the literature, our case report warrants further studies to standardize dosage for this rare intervention.</p>","PeriodicalId":44227,"journal":{"name":"Journal of Critical Care Medicine","volume":"11 2","pages":"192-195"},"PeriodicalIF":0.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095101","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}