Critical Care Research and Practice最新文献

{"title":"Meeting the Unmet Need in the Management of MDR Gram-Positive Infections with Oral Bactericidal Agent Levonadifloxacin.","authors":"Yatin Mehta,&nbsp;K C Mishra,&nbsp;Yashesh Paliwal,&nbsp;Pradeep Rangappa,&nbsp;Sharmili Sinha,&nbsp;Sandeep Bhapkar","doi":"10.1155/2022/2668199","DOIUrl":"https://doi.org/10.1155/2022/2668199","url":null,"abstract":"<p><p>Levonadifloxacin (intravenous) and its oral prodrug alalevonadifloxacin are broad-spectrum antibacterial agents developed for the treatment of difficult-to-treat infections caused by multidrug-resistant Gram-positive bacteria, especially methicillin-resistant <i>Staphylococcus aureus</i>, atypical bacteria, anaerobic bacteria, and biodefence pathogens as well as Gram-negative bacteria. Levonadifloxacin has a well-defined mechanism of action involving a strong affinity for DNA gyrase as well as topoisomerase IV. Alalevonadifloxacin with widely differing solubility and oral bioavailability has pharmacokinetic profile identical to levonadifloxacin. Unlike existing MRSA drugs such as vancomycin and linezolid, which cause unfavorable side effects like nephrotoxicity, bone-marrow toxicity, and muscle toxicity, levonadifloxacin/alalevonadifloxacin has demonstrated superior safety and tolerability features with no serious adverse events. Levonadifloxacin/alalevonadifloxacin could be a useful weapon in the battle against infections caused by resistant microorganisms and could be a preferred antibiotic of choice for empirical therapy in the future.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9185222","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":"Non-Neurological Complications after Mechanical Thrombectomy for Acute Ischemic Stroke: A Retrospective Single-Center Study.","authors":"Pierre Goffin,&nbsp;Romain Thouny,&nbsp;Julien Guntz,&nbsp;Denis Brisbois,&nbsp;Philippe Desfontaines,&nbsp;Pierre Demaret","doi":"10.1155/2022/5509081","DOIUrl":"https://doi.org/10.1155/2022/5509081","url":null,"abstract":"<p><strong>Introduction: </strong>The global burden of stroke is high and mechanical thrombectomy is the cornerstone of the treatment. Incidences of acute non-neurological-complications are poorly described. Improve knowledge about these complications may allow to better prevent, detect and/or manage them. The aim is to identify risk markers of death or poor evolution.</p><p><strong>Method: </strong>We conducted a retrospective single-center study to analyzed the incidence of non-neurologicalcomplications after mechanical thrombectomy in acute ischemic stroke. Patients who had experienced a stroke and undergone thrombectomy were identified using a registry in which we prospectively collected data from each patient admitted to our hospital with a diagnosis of stroke. Quantitative and qualitative variables were analyses. The association between studied variables and hospital death was assessed using simple logistic regression models.</p><p><strong>Result: </strong>361 patients were reviewed but 16 were excluded due to a lack of medical information. Between 2012 and 2019, 345 patients were included. The median admission NIHSS score was 15. Seven percent of the patients died in the ICU. The following independent risk markers of death in the ICU were identified by logistic regression: respiratory complication, hypotension, infectious complication, and hyperglycemia.</p><p><strong>Conclusion: </strong>In this large retrospective study of stroke, respiratory complications and pulmonary infections represented the most important non-neurological adverse events encountered in the ICU and associated with a risk of death.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9803559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10817943","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 of Adult Sepsis Patients in the Intensive Care Units in a Tertiary Hospital in Jordan: An Observational Study.","authors":"Anas H A Abu-Humaidan,&nbsp;Fatima M Ahmad,&nbsp;Maysaa' A Al-Binni,&nbsp;Amjad Bani Hani,&nbsp;Mahmoud Abu Abeeleh","doi":"10.1155/2021/2741271","DOIUrl":"https://doi.org/10.1155/2021/2741271","url":null,"abstract":"<p><p>Sepsis is a global health issue that is commonly encountered in the intensive care unit (ICU) and is associated with high morbidity and mortality. Available data regarding sepsis in low- and middle-income countries (LMIC) is lacking compared to higher income countries, especially using updated sepsis definitions. The lack of recent data on sepsis in Jordan prompted us to investigate the burden of sepsis among Jordanian ICU patients. We conducted a prospective cohort study at Jordan University Hospital, a tertiary teaching hospital in the capital, Amman. All adult patients admitted to the adult ICUs between June 2020 and January 2021 were included in the study. Patients' clinical and demographic data, comorbidities, ICU length of stay (LOS), medical interventions, microbiological findings, and mortality rate were studied. Descriptive and inferential statistics were used to analyse data from patients with and without sepsis. We observed 194 ICU patients during the study period; 45 patients (23.3%) were diagnosed with sepsis using the Sepsis-3 criteria. Mortality rate and median ICU LOS in patients who had sepsis were significantly higher than those in other ICU patients (mortality rate, 57.8% vs. 6.0%, <i>p</i> value < 0.001, resp., and LOS 7 days vs. 4 days, <i>p</i> value < 0.001, resp.). Additionally, sepsis patients had a higher combined number of comorbidities (2.27 ± 1.51 vs. 1.27 ± 1.09, <i>p</i> value < 0.001). The use of mechanical ventilation, endotracheal intubation, and blood transfusions were all significantly more common among sepsis patients. A causative organism was isolated in 68.4% of sepsis patients with a prevalence of Gram-negative bacteria in 77.1% of cases. While the occurrence of sepsis in the ICU in Jordan is comparable to other regions in the world, the mortality rate of sepsis patients in the ICU remains high. Further studies from LMIC are required to reveal the true burden of sepsis globally.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8736695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39800925","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 Spontaneous and Mechanical Ventilation on Frequency-Based Measures of Heart Rate Variability.","authors":"Khlood Bubshait,&nbsp;Yasmine Alabbasi","doi":"10.1155/2021/8709262","DOIUrl":"https://doi.org/10.1155/2021/8709262","url":null,"abstract":"<p><p>Frequency-based measures of heart rate variability have been shown to be a useful physiological marker in both clinical and research settings providing insight into the functioning of the autonomic nervous system. Ongoing interactions between the autonomic nervous system control of the heart and lung occurs during each ventilation cycle because of their anatomical position within the closed thoracic cavity. Mechanical ventilation and subsequent removal change the normal ventilator mechanics producing alterations in the tidal volume, intrathoracic pressure, and oxygen delivery. A noninvasive method called heart rate variability (HRV) can be used to evaluate this interaction during ventilation and can be quantified by applying frequency-based measures of the variability between heartbeats. Although HRV is a reliable method to measure alteration of the autonomic nervous system (ANS) function and cardiopulmonary interaction, there have been limited reports concerning the changes in the frequency-based measure of HRV during both spontaneous and mechanical ventilation. The purpose of this methodological study is therefore to describe the physiological influence of both spontaneous and mechanical ventilation on frequency-based measures of HRV.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8720601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39877509","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 mNUTRIC-Score for Nutrition Risk Assessment and Prognosis Prediction in Critically Ill Patients with COVID-19: A Retrospective Observational Study.","authors":"Francisco G Yanowsky-Escatell,&nbsp;Areli L Ontiveros-Galindo,&nbsp;Kevin J Arellano-Arteaga,&nbsp;Luis M Román-Pintos,&nbsp;Carlos A Andrade-Castellanos,&nbsp;Diana M Hernández-Corona,&nbsp;Tonatiuh González-Heredia,&nbsp;Geannyne Villegas-Rivera","doi":"10.1155/2021/5866468","DOIUrl":"https://doi.org/10.1155/2021/5866468","url":null,"abstract":"<p><strong>Introduction: </strong>Nutritional risk is highly prevalent in patients with COVID-19. Relevant data on nutritional assessment in the critically ill population are scarce. This study was conducted to evaluate the modified Nutrition Risk in the Critically Ill (mNUTRIC)-Score as a mortality risk factor in mechanically ventilated patients with COVID-19.</p><p><strong>Methods: </strong>We conducted this retrospective observational study in critically ill patients with COVID-19. Patients' characteristics and clinical information were obtained from electronic medical records. The nutritional risk for each patient was assessed at the time of mechanical ventilation using the mNUTRIC-Score. The major outcome was 28-day mortality.</p><p><strong>Results: </strong>Ninety-eight patients were analyzed (mean age, 57.22 ± 13.66 years, 68.4% male); 46.9% of critically ill COVID-19 patients were categorized as being at high nutrition risk (mNUTRIC-Score of ≥5). A multivariate logistic regression model indicated that high nutritional risk has higher 28-day hospital mortality (OR = 4.206, 95% CI: 1.147-15.425, <i>p</i>=0.030). A multivariate Cox regression analysis showed that high-risk mNUTRIC-Score had a significantly increased full-length mortality risk during hospitalization (OR = 1.991, 95% CI: 1.219-3.252, <i>p</i>=0.006).</p><p><strong>Conclusion: </strong>The mNUTRIC-Score is an independent mortality risk factor during hospitalization in critically ill COVID-19 patients.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641337","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":"Prevalence and Trajectory of COVID-19-Associated Hypercoagulability Using Serial Thromboelastography in a South African Population.","authors":"Sarah Alexandra van Blydenstein,&nbsp;Colin Nigel Menezes,&nbsp;Nicole Miller,&nbsp;Naomi Johnson,&nbsp;Bavinash Pillay,&nbsp;Barry F Jacobson,&nbsp;Shahed Omar","doi":"10.1155/2021/3935098","DOIUrl":"https://doi.org/10.1155/2021/3935098","url":null,"abstract":"<p><strong>Introduction: </strong>The coagulation abnormalities resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been attributed to inflammation and subsequent cytokine storm. Thromboelastography (TEG) is a point-of-care test used to assess clot formation and degradation in whole blood and is an indicator of the overall real-time coagulopathic state of the patient.</p><p><strong>Methods: </strong>A single-centre, prospective, observational cohort study was conducted in South Africa, analysing the coagulation patterns of 41 patients with hypoxia related to SARS-CoV-2 using serial thromboelastography (TEG) on admission, after 48 hours, and at resolution of hypoxia/day 10. Results: Two-thirds (<i>n</i> = 26) were women. The median age was 61 (IQR 50-67), and the majority (88%) were Black patients. Almost half (22) of the patients were critically ill and ventilated, with median SOFA and SAPS2 scores of 3 and 22 (IQR2-4 and 18-30), respectively. The prevalence of hypercoagulability was 0.54 (95% CI 0.46-0.62), whilst 29/41 (0.71, CI 0.64-0.78)) met the definition of hypofibrinolysis. Differences between the hypercoagulable (HC) and non-hypercoagulable groups remained apparent at 48 hours after anticoagulation. At this time point, the K time was significantly lower (<i>p</i> ˂ 0,01), and the <i>α</i>-angle (<i>p</i> ˂ 0,01) and maximum amplitude (MA) (<i>p</i> ˂ 0,01) were significantly higher in the HC cohort. At resolution of hypoxia, or day 10, only MA was significantly higher in the hypercoagulable group compared to the non-hypercoagulable group (<i>p</i> = 0.01). The initial impairment in fibrinolysis (Ly30), <i>α</i> angle, and MA were significantly associated with mortality, with <i>p</i> values of 0.006, 0.031, and 0.04, respectively.</p><p><strong>Conclusions: </strong>In this South African population, hypercoagulability was a highly prevalent phenomenon in COVID-19 disease. It was typified by hypofibrinolysis and a persistently elevated MA, despite anticoagulation therapy.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625832","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":"Assessment of Metabolic Dysfunction in Sepsis in a Retrospective Single-Centre Cohort.","authors":"Julien Goutay,&nbsp;Juliette Perche,&nbsp;Aurelia Toussaint,&nbsp;Elodie Drumez,&nbsp;Michael Howsam,&nbsp;Claire Bourel,&nbsp;Benoit Brassart,&nbsp;Alexandre Pierre,&nbsp;Morgan Caplan,&nbsp;Arthur Durand,&nbsp;Marion Houard,&nbsp;Saad Nseir,&nbsp;Raphael Favory,&nbsp;Sébastien Preau","doi":"10.1155/2021/3045454","DOIUrl":"https://doi.org/10.1155/2021/3045454","url":null,"abstract":"<p><strong>Objective: </strong>Our primary aim was to assess selected metabolic dysfunction parameters, both independently and as a complement to the SOFA score, as predictors of short-term mortality in patients with infection admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>We retrospectively enrolled all consecutive adult patients admitted to the eight ICUs of Lille University Hospital, between January 2015 and September 2016, with suspected or confirmed infection. We selected seven routinely measured biological and clinical parameters of metabolic dysfunction (maximal arterial lactatemia, minimal and maximal temperature, minimal and maximal glycaemia, cholesterolemia, and triglyceridemia), in addition to age and the Charlson's comorbidity score. All parameters and SOFA scores were recorded within 24 h of admission.</p><p><strong>Results: </strong>We included 956 patients with infection, among which 295 (30.9%) died within 90 days. Among the seven metabolic parameters investigated, only maximal lactatemia was associated with higher risk of 90-day hospital mortality in SOFA-adjusted analyses (SOFA-adjusted OR, 1.17; 95%CI, 1.10 to 1.25; <i>p</i> < 0.001). Age and the Charlson's comorbidity score were also statistically associated with a poor prognosis in SOFA-adjusted analyses. We were thus able to develop a metabolic failure, age, and comorbidity assessment (MACA) score based on scales of lactatemia, age, and the Charlson's score, intended for use in combination with the SOFA score.</p><p><strong>Conclusions: </strong>The maximal lactatemia level within 24 h of ICU admission is the best predictor of short-term mortality among seven measures of metabolic dysfunction. Our combined \"SOFA + MACA\" score could facilitate early detection of patients likely to develop severe infections. Its accuracy requires further evaluation.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8712182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39633218","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":"Diabetic Ketoacidosis Updates: Titratable Insulin Infusions and Long-Acting Insulin Early.","authors":"Justin Kinney,&nbsp;Oshin Baroi,&nbsp;Mania Gharibian","doi":"10.1155/2021/1601553","DOIUrl":"https://doi.org/10.1155/2021/1601553","url":null,"abstract":"<p><strong>Background: </strong>To compare a titratable insulin infusion order set (vs. nontitratable) and early administration of long-acting insulin in adult patients with diabetic ketoacidosis (DKA).</p><p><strong>Methods: </strong>Single health system, retrospective study of adult patients admitted to the intensive care unit (ICU) for DKA. The primary outcomes were insulin infusion duration and ICU/hospital length of stays (LoS). Secondary outcomes included ICU/hospital survival, hypoglycemia, and hypokalemia.</p><p><strong>Results: </strong>151 patients were included in the titratable versus nontitratable insulin infusion comparison. Patients treated with the titratable insulin had shorter hospitalization (6.4 vs. 10.4 days, <i>p</i>=0.03) and reduced the number hypoglycemic events by over half (20.6% vs. 46.0%, <i>p</i> < 0.01). 110 patients were identified to compare overlapping a long-acting insulin for more than 4 h with the insulin infusion versus the standard 1-2 h overlap. Patients who received the insulin early spent over 18 h longer on the infusion (<i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>A titratable insulin infusion added to the institutional DKA order set was associated with fewer days in the hospital and a significant reduction in hypoglycemic events. Furthermore, overlapping the long-acting insulin earlier with the insulin infusion early showed no benefit and could potentially be worse than the standard overlap.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8694948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39625831","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":"Correlation of Serum Albumin Level to Lung Ultrasound Score and Its Role as Predictors of Outcome in Acute Respiratory Distress Syndrome Patients: A Prospective Observational Study.","authors":"Souvik Chaudhuri,&nbsp;Sagar S Maddani,&nbsp;Shwethapriya Rao,&nbsp;Sirish Gauni,&nbsp;N R Arjun,&nbsp;Pratibha Todur,&nbsp;Nitin Gupta","doi":"10.1155/2021/4594790","DOIUrl":"https://doi.org/10.1155/2021/4594790","url":null,"abstract":"<p><strong>Background: </strong>There is ambiguity in the literature regarding hypoalbuminemia as a cause of extravascular lung water and acute respiratory distress syndrome (ARDS) outcomes. The aim of the study was to determine if low serum albumin on admission leads to lung deaeration and higher lung ultrasound score (LUSS) in ARDS patients. <i>Patients and Methods</i>. It was a prospective observational study in which 110 ARDS patients aged between 18 and 70 years were recruited. Serum albumin level and lung ultrasound score were assessed on the day of ICU admission. Length of ICU stay and hospital mortality were recorded.</p><p><strong>Results: </strong>The mean and standard deviation of serum albumin level in mild, moderate, and severe ARDS was 2.92 ± 0.65 g/dL, 2.91 ± 0.77 g/dL, and 3.21 ± 0.85 g/dL, respectively. Albumin level was not correlated to the global LUSS (Pearson correlation <i>r</i> -0.006, <i>p</i>=0.949) and basal LUSS (<i>r</i> -0.066, <i>p</i>=0.513). The cut-off value of albumin for predicting a prolonged length of ICU stay (≥10 days) in ARDS patients was <3.25 g/dL with AUC 0.623, <i>p</i> < 0.05, sensitivity of 86.67%, specificity of 45.45%, and 95% confidence interval (CI) [0.513-0.732], and on multivariate analysis it increased the odds of prolonged ICU stay by 8.9 times (Hosmer and Lemeshow <i>p</i> value 0.810, 95% CI [2.760-28.72]). Serum albumin at admission was not a predictor of mortality. LUSS on the day of admission was not useful to predict either a prolonged length of ICU stay or mortality. Basal LUSS contributed about 56% of the global LUSS in mild and moderate ARDS, and 53% in severe ARDS.</p><p><strong>Conclusion: </strong>Serum albumin level was unrelated to LUSS on admission in ARDS patients. Albumin level <3.25 g/dL increased the chances of a prolonged length of ICU stay (≥10 days) but was not associated with an increase in mortality. LUSS on the day of admission could not predict either a prolonged length of ICU stay or mortality. This trial is registered with CTRI/2019/11/021857.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8670905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39845684","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":"Correlation between Handgrip Strength and Rapid Shallow Breathing Index for Assessment of Weaning from Mechanical Ventilation.","authors":"Narongkorn Saiphoklang,&nbsp;Thanapon Keawon","doi":"10.1155/2021/4637528","DOIUrl":"https://doi.org/10.1155/2021/4637528","url":null,"abstract":"Background Assessment of weaning from mechanical ventilation (MV) is an important process. Rapid shallow breathing index (RSBI) is a standard tool to evaluate a patient's readiness before the spontaneous breathing trial (SBT). Handgrip strength (HGS) is an alternative method for assessment of respiratory muscle strength. Relationship between HGS and RSBI has not been explored. This study aimed to determine the correlation between HGS and RSBI to predict successful extubation in mechanically ventilated patients. Methods A prospective study was conducted in screened 120 patients requiring MV with tracheal intubation >48 h. HGS was performed at 48 h after intubation, 10 min before and 30 min after SBT, and 1 h after extubation. RSBI was performed at 10 min before SBT. Results A total of 93 patients (58% men) were included in the final analysis. Mean age was 71.6 ± 15.2 years. Patients admitted in general medical wards were 84.9%. APACHE II score was 13.5 ± 4.7. Most patients were intubated from pneumonia (39.8%). Weaning failure was 6.5%. The main result shows that HGS was negatively correlated with RSBI (regression coefficient −0.571, P < 0.001). The equation for predicting RSBI, derived from the linear regression model, was predicted RSBI (breaths/min/L) = 39.285 + (age ∗ 0.138)–(HGS ∗ 0.571). Conclusions HGS had significantly negative correlation with RSBI for assessment of weaning from MV. A prospective study of the HGS cutoff value is needed to investigate the difference between patients who succeeded and those who failed extubation. This trial is registered with TCTR20180323004.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2021-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8651303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39709817","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}