Critical Care Research and Practice最新文献

{"title":"ICU Length of Stay and Factors Associated with Longer Stay of Major Trauma Patients with Multiple Rib Fractures: A Retrospective Observational Study","authors":"Hesham S Abdelwahed, F. E. Martinez","doi":"10.1155/2022/6547849","DOIUrl":"https://doi.org/10.1155/2022/6547849","url":null,"abstract":"Background Chest injury with multiple rib fractures is the most common injury among major trauma patients in New South Wales (23%) and is associated with a high rate of mortality and morbidity. The aim of this study was to determine the intensive care unit (ICU) length of stay (LOS) among major trauma patients with multiple rib fractures and to identify factors associated with a prolonged ICU LOS. Materials and Methods Single-centre, retrospective observational cohort study of adult patients with 3 or more traumatic rib fractures, who were admitted to ICU between June 2014 and June 2019. A comparison was made between patients who stayed in ICU for less than 7 days and those that stay for 7 or more days. Results Among 215 patients who were enrolled, 150 (69.7%) were male, the median Injury Severity Score (ISS) was 24 (interquartile range (IQR): 17–32). The median ICU LOS was 4 (IQR: 2–7) days and the average ICU LOS was 6.5 (SD 8.5; 95% CI 5.3–7.6) days. The median number of rib fractures was 6 (IQR: 5–9) and 76 (35.3%) patients had a flail chest. Patients who stayed longer than 7 days in ICU had higher ISS, higher APACHE-II score, greater number of rib fractures, higher rate of lung contusions, and required more respiratory support of any type. Conclusions ISS, number of rib fractures, lung contusion, and flail chest were associated with prolonged ICU LOS in patients with traumatic multiple rib fractures.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43988301","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 Identical External Reference Point Standardized to the Zero-Reference Level for Measuring Both Central and Jugular Venous Pressures: An Observational Study.","authors":"Niraj Karmacharya,&nbsp;Madhur Dev Bhattarai,&nbsp;Amita Pradhan","doi":"10.1155/2022/7329863","DOIUrl":"https://doi.org/10.1155/2022/7329863","url":null,"abstract":"<p><strong>Background: </strong>Studies report discrepancies between CVP and JVP measurements. The mid-thoracic plane (MTP) at the anterior fourth intercostal space level indicates the zero-reference level (ZRL) for venous pressure measurement, and the midaxillary line (MAL) at fourth intercostal space is a point near the ZRL in the supine position. JVP is usually measured from the sternal angle (SA) with further addition of 5 cm (JVP-SA + 5) and CVP in the supine position from MAL (CVP-MAL). However, no report has compared CVP measured from MTP (CVP-MTP) with CVP-MAL and with JVP from MTP (JVP-MTP) and JVP-SA + 5.</p><p><strong>Methods: </strong>We measured JVP-MTP and JVP-SA + 5 in appropriate reclining positions and subsequently CVP-MTP and CVP-MAL in the supine position blindly in 150 patients. We compared the pressures by Pearson correlation and Bland-Altman plots.</p><p><strong>Results: </strong>CVP-MTP and CVP-MAL demonstrated similar means (<i>p</i> = 0.129), strong positive linear relationship (<i>r</i> = 0.908), and good agreement (near-zero mean difference) with each other. JVP-MTP was about 1 cm higher than JVP-SA + 5 (<i>p</i> < 0.001). JVP-MTP displayed higher correlation coefficients and better agreements with both CVPs than JVP-SA+5. Correlation coefficients and mean differences of both CVPs with JVP-MTP were almost equal, about 0.83 and 1 cm, and with JVP-SA + 5 also almost equal, about 0.72 and 2 cm, respectively.</p><p><strong>Conclusions: </strong>JVP tallies better with CVP examined in the supine position when both are measured from MTP as the identical external reference point (ERP), and MAL can be used as MTP to measure CVP in the supine position. Our findings indicate the way to explore the matching of CVP and JVP to the full extent possible by standardizing their measurements from other identical ERPs to that from the zero-reference level MTP. Their further study in similar higher reclining positions from identical ERPs, such as MTP, MAL, and SA with the addition of higher numbers instead of 5 cm, is warranted standardizing other measurements to that from MTP.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2022 ","pages":"7329863"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9792246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10452846","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":"Discrepancies Between Bayesian Vancomycin Models Can Affect Clinical Decisions in the Critically Ill.","authors":"Asad E Patanwala,&nbsp;Danijela Spremo,&nbsp;Minji Jeon,&nbsp;Yann Thoma,&nbsp;Jan-Willem C Alffenaar,&nbsp;Sophie Stocker","doi":"10.1155/2022/7011376","DOIUrl":"https://doi.org/10.1155/2022/7011376","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the agreement in 24-hour area under the curve (AUC₂₄) value estimates between commonly used vancomycin population pharmacokinetic models in the critically ill.</p><p><strong>Materials and methods: </strong>Adults admitted to intensive care who received intravenous vancomycin and had a serum vancomycin concentration available were included. AUC₂₄ values were determined using Tucuxi (revision cd7bd7a8) for dosing intervals with a vancomycin concentration using three models (Goti 2018, Colin 2019, and Thomson 2009) previously evaluated in the critically ill. AUC₂₄ values were categorized as subtherapeutic (<400 mg·h/L), therapeutic (400-600 mg·h/L), or toxic (>600 mg·h/L), assuming a minimum inhibitory concentration of 1 mg/L. AUC₂₄ value categorization was compared across the three models and reported as percent agreement.</p><p><strong>Results: </strong>Overall, 466 AUC₂₄ values were estimated in 188 patients. Overall, 52%, 42%, and 47% of the AUC₂₄ values were therapeutic for the Goti, Colin, and Thomson models, respectively. The agreement of AUC₂₄ values between all three models was 48% (223/466), Goti-Colin 59% (193/466), Goti-Thomson 68% (318/466), and Colin-Thomson 67% (314/466).</p><p><strong>Conclusion: </strong>In critically ill patients, vancomycin AUC₂₄ values obtained from different pharmacokinetic models are often discordant, potentially contributing to differences in dosing decisions. This highlights the importance of selecting the optimal model.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2022 ","pages":"7011376"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9767744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423284","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":"Predictors of ICU Mortality among Mechanically Ventilated Patients: An Inception Cohort Study from a Tertiary Care Center in Addis Ababa, Ethiopia.","authors":"Finot Debebe,&nbsp;Alberto Goffi,&nbsp;Tewodros Haile,&nbsp;Fetiya Alferid,&nbsp;Haimanot Estifanos,&nbsp;Neill K J Adhikari","doi":"10.1155/2022/7797328","DOIUrl":"https://doi.org/10.1155/2022/7797328","url":null,"abstract":"<p><strong>Background: </strong>Mechanical ventilation is a life-saving intervention for patients with critical illnesses, yet it is associated with higher mortality in resource-constrained settings. This study intended to determine factors associated with the mortality of mechanically ventilated adult intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>A one-year retrospective inception cohort study was conducted using manual chart review in ICU patients (age >13) admitted to Tikur Anbessa Specialized Hospital (Addis Ababa, Ethiopia) from September 2019 to September 2020; mechanically ventilated patients were followed to hospital discharge. Demographic, clinical, and outcome data were collected; logistic regression was used to determine mortality predictors in the ICU.</p><p><strong>Result: </strong>A total of 160 patients were included; 85/160 (53.1%) were females and the mean (SD) age was 38.9 (16.2) years. The commonest indication for ICU admission was a respiratory problem (<i>n</i> = 97/160, 60.7%). ICU and hospital mortality were 60.7% (<i>n</i> = 97/160) and 63.1% (<i>n</i> = 101/160), respectively. Coma (Glasgow Coma Score <8 or 7 with an endotracheal tube (7T)) (adjusted odds ratio [AOR] 6.3, 95% confidence interval 1.19-33.00), cardiovascular diagnosis (AOR 5.05 [1.80-14.15]), and a very low serum albumin level (<2 g/dl) (AOR 4.9 [1.73-13.93]) were independent predictors of mortality (<i>P</i> < 0.05). The most commonly observed complication was ICU acquired infection (<i>n</i> = 48, 30%).</p><p><strong>Conclusions: </strong>ICU mortality in ventilated patients is high. Coma, a very low serum albumin level (<2 g/dl), and cardiovascular diagnosis were independent predictors of mortality. A multifaceted approach focused on developing and implementing context appropriate guidelines and improving skilled healthcare worker availability may prove effective in reducing mortality.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2022 ","pages":"7797328"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10461347","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":"Ketamine Infusion for Sedation and Analgesia during Mechanical Ventilation in the ICU: A Multicenter Evaluation.","authors":"Kathryn M Pendleton,&nbsp;Laurel E Stephenson,&nbsp;Nick Goeden,&nbsp;Anna R Benson,&nbsp;Qi Wang,&nbsp;Salman B Mahmood,&nbsp;Kelly A Considine,&nbsp;Matthew E Prekker","doi":"10.1155/2022/9853344","DOIUrl":"https://doi.org/10.1155/2022/9853344","url":null,"abstract":"<p><strong>Methods: </strong>We reviewed the electronic medical record of critically ill adults who received a continuous infusion of ketamine for ≥24 hours during invasive mechanical ventilation in three hospitals over a two-year period. We captured data including ketamine indication, dose, unintended effects, and adjustments to coadministered sedatives or opioids. We analyzed these data to determine the incidence of reported unintended effects of ketamine infusion (primary outcome) and changes in exposure to coadministered sedatives or opioids during ketamine use (secondary outcome).</p><p><strong>Results: </strong>95 mechanically ventilated adults received a ketamine infusion for a median duration of 75 hours (interquartile range [IQR] 44-115) at a mean ± standard deviation (SD) infusion rate of 1.3 ± 0.5 mg/kg/hour for the first 24 hours. At least one unintended effect attributed to ketamine was documented in 24% of cases, most frequently tachycardia (6%) and sialorrhea (6%). Other sedative or opioid infusions were administered with ketamine in 76% and 92% of cases, respectively. Comparing the total amount of sedative or opioid administered in the 24 hours prior to ketamine infusion with the total amount administered during the first 24 hours on ketamine, there were no significant differences in propofol, midazolam, or dexmedetomidine exposure, but the average fentanyl exposure was higher after ketamine (2740 ± 1812 mcg) than before (1975 ± 1860 mcg) (absolute difference 766 mcg, 95% confidence interval [CI] 442 to 1089 mcg).</p><p><strong>Conclusions: </strong>In this multicenter cohort of critically ill, mechanically ventilated adults, ketamine infusion was primarily used as an adjunct to conventional sedative and opioid infusions, with noticeable but unintended effects potentially related to ketamine in nearly one-quarter of cases.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2022 ","pages":"9853344"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10697377","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":"Using Residual Blood from the Arterial Blood Gas Test to Perform Therapeutic Drug Monitoring of Vancomycin: An Example of Good Clinical Practice Moving towards a Sustainable Intensive Care Unit.","authors":"T J L Smeets,&nbsp;D van de Velde,&nbsp;B C P Koch,&nbsp;H Endeman,&nbsp;N G M Hunfeld","doi":"10.1155/2022/9107591","DOIUrl":"https://doi.org/10.1155/2022/9107591","url":null,"abstract":"<p><strong>Background: </strong>Regarding sustainability in the intensive care unit (ICU), there is increasing interest in reducing material waste and avoiding unnecessary procedures. Therapeutic drug monitoring (TDM) of vancomycin, using a dedicated tube, is standard clinical care during treatment with vancomycin. Furthermore, in the ICU, on a daily basis, arterial blood gas (ABG) tests are frequently performed throughout the day. After analysis, a variable volume of blood is discarded. Lithium heparin (LiHep) syringes for ABG tests differ from normally used dipotassium ethylenediaminetetraacetic acid (K₂EDTA) tubes. The primary objective was to compare both containers and validate the use of LiHep syringes. Secondary objectives were to evaluate the potential impact on saving materials, nursing time, and costs when implementing vancomycin TDM via LiHep syringes.</p><p><strong>Methods: </strong>Vancomycin analysis from sampling in lithium heparin (LiHep) syringes for ABG tests was validated and compared with the concentrations from conventional sampling in K₂EDTA tubes. For method comparison, a Bland-Altman plot and Deming regression analysis were performed. The method was validated for inter- and intra-day precision and accuracy. Vancomycin was analyzed by means of the validated method using a particle-enhanced turbidimetric inhibition immunoassay (PETINIA) autoanalyzer. Furthermore, an analysis was conducted to evaluate the potential impact of implementing vancomycin sampling via ABG tests on savings in materials, nursing time, and costs.</p><p><strong>Results: </strong>From 18 patients, 24 plasma samples in both K₂EDTA tubes and LiHep syringes were obtained and compared. The mean relative difference between the two containers was -2.0% (-3.0 to -0.93%). Both the Deming regression analysis and the Bland-Altman plot met the acceptance criteria. Potentially, over 1000 blood draws and accompanying materials and packaging can be saved when vancomycin samples are obtained by means of scavenged LiHep syringes. The vancomycin analysis for LiHep syringes showed a total interday precision of 1.95% and an accuracy of 99.7%. The total intraday precision was 2.22%, and the accuracy was 99.2%. Accuracy and precision values were within the acceptance criteria of recovery 85 to 115% and ≤15%, respectively.</p><p><strong>Conclusion: </strong>No significant differences were found in vancomycin concentration between the two analyses, and the LiHep analysis was validated for further implementation in clinical care. Residual blood from ABG test samples can be used for TDM of vancomycin, resulting in a potential reduction of materials used and the number of blood draws. These results will contribute to a more sustainable TDM process with benefits for the patient.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2022 ","pages":"9107591"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9810402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10860061","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":"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":"2022 ","pages":"2668199"},"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":"2022 ","pages":"5509081"},"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":"Awareness and Perception of Healthcare Providers about Proxy Consent in Critical Care Research.","authors":"Rania Mahafzah, Karem H Alzoubi, Omar F Khabour, Rana Abu-Farha","doi":"10.1155/2021/7614517","DOIUrl":"10.1155/2021/7614517","url":null,"abstract":"<p><strong>Objective: </strong>Proxy consent respects patients' autonomy when they are incapable of providing consent for research participation. Healthcare providers need to understand the ethical regulations and practices relevant to the proxy consent process. Thus, this study aimed to assess the knowledge and attitudes of healthcare providers about research proxy consent in the ICU setting.</p><p><strong>Methods: </strong>A cross-sectional survey-based design was used in the study. Study participants were resident and specialist physicians, registered nurses, and registered pharmacists from ICU units in Jordan. Participants were asked to fill out a questionnaire developed to assess their knowledge and attitudes towards informed proxy consent for research studies conducted at the ICU.</p><p><strong>Results: </strong>In this study, 145 healthcare providers completed the study questionnaire. The healthcare providers agreed that the purpose of the proxy consent is to inform the participants about the potential benefits (66.9%) and risks (66.9%) related to the research to study and respect patient's autonomy (44%), to discuss alternative options (62.1%), and to protect the researchers from any litigation (84.1%). Regarding the assessment of proxy consent, 65.5% of respondents believed that relatives are considered as an authorized legal representative for an informed consent decision on behalf of their ICU patients (65.5%) as they are knowledgeable about patients' values and preferences and have the desire to provide the necessary help. Respondents also agreed that the informed consent process should explain research protocols and procedures (76.6%), therapeutic alternatives (84.1%), potential benefits (41.4%), and potential risks (44.1%) and that participation in the research is voluntary (66.9%). No significant differences in the responses were found among different groups of healthcare providers.</p><p><strong>Conclusion: </strong>The majority of healthcare providers had inadequate awareness about the ethical aspects regarding the informed proxy consent process. Providing training regarding the informed consent process can improve the quality of the proxy consent process in clinical research studies in the ICU setting.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2021 ","pages":"7614517"},"PeriodicalIF":1.8,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10587318","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":"COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines.","authors":"Onion Gerald V Ubaldo, Jose Emmanuel M Palo, Jude Erric L Cinco","doi":"10.1155/2021/7510306","DOIUrl":"10.1155/2021/7510306","url":null,"abstract":"<p><p>On January 30, 2020, the WHO declared the novel coronavirus of 2019 a pandemic, causing millions of cases and thousands of deaths worldwide, exposing the vulnerabilities of healthcare systems around the world with each country having its own experience. These ranged from patient clinical profiles to management recommendations and to government interventions. There is a paucity of published data regarding Philippine experience. This study is a retrospective, descriptive study of ninety-one COVID-19 probable patients admitted in the COVID ICU of The Medical City from March 16 to May 7, 2020. We described clinical and demographic characteristics amongst COVID-19-confirmed and -negative patients. Therapeutic interventions including COVID-19 investigational drug use and other organ failure strategies were noted and tested for association with ICU survivors and nonsurvivors. We observed that there was no therapeutic intervention that was associated with improved outcomes, with some interventions showing trends favoring the ICU nonsurvivor group. These interventions include, but are not limited to, the use of hydroxychloroquine and tocilizumab, and prone positioning. We also observed that a higher SAPS-3 score was associated with the COVID-19 positive group and the ICU nonsurvivor group. On PubMed search, there seems to be no Philippine-specific literature regarding COVID-19 ICU experience. Further investigations to include more variables are recommended.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2021 ","pages":"7510306"},"PeriodicalIF":1.7,"publicationDate":"2021-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10656969","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}