Critical Care Research and Practice最新文献

{"title":"Sleep Promotion among Critically Ill Patients: Earplugs/Eye Mask versus Ocean Sound-A Randomized Controlled Trial Study.","authors":"Abhilasha Chaudhary, Vinay Kumari, Neetu Neetu","doi":"10.1155/2020/8898172","DOIUrl":"10.1155/2020/8898172","url":null,"abstract":"<p><strong>Background: </strong>Poor sleep quality is common in the intensive care unit (ICU), where several factors including environmental factors contribute to sleep deprivation.</p><p><strong>Objective: </strong>This study aims to assess and compare the effectiveness of earplugs and eye mask versus ocean sound on sleep quality among ICU patients.</p><p><strong>Design: </strong>A true experimental crossover design was used. <i>Setting</i>. Medical ICU of the Maharishi Markandeshwar Institute of Medical Sciences and Research Hospital, Mullana, India. <i>Participants.</i> Sixty-eight patients admitted in the medical ICU were randomly allocated by lottery methods into group 1 and group 2.</p><p><strong>Methods: </strong>Nocturnal nine-hour (10 : 00 pm to 7 : 00 am) for a four-night period were measured. Earplugs and eye mask versus ocean sound were crossed over between two groups. Subjective sleep quality of four nights was assessed using a structured sleep quality scale. Scores for each question range from 0 to 3, with a higher score indicating poor sleep quality.</p><p><strong>Results: </strong>Repeated measures ANOVA showed that there was a significant change in the sleep quality score (<i>p</i>=0.001), which showed that sleep quality score was improved after the administration of earplugs and eye mask and ocean sound. Fisher's LSD post hoc comparison showed a significant difference (<i>p</i>=0.001).</p><p><strong>Conclusion: </strong>Earplugs and eye mask were better than ocean sound in improving sleep quality. Earplugs, eye mask, and ocean sound are safe and cost effective, which could be used as an adjuvant to pharmacological interventions to improve sleep quality among ICU patients. However, further research in this area needs to be conducted. This trial is registered with NCT03215212.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"8898172"},"PeriodicalIF":1.8,"publicationDate":"2020-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39151886","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":"Simulation-Based Rapid Development and Implementation of a Novel Barrier Enclosure for Use in COVID-19 Patients: The SplashGuard CG.","authors":"Tine François, Laurence Tabone, Arielle Levy, Laurence Alix Seguin, Taher Touré, Carl Eric Aubin, Philippe Jouvet","doi":"10.1155/2020/3842506","DOIUrl":"10.1155/2020/3842506","url":null,"abstract":"<p><strong>Background: </strong>The current COVID-19 pandemic has resulted in over 54,800,000 SARS-CoV-2 infections worldwide with a mortality rate of around 2.5%. As observed in other airborne viral infections such as influenza and SARS-CoV-1, healthcare workers are at high risk for infection when performing aerosol-generating medical procedures (AGMP). Additionally, the threats of a global shortage of standard personal protective equipment (PPE) prompted many healthcare workers to explore alternative protective enclosures, such as the \"aerosol box\" invented by a Taiwanese anesthetist. Our study includes the design process of a protective barrier enclosure and its subsequent clinical implementation in the management of critically ill adults and children infected with SARS-CoV-2.</p><p><strong>Methods and results: </strong>The barrier enclosure was designed for use in our tertiary care facility and named \"SplashGuard CG\" (CG for Care Givers). The device has been adapted using a multi- and interdisciplinary approach, with collaboration between physicians, respiratory therapists, nurses, and biomechanical engineers. Computer-aided design and simulation sessions throughout the entire process facilitated the rapid and safe implementation of the SplashGuard CG in different settings (intensive care unit, emergency department, and the operating room) during AGMPs such as bag-valve-mask ventilation, nasopharyngeal suctioning, intubation and extubation, and noninvasive ventilation. Indications for use and anticipatory precautions were communicated to all healthcare workers using the SplashGuard CG. The entire process was completed within one month.</p><p><strong>Conclusion: </strong>The rapid design, development, and clinical implementation of a new barrier enclosure, the \"SplashGuard CG,\" was feasible in this time of crisis thanks to close collaboration between medical and engineering teams and the use of recurring simulation sessions to test and improve the initial prototypes. Following this accelerated process, it is necessary to maintain team skills, monitor any undesirable effects, and evaluate and continuously improve this new device.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"3842506"},"PeriodicalIF":1.8,"publicationDate":"2020-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7747007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38766276","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 Fluid Overload on Attributable Morbidity after Cardiac Surgery: A Retrospective Study.","authors":"Vildan Koc, Laura Delmas Benito, Eldert de With, E Christiaan Boerma","doi":"10.1155/2020/4836862","DOIUrl":"10.1155/2020/4836862","url":null,"abstract":"<p><strong>Introduction: </strong>Although the detrimental effects of excessive perioperative fluid administration are generally well established, data in the setting of cardiac surgery remain less robust.</p><p><strong>Methods: </strong>In this retrospective single-center observational study, the total fluid balance in the first 12 hours during and after surgery was evaluated. Primary endpoint was the relationship between total fluid balance and the incidence of prolonged mechanical ventilation. For this purpose, data were divided into quartiles (Q); prolonged mechanical ventilation and prolonged length of stay (LOS) in the ICU were defined as Q4. Secondary endpoints were prolonged LOS in the ICU, incidence of acute kidney injury (AKI; defined as a 1.5-fold increase in serum creatinine during, relative to baseline), and ICU mortality.</p><p><strong>Results: </strong>In a 3-year period, 748 patients were included. In a univariate analysis, the median duration of mechanical ventilation was 2.9 h [2.4-3.7] in Q1 of the fluid balance and increased significantly to 4.7 h [3.1-9.2] in Q4 of the fluid balance (<i>p</i> < 0.001). In addition, patients in Q4 of the fluid balance had a significantly longer LOS in the ICU, as well as a higher incidence of AKI and ICU mortality. In a multivariate analysis, Q4 of the fluid balance was independently associated with prolonged mechanical ventilation (OR 4.9, CI 2.9-8.4, <i>p</i> < 0.001) and prolonged LOS in the ICU (OR 11.3 CI 6.1-20,9, <i>p</i> < 0.001), but not with the incidence of AKI or ICU mortality.</p><p><strong>Conclusions: </strong>Perioperative fluid administration in cardiac surgery patients was independently associated with prolonged mechanical ventilation and prolonged LOS in the ICU.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"4836862"},"PeriodicalIF":1.7,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4836862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854677","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":"Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit.","authors":"Gopala Krishna Alaparthi,&nbsp;Aishwarya Gatty,&nbsp;Stephen Rajan Samuel,&nbsp;Sampath Kumar Amaravadi","doi":"10.1155/2020/7840743","DOIUrl":"https://doi.org/10.1155/2020/7840743","url":null,"abstract":"Purpose Patients admitted to the intensive care unit (ICU) are generally confined to bed leading to limited mobility that may have detrimental effects on different body systems. Early mobilization prevents or reduces these effects and improves outcomes in patients following critical illness. The purpose of this review is to summarize different aspects of early mobilization in intensive care. Methods Electronic databases of PubMed, Google Scholar, ScienceDirect, and Scopus were searched using a combination of keywords. Full-text articles meeting the inclusion criteria were selected. Results Fifty-six studies on various aspects such as the effectiveness of early mobilization in various intensive care units, newer techniques in early mobilization, outcome measures for physical function in the intensive care unit, safety, and practice and barriers to early mobilization were included. Conclusion: Early mobilization is found to have positive effects on various outcomes in patients with or without mechanical ventilation. The newer techniques can be used to facilitate early mobilization. Scoring systems—specific to the ICU—are available and should be used to quantify patients' status at different intervals of time. Early mobilization is not commonly practiced in many countries. Various barriers to early mobilization have been identified, and different strategies can be used to overcome them.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"7840743"},"PeriodicalIF":1.7,"publicationDate":"2020-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7840743","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38352150","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":"Prone Position after Liberation from Prolonged Mechanical Ventilation in COVID-19 Respiratory Failure.","authors":"Andrei Karpov, Anish R Mitra, Sarah Crowe, Gregory Haljan","doi":"10.1155/2020/6688120","DOIUrl":"10.1155/2020/6688120","url":null,"abstract":"<p><strong>Design: </strong>This is a retrospective case series describing the feasibility and tolerability of postextubation prone positioning (PEPP) and its impact on physiologic parameters in a tertiary intensive care unit during the COVID-19 pandemic. <i>Setting and Patients</i>. This study was conducted on patients with COVID-19 respiratory failure hospitalized in a tertiary Intensive Care Unit at Surrey Memorial Hospital during the COVID-19 pandemic. <i>Measurements and Results</i>. We did not find prior reports of PEPP following prolonged intubation in the literature. Four patients underwent a total of 13 PEPP sessions following liberation from prolonged mechanical ventilation. Each patient underwent a median of 3 prone sessions (IQR: 2, 4.25) lasting a median of 1.5 hours (IQR: 1.2, 2.1). PEPP sessions were associated with a reduction in median oxygen requirements, patient respiratory rate, and reintubation rate. The sessions were well tolerated by patients, nursing, and the allied health team.</p><p><strong>Conclusions: </strong>The novel practice of PEPP after liberation from prolonged mechanical ventilation in patients with COVID-19 respiratory failure is feasible and well tolerated, and may be associated with favourable clinical outcomes including improvement in oxygenation and respiratory rate and a low rate of reintubation. Larger prospective studies of PEPP are warranted.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"6688120"},"PeriodicalIF":1.7,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6688120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38705803","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":"Central Venous Catheter Insertion: A Scoring System for Evaluation of Both the Procedure and the Operator (CVCI Score/Gaber Score).","authors":"Sayed Gaber,&nbsp;Ahmed Yehia,&nbsp;Beshoy Nabil,&nbsp;Ahmed Samir","doi":"10.1155/2020/8156801","DOIUrl":"https://doi.org/10.1155/2020/8156801","url":null,"abstract":"Introduction Currently, there is no method to assess the performance while inserting a central venous catheter. We suggest a new scoring system for evaluation of both the technique as well as the operator, and then we applied it for the comparison between the landmark and ultrasound techniques to assess its validity. Methods. Four hundred patients were divided into two equal groups: group (A): internal jugular vein (IJV) and group (B): subclavian vein (SV). The landmark technique and the ultrasound guidance were used equally (100 patients for each) in both groups. Results In group (A), 20% of patients in the landmark group achieved score 4, while 82% of patients in the ultrasound group achieved the same score. This suggests that the ultrasound technique for catheterization of IJV decreased overall complications and improved the success rate. In group (B), there were 70% of patients in the landmark group who achieved score 5, while 49% of patients in the ultrasound group achieved the same score which proposes that the landmark technique might be deceptively better than the ultrasound technique for catheterization of SV. This could be because the time required for catheterization of SV by the ultrasound technique was longer than that in the landmark technique. Overall complications of 15% with the landmark technique vs. 2% with ultrasound guidance in this group of patients are not only statistically significant but also increase morbidity and mortality with a highly invasive procedure. Complications and their incidences are by far more significant than seconds of time. Our results suggest that the ultrasound technique could decrease the incidence of overall complications, but it is time-consuming in group (B). These results support the validity of our new scoring system. Conclusion We suggest a new scoring system for CVC insertion that can be used for evaluation of both the technique and the operator. It can evaluate the performance of junior staff and follow their progress. It can be applied in the medical and critical care practice as well as the quality management privileges and protocols.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"8156801"},"PeriodicalIF":1.7,"publicationDate":"2020-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8156801","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38613992","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 Attitudes of Relatives of ICU Patients toward Informed Consent for Clinical Research.","authors":"Rania Mahafzah,&nbsp;Karem H Alzoubi,&nbsp;Omar F Khabour","doi":"10.1155/2020/2760168","DOIUrl":"https://doi.org/10.1155/2020/2760168","url":null,"abstract":"Background Informed consent is a key ethical requirement for biomedical research that is implemented to ensure autonomy and voluntary participation. However, patients in the intensive care unit (ICU) may be unconscious or severely ill and thus lack the capacity for decisions about research participation. Thus, relatives or guardians are usually asked to provide informed consent prior to the inclusion of ICU patients in research. Aims This study aimed to assess the attitudes and preferences of relatives of ICU patients toward informed consent in biomedical research in Jordan. Subjects and Methods. A sample of 184 relatives with a critically ill next of kin in the ICU was anonymously surveyed regarding their attitudes and preferences toward giving informed consent for biomedical research on behalf of their patients. Results The study showed that the majority of relatives had a positive attitude toward the informed consent process on behalf of their patients in the ICU (72.3%). The perception that participation in research would be directly beneficial to their patient was the most significant reason to provide informed consent among relatives. The degree of relatedness to the patient was significantly associated with the decision to provide informed consent on behalf of the patients in the ICU. Additionally, more than 70% of the relatives strongly agreed to take part in clinical research if they were to be unconscious patients in the ICU. Moreover, the majority of the respondents agreed that their first-degree relatives would give consent on their behalf. Conclusion Relatives with a critically ill next of kin in the ICU had positive attitudes toward providing informed consent on behalf of their patients. This was motivated by the direct benefit from the research to their patient.","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"2760168"},"PeriodicalIF":1.7,"publicationDate":"2020-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2760168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38649708","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":"Knowledge, Attitude, and Performance of ICU, CCU, and Emergency Wards Nurses in Kermanshah, Iran, regarding Organ Donation.","authors":"Maryam Janatolmakan,&nbsp;Ali Soroush,&nbsp;Roghayeh Nouri,&nbsp;Bahare Andayeshgar,&nbsp;Alireza Khatony","doi":"10.1155/2020/5167623","DOIUrl":"https://doi.org/10.1155/2020/5167623","url":null,"abstract":"<p><strong>Background: </strong>Providing an organ for donation is a major problem worldwide and nurses play an important role in facilitating the process of organ donation. This study is aimed at investigating the knowledge, attitude, and performance of nurses working in the ICU, CCU, and emergency wards regarding organ donation.</p><p><strong>Methods: </strong>In this descriptive-analytical study, 185 nurses working in ICU, CCU, and emergency wards were studied through systematic random sampling. The data collection was done by a self-administered questionnaire.</p><p><strong>Results: </strong>The mean knowledge of nurses was 8.9 ± 1.4 out of 10. There was a significant relationship between knowledge of nurses regarding donation and religion and having organ donation card (<i>P</i> < 0.001). The mean attitude of nurses was 7.8 ± 2.2 out of 8. The variables, including \"having a donation card and marriage,\" were associated with attitude of nurses toward organ donation. The mean performance of nurses was 0.4 ± 0.7 out of 3. There was a significant relationship between performance of nurses and having a donation card (<i>P</i> < 0.001). Knowledge was the strongest predictor of nurses' performance (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The studied nurses showed sufficient knowledge and favorable attitude toward organ donation; however, they had poor performance. It is suggested to hold training courses to improve performance of nurses. The revision of the nursing students' curriculum as future nurses should also be considered.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"5167623"},"PeriodicalIF":1.7,"publicationDate":"2020-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/5167623","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38493518","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":"Dermatological Manifestations in the Intensive Care Unit: A Practical Approach.","authors":"Mariona Badia,&nbsp;José Manuel Casanova,&nbsp;Lluís Serviá,&nbsp;Neus Montserrat,&nbsp;Jordi Codina,&nbsp;Javier Trujillano","doi":"10.1155/2020/9729814","DOIUrl":"https://doi.org/10.1155/2020/9729814","url":null,"abstract":"<p><p>Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life); DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"9729814"},"PeriodicalIF":1.7,"publicationDate":"2020-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7533796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38499009","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":"Lactate Arterial-Central Venous Gradient among COVID-19 Patients in ICU: A Potential Tool in the Clinical Practice.","authors":"Giuseppe Nardi,&nbsp;Gianfranco Sanson,&nbsp;Lucia Tassinari,&nbsp;Giovanna Guiotto,&nbsp;Antonella Potalivo,&nbsp;Jonathan Montomoli,&nbsp;Fernando Schiraldi","doi":"10.1155/2020/4743904","DOIUrl":"https://doi.org/10.1155/2020/4743904","url":null,"abstract":"<p><strong>Objective: </strong>In physiological conditions, arterial blood lactate concentration is equal to or lower than central venous blood lactate concentration. A reversal in this rate (i.e., higher lactate concentration in central venous blood), which could reflect a derangement in the mitochondrial metabolism of lung cells induced by inflammation, has been previously reported in patients with ARDS but has been never explored in COVID-19 patients. The aim of this study was to explore if the COVID-19-induced lung cell damage was mirrored by an arterial lactatemia higher than the central venous one; then if the administration of anti-inflammatory therapy (i.e., canakinumab 300 mg subcutaneous) could normalize such abnormal lactate a-cv difference.</p><p><strong>Methods: </strong>A prospective cohort study was conducted, started on March 25, 2020, for a duration of 10 days, enrolling 21 patients affected by severe COVID-19 pneumonia undergoing mechanical ventilation consecutively admitted to the ICU of the Rimini Hospital, Italy. Arterial and central venous blood samples were contemporarily collected to calculate the difference between arterial and central venous lactate (Delta a-cv lactate) concentrations within 24 h from tracheal intubation (<i>T</i> ₀) and 24 hours after canakinumab administration (<i>T</i> ₁).</p><p><strong>Results: </strong>At <i>T</i> ₀, 19 of 21 (90.5%) patients showed a pathologic Delta a-cv lactate (median 0.15 mmol/L; IQR 0.07-0.25). In the 13 patients undergoing canakinumab administration, at <i>T</i> ₁, Delta a-cv lactate decreased in 92.3% of cases, the decrease being statistically significant (<i>T</i> ₀: median 0.24, IQR 0.09-0.31 mmol/L; <i>T</i> ₁: median -0.01, IQR -0.08-0.04 mmol/L; <i>p</i>=0.002).</p><p><strong>Conclusion: </strong>A reversed Delta a-cv lactate might be interpreted as one of the effects of COVID-19-related cytokine storm, which could reflect a derangement in the mitochondrial metabolism of lung cells induced by severe inflammation or other uncoupling mediators. In addition, Delta a-cv lactate decrease might also reflect the anti-inflammatory activity of canakinumab. Our preliminary findings need to be confirmed by larger outcome studies.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":"2020 ","pages":"4743904"},"PeriodicalIF":1.7,"publicationDate":"2020-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4743904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38453472","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}