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A randomised, controlled, feasibility trial comparing vasopressors infused via peripheral cannula versus central venous access for critically ill adults: The VIPCA trial 一项随机、对照、可行性试验,比较危重成人患者外周静脉输注血管加压剂与中心静脉输注血管加压剂:VIPCA试验
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-04-17 DOI: 10.1016/j.ccrj.2025.100106
Mahesh Ramanan FCICM PhD , Yogesh Apte FCICM MDS , Stacey Watts RN GradCert (Crit Care) , Thomas Holland FACEM MBBS , April Hatt RNA , Alison Craswell RN PhD , Frances Lin RN PhD , Alexis Tabah FCICM MDR , Robert S. Ware PhD , Joshua Byrnes PhD , Christopher Anstey FCICM PhD , Gerben Keijzers FACEM PhD
{"title":"A randomised, controlled, feasibility trial comparing vasopressors infused via peripheral cannula versus central venous access for critically ill adults: The VIPCA trial","authors":"Mahesh Ramanan FCICM PhD ,&nbsp;Yogesh Apte FCICM MDS ,&nbsp;Stacey Watts RN GradCert (Crit Care) ,&nbsp;Thomas Holland FACEM MBBS ,&nbsp;April Hatt RNA ,&nbsp;Alison Craswell RN PhD ,&nbsp;Frances Lin RN PhD ,&nbsp;Alexis Tabah FCICM MDR ,&nbsp;Robert S. Ware PhD ,&nbsp;Joshua Byrnes PhD ,&nbsp;Christopher Anstey FCICM PhD ,&nbsp;Gerben Keijzers FACEM PhD","doi":"10.1016/j.ccrj.2025.100106","DOIUrl":"10.1016/j.ccrj.2025.100106","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the feasibility of conducting a definitive randomised trial to determine whether, in critically ill patients requiring intensive care unit admission, early CVC insertion compared with late CVC insertion leads to increased days-alive-and-out-of-hospital at 30 days (DAH-30) post-treatment.</div></div><div><h3>Design, settings and participants</h3><div>We conducted a single-centre, parallel-group, feasibility randomised controlled trial with critically ill patients receiving vasopressor infusions randomised in a 1:1 ratio to receive early CVC insertion (within 4 h) or late CVC insertion (after 12 h). All patients received vasopressor infusions via a peripheral intravenous cannula (PIVC) while awaiting CVC insertion. The primary clinical outcome was DAH-30 and the primary feasibility outcome was assessed by evaluating protocol adherence, rates of recruitment, randomisation of eligible patients, retention, follow-up and missing data.</div></div><div><h3>Results</h3><div>We enrolled 40 patients, 20 patients per group between January 2023 and May 2024. Protocol adherence was significantly lower in the early CVC group (55 %) compared to the late CVC group (100 %, p &lt; 0.001). The early CVC group had a median time to CVC insertion of 3.3 h (interquartile range (IQR) 1.2–3.7 h), within the 4-h target. The early and late CVC groups had a median (IQR) of 13.5 (0.0–23.5) and 19.0 (5.0–23.0) DAH-30 respectively (P = 0.18). PIVC complications were similar between the two groups with no severe complications. There were no complications among the 18 CVCs inserted during the trial.</div></div><div><h3>Conclusions</h3><div>Protocol adherence in the early CVC was much lower than the late CVC. Some protocol modifications will be required to enable the conduct of a larger-scale definitive trial.</div></div><div><h3>Trial Registration</h3><div>ACTRN12621000721808 (Australia New Zealand Clinical Trials Registry).</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 2","pages":"Article 100106"},"PeriodicalIF":1.4,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143838937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trends in pulmonary artery catheter use for cardiac surgery, 2013–2023: Analysis of Australian medicare data 2013-2023年心脏手术肺动脉导管使用趋势:澳大利亚医疗保险数据分析
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-28 DOI: 10.1016/j.ccrj.2025.100100
Luke A. Perry MBBS(Hons), BSc, Andrew Silvers FANZCA, Jayme Bennetts FRACS, Julian Smith FRACS, Lisa Q. Rong MD, MSCE, FASE, FACC, Mario Gaudino MD, PhD, MSCE, FEBCTS, FACC, FAHA, Lachlan F. Miles MBBS (Hons), PGCertCU, PhD, GChPOM, FANZCA
{"title":"Trends in pulmonary artery catheter use for cardiac surgery, 2013–2023: Analysis of Australian medicare data","authors":"Luke A. Perry MBBS(Hons), BSc,&nbsp;Andrew Silvers FANZCA,&nbsp;Jayme Bennetts FRACS,&nbsp;Julian Smith FRACS,&nbsp;Lisa Q. Rong MD, MSCE, FASE, FACC,&nbsp;Mario Gaudino MD, PhD, MSCE, FEBCTS, FACC, FAHA,&nbsp;Lachlan F. Miles MBBS (Hons), PGCertCU, PhD, GChPOM, FANZCA","doi":"10.1016/j.ccrj.2025.100100","DOIUrl":"10.1016/j.ccrj.2025.100100","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 2","pages":"Article 100100"},"PeriodicalIF":1.4,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Organ donation from extracorporeal membrane oxygenation and ventricular assist devices in Victoria, Australia: Characteristics and trends 澳大利亚维多利亚州体外膜氧合和心室辅助装置器官捐献:特点和趋势
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2025.100102
Viveka K. Nainani MBBS BMedSci , Byron Arcia Data analyst , David Pilcher MBBS MRCP (UK) FCICM FRACP , Joshua Ihle FCICM , Arne Diehl FCICM , Samuel Radford FCICM FRACP , Rohit D'Costa FRACP FCICM MBioEth , Vinodh B. Nanjayya FCICM
{"title":"Organ donation from extracorporeal membrane oxygenation and ventricular assist devices in Victoria, Australia: Characteristics and trends","authors":"Viveka K. Nainani MBBS BMedSci ,&nbsp;Byron Arcia Data analyst ,&nbsp;David Pilcher MBBS MRCP (UK) FCICM FRACP ,&nbsp;Joshua Ihle FCICM ,&nbsp;Arne Diehl FCICM ,&nbsp;Samuel Radford FCICM FRACP ,&nbsp;Rohit D'Costa FRACP FCICM MBioEth ,&nbsp;Vinodh B. Nanjayya FCICM","doi":"10.1016/j.ccrj.2025.100102","DOIUrl":"10.1016/j.ccrj.2025.100102","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the characteristics and the trend of organ donation from donors on extracorporeal membrane oxygenation (ECMO) or ventricular assist devices (LVAD).</div></div><div><h3>Design</h3><div>Retrospective, observational, cohort study from June 2014 to June 2021.</div></div><div><h3>Setting</h3><div>A multicentre study in Victoria, Australia, using DonateLife Victoria databases.</div></div><div><h3>Participants</h3><div>All patients on ECMO/LVAD were referred to DonateLife for organ donation.</div></div><div><h3>Main outcome measures</h3><div>Number, proportion, time trend and type of organ donations from the patients on ECMO/LVAD.</div></div><div><h3>Results</h3><div>There were 78 donor referrals [mean (SD) age 42 (18.8) yrs, 56 (72 %) males] from patients on Veno-arterial ECMO (73 %), Veno-venous ECMO (16 %) or LVAD (6.4 %), of which 37 (47 %) donated. The annual median (IQR) referral and donation rates were 8 (5–10)/year and 4 (3–7)/year, respectively. Medical contraindications were the main reason for declining organ donation [21(51 %)]. Donation after neurological determination of death (DNDD) occurred in 20 (54 %), and donation after circulatory determination of death (DCDD) in 17 (46 %). The median (IQR) time from admission to referral for donation was longer in DCDD compared to DNDD patients. Eighty-three organs were retrieved from 37 donors (2.24 organs per donor), out of which 68 organs (82 %) were transplanted in 68 recipients. Kidneys were the most common organs retrieved (73 %) and transplanted (79 %).</div></div><div><h3>Conclusion</h3><div>Organ donation on ECMO/LVAD occurs only in half of the referred patients. Further studies are needed to ascertain the barriers to donations and to assess the long-term outcomes of these donations.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100102"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143609205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intensive care admissions for adults with treated kidney failure in Australia: A national retrospective cohort study 澳大利亚治疗肾衰竭的成人重症监护入院:一项全国性回顾性队列研究
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2025.100099
Dominic Keuskamp PhD , Christopher E. Davies PhD , Paul J. Secombe BMBS (Hons) MClinSc FCICM , David V. Pilcher MBBS MRCP(UK) FRACP FCICM , Shaila Chavan MSPH , Sarah L. Jones MBChB (Hons) MRCP(UK) DICM(UK) FCICM FRACP , Benjamin E. Reddi MA PhD FRCP(UK) FCICM , Stephen P. McDonald MBBS (Hons) PhD FRACP
{"title":"Intensive care admissions for adults with treated kidney failure in Australia: A national retrospective cohort study","authors":"Dominic Keuskamp PhD ,&nbsp;Christopher E. Davies PhD ,&nbsp;Paul J. Secombe BMBS (Hons) MClinSc FCICM ,&nbsp;David V. Pilcher MBBS MRCP(UK) FRACP FCICM ,&nbsp;Shaila Chavan MSPH ,&nbsp;Sarah L. Jones MBChB (Hons) MRCP(UK) DICM(UK) FCICM FRACP ,&nbsp;Benjamin E. Reddi MA PhD FRCP(UK) FCICM ,&nbsp;Stephen P. McDonald MBBS (Hons) PhD FRACP","doi":"10.1016/j.ccrj.2025.100099","DOIUrl":"10.1016/j.ccrj.2025.100099","url":null,"abstract":"<div><h3>Objective</h3><div>Limited data are available on intensive care unit (ICU) admissions for adults receiving kidney replacement therapy (KRT – dialysis or transplantation) in Australia. Our aim is to characterise admissions for patients receiving long-term dialysis and kidney transplant recipients relative to the general intensive care population in Australia.</div></div><div><h3>Design</h3><div>Retrospective registry-based data linkage cohort study.</div></div><div><h3>Setting</h3><div>All ICUs in Australia that reported to the Australian and New Zealand Intensive Care Society Adult Patient Database, 1 January 2018–31 December 2020.</div></div><div><h3>Participants</h3><div>All admissions were included. Data were deterministically linked to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Subgroups analysed were defined by sex, age, admission type, APACHE III-j diagnostic category, diabetes status, body mass index (BMI), dialysis modality, dialysis vintage, and kidney transplant vintage.</div></div><div><h3>Outcome measures</h3><div>Admission to ICU for patients receiving KRT at the time of admission (as reported to the ANZDATA Registry).</div></div><div><h3>Results</h3><div>Patients receiving long-term dialysis prior to admission and those with a kidney transplant numbered 2826 (0.6% of all admissions) and 1194 (0.3%), respectively. Age-sex standardised admission rates relative to the non-KRT cohort (n = 438,271 or 99.1%) were highest for long-term dialysis patients (relative rate 10.18 [95% CI: 9.46,10.93]) and associated with diabetes and sepsis, cardiovascular and respiratory diagnoses.</div></div><div><h3>Conclusions</h3><div>Rates of ICU admission for people receiving long-term dialysis or kidney transplantation were many times higher than the general population, with particularly increased relative risk among younger age groups and for key medical diagnoses. Given the burden on patients and health services, exploration of strategies to reduce this risk is important.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100099"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey 接受去甲肾上腺素治疗的重症监护病房患者的平均动脉压目标:一项国际调查
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2024.12.001
Paul J. Young MBChB, PhD , Rinaldo Bellomo MBBS, MD, FCICM, FRACP , Abdulrahman Al-Fares MBChB, FRCPC, ABIM, MRCP , David GC. Antognini MBBS , Yaseen M. Arabi MD , Muhammad Sheharyar Ashraf MD , Sean M. Bagshaw MD, MSc , Alastair J. Brown MBChB , Sarah Buabbas MD , Lewis Campbell MBChB, MSc , Jonathan M. Chen MBChB , Ross C. Freebairn MBChB , Tomoko Fujii MD, PhD , Mohd Shahnaz Hasan MBBS, MAnes , Aditi Jain DNB, FRCPC, FCCCM, AFIC , Nai An Lai MBBS, MRCSEd, FRCP(Edin), FCICM , Sanjay Lakhey MD , Matthew Mac Partlin MBChB, FCICM, FACEM, MRCPI , Sam Marment MBChB , James P.A. McCullough MBChB, MMed , François Lamontagne MD, MSc
{"title":"Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey","authors":"Paul J. Young MBChB, PhD ,&nbsp;Rinaldo Bellomo MBBS, MD, FCICM, FRACP ,&nbsp;Abdulrahman Al-Fares MBChB, FRCPC, ABIM, MRCP ,&nbsp;David GC. Antognini MBBS ,&nbsp;Yaseen M. Arabi MD ,&nbsp;Muhammad Sheharyar Ashraf MD ,&nbsp;Sean M. Bagshaw MD, MSc ,&nbsp;Alastair J. Brown MBChB ,&nbsp;Sarah Buabbas MD ,&nbsp;Lewis Campbell MBChB, MSc ,&nbsp;Jonathan M. Chen MBChB ,&nbsp;Ross C. Freebairn MBChB ,&nbsp;Tomoko Fujii MD, PhD ,&nbsp;Mohd Shahnaz Hasan MBBS, MAnes ,&nbsp;Aditi Jain DNB, FRCPC, FCCCM, AFIC ,&nbsp;Nai An Lai MBBS, MRCSEd, FRCP(Edin), FCICM ,&nbsp;Sanjay Lakhey MD ,&nbsp;Matthew Mac Partlin MBChB, FCICM, FACEM, MRCPI ,&nbsp;Sam Marment MBChB ,&nbsp;James P.A. McCullough MBChB, MMed ,&nbsp;François Lamontagne MD, MSc","doi":"10.1016/j.ccrj.2024.12.001","DOIUrl":"10.1016/j.ccrj.2024.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate intensive care doctors’ views about a large-scale pragmatic minimum mean arterial pressure (MAP) targets trial and their attitudes and beliefs about minimum MAP targets in different clinical scenarios.</div></div><div><h3>Design</h3><div>An online survey was conducted.</div></div><div><h3>Setting and participants</h3><div>An online survey was distributed to intensive care doctors in sites participating in a large-scale international randomised clinical trial evaluating oxygen therapy targets in 15 countries and to additional intensive care clinicians from Canada.</div></div><div><h3>Main outcome measures</h3><div>Outcomes included the expressed level of support for a large pragmatic trial to evaluate minimum MAP targets in critically ill adults and stated current practice and acceptability of minimum MAP for specific scenarios.</div></div><div><h3>Results</h3><div>The response rate to our survey for respondents who work in sites participating in the mega randomised registry trial research program was 265 out of 701 (37.8%), with an additional 56 out of 256 (21.8%) responses obtained from a direct email containing a link to the survey sent to intensive care clinicians in Canada. A total of 309 of 321 respondents (96.3%) were supportive, in principle, of conducting a very large pragmatic trial to evaluate MAP targets in intensive care unit patients receiving noradrenaline. The commonest response in all scenarios was to agree that the optimal minimum MAP target was uncertain. In all scenarios, except for active bleeding, the most common reported minimum MAP target was 65 mmHg; for patients who were actively bleeding, the most common reported target was 60 mmHg.</div></div><div><h3>Conclusions</h3><div>Our data suggest that intensive care clinicians are broadly supportive of a large-scale pragmatic minimum MAP targets in intensive care unit patients receiving noradrenaline.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100095"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
In-hospital mortality in patients admitted to Australian intensive care units with COVID-19 between 2020 and 2024 2020年至2024年期间澳大利亚重症监护病房收治的COVID-19患者的住院死亡率
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2024.11.003
Matthew T. Donnan MBBS , Peinan Zhao PhD , Allen C. Cheng MBBS PhD , Aaliya Ibrahim MClinEpid , Annamaria Palermo RN, BA , Benjamin Reddi FCICM PhD , Claire Reynolds MNurs , Craig French MBBS , Edward Litton MBChB PhD , Hannah Rotherham MBBS , Husna Begum PhD , Jamie Cooper MD MBBS , Jodi Dumbrell MPH , Lewis Campbell FCICM MSc. , Mark Plummer PhD , Mahesh Ramanan FCICM MMed , Patricia Alliegro MD , Richard E. McAllister RN, BN , Simon Erickson MBBS, CICM , Shweta Priyadarshini FCICM MBBS , Aidan Burrell MBBS PhD
{"title":"In-hospital mortality in patients admitted to Australian intensive care units with COVID-19 between 2020 and 2024","authors":"Matthew T. Donnan MBBS ,&nbsp;Peinan Zhao PhD ,&nbsp;Allen C. Cheng MBBS PhD ,&nbsp;Aaliya Ibrahim MClinEpid ,&nbsp;Annamaria Palermo RN, BA ,&nbsp;Benjamin Reddi FCICM PhD ,&nbsp;Claire Reynolds MNurs ,&nbsp;Craig French MBBS ,&nbsp;Edward Litton MBChB PhD ,&nbsp;Hannah Rotherham MBBS ,&nbsp;Husna Begum PhD ,&nbsp;Jamie Cooper MD MBBS ,&nbsp;Jodi Dumbrell MPH ,&nbsp;Lewis Campbell FCICM MSc. ,&nbsp;Mark Plummer PhD ,&nbsp;Mahesh Ramanan FCICM MMed ,&nbsp;Patricia Alliegro MD ,&nbsp;Richard E. McAllister RN, BN ,&nbsp;Simon Erickson MBBS, CICM ,&nbsp;Shweta Priyadarshini FCICM MBBS ,&nbsp;Aidan Burrell MBBS PhD","doi":"10.1016/j.ccrj.2024.11.003","DOIUrl":"10.1016/j.ccrj.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and compare the demographics, management, and outcomes for patients with COVID-19 admitted to intensive care units (ICUs) in Australia across the various waves of the COVID pandemic.</div></div><div><h3>Design, setting, and participants</h3><div>People aged ≥16 years who were admitted to a participating ICU with confirmed COVID-19 in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia study between February 2020 and May 2024.</div></div><div><h3>Main outcome measures</h3><div>Primary outcome: In-hospital mortality. Secondary outcomes: ICU mortality; ICU and hospital lengths of stay; supportive and disease-specific therapies.</div></div><div><h3>Results</h3><div>From 27 February 2020 to 18 May 2024, 10171 people were admitted to 72 ICUs with confirmed COVID-19 disease. The <em>Wild Type w</em>ave included 518 (5.1%) patients, the <em>Delta</em> wave 2467 (24.3%) patients, and the <em>Omicron</em> wave 7186 (70.7%) patients. The median (IQR) age was 61 (49–70) years, 54 (41–66) years, and 65 (45–75) years, respectively (P &lt; 0.001). The proportion of vaccinated cases increased in successive waves (1% vs 23.9% vs 65.1%) but plateaued in the <em>Omicron</em> subvariant waves (range 60.0%–71.9%). Invasive mechanical ventilation use decreased across successive waves (52.5% vs 43.6% vs 31.7%, P &lt; 0.001). Use of extracorporeal membrane oxygenation was highest during the <em>Delta</em> wave (3.6%, 83 patients, median duration 18 days [IQR 9.8–35]). Multivariable analysis demonstrated an increased risk of in-hospital mortality among patients admitted during the D<em>elta</em> (adjusted HR 1.80, 95% CI: 1.38–2.35, <em>p</em> &lt; 0.001) and <em>Omicron</em> (adjusted HR 1.88, 95% CI: 1.46–2.42, <em>p</em> &lt; 0.001) waves when compared to the <em>Wild Type</em> wave.</div></div><div><h3>Conclusion</h3><div>COVID-19 continues to manifest significant morbidity and mortality in those requiring ICU admission. Despite a reduced need for ICU level supports, patients admitted during the <em>Omicron</em> wave demonstrated the highest in-hospital mortality.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100094"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A framework and analytical exploration for a data-driven update of the Sequential Organ Failure Assessment (SOFA) score in sepsis 脓毒症中顺序器官衰竭评估(SOFA)评分数据驱动更新的框架和分析探索
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2025.100105
Drago Plečko PhD , Nicolas Bennett PhD , Ida-Fong Ukor MBBS , Niklas Rodemund MD , Ary Serpa-Neto MD, PhD , Peter Bühlmann PhD
{"title":"A framework and analytical exploration for a data-driven update of the Sequential Organ Failure Assessment (SOFA) score in sepsis","authors":"Drago Plečko PhD ,&nbsp;Nicolas Bennett PhD ,&nbsp;Ida-Fong Ukor MBBS ,&nbsp;Niklas Rodemund MD ,&nbsp;Ary Serpa-Neto MD, PhD ,&nbsp;Peter Bühlmann PhD","doi":"10.1016/j.ccrj.2025.100105","DOIUrl":"10.1016/j.ccrj.2025.100105","url":null,"abstract":"<div><h3>Objective</h3><div>The Sepsis-3 consensus statement emphasised the need for data-based approaches to organ failure assessment and use the Sequential Organ Failure Assessment (SOFA) for this purpose. We aimed to develop a framework for a data-driven update to the SOFA score for patients with sepsis.</div></div><div><h3>Design</h3><div>Systematic analysis of potential markers of organ dysfunction in a retrospective, observational study.</div></div><div><h3>Setting</h3><div>Intensive care units from three tertiary hospital centres in the United States, the Netherlands, and Austria were included in the study.</div></div><div><h3>Participants</h3><div>28 100 American, 5339 Dutch, and 2450 Austrian patients with suspected sepsis were included in this study.</div></div><div><h3>Measurements and main results</h3><div>We assessed 56 organ function variables. We applied area under curve maximisation procedures to optimise the predictive power for mortality. We chose the most predictive biomarker for existing organ dysfunction domains and added a metabolic domain. We compared the area under the receiver operating characteristic curve and the area under the precision recall curve of the data-driven approach against the current SOFA system. The novel approach outperformed the current SOFA in all domains and databases (the area under the receiver operating characteristic curve: for US patients: 0.766 vs. 0.727, mortality: 10.7%; for Dutch patients: 0.70 vs. 0.653, mortality: 22.0%; for Austrian patients: 0.704 vs. 0.665, mortality: 22.0%; all p &lt; 0.01 for the best performing score). The precision-recall curve confirmed such observations.</div></div><div><h3>Conclusions</h3><div>We developed and validated a framework for a data-driven update to the SOFA to identify and classify organ dysfunction in suspected septic patients. This framework can be used to revise the SOFA score and its application to the identification and classification of sepsis.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100105"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sleep in the ICU – A complex challenge requiring multifactorial solutions 重症监护病房的睡眠-需要多因素解决的复杂挑战
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2025.100097
Oystein Tronstad BPhty , John F. Fraser MBChB, PhD, FRCP Glas, FRCA, FFARCSI, FCICM
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引用次数: 0
Protocol for the development of NHMRC-endorsed guidelines for extracorporeal membrane oxygenation using GRADE methodology 制定使用GRADE方法的nhmrc认可的体外膜氧合指南的协议
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2024.11.002
Sally F. Newman BN, PGCert , Zachary Munn PhD, GradDip HlthSc, BMedRad , Craig French FCICM , Hergen Buscher DEAA, EDIC, FCICM , Daniel Thomas Chung BMed MD , Myles Smith MBBS, MBiostat, EDIC, FCICM , Madeline Wilkinson MD, MN , Priya Nair MBBS MD, FCICM, PhD
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引用次数: 0
Excessive vasopressors or excessive hypotension: Searching for the goldilocks zone in mean arterial pressure targets 过度的血管加压或过度的低血压:寻找平均动脉压目标的金发姑娘区
IF 1.4 4区 医学
Critical Care and Resuscitation Pub Date : 2025-03-01 DOI: 10.1016/j.ccrj.2025.100101
Paul J. Young FCICM, PhD, Kyle C. White FCICM, MPH
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引用次数: 0
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