世界危重病急救学杂志(英文版)最新文献

{"title":"Correlation between mechanical power and lung ultrasound score and association with clinical outcomes in acute respiratory distress syndrome.","authors":"Prannoy G Mathen, Navneet Sharma, Revathi S Nair, Anas Valiyaparambath, Harsimran Kaur, Ankur Gupta, Ripudaman Sharma, Ashok K Pannu","doi":"10.5492/wjccm.119057","DOIUrl":"10.5492/wjccm.119057","url":null,"abstract":"<p><strong>Background: </strong>Mechanical power (MP) integrates tidal volume, airway pressures, flow, and respiratory rate into a single estimate of ventilatory energy delivery and serves as an integrative physiologic marker of ventilator-induced lung injury. Lung ultrasound score (LUS) is a bedside tool that quantifies lung aeration loss, reflecting the structural expression of lung injury in acute respiratory distress syndrome (ARDS). However, data correlating MP with LUS and clinically relevant outcomes in ARDS remain limited.</p><p><strong>Aim: </strong>To explore whether MP is associated with lung ultrasound-derived aeration loss and clinical outcomes in moderate-to-severe ARDS.</p><p><strong>Methods: </strong>This prospective observational study enrolled adult patients with moderate-to-severe ARDS requiring invasive mechanical ventilation for more than 48 hours. MP and LUS were assessed at 0, 24, 48, and 72 hours. Their association was evaluated using Pearson correlation analysis. Associations between MP and 28-day mortality and weaning outcomes were analyzed using logistic regression and receiver operating characteristic curve analysis. Mean MP was defined as the arithmetic mean across the four time points.</p><p><strong>Results: </strong>Forty-four patients were included. MP was strongly correlated with LUS at baseline (<i>r</i> = 0.84, 95%CI: 0.72-0.91), 24 hours (<i>r</i> = 0.83, 95%CI: 0.71-0.91), 48 hours (<i>r</i> = 0.91, 95%CI: 0.85-0.95), and 72 hours (<i>r</i> = 0.93, 95%CI: 0.87-0.96) (all <i>P</i> < 0.001). In exploratory analyses, higher mean MP was associated with increased mortality [odds ratio (OR) = 2.11 per J/minute increase, 95%CI: 1.31-3.39] and demonstrated numerically higher area under the receiver operating characteristic curve than driving pressure (0.98, 95%CI: 0.94-1.00 <i>vs</i> 0.91, 95%CI: 0.82-0.98). Higher mean MP was also associated with difficult (OR = 2.20, 95%CI: 1.11-4.36) and prolonged weaning (OR = 1.61, 95%CI: 1.04-2.50).</p><p><strong>Conclusion: </strong>MP parallels lung ultrasound-derived aeration loss in ARDS and demonstrates associations with mortality and adverse weaning, supporting its potential role as an integrative physiologic marker in individualized ventilatory management.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 3","pages":"119057"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908346","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":"Hemophagocytic lymphohistiocytosis in critically ill patients: A guide for clinicians.","authors":"Wagner Nedel","doi":"10.5492/wjccm.120840","DOIUrl":"10.5492/wjccm.120840","url":null,"abstract":"<p><p>Hemophagocytic lymphohistiocytosis (HLH) is a critical syndrome of immune dysregulation, marked by a hyperinflammatory cytokine storm and multiorgan failure. While primary forms are genetic, secondary HLH in adults is more prevalent and frequently precipitated by infections (notably viral), malignancies, or autoimmune diseases. Distinguishing secondary HLH from sepsis and multiorgan failure presents a significant clinical challenge due to overlapping clinical features, such as persistent fever and cytopenias. Diagnosis relies on clinical judgment and predictive frameworks like the HLH-2004 criteria or the HScore. Although elevated ferritin levels are a hallmark biomarker, isolated values lack sufficient specificity, necessitating a multifaceted diagnostic approach. Treatment strategies focus on controlling hyperinflammation while addressing the underlying trigger. Initial therapies often include corticosteroids, intravenous immunoglobulin, or the interleukin-1 receptor antagonist anakinra, with etoposide reserved for severe or refractory cases. Despite advances in management, mortality rates in the intensive care unit remain high, particularly when invasive organ support is required. Early recognition and multidisciplinary collaboration are essential to improve outcomes in this heterogeneous patient population. Further research is necessary to refine diagnostic cutoffs and identify personalized, phenotype-specific therapeutic interventions.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 3","pages":"120840"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907829","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":"From carbon cost to climate care: Greening our intensive care units.","authors":"Sargam Goel, Sahil Kataria, Deven Juneja","doi":"10.5492/wjccm.119925","DOIUrl":"10.5492/wjccm.119925","url":null,"abstract":"<p><p>Healthcare systems are major contributors to global greenhouse gas emissions, with intensive care units (ICUs) among the most carbon-intensive environments due to continuous energy demand, extensive reliance on single-use medical devices, and high pharmaceutical consumption. This narrative review examines the environmental footprint of ICUs, synthesising contemporary life-cycle evidence and international case studies describing feasible and clinically safe sustainability interventions in critical care. We outline practical strategies for ICU decarbonisation, including energy-efficient infrastructure, sustainable procurement, waste reduction, digital optimisation, and re-evaluation of low-value clinical practices. Importantly, many of these interventions align with established quality-improvement principles and are associated with clinical co-benefits such as reduced iatrogenic harm, improved patient comfort, and enhanced staff wellbeing. Broader policy frameworks, including the Sustainable Development Goals and national net-zero healthcare commitments, are discussed as enabling levers for system-level adoption. Greening ICUs should therefore be viewed not as a competing priority, but as an opportunity to deliver safer, more resilient, and patient-centred critical care while advancing planetary health.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 3","pages":"119925"},"PeriodicalIF":0.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907875","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":"Effects of ketone bodies supplementation in patients with heart failure: A systematic review and meta-analysis.","authors":"Ahmed K Siddiqi, Syed S Javaid, Akash Kumar, Nomesh Kumar, Mateen Ahmad, Shanzay Akhtar, Ahsan R Raja, Diksha Ladhani, Nisha Kumari, Sooraj Kumar","doi":"10.5492/wjccm.v15.i2.117717","DOIUrl":"10.5492/wjccm.v15.i2.117717","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ketone bodies, especially β-hydroxybutyrate, have shown the potential to improve hemodynamic outcomes such as cardiac output (CO) and left ventricular ejection fraction (LVEF) in patients with heart failure (HF). However, the overall effectiveness of ketone body supplementation in this population remains uncertain. Therefore, we conducted this systematic review and meta-analysis to evaluate the impact of ketone body supplementation on cardiac and hemodynamic parameters in patients with HF while accounting for the limited and emerging nature of the available randomized evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the impact of ketone body supplementation on cardiac and hemodynamic parameters in patients with HF while accounting for the limited and emerging nature of the available randomized evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed, Scopus, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted from inception to March 2025, with additional screening of ClinicalTrials.gov for unpublished or ongoing trials. Randomized controlled trials (RCTs) comparing ketone body supplementation with placebo in patients with HF were included. Statistical analyses were performed using a random-effects model in RevMan 5.4 to calculate weighted mean differences (MDs) with 95% confidence intervals (CIs). Outcomes assessed included CO, systemic vascular resistance, LVEF, heart rate, venous oxygen saturation, pulmonary capillary wedge pressure, and other cardiac functional indices. Given the small number of included studies, subgroup analyses were considered exploratory.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four randomized controlled trials involving a total of 94 patients were included. Compared with placebo, ketone supplementation was associated with a significant increase in CO (MD = 1.11, 95%CI: 0.13-2.09, &lt;i&gt;P&lt;/i&gt; = 0.03) and a reduction in systemic vascular resistance (MD = -252.61, 95%CI: -475.72 to -29.50, &lt;i&gt;P&lt;/i&gt; = 0.03). Improvements were also observed in LVEF (MD = 3.31, 95%CI: 0.39-6.22, &lt;i&gt;P&lt;/i&gt; = 0.03), venous oxygen saturation (MD = 3.33, 95%CI: -0.01 to 6.68, &lt;i&gt;P&lt;/i&gt; = 0.05), and pulmonary capillary wedge pressure (MD = -1.09, 95%CI: -1.60 to -0.59, &lt;i&gt;P&lt;/i&gt; &lt; 0.0001), along with an increase in heart rate (MD = 4.08, 95%CI: 3.00-5.17, &lt;i&gt;P&lt;/i&gt; &lt; 0.0001). Subgroup analyses by HF phenotype (HF with reduced ejection fraction &lt;i&gt;vs&lt;/i&gt; HF with preserved ejection fraction) suggested differential effects; however, several subgroups included only one study and should be interpreted as hypothesis-generating only. No statistically significant changes were observed in global longitudinal strain, left ventricular end-diastolic volume, or tricuspid annular plane systolic excursion, and substantial heterogeneity and potential small-study effects limit the robustness of pooled estimates.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Ketone body supplementation was associated with short-term impr","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"117717"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221152","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":"Navigating the veins: A comprehensive review of vasoactive agent infusion <i>via</i> peripheral routes.","authors":"Omender Singh, Deven Juneja","doi":"10.5492/wjccm.v15.i2.118811","DOIUrl":"10.5492/wjccm.v15.i2.118811","url":null,"abstract":"<p><p>Peripheral venous catheters (PVCs) are almost always present in patients in the intensive care unit. Still, they are seldom used to administer vesicant or irritant drugs, including vasoactive agents, due to concerns about extravasation and local tissue injury. However, emerging evidence indicates that PVCs are safe and effective for this purpose, offering distinct clinical advantages and obviating the need for more invasive central venous catheter insertion. Implementing a standardized protocol to ensure the appropriate size and placement of PVC, optimizing the dosage and duration of vasopressors, and establishing vigilant nursing monitoring can facilitate the safe administration of vasopressors <i>via</i> PVC, with substantial implications for the early management of shock, particularly in resource-constrained settings.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"118811"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221187","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":"Surgical fecal diversion <i>vs</i> non-diversion in perineal necrotizing soft tissue infections: A systematic review and meta-analysis.","authors":"Marcelo Augusto Fontenelle Ribeiro Junior, Sharon M Henry, Husna Irfan Thalib, Sariya Khan, Agata Grochowska-Krystman, Lucas Fontenelle Vieira, Sachin Reddi, Rafael Dib Possiedi","doi":"10.5492/wjccm.v15.i2.117985","DOIUrl":"10.5492/wjccm.v15.i2.117985","url":null,"abstract":"<p><strong>Background: </strong>Perineal necrotizing soft tissue infections (P-NSTI) are aggressive and potentially fatal conditions. Surgical fecal diversion (SFD) is often used to reduce contamination, but whether non-diversion provides comparable outcomes remains uncertain. We hypothesized that non-diversion does not confer worse outcomes than SFD.</p><p><strong>Aim: </strong>To evaluate clinical outcomes of non-diversion compared with SFD in adults with P-NSTI.</p><p><strong>Methods: </strong>Systematic review and meta-analysis following PRISMA and Cochrane standards. PubMed, EMBASE, Scopus, Web of Science and Cochrane Library were searched without date restrictions. Adults with P-NSTI comparing non-diversion <i>vs</i> SFD were included when outcomes were numerically extractable. Outcomes were mortality, hospital length of stay (LOS), number of surgical procedures and intensive care unit (ICU) admission. Random-effects models were used. Risk of bias was assessed with ROBINS-I and certainty of evidence with GRADE (PROSPERO CRD420251241839).</p><p><strong>Results: </strong>Thirty-six studies including 1751 patients were analyzed. In studies with reconstructed groups, mortality favored non-diversion, whereas no difference was observed in studies with predefined groups. Overall pooled analysis showed lower mortality with non-diversion (odds ratio 0.65; 95% confidence interval: 0.46-0.91; <i>P</i> = 0.01; <i>I</i> ² = 24%), limited by serious confounding by indication. Hospital LOS showed substantial heterogeneity; excluding one outlier study favored non-diversion. ICU admission and number of surgical procedures did not differ. Certainty of evidence was very low for all outcomes.</p><p><strong>Conclusion: </strong>No consistent outcome differences are demonstrated between non-diversion and SFD, and apparent mortality differences likely reflect baseline severity rather than treatment effect, with insufficient evidence to define superiority.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"117985"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220696","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":"Integrating structured point-of-care ultrasound into dengue fever management: A mini review and comprehensive clinical guide.","authors":"Zhi-Yuan Lee, Wei-Ven Chin","doi":"10.5492/wjccm.v15.i2.114264","DOIUrl":"10.5492/wjccm.v15.i2.114264","url":null,"abstract":"<p><p>Dengue fever is one of the most common mosquito-borne viral diseases and poses a significant health threat. The primary management involves hydration tailored to the disease stage and severity. Although many cases are mild, dengue can rapidly progress within hours. Complications such as plasma leakage and bleeding are difficult to detect through routine clinical assessment alone. In this context, point-of-care ultrasound (POCUS) has emerged as a valuable bedside tool for the early detection of fluid shifts and plasma leakage. Ultrasound findings in dengue-related plasma leakage include gallbladder wall thickening, ascites, pleural effusions, and other third-space fluid shifts. These sonographic signs often precede the clinical presentation of plasma leakage and can serve as early indicators for impending shock. Regular ultrasound assessment facilitates risk stratification and timely intervention, potentially reducing progression to dengue shock syndrome. Currently, there is no validated POCUS protocol specific to dengue assessment. We propose a standardized, structured ultrasound protocol focusing on key diagnostic parameters, coupled with serial serum hematocrit and lactate measurements for a comprehensive evaluation. This approach facilitates earlier identification of at-risk patients, thereby improving patient management, preventing clinical deterioration, and reducing morbidity and mortality associated with severe dengue.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"114264"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221170","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":"Letter to the Editor: Optimal device for emergency intubation - a commentary on the complementary role of intubating laryngeal mask airway-video laryngoscope.","authors":"Yagnang K Vyas","doi":"10.5492/wjccm.v15.i2.117117","DOIUrl":"10.5492/wjccm.v15.i2.117117","url":null,"abstract":"<p><p>The randomized controlled trial by Aggarwal <i>et al</i> recently published in <i>World Journal of Critical Care Medicine,</i> compared the intubating laryngeal mask airway (ILMA) with the Camera Macintosh video laryngoscope (VL) for emergency intubation in critically ill adults. In this randomized cohort of 58 patients, the VL demonstrated a higher first-attempt success rate, shorter intubation time, and superior glottic visualization compared to the ILMA. However, the role of the ILMA in specific high-risk scenarios warrants continued consideration. Adverse events were comparable between the two devices. The VL appears preferable as the primary device for emergency airway management, while the ILMA serves as an effective rescue option. Additionally, the ILMA remains useful in cases of restricted mouth opening and difficult airway scenarios.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"117117"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221178","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":"Letter to the Editor: Chest X-ray-based severity scores in COVID-19 - what do they tell us about oxygen needs?","authors":"Ankur Khandelwal, Habib Md Reazaul Karim, Anirban Bhattacharjee","doi":"10.5492/wjccm.v15.i2.119458","DOIUrl":"10.5492/wjccm.v15.i2.119458","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic placed unprecedented strain on emergency departments (ED), demanding rapid, reliable, and widely accessible tools to guide early clinical decision-making. While computed tomography offers high sensitivity for detecting pulmonary involvement, its routine use is limited by cost, logistics, and patient volume. In this context, chest radiography despite its lower sensitivity regains relevance when combined with structured severity scoring systems. Mohammed <i>et al</i> published a study in the <i>World Journal of Critical Care Medicine</i> provides timely and pragmatic evidence on the clinical utility of two established chest X-ray-based scores, the Radiographic Assessment of Lung Edema and the BRIXIA score, in predicting oxygen support requirements in COVID-19 patients. By correlating radiographic severity with the need for escalating oxygen delivery devices, the authors demonstrate that higher scores reliably identify patients likely to require advanced respiratory support in the ED. Importantly, the study highlights that these scores perform best in predicting higher levels of support, rather than excluding mild disease, underscoring their value in triage and resource allocation. A notable strength of this work is the rigorous assessment of inter- and intra-rater reliability following structured clinician training, confirming that both scores can be applied consistently across specialties. Although predictive accuracy diminishes later during hospitalization reflecting the multifactorial nature of clinical deterioration, the findings reinforce chest radiography as a rapid, low-cost, and globally available prognostic tool. This letter underscores how standardized chest X-ray scorings can meaningfully inform frontline decisions during respiratory pandemics and beyond.</p>","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"119458"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221189","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":"High-density lipoprotein-cholesterol and triglyceride levels and their prognosis in critically ill septic patients.","authors":"Wagner Nedel, Lílian R Henrique, João Alberto S Deuschle, Luiz H de Oliveira, Laura V de Lima, Giovana T Jahnke, Luis V Portela","doi":"10.5492/wjccm.v15.i2.117211","DOIUrl":"10.5492/wjccm.v15.i2.117211","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lipoproteins, particularly high-density lipoproteins (HDLs), have the ability to bind to lipopolysaccharides, the primary component of the extracellular membrane of gram-negative bacteria, as well as to lipoteichoic acid, an immunostimulant derived from gram-positive bacteria. Triglyceride (TG) levels are also indicators of acute inflammation. Altered levels of both are prevalent in sepsis, rendering them potential biomarkers that are cost-effective and readily applicable in clinical practice for monitoring these patients. It is crucial to compare the levels of these molecules with those of more traditional and costly biomarkers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the association between HDL and TG levels in the diagnosis of sepsis (HDL/TG day 1), as well as the association between the ratio of HDL and TG levels on days 3 and day 1 (HDL/TG ratio) and 28-day mortality in patients with sepsis. We also compared the serum levels of HDL and TG levels with traditional inflammatory markers used in the prognostic assessment of sepsis: Interleukin (IL)-1β, IL-6, and IL-10, measured serially in patients with sepsis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a prospective cohort study. Adult patients (&gt; 18 years of age) admitted to the intensive care unit with sepsis and receiving vasopressors were included. We recorded the epidemiological and clinical characteristics, as well as the severity scores, at the time of sepsis diagnosis and on day 3 of sepsis management. We measured HDL 1, TG 1, IL-1β, IL-6, IL-10, and C-reactive protein (CRP) levels upon the diagnosis of sepsis and on day 3 and calculated the HDL and TG ratios. The main outcome was 28-days mortality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seventy-five patients had measurements on day 1 (male:female ratio 58%:42%), and 50 patients had measurements on day 3. Patients who died had lower HDL 1 [9 mg/dL (5-17) &lt;i&gt;vs&lt;/i&gt; 18.5 mg/dL (8-31), &lt;i&gt;P&lt;/i&gt; = 0.02] but did not have lower TG levels on day 1 [142 mg/dL (83-224) &lt;i&gt;vs&lt;/i&gt; 148 mg/dL (97-196), &lt;i&gt;P&lt;/i&gt; = 0.97]. Additionally, patients who succumbed exhibited a non-statistically significant increase in the HDL ratio [1.26 (1-1.79) &lt;i&gt;vs&lt;/i&gt; 1.16 (1.01-1.39), &lt;i&gt;P&lt;/i&gt; = 0.29] and a non-statistically significant increase in the TG ratio [1.16 (0.85-1.36) &lt;i&gt;vs&lt;/i&gt; 1.02 (0.67-1.36), &lt;i&gt;P&lt;/i&gt; = 0.69]. HDL levels on day 1 were negatively associated with IL-10 on day 1 (Pearson's &lt;i&gt;r&lt;/i&gt; = -0.37; &lt;i&gt;P&lt;/i&gt; &lt; 0.01) and with CRP on day 1 (Pearson's &lt;i&gt;r&lt;/i&gt; = -0.52; &lt;i&gt;P&lt;/i&gt; &lt; 0.01), but not with IL-6 (&lt;i&gt;P&lt;/i&gt; = 0.19) or IL-1β (&lt;i&gt;P&lt;/i&gt; = 0.62). TG 1 was positively associated with CRP on day 1 (Pearson's &lt;i&gt;r&lt;/i&gt; = 0.57, &lt;i&gt;P&lt;/i&gt; &lt; 0.01) but not with IL-6 (&lt;i&gt;P&lt;/i&gt; = 0.21), IL-10 (&lt;i&gt;P&lt;/i&gt; = 0.12), or IL-1β (&lt;i&gt;P&lt;/i&gt; = 0.09).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;HDL levels are a promising biomarker for the evaluation of patients with sepsis, and their levels correlate with traditional biomarkers in this field, such as CRP and IL-","PeriodicalId":66959,"journal":{"name":"世界危重病急救学杂志(英文版)","volume":"15 2","pages":"117211"},"PeriodicalIF":0.0,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221141","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}