Critical care science最新文献

{"title":"The relationship between nursing workload and quality of care in intensive care units.","authors":"Arnaud Bruyneel, Alberto Lucchini, Jérôme E Dauvergne","doi":"10.62675/2965-2774.20250381","DOIUrl":"https://doi.org/10.62675/2965-2774.20250381","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250381"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746327","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":"To: Prognostic significance of gastrointestinal dysfunction in critically ill patients with COVID-19.","authors":"Josef Finsterer, Fulvio Alexandre Scorza, Carla Alessandra Scorza","doi":"10.62675/2965-2774.20250014","DOIUrl":"https://doi.org/10.62675/2965-2774.20250014","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250014"},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746328","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":"Apnea testing for brain death confirmation in VV-ECMO patients with very low sweep flow: a case reports and practical physiological insights.","authors":"Carine Carrijo de Faria, Pedro Vitale Mendes, Luis Carlos Cardoso Maia Junior, Gabriel Afonso Dutra Kreling, Marcelo Park","doi":"10.62675/2965-2774.20250373","DOIUrl":"10.62675/2965-2774.20250373","url":null,"abstract":"<p><p>In recent years, venovenous extracorporeal membrane oxygenation has become a critical therapeutic tool for patients with severe respiratory failure. Neurological complications, including brain death, are common in this population, and confirming brain death in venovenous extracorporeal membrane oxygenation-supported patients presents unique challenges. In Brazil, an apnea test is mandatory for confirming brain death. However, its application in patients on venovenous extracorporeal membrane oxygenation, which predominantly addresses venoarterial extracorporeal membrane oxygenation cases, is not well defined in the literature. This report outlines our standardized approach for conducting apnea tests in three patients with suspected brain death during ongoing venovenous extracorporeal membrane oxygenation support. We describe three cases from a cohort of 93 extracorporeal membrane oxygenation patients treated for severe respiratory failure. The apnea test was conducted after 24 hours of observation without sedation. Given the physiological nuances of extracorporeal membrane oxygenation, where carbon dioxide clearance is primarily influenced by sweep flow, we adopted a low-sweep-flow protocol (200mL/minute) to achieve a partial pressure of carbon dioxide greater than 55mmHg, consistent with brain death criteria. In cases of severe hypoxemia during the test, extracorporeal membrane oxygenation blood flow can be temporarily increased to maintain oxygenation. All patients received concurrent renal support, which also facilitated carbon dioxide clearance. Our findings suggest that the apnea test with very low sweep flow is a safe and feasible method for diagnosing brain death in venovenous extracorporeal membrane oxygenation-supported patients. This physiologically grounded approach provides a clinically viable strategy for managing the complex interplay between gas exchange, oxygenation, and carbon dioxide clearance during the apnea test.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250373"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644275","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":"Inhaled sevoflurane use for myoclonic status secondary to bupropion intoxication.","authors":"Artur Ribeiro Canasiro, Marcelo Park, Luis Carlos Maia Cardozo Junior, Giovanna Rego Vilar, Ludhmila Abrahão Hajjar","doi":"10.62675/2965-2774.20250296","DOIUrl":"10.62675/2965-2774.20250296","url":null,"abstract":"<p><p>A 26-year-old female with a history of depression was admitted after ingesting 7.5g of bupropion. Her clinical status rapidly deteriorated into a coma and myoclonic status, which was complicated by lung aspiration. Initial treatment with high-dose midazolam and later propofol failed to control her myoclonus. Sevoflurane inhalation therapy (6.5 mg/hour) was initiated, and complete resolution of myoclonus was achieved within hours. Propofol was discontinued, and the sevoflurane dose was gradually tapered over 24 hours without myoclonus recurrence. The patient awoke agitated but neurologically intact, was extubated, and fully recovered by Day 10. This case highlights the efficacy of sevoflurane in managing refractory myoclonic status due to bupropion toxicity, especially when electroencephalogram monitoring is unavailable. Sevoflurane rapid titration and elimination allow precise sedation control and safe neurological assessment. Inhaled anesthetics may also be beneficial in other ICU scenarios, including status epilepticus, severe asthma, and hemodynamic instability. This successful outcome demonstrates the potential of sevoflurane as an alternative therapy in critical toxicological emergencies.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250296"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644277","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":"Organosilane for surface cleaning in intensive care units: protocol for a cluster randomized controlled trial with crossover.","authors":"Antonio Paulo Nassar Junior, Claudia Vallone Silva, Camila Gosenheimer Righi, Isabella Lott Bezerra, Andrea de Carvalho, Ana Cristina Lagoeiro Patrocínio, Eduvirgens Maria Couto de Souza, Mirian Batista Rodrigues, Tiago Mendonça Dos Santos, Luiz Felipe Valter de Oliveira, Ana Paula Christoff, Bianca Luise Teixeira, Bruno Adler Maccagnan Pinheiro Besen, Viviane Cordeiro Veiga, Alexandre Biasi Cavalcanti, Bruno Martins Tomazini, Adriano José Pereira","doi":"10.62675/2965-2774.20250319","DOIUrl":"10.62675/2965-2774.20250319","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether surface disinfection with organosilane in the intensive care unit reduces the occurrence of healthcare-associated infections.</p><p><strong>Methods: </strong>This multicenter, controlled, cluster-randomized trial includes 14 intensive care units in Brazil from November 2023 to December 2024. The local hygiene team of the included intensive care units will disinfect bed surfaces with organosilane or with usual care for 6 months, followed by a sequential crossover of another 6 months. The primary outcome is the incidence of healthcare-associated infections, specifically ventilator-associated pneumonia, central-line-associated bloodstream infections, and catheter-associated urinary tract infections. The secondary endpoints are the contamination of the environment by multidrug-resistant microorganisms (i.e., oxacillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus faecium, carbapenem-resistant Enterobacter, Pseudomonas, and Acinetobacter), the incidence of specific infections (i.e., ventilator-associated pneumonia, central-line associated bloodstream infection, and catheter-associated urinary tract infection) and the cost of the patient's intensive care unit stay. We will enroll all adult patients admitted after the study begins in each participant's intensive care unit.</p><p><strong>Ethics and dissemination: </strong>The institutional review board of the coordinator center and each enrolled center approved the study protocol. We will disseminate the results in peer-reviewed journals and at scientific meetings, regardless of the study's outcome.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250319"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644278","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":"Global insights into traumatic brain injury. The low- and middle-income countries' perspective.","authors":"Cássia Righy, Carla Bittencourt Rynkowski, Ricardo Turon","doi":"10.62675/2965-2774.20250255","DOIUrl":"10.62675/2965-2774.20250255","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250255"},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144644276","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":"Peer review for medical journals: why and how?","authors":"Wagner Luis Nedel, David Garcia Nora, Roberta Muriel Longo Roepke, Lívia Maria Garcia Melro, Márcio Manozzo Boniatti","doi":"10.62675/2965-2774.20250098","DOIUrl":"10.62675/2965-2774.20250098","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250098"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562144","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 relevance of including delirium in the assessment of sepsis-associated neurological disorders that cause changes in consciousness or confusion.","authors":"Roberta Esteves Vieira de Castro, Yu Kawai, Daniela Nasu Monteiro Medeiros, Arnaldo Prata-Barbosa, Neelima Marupudi","doi":"10.62675/2965-2774.20250211","DOIUrl":"10.62675/2965-2774.20250211","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250211"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562145","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":"Target trial emulation on dexmedetomidine for critically ill patients: all that glitters is not gold.","authors":"Bruna Brandao Barreto, Lisa Burry, Dimitri Gusmao-Flores","doi":"10.62675/2965-2774.20250118","DOIUrl":"10.62675/2965-2774.20250118","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250118"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499685","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":"Artificial intelligence for the prediction of postoperative complications in the critically ill.","authors":"Vanessa Moll, Ashish K Khanna, Piyush Mathur","doi":"10.62675/2965-2774.20250025","DOIUrl":"10.62675/2965-2774.20250025","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250025"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499683","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}