Critical care science最新文献

{"title":"Severity of illness scores in the pediatric intensive care unit: a practical guide.","authors":"María Del Pilar Arias López, Arnaldo Prata-Barbosa, Fernanda Lima-Setta","doi":"10.62675/2965-2774.20240205-en","DOIUrl":"10.62675/2965-2774.20240205-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240205en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514041","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 pediatric acute potassium chloride correction infusions on the serum potassium concentration.","authors":"Jade Miller, Alex Dewar, Andrew Wignell, Patrick Davies","doi":"10.62675/2965-2774.20240113-en","DOIUrl":"10.62675/2965-2774.20240113-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240113en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514042","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":"Comparison of the effectiveness of awake-prone positioning and high-flow nasal oxygen in patients with COVID-19-related acute respiratory failure between different waves.","authors":"Mariano Esperatti, Matías Olmos, Marina Busico, Adrian Gallardo, Alejandra Vitali, Jorgelina Quintana, Hiromi Kakisu, Bruno Leonel Ferreyro, Nora Angélica Fuentes, Javier Osatnik, Santiago Nicolas Saavedra, Agustin Matarrese, Greta Dennise Rebaza Niquin, Elizabeth Gisele Wasinger, Giuliana Mast, Facundo Juan Andrada, Ana Inés Lagazio, Nahuel Esteban Romano, Marisol Mariela Laiz, Jose Garcia Urrutia, Mariela Adriana Mogaadouro, Micaela Ruiz Seifert, Emilce Mastroberti, Claudia Navarro Moreno, Anabel Miranda Tirado, María Constanza Viñas, Juan Manuel Pintos, Maria Eugenia Gonzalez, Maite Mateos, Verónica Barbaresi, Ana Elizabeth Grimbeek, Leonel Stein, Ariel Juan Latronico, Silvia Laura Menéndez, Alejandra Dominga Basualdo, Romina Castrillo","doi":"10.62675/2965-2774.20240065-en","DOIUrl":"10.62675/2965-2774.20240065-en","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness of the awake-prone position on relevant clinical outcomes in patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen between different waves in Argentina.</p><p><strong>Methods: </strong>This multicenter, prospective cohort study included adult patients with COVID-19-related acute respiratory failure requiring high-flow nasal oxygen. The main exposure position was the awake-prone position (≥ 6 hours/day) compared to the non-prone position. The primary outcome was endotracheal intubation, and the secondary outcome was in-hospital mortality. The inverse probability weighting-propensity score was used to adjust the conditional probability of treatment assignment. We then adjusted for contextual variables that varied over time and compared the effectiveness between the first and second waves.</p><p><strong>Results: </strong>A total of 728 patients were included: 360 during the first wave and 368 during the second wave, of whom 195 (54%) and 227 (62%) remained awake-prone for a median (p25 - 75) of 12 (10 - 16) and 14 (8 - 17) hours/day, respectively (Awake-Prone Position Group). The ORs (95%CIs) for endotracheal intubation in the Awake-Prone Position Group were 0.25 (0.13 - 0.46) and 0.19 (0.09 - 0.31) for the first and second waves, respectively (p = 0.41 for comparison between waves). The ORs for in-hospital mortality in the awake-prone position were 0.35 (0.17 - 0.65) and 0.22 (0.12 - 0.43), respectively (p = 0.44 for comparison between waves).</p><p><strong>Conclusion: </strong>The awake-prone position was associated with a reduction in the risk of endotracheal intubation and in-hospital mortality. These effects were independent of the context in which the intervention was applied, and no differences were observed between the different waves.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240065en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514039","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":"To: Outcomes of critically ill pregnant COVID-19 patients: a cohort study.","authors":"Josef Finsterer","doi":"10.62675/2965-2774.20240122-en","DOIUrl":"10.62675/2965-2774.20240122-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240122en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11554299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514043","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":"Delirium severity in the intensive care unit.","authors":"Rodrigo Bernardo Serafim, Maria Carolina Paulino, Tarek Sharshar, Bertrand Hermann","doi":"10.62675/2965-2774.20240139-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240139-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240139en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486069","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":"Exhaled air profile in the early diagnosis of ventilator-associated pneumonia.","authors":"Rodrigo Cruvinel Figueiredo, Jackelyne Lopes Silva, Igor Bianchini, Luana Bezerra Gonçalves Rocha, Renata Casagrande Goncalves, Cristiane Ritter, Felipe Dal-Pizzol","doi":"10.62675/2965-2774.20240194-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240194-en","url":null,"abstract":"<p><strong>Objective: </strong>To predict exhaled air in patients undergoing mechanical ventilation during bedside diagnosis of ventilator-associated pneumonia.</p><p><strong>Methods: </strong>Air samples were collected through the expiratory branch of the mechanical ventilation circuit during the hospitalization of patients at the intensive care unit of Hospital São José in Criciúma (SC), Brazil. In this study, 83 participants were divided into two groups, namely, the group with and the group without ventilator-associated pneumonia.</p><p><strong>Results: </strong>The analysis of three air patterns revealed a predictive value for the diagnosis of ventilator-associated pneumonia. The analyses of samples from the first 12 hours of invasive mechanical ventilation were able to predict ventilator-associated pneumonia (p = 0.018). However, none of the other air samples collected during hospitalization were useful in identifying the severity or predicting early or late ventilator-associated pneumonia.</p><p><strong>Conclusion: </strong>The use of a gas analyzer may be helpful for the early identification of patients admitted to intensive care who will develop ventilator-associated pneumonia.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240194en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486070","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":"Demystifying the oncologic patient in the intensive care unit.","authors":"Antonio Paulo Nassar Junior, Laura Inez de Oliveira Santos","doi":"10.62675/2965-2774.20240054-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240054-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240054en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482302","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":"Reply to: Factors associated with mortality in mechanically ventilated patients with severe acute respiratory syndrome due to COVID-19 evolution.","authors":"Luis Felipe da Fonseca Reis, João Paulo Arruda de Oliveira, Arthur de Sá Ferreira, Agnaldo José Lopes","doi":"10.62675/2965-2774.20240213-en","DOIUrl":"10.62675/2965-2774.20240213-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240213en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395712","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":"Association between hair cortisol concentration and acute stress symptoms in family members of critically ill patients: a cross-sectional study.","authors":"Cláudia Severgnini Eugênio, Thiago Wendt Viola, Francisco Sindermann Lumertz, Adriana Valéria Hoffmeister Daltrozo, Maria Eduarda Ramos Saraiva, Júlia Borges Casagrande, Rafael Fernandes Zanin, Márcio Manozzo Boniatti","doi":"10.62675/2965-2774.20240043-en","DOIUrl":"10.62675/2965-2774.20240043-en","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate whether there is an association between hair cortisol concentrations and acute stress symptoms in family members of critically ill patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in an adult intensive care unit of a tertiary hospital in Porto Alegre, Brazil, from August 2021 to February 2022. Family members of intensive care unit patients admitted for more than 10 days were approached for enrollment. We collected sociodemographic data and assessed resilience, religiosity, and symptoms of acute stress among family members. Samples of family members' hair were collected shortly after the interview to measure the hair cortisol concentration.</p><p><strong>Results: </strong>A total of 110 family members were included in this study. Eighty-eight (80.0%) family members presented with symptoms of acute stress. The median hair cortisol concentration was 2.37pg/mg (1.16 - 5.06pg/mg). There was no significant difference in hair cortisol concentration between family members with and without acute stress symptoms (p = 0.419). According to the multivariate analysis, only the fact that the patient was alert at the time of the family member's interview was significantly associated with the prevalence of acute stress symptoms in the family member.</p><p><strong>Conclusion: </strong>We did not find an association between the hair cortisol concentration of family members in hair segments in the months prior to admission to the intensive care unit and the occurrence of acute stress symptoms.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240043en"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395711","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":"Advancing insights in critical COVID-19: unraveling lymphopenia through propensity score matching - Findings from the Multicenter LYMPH-COVID Study.","authors":"José Pedro Cidade, Vicente Cês Souza-Dantas, Rafaela Braga Mamfrim, Renata Carnevale Miranda, Henrique Tommasi Caroli, Natália Almeida Oliveira, Alessandra Figueiredo Thompson, Gabriela E Oliveira, Pedro Póvoa","doi":"10.62675/2965-2774.20240236-en","DOIUrl":"10.62675/2965-2774.20240236-en","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the impact of lymphopenia on critical COVID-19 patient outcomes.</p><p><strong>Methods: </strong>We conducted a multicenter prospective cohort study across five hospitals in Portugal and Brazil from 2020 to 2021. The study included adult patients admitted to the intensive care unit with SARS-CoV-2 pneumonia. Patients were categorized into two groups based on their lymphocyte counts within 48 hours of intensive care unit admission: the Lymphopenia Group (lymphocyte serum count < 1 × 109/L) and the Nonlymphopenia Group. Multivariate logistic regression, propensity score matching, Kaplan‒Meier survival curve analysis and Cox proportional hazards regression analysis were used.</p><p><strong>Results: </strong>A total of 912 patients were enrolled, with 191 (20.9%) in the Nonlymphopenia Group and 721 (79.1%) in the Lymphopenia Group. Lymphopenia patients displayed significantly elevated disease severity indices, including Sequential Organ Failure Assessment and Simplified Acute Physiology Score 3 scores, at intensive care unit admission (p = 0.001 and p < 0.001, respectively). Additionally, they presented heightened requirements for vasopressor support (p = 0.045) and prolonged intensive care unit and in-hospital stays (both p < 0.001). Multivariate logistic regression analysis after propensity score matching revealed a significant contribution of lymphopenia to mortality, with an odds ratio of 1,621 (95%CI: 1,275 - 2,048; p < 0.001). Interaction models revealed an increase of 8% in mortality for each decade of longevity in patients with concomitant lymphopenia. In the subanalysis utilizing three-group stratification, the Severe Lymphopenia Group had the highest mortality rate, not only in direct comparisons but also in Kaplan‒Meier survival analysis (log-rank test p = 0.0048).</p><p><strong>Conclusion: </strong>Lymphopenia in COVID-19 patients is associated with increased disease severity and an increased risk of mortality, underscoring the need for prompt support for critically ill high-risk patients. These findings offer important insights into improving patient care strategies for COVID-19 patients.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240236en"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367680","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}