Critical care sciencePub Date : 2025-01-27eCollection Date: 2025-01-01DOI: 10.62675/2965-2774.20250156
Eduardo Butturini de Carvalho, Bruno Valle Pinheiro, Pedro Leme Silva
{"title":"Peripheral arterial oxygen saturation to fraction of inspired oxygen ratio: a versatile parameter for critically ill patients.","authors":"Eduardo Butturini de Carvalho, Bruno Valle Pinheiro, Pedro Leme Silva","doi":"10.62675/2965-2774.20250156","DOIUrl":"10.62675/2965-2774.20250156","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250156"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069916","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}
Critical care sciencePub Date : 2025-01-27eCollection Date: 2025-01-01DOI: 10.62675/2965-2774.20250250
José Roberto Fioretto, Susiane Oliveira Klefens, Mário Ferreira Carpi, Marcos Aurélio Moraes, Rossano César Bonatto, Ana Lúcia Anjos Ferreira, Camila Renata Corrêa, Cilmery Suemi Kurokawa, Carlos Fernando Ronchi
{"title":"Lycopene supplementation reduces inflammatory, histopathological and DNA damage in an acute lung injury rabbit model.","authors":"José Roberto Fioretto, Susiane Oliveira Klefens, Mário Ferreira Carpi, Marcos Aurélio Moraes, Rossano César Bonatto, Ana Lúcia Anjos Ferreira, Camila Renata Corrêa, Cilmery Suemi Kurokawa, Carlos Fernando Ronchi","doi":"10.62675/2965-2774.20250250","DOIUrl":"10.62675/2965-2774.20250250","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of lycopene supplementation on inflammation, lung histopathology and systemic DNA damage in an experimentally induced lung injury model, ventilated by conventional mechanical ventilation and high-frequency oscillatory ventilation, compared with a control group.</p><p><strong>Methods: </strong>Fifty-five rabbits sampled by convenience were supplemented with 10mg/kg lycopene for 21 days prior to the experiment. Lung injury was induced by tracheal infusion of warm saline. The rabbits were randomly assigned to the control group and subjected to protective conventional mechanical ventilation (n = 5) without supplementation or the experimental group that was subjected to acute lung injury and provided conventional mechanical ventilation and high-frequency oscillatory ventilation with and without lycopene supplementation (n = 10 rabbits in each group). Lung oxidative stress and the inflammatory response were assessed based on the number of polymorphonuclear leukocytes in bronchoalveolar lavage fluid, DNA damage and pulmonary histological damage.</p><p><strong>Results: </strong>A significant worsening of oxygenation and a decrease in static lung compliance was noted in all groups after pulmonary injury induction (partial pressure of oxygen before 451.86 ± 68.54 and after 71 ± 19.27, p < 0.05). After 4 hours, the high-frequency oscillatory ventilation groups with and without lycopene supplementation as well as the group receiving protective conventional mechanical ventilation with lycopene supplementation showed significant oxygenation improvement compared with the protective conventional mechanical ventilation group without supplementation (partial pressure of oxygen of the group with mechanical ventilation without lycopene of 102 ± 42, of the group that received conventional protective mechanical ventilation with lycopene supplementation of 362 ± 38, of the high-frequency group without lycopene supplementation of 420 ± 28 and of the high-frequency group with lycopene supplementation of 422 ± 25; p < 0.05). Compared with rabbits not receiving supplementation, those in the groups that received protective conventional mechanical ventilation with lycopene supplementation and high-frequency oscillatory ventilation with lycopene supplementation had significantly less inflammation as well as less histological injury (p < 0.05). Compared with rabbits subjected to protective conventional mechanical ventilation, significantly lower DNA damage was observed in rabbits supplemented with lycopene (p < 0.05).</p><p><strong>Conclusion: </strong>Lycopene supplementation reduces inflammatory and histopathological lung injuries, regardless of the associated ventilatory mode. In addition, lycopene improved oxygenation and reduced DNA damage when protective conventional mechanical ventilation was used.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250250"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069827","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":"Early weaning from invasive mechanical ventilation via high-flow nasal oxygen versus conventional weaning in patients with hypoxemic respiratory failure: a prospective randomized controlled study.","authors":"Hareesh Ayyawar, Pradeep Bhatia, Sadik Mohammed, Nikhil Kothari, Bharat Paliwal, Ankur Sharma","doi":"10.62675/2965-2774.20250157","DOIUrl":"10.62675/2965-2774.20250157","url":null,"abstract":"<p><strong>Objective: </strong>Although the efficacy of high-flow nasal oxygen therapy in delaying or avoiding intubation in patients with hypoxemic respiratory failure has been studied, its potential for facilitating early weaning from invasive mechanical ventilation remains unexplored.</p><p><strong>Methods: </strong>In this randomized controlled trial, 80 adults with acute hypoxemic respiratory failure requiring invasive mechanical ventilation for > 48 hours were enrolled and divided into two groups: conventional weaning and early weaning via high-flow nasal oxygen. In the conventional weaning group, the spontaneous breathing trial was performed after the PaO2/FiO2 ratio was ≥ 200, whereas in the high-flow nasal oxygen group, the spontaneous breathing trial was conducted earlier when the PaO2/FiO2 ratio was 150 - 200. Following each successful spontaneous breathing trial, patients were extubated and put on oxygen supplementation via a venturi mask or high-flow nasal oxygen on the basis of their group allocation. The primary objective was to compare extubation failure (reintubation within 48 hours). The secondary objectives were to compare total invasive mechanical ventilation, oxygen requirement and sedation requirement days, ventilator-associated pneumonia incidence, invasive mechanical ventilation-free days, intensive care unit length of stay, and intensive care unit all-cause mortality.</p><p><strong>Results: </strong>Extubation failure was not significantly different between the high-flow nasal oxygen group and the conventional weaning group [12.5% versus 25%, respectively; odds ratio (95%CI) 0.5 (0.19 - 1.33)] (p = 0.25). Early weaning from invasive mechanical ventilation via high-flow nasal oxygen was associated with significantly increased invasive mechanical ventilation-free days and total oxygen requirement days (p = 0.02 and p = 0.01, respectively). No significant between-group differences were observed in total invasive mechanical ventilation days, ventilator-associated pneumonia incidence, intensive care unit length of stay, sedation duration, or all-cause mortality.</p><p><strong>Conclusion: </strong>Among patients with acute hypoxemic respiratory failure, early extubation with high-flow nasal oxygen is a feasible and superior alternative to the conventional method of weaning, as it increases the number of invasive mechanical ventilation-free days.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250157"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069785","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}
Critical care sciencePub Date : 2025-01-27eCollection Date: 2025-01-01DOI: 10.62675/2965-2774.20250076
Ricardo Turon, Pedro Kurtz, Carla Rynkowski, Letícia Petterson, Bruno Gonçalves, Vanessa de Caro, Marco Prazeres, Fernando Augusto Bozza, Cassia Righy
{"title":"Ventriculitis incidence and outcomes in patients with aneurysmal subarachnoid hemorrhage: a prospective observational study.","authors":"Ricardo Turon, Pedro Kurtz, Carla Rynkowski, Letícia Petterson, Bruno Gonçalves, Vanessa de Caro, Marco Prazeres, Fernando Augusto Bozza, Cassia Righy","doi":"10.62675/2965-2774.20250076","DOIUrl":"10.62675/2965-2774.20250076","url":null,"abstract":"<p><strong>Objective: </strong>To define the incidence of ventriculostomy-associated infections and their impact on the mortality and functional outcomes of patients with aneurysmal subarachnoid hemorrhage.</p><p><strong>Methods: </strong>We prospectively included all consecutive adult aneurysmal subarachnoid hemorrhage patients admitted to the neurological intensive care units of the Instituto Estadual do Cérebro Paulo Niemeyer (Rio de Janeiro, Brazil) and Hospital Cristo Redentor (Rio Grande do Sul, Brazil) who required external ventricular drains from July 2015 to December 2020. Daily clinical and laboratory variables were collected at admission and during the hospital stay. The presence of ventriculostomy-associated infections was evaluated daily, according to the Centers for Disease Control and Prevention and Infectious Diseases Society of America criteria. Hospital and 12-month outcomes were compared between patients with and without ventriculostomy-associated infections via both univariate and multivariate analyses.</p><p><strong>Results: </strong>Out of the 676 patients screened, 271 received external ventricular drains (40%) and were included in the study. The mean age was 54 years (IQR 46-63), 198 were female (72%), 47% had poor grade status (World Federation of Neurological Surgeons scale 4 and 5), and 75% had modified Fisher 3 or 4. The mean time from admission to external ventricular drain placement was 8.8 days. Ventriculostomy-associated infections developed in 127 patients (47%), and the mean time from external ventricular drain to ventriculostomy-associated infection diagnosis was 4.4 days. Hospital and 12-month mortality rates did not differ between the ventriculostomy-associated infection group and the nonventriculostomy-associated infection group (36% versus 40% and 43% versus 49%, respectively). Poor functional outcomes, defined as modified Rankin scores of 4 to 6, showed no difference between groups at hospital discharge (ventriculostomy-associated infections 75% versus nonventriculostomy-associated infections 73%; p = NS) or at 12 months (ventriculostomy-associated infections 49% versus nonventriculostomy-associated infections 53%; p = NS).</p><p><strong>Conclusion: </strong>Ventriculostomy-associated infections are common complications after aneurysmal subarachnoid hemorrhage. Although it was not associated with hospital mortality or functional outcomes in our cohort, improving diagnostic accuracy and preventive measures is essential for better understanding the long-term impact of one of the most severe infectious complications after aneurysmal subarachnoid hemorrhage.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250076"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069940","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}
Critical care sciencePub Date : 2025-01-27eCollection Date: 2025-01-01DOI: 10.62675/2965-2774.20250140
Nicolas Orozco, Gustavo García-Gallardo, Alexandre Biasi Cavalcanti, Tiago Mendonça Dos Santos, Gustavo Ospina-Tascón, Jan Bakker, Sebastián Morales, Karla Ramos, Leyla Alegria, Jean Louis Teboul, Daniel De Backer, Antoine Vieillard-Baron, Liliana Vallecilla Fernandez, Lucas Martins de Lima, Lucas Petri Damiani, Erica Ribeiro Sady, Eliana Vieira Santucci, Glenn Hernandez, Eduardo Kattan
{"title":"Statistical analysis plan for hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: the ANDROMEDA-SHOCK-2 randomized clinical trial.","authors":"Nicolas Orozco, Gustavo García-Gallardo, Alexandre Biasi Cavalcanti, Tiago Mendonça Dos Santos, Gustavo Ospina-Tascón, Jan Bakker, Sebastián Morales, Karla Ramos, Leyla Alegria, Jean Louis Teboul, Daniel De Backer, Antoine Vieillard-Baron, Liliana Vallecilla Fernandez, Lucas Martins de Lima, Lucas Petri Damiani, Erica Ribeiro Sady, Eliana Vieira Santucci, Glenn Hernandez, Eduardo Kattan","doi":"10.62675/2965-2774.20250140","DOIUrl":"10.62675/2965-2774.20250140","url":null,"abstract":"<p><strong>Background: </strong>ANDROMEDA-SHOCK 2 is an international, multicenter, randomized controlled trial comparing hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock to standard care resuscitation to test the hypothesis that the former is associated with lower morbidity and mortality in terms of hierarchal analysis of outcomes.</p><p><strong>Objective: </strong>To report the statistical plan for the ANDROMEDA--SHOCK 2 randomized clinical trial.</p><p><strong>Methods: </strong>We briefly describe the trial design, patients, methods of randomization, interventions, outcomes, and sample size. We portray our planned statistical analysis for the hierarchical primary outcome using the stratified win ratio method, as well as the planned analysis for the secondary and tertiary outcomes. We also describe the subgroup and sensitivity analyses. Finally, we provide details for presenting our results, including mock tables, baseline characteristics, and the effects of treatments on outcomes.</p><p><strong>Conclusion: </strong>According to best trial practices, we report our statistical analysis plan and data management plan prior to locking the database and initiating the analyses. We anticipate that this practice will prevent analysis bias and improve the utility of the study's reported results.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250140"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069945","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}
Critical care sciencePub Date : 2025-01-27eCollection Date: 2025-01-01DOI: 10.62675/2965-2774.20250250ed
Viviane Cordeiro Veiga, André Kalil, Pedro Henrique Rigotti Soares, Pedro Póvoa
{"title":"Ventriculostomy-associated infections: a healthcare issue in the neurointensive care unit.","authors":"Viviane Cordeiro Veiga, André Kalil, Pedro Henrique Rigotti Soares, Pedro Póvoa","doi":"10.62675/2965-2774.20250250ed","DOIUrl":"10.62675/2965-2774.20250250ed","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"37 ","pages":"e20250250ed"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11805456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069958","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}
Critical care sciencePub Date : 2024-12-20eCollection Date: 2024-01-01DOI: 10.62675/2965-2774.20240179-en
José Pedro Cidade, Gonçalo Guerreiro, Pedro Póvoa
{"title":"A clinical guide to assess the immune response to sepsis: from bench to bedside.","authors":"José Pedro Cidade, Gonçalo Guerreiro, Pedro Póvoa","doi":"10.62675/2965-2774.20240179-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240179-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240179en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959467","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}
Critical care sciencePub Date : 2024-12-20eCollection Date: 2024-01-01DOI: 10.62675/2965-2774.20240251-en
Safira A Wortel, Ferishta Bakhshi-Raiez, Ameen Abu-Hanna, Dave A Dongelmans, Nicolette F de Keizer, Aletta Houwink, Allard Dijkhuizen, Annelies Draisma, Annemiek Rijkeboer, Arjan Cloïn, Arthur de Meijer, Auke Reidinga, Barbara Festen-Spanjer, Bas van Bussel, Bob Eikemans, Cretièn Jacobs, David Moolenaar, Dharmanand Ramnarain, Dick Koning, Dirk Boer, Dirk Verbiest, Eline van Slobbe-Bijlsma, Ellen van Koppen, Els Rengers, Erik van Driel, Eva Verweij, Freya van Iersel, Gert Brunnekreef, Hans Kieft, Herman Kreeftenberg, Ilanit Hené, Inge Janssen, Ionana Drogt, Iwan van der Horst, Jan Jaap Spijkstra, Jan Rozendaal, Jannet Mehagnoul-Schipper, Jelle Epker Erasmus, Jessica Holtkamp, Johan Lutisan, Jos van Oers, Judith Lens, Laura van Gulik, Lettie van den Berg, Louise Urlings-Strop, Lyuba Georgieva, Maarten van Lieshout, Marga Hoogendoorn, Marissa Vrolijk-de Mos, Mart de Graaff, Martha de Bruin, Martijn Hoeksema, Martijn van Tellingen, Michel Barnas, Michiel Erkamp, Niels Gritters, Nuray Kusadasi, Paul Elbers, Peter Koetsier, Peter Spronk, Peter van der Voort, Ralph Pruijsten, Remko de Jong, Robert-Jan Bosman, Ronald Wesselink, Ronny Schnabel, Roy van den Berg, Ruud de Waal, Sesmu Arbous, Silvia Knape, Stefaan Hendriks, Tim Frenzel, Tom Dormans, Tom Rijpstra, Vera Silderhuis, Wouter de Ruijter
{"title":"Long-term mortality of Dutch COVID-19 patients admitted to the intensive care medicine: a retrospective analysis from a national quality registry.","authors":"Safira A Wortel, Ferishta Bakhshi-Raiez, Ameen Abu-Hanna, Dave A Dongelmans, Nicolette F de Keizer, Aletta Houwink, Allard Dijkhuizen, Annelies Draisma, Annemiek Rijkeboer, Arjan Cloïn, Arthur de Meijer, Auke Reidinga, Barbara Festen-Spanjer, Bas van Bussel, Bob Eikemans, Cretièn Jacobs, David Moolenaar, Dharmanand Ramnarain, Dick Koning, Dirk Boer, Dirk Verbiest, Eline van Slobbe-Bijlsma, Ellen van Koppen, Els Rengers, Erik van Driel, Eva Verweij, Freya van Iersel, Gert Brunnekreef, Hans Kieft, Herman Kreeftenberg, Ilanit Hené, Inge Janssen, Ionana Drogt, Iwan van der Horst, Jan Jaap Spijkstra, Jan Rozendaal, Jannet Mehagnoul-Schipper, Jelle Epker Erasmus, Jessica Holtkamp, Johan Lutisan, Jos van Oers, Judith Lens, Laura van Gulik, Lettie van den Berg, Louise Urlings-Strop, Lyuba Georgieva, Maarten van Lieshout, Marga Hoogendoorn, Marissa Vrolijk-de Mos, Mart de Graaff, Martha de Bruin, Martijn Hoeksema, Martijn van Tellingen, Michel Barnas, Michiel Erkamp, Niels Gritters, Nuray Kusadasi, Paul Elbers, Peter Koetsier, Peter Spronk, Peter van der Voort, Ralph Pruijsten, Remko de Jong, Robert-Jan Bosman, Ronald Wesselink, Ronny Schnabel, Roy van den Berg, Ruud de Waal, Sesmu Arbous, Silvia Knape, Stefaan Hendriks, Tim Frenzel, Tom Dormans, Tom Rijpstra, Vera Silderhuis, Wouter de Ruijter","doi":"10.62675/2965-2774.20240251-en","DOIUrl":"https://doi.org/10.62675/2965-2774.20240251-en","url":null,"abstract":"<p><strong>Objective: </strong>To describe the 12-month mortality of Dutch COVID-19 intensive care unit patients, the total COVID-19 population and various subgroups on the basis of the number of comorbidities, age, sex, mechanical ventilation, and vasoactive medication use.</p><p><strong>Methods: </strong>We included all patients admitted with COVID-19 between March 1, 2020, and March 29, 2022, from the Dutch National Intensive Care (NICE) database. The crude 12-month mortality rate is presented via Kaplan-Meier survival curves for each patient subgroup. We used Cox regression models to analyze the effects of patient characteristics on 12-month mortality after hospital discharge.</p><p><strong>Results: </strong>We included 16,605 COVID-19 patients. The in-hospital mortality rate was 28.1%, and the 12-month mortality rate after intensive care unit admission was 29.8%. Among hospital survivors, 12-month mortality after hospital discharge was 2.5% (300/11,931). The hazard of death at 12 months after hospital discharge was greater in patients between 60 and 79 years (HR 4.74; 95%CI 2.23 - 10.06) and ≥ 80 years (HR 22.77; 95%CI 9.91 - 52.28) than in patients < 40 years of age; in male patients than in female patients (HR 1.38; 95%CI 1.07 - 1.78); and in patients with one (adjusted HR 1.95; 95%CI 1.5 - 2.53), two (adjusted HR 4.49; 95%CI 3.27 - 6.16) or more than two comorbidities (adjusted HR 4.99; 95%CI 2.62 - 9.5) than in patients with no comorbidities. Neither vasoactive medication use nor mechanical ventilation resulted in statistically significant results.</p><p><strong>Conclusion: </strong>For Dutch COVID-19 intensive care unit patients, most deaths occurred during their hospital stay. For hospital survivors, the crude 12-month mortality rate was low. Patient age (older than 60), sex and the number of comorbidities were associated with a greater hazard of death at 12 months after hospital discharge, whereas mechanical ventilation and vasoactive medication were not.</p>","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e202400251en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959600","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}
Critical care sciencePub Date : 2024-12-20eCollection Date: 2024-01-01DOI: 10.62675/2965-2774.20240065-en
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
{"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":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959470","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}
Critical care sciencePub Date : 2024-12-16eCollection Date: 2024-01-01DOI: 10.62675/2965-2774.20240262-en
Fernanda Chohfi Atallah, Regis Goulart Rosa, Kathryn Puxty
{"title":"Prognostic indicators in intensive care unit oncology patients: bridging short-term and long-term survival.","authors":"Fernanda Chohfi Atallah, Regis Goulart Rosa, Kathryn Puxty","doi":"10.62675/2965-2774.20240262-en","DOIUrl":"10.62675/2965-2774.20240262-en","url":null,"abstract":"","PeriodicalId":72721,"journal":{"name":"Critical care science","volume":"36 ","pages":"e20240262en"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856944","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}