Journal of intensive medicine最新文献

{"title":"High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Con","authors":"Gabriel Kemoun ,&nbsp;Alexandre Demoule","doi":"10.1016/j.jointm.2024.12.005","DOIUrl":"10.1016/j.jointm.2024.12.005","url":null,"abstract":"<div><div>Over the past decade and boosted by the coronavirus disease 2019 (COVID-19) pandemic, high-flow nasal oxygen (HFNO) has been increasingly used in the intensive care unit (ICU) to treat acute hypoxemic respiratory failure (AHRF). In this review, we show that despite this wide and rapid increase in the use of HFNO to treat AHRF, HFNO does not fulfill all the criteria of a “reference treatment”. First, there are some inconsistencies between the studies that provided a positive signal toward the possible benefit of HFNO in AHRF. The two high-quality studies were negative in terms of primary outcome although they provided promising signals in favor of HFNO in terms of secondary outcomes or unplanned secondary analysis. The significance of the only positive study suffers from notable limitations and other trials, conducted in COVID-19 and in immunocompromised patients, are definitely negative and do not even provide promising signals in favor of HFNO. Of note, authors of some of the large randomized controlled trials (RCTs) on HFNO have received grants or personal fees from manufacturers of HFNO devices. Second, meta-analyses do not show positive results regarding the efficacy of HFNO on mortality and recent guidelines do not support its use to improve this outcome, although they recommend HFNO use to reduce intubation rate. Third, HFNO is associated with risks that should be accounted for. There are concerns that HFNO may delay intubation, which is in turn associated with higher mortality and prolonged length of stay. In addition, with HFNO, high inspiratory effort may generate high lung strain and overstretch, a phenomenon termed patient self-inflicted lung injury (P-SILI). Fourth, there are concerns regarding access to HFNO in resource-limited settings. Fifth, there are also concerns regarding the deleterious environmental impact of HFNO due to the high volume of consumables and high oxygen flow, which remain to be precisely quantified and balanced with the potential reduction in intubation rate. Considering all these limitations, HFNO is not yet the reference treatment for AHRF.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 230-236"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522356","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":"High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Pro","authors":"Jean-Pierre Frat ,&nbsp;Sylvain Le Pape","doi":"10.1016/j.jointm.2024.12.003","DOIUrl":"10.1016/j.jointm.2024.12.003","url":null,"abstract":"<div><div>In patients with hypoxemic acute respiratory failure (ARF), the first-line treatment is oxygen therapy, which may include the administration of high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), or continuous positive airway pressure (CPAP). In addition to improving oxygenation, HFNO and NIV reduce the work of breathing as compared to standard oxygen, while CPAP does not. However, tolerance to NIV and CPAP is clinically challenging, resulting in treatment interruption in 10 %–20 % of cases. Compared to standard oxygen, HFNO has been shown to reduce the risk of intubation, while the benefits of NIV or CPAP, even when delivered via a helmet, require further evaluation. Although evidence for the efficacy of HFNO in reducing mortality remains inconclusive, HFNO has emerged as the reference treatment and is recommended for patients with hypoxemic ARF given its benefit in reducing the risk of intubation.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 222-229"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522355","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":"Free flow Helmet continuous positive airway pressure: The devil is in the “valve's” details!","authors":"Sergio Lassola ,&nbsp;Eleonora Balzani ,&nbsp;Silvia De Rosa ,&nbsp;Marta Turella ,&nbsp;Giacomo Bellani","doi":"10.1016/j.jointm.2025.03.003","DOIUrl":"10.1016/j.jointm.2025.03.003","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 219-221"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522612","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":"Timing of initiating renal replacement therapy in acute kidney injury","authors":"Saber Davide Barbar ,&nbsp;Marine Jacquier ,&nbsp;Thomas Maldiney","doi":"10.1016/j.jointm.2024.12.004","DOIUrl":"10.1016/j.jointm.2024.12.004","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 246-248"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522358","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":"Noninvasive respiratory supports for acute hypoxemic respiratory failure","authors":"Arnaud W. Thille ,&nbsp;Rémi Coudroy","doi":"10.1016/j.jointm.2025.04.001","DOIUrl":"10.1016/j.jointm.2025.04.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 214-215"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522610","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":"The association of blood eosinophil levels with sepsis and mortality risk: An observational and Mendelian Randomization Study","authors":"Jiajia Ren ,&nbsp;Xiaoming Gao ,&nbsp;Jueheng Liu ,&nbsp;Mingzhu Liu ,&nbsp;Aihui Dai ,&nbsp;Chuchu Zhang ,&nbsp;Guorong Deng ,&nbsp;Xi Xu ,&nbsp;Ruohan Li ,&nbsp;Jiamei Li ,&nbsp;Gang Wang","doi":"10.1016/j.jointm.2025.03.001","DOIUrl":"10.1016/j.jointm.2025.03.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 292-294"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522365","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":"Nationwide survey on ICU visiting policies in Mainland of China: Current practices and perspectives","authors":"Yanxia Huang ,&nbsp;Mei Meng ,&nbsp;Xiaojun Pan ,&nbsp;Sheng Zhang,&nbsp;Lidi Zhang,&nbsp;Jiao Liu,&nbsp;Dechang Chen","doi":"10.1016/j.jointm.2024.12.009","DOIUrl":"10.1016/j.jointm.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Family presence is essential in reducing delirium and promoting early recovery of patients in the intensive care unit (ICU). This study was conducted through a questionnaire survey to examine the current visitation policies of ICUs in China and explore flexible visitation options.</div></div><div><h3>Methods</h3><div>Two versions of independently developed questionnaire, informed by relevant literature, was distributed in two versions: a medical staff questionnaire and a family questionnaire. The survey was administered online and conducted anonymously, with participants completing it after scanning a two-dimensional bar code. Data were collected from January 2020 to June 2020. We accessed the difference between the two groups were compared and the association between factors associated with family satisfaction were assessed.</div></div><div><h3>Results</h3><div>A total of 1200 hospitals across 30 provinces participated, yielding 16,359 valid responses (13,483 from medical staff and 2876 from family members). Currently, 90.5 % of the ICUs allow once-daily visitation, whereas only 1.2 % permit unrestricted visitation. Family care was allowed in 15.0 % of the ICUs at the end of the patient's life, and 30.3 % allowed flexible visitation for rehabilitation exercises. Among medical staff, 73.9 % of doctors and 58.7 % of nurses supported flexible visitation when rehabilitation exercises are needed. In addition, 73.3 % of family members were willing to help with rehabilitation exercises, and 77.3 % were satisfied with the existing visitation policies.</div></div><div><h3>Conclusions</h3><div>Most ICUs in mainland of China enforce restrictive visitation policies, most medical staff and family members accept. Moreover, flexible visitation policies for rehabilitation purposes may be increasingly acceptable in the future.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 269-275"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522362","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":"Future directions in sepsis research","authors":"Craig M. Coopersmith","doi":"10.1016/j.jointm.2025.03.004","DOIUrl":"10.1016/j.jointm.2025.03.004","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 211-213"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522456","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":"Carnitine deficiency in intensive care unit patients undergoing continuous renal replacement therapy—An underrecognized issue with potential for severe complications","authors":"Arnaud Robert ,&nbsp;Julien Moury ,&nbsp;Gauthier Nendumba ,&nbsp;Benedicte Hauqiert ,&nbsp;Ovidiu Vornicu ,&nbsp;Sydney Blackman ,&nbsp;Emily Perriens ,&nbsp;Nathan De Lissnyder ,&nbsp;Andriy Shchukin ,&nbsp;Farah El Yaakoubi ,&nbsp;Clara Saad ,&nbsp;Cyril Schmit ,&nbsp;Anne-Sophie Dincq ,&nbsp;Patrick Evrard ,&nbsp;Pierre Bulpa ,&nbsp;Isabelle Michaux ,&nbsp;Patrick M. Honore","doi":"10.1016/j.jointm.2024.12.002","DOIUrl":"10.1016/j.jointm.2024.12.002","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 249-251"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522359","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":"Title Page","authors":"","doi":"10.1016/S2667-100X(25)00042-8","DOIUrl":"10.1016/S2667-100X(25)00042-8","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages i-ii"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522455","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}