Journal of intensive medicine最新文献

{"title":"How much tidal volume is sufficiently low to be called “protective lung ventilation”","authors":"","doi":"10.1016/j.jointm.2024.03.002","DOIUrl":"10.1016/j.jointm.2024.03.002","url":null,"abstract":"<div><p>Ultra-low tidal volume (ULT) is an appealing alternative for severe acute respiratory distress syndrome (ARDS) patients with the aim to alleviate excess lung stress and strain. A recent article showed that ULT without extracorporeal carbon dioxide removal did not improve prognosis in moderate-to-severe coronavirus disease 2019-related ARDS patients. However, several reasons should be considered before drawing the definite conclusion about the ULT strategy in severe ARDS.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 4","pages":"Pages 480-481"},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000434/pdfft?md5=7d6000d11f2c91b19970146dc1a5ffdd&pid=1-s2.0-S2667100X24000434-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761519","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":"Severe aspiration pneumonia in the elderly","authors":"Sebastian Ocrospoma ,&nbsp;Marcos I. Restrepo","doi":"10.1016/j.jointm.2023.12.009","DOIUrl":"10.1016/j.jointm.2023.12.009","url":null,"abstract":"<div><p>The global population is aging at an unprecedented rate, resulting in a growing and vulnerable elderly population in need of efficient comprehensive healthcare services that include long-term care and skilled nursing facilities. In this context, severe aspiration pneumonia, a condition that carries substantial morbidity, mortality, and financial burden, especially among elderly patients requiring admission to the intensive care unit, has attracted greater concern. Aspiration pneumonia is defined as a pulmonary infection related to aspiration or dysphagia in etiology. Prior episodes of coughing on food or liquid intake, a history of relevant underlying conditions, abnormalities on videofluoroscopy or water swallowing, and gravity-dependent shadow distribution on chest imaging are among the clues that suggest aspiration. Patients with aspiration pneumonia tend to be elderly, frail, and suffering from more comorbidities than those without this condition. Here, we comprehensively address the epidemiology, clinical characteristics, diagnosis, treatment, prevention, and prognosis of severe aspiration community-acquired pneumonia in the elderly to optimize care of this high-risk demographic, enhance outcomes, and minimize the healthcare costs associated with this illness. Emphasizing preventive measures and effective management strategies is vital in ensuring the well-being of our aging population.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 307-317"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000173/pdfft?md5=b2c35ed3a2e7b84c59cce380d1992e47&pid=1-s2.0-S2667100X24000173-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784757","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":"Pathophysiological dynamics in the contact, coagulation, and complement systems during sepsis: Potential targets for nafamostat mesilate","authors":"","doi":"10.1016/j.jointm.2024.02.003","DOIUrl":"10.1016/j.jointm.2024.02.003","url":null,"abstract":"<div><p>Sepsis is a life-threatening syndrome resulting from a dysregulated host response to infection. It is the primary cause of death in the intensive care unit, posing a substantial challenge to human health and medical resource allocation. The pathogenesis and pathophysiology of sepsis are complex. During its onset, pro-inflammatory and anti-inflammatory mechanisms engage in intricate interactions, possibly leading to hyperinflammation, immunosuppression, and long-term immune disease. Of all critical outcomes, hyperinflammation is the main cause of early death among patients with sepsis. Therefore, early suppression of hyperinflammation may improve the prognosis of these patients. Nafamostat mesilate is a serine protease inhibitor, which can inhibit the activation of the complement system, coagulation system, and contact system. In this review, we discuss the pathophysiological changes occurring in these systems during sepsis, and describe the possible targets of the serine protease inhibitor nafamostat mesilate in the treatment of this condition.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 4","pages":"Pages 453-467"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000343/pdfft?md5=a5ef2146e5925d67ab478d7267460b9b&pid=1-s2.0-S2667100X24000343-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794672","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":"Relevance of plasma lipoproteins and small metabolites in assessment of nutritional status among patients with severe injuries","authors":"","doi":"10.1016/j.jointm.2024.02.004","DOIUrl":"10.1016/j.jointm.2024.02.004","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to identify plasma lipoproteins and small metabolites associated with high risk of malnutrition during intensive care unit (ICU) stay in patients with severe injuries.</p></div><div><h3>Methods</h3><p>This observational prospective exploratory study was conducted at two level-1 trauma centers in the Netherlands. Adult patients (aged ≥18 years) who were admitted to the ICU for more than 48 h between July 2018 and April 2022 owing to severe injuries (polytrauma, as defined by Injury Severity Scores of ≥16) caused by blunt trauma were eligible for inclusion. Partial least squares discriminant analysis was used to analyze the relationship of 112 lipoprotein-related components and 23 small metabolites with the risk of malnutrition (modified Nutrition Risk in Critically Ill score). Malnutrition was diagnosed based on Subjective Global Assessment scores. The relationship of lipoprotein properties and small metabolite concentrations with malnutrition (during ICU admission) was evaluated using mixed effects logistic regression.</p></div><div><h3>Results</h3><p>Overall, 51 patients were included. Lower (very) low-density lipoprotein ([V]LDL) (free) cholesterol and phospholipid levels, low particle number, and higher levels of LDL triglycerides were associated with a higher risk of malnutrition (variable importance in projection [VIP] value &gt;1.5). Low levels of most (V)LDL and intermediate-density lipoprotein subfractions and high levels of high-density lipoprotein Apo-A1 were associated with the diagnosis of malnutrition (VIP value &gt;1.5). Increased levels of dimethyl sulfone, trimethylamine N-oxide, creatinine, N, N-dimethylglycine, and pyruvic acid and decreased levels of creatine, methionine, and acetoacetic acid were also indicative of malnutrition (VIP value &gt;1.5). Overall, 14 lipoproteins and 1 small metabolite were significantly associated with a high risk of malnutrition during ICU admission (<em>P</em> &lt;0.05); however, the association did not persist after correcting the false discovery rate (<em>P</em>=0.35 for all).</p></div><div><h3>Conclusion</h3><p>Increased triglyceride in several lipoprotein subfractions and decreased levels of other lipoprotein subfraction lipids and several small metabolites (involved in the homocysteine cycle, ketone body formation, and muscle metabolism) may be indicative of malnutrition risk. Following validation in larger cohorts, these indicators may guide institution of preventive nutritional measures in patients admitted to the ICU with severe injuries.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 4","pages":"Pages 496-507"},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000380/pdfft?md5=b352dc663650351f572332b8c2564c95&pid=1-s2.0-S2667100X24000380-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759253","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":"Septic cardiomyopathy phenotype in the critically ill may depend on antimicrobial resistance","authors":"Vasiliki Tsolaki ,&nbsp;Kyriaki Parisi ,&nbsp;George E. Zakynthinos ,&nbsp;Efrosini Gerovasileiou ,&nbsp;Nikitas Karavidas ,&nbsp;Vassileios Vazgiourakis ,&nbsp;Epaminondas Zakynthinos ,&nbsp;Demosthenes Makris","doi":"10.1016/j.jointm.2023.11.009","DOIUrl":"10.1016/j.jointm.2023.11.009","url":null,"abstract":"<div><h3>Background</h3><p>Sepsis is a life-threatening organ dysfunction, and septic cardiomyopathy (SCM) may complicate the course of the disease. Infection with multidrug-resistant (MDR) pathogens has been linked with worse outcomes. This study aims to evaluate SCM in patients with infections caused by different antimicrobial-resistant phenotypes.</p></div><div><h3>Method</h3><p>This retrospective study included patients with sepsis/septic shock, hospitalized, and intubated in the intensive care unit of the University Hospital of Larissa between January 2022 and September 2023 with echocardiographic data during the first two days after infection onset. The patients were divided into two groups: non-MDR-SCM group and MDR-SCM group. The cardiac function was compared between the two groups.</p></div><div><h3>Result</h3><p>A total of 62 patients were included in the study. Forty-four patients comprised the MDR-SCM and 18 the non-MDR-SCM group. Twenty-six patients (41.9%) presented with left ventricular (LV) systolic dysfunction, and ≤35% right ventricular fractional area change (RVFAC) was present in 56.4%. LV systolic function was more severely impaired in the non-MDR-SCM group (left ventricular ejection fraction, 35.8% ±4.9% <em>vs</em>. 45.6%±2.4%, <em>P</em>=0.049; LV outflow tract velocity time integral, [10.1±1.4] cm <em>vs</em>. [15.3±0.74] cm, <em>P</em>=0.001; LV-Strain, –9.02%±0.9% <em>vs</em>. –14.02%±0.7%, <em>P</em>=0.001). The MDR-SCM group presented with more severe right ventricular (RV) dilatation (right ventricular end-diastolic area/left ventricular end-diastolic area, 0.81±0.03 <em>vs.</em> 0.7±0.05, <em>P</em>=0.042) and worse RV systolic function (RVFAC, 32.3%±1.9% <em>vs</em>. 39.6%±2.7%, <em>P</em>=0.035; tricuspid annular plane systolic excursion, [15.9±0.9] mm <em>vs</em>. [18.1±0.9] mm, <em>P</em>=0.165; systolic tissue Doppler velocity measured at the lateral tricuspid annulus, [9.9±0.5] cm/s <em>vs</em>. [13.1±0.8] cm/s, <em>P</em>=0.002; RV-strain, –11.1%±0.7% <em>vs</em>. –15.1%±0.9%, <em>P</em>=0.002).</p></div><div><h3>Conclusion</h3><p>SCM related to MDR infection presents with RV systolic dysfunction predominance, while non-MDR-SCM is mainly depicted with LV systolic dysfunction impairment.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 355-361"},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000100/pdfft?md5=7cd85d81d6c78960d1e103c5c4495df7&pid=1-s2.0-S2667100X24000100-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764610","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":"Recombinant human thrombopoietin in alleviating endothelial cell injury in sepsis","authors":"Yun Xie,&nbsp;Hui Lv,&nbsp;Daonan Chen,&nbsp;Peijie Huang,&nbsp;Shaohong Wu,&nbsp;Hongchao Shi,&nbsp;Qi Zhao,&nbsp;Ruilan Wang","doi":"10.1016/j.jointm.2023.12.006","DOIUrl":"10.1016/j.jointm.2023.12.006","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the effect of recombinant human thrombopoietin (rhTPO) on clinical prognosis by exploring changes in endothelial cell injury markers and inflammatory factors in patients with sepsis after treatment with rhTPO.</p></div><div><h3>Methods</h3><p>This retrospective observational study involved patients with sepsis (diagnosed according to Sepsis 3.0) admitted to Shanghai General Hospital intensive care unit from January 1, 2019 to December 31, 2022. Patients were divided into two groups (control and rhTPO) according to whether they received rhTPO. Baseline information, clinical data, prognosis, and survival status of the patients, as well as inflammatory factors and immune function indicators were collected. The main monitoring indicators were endothelial cell-specific molecule (ESM-1), human heparin-binding protein (HBP), and CD31; secondary monitoring indicators were interleukin (IL)-6, tumor necrosis factor (TNF)-α, extravascular lung water index, platelet, antithrombin III, fibrinogen, and international normalized ratio. We used intraperitoneal injection of lipopolysaccharide (LPS) to establish a mouse model of sepsis. Mice were randomly divided into four groups: normal saline, LPS, LPS + rhTPO, and LPS + rhTPO + LY294002. Plasma indicators in mice were measured by enzyme-linked immunosorbent assay.</p></div><div><h3>Results</h3><p>A total of 84 patients were included in the study. After 7 days of treatment, ESM-1 decreased more significantly in the rhTPO group than in the control group compared with day 1 (median=38.6 [interquartile range, IQR: 7.2 to 67.8] pg/mL <em>vs.</em> median=23.0 [IQR: −15.7 to 51.5] pg/mL, <em>P</em>=0.008). HBP and CD31 also decreased significantly in the rhTPO group compared with the control group (median=59.6 [IQR: −1.9 to 91.9] pg/mL <em>vs.</em> median=2.4 [IQR: −23.2 to 43.2] pg/mL; median=2.4 [IQR: 0.4 to 3.5] pg/mL <em>vs.</em> median=−0.6 [IQR: −2.2 to 0.8] pg/mL, <em>P</em> &lt;0.001). Inflammatory markers IL-6 and TNF-α decreased more significantly in the rhTPO group than in the control group compared with day 1 (median=46.0 [IQR: 15.8 to 99.1] pg/mL <em>vs.</em> median=31.2 [IQR: 19.7 to 171.0] pg/mL, <em>P</em> &lt;0.001; median=17.2 [IQR: 6.4 to 23.2] pg/mL <em>vs.</em> median=0.0 [IQR: 0.0 to 13.8] pg/mL, <em>P</em>=0.010). LPS + rhTPO-treated mice showed significantly lower vascular von Willebrand factor (<em>P</em>=0.003), vascular endothelial growth factor (<em>P</em>=0.002), IL-6 (<em>P</em> &lt;0.001), and TNF-α (<em>P</em> &lt;0.001) than mice in the LPS group. Endothelial cell damage factors vascular von Willebrand factor (<em>P</em>=0.012), vascular endothelial growth factor (<em>P</em>=0.001), IL-6 (<em>P</em> &lt;0.001), and TNF-α (<em>P</em>=0.001) were significantly elevated by inhibiting the PI3K/Akt pathway.</p></div><div><h3>Conclusion</h3><p>rhTPO alleviates endothelial injury and inflammatory indices in sepsis, and may regulate septic endothelial cell","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 3","pages":"Pages 384-392"},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000082/pdfft?md5=0d5c0ad6b53ef35c58b4152fa3f88aae&pid=1-s2.0-S2667100X24000082-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760516","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":"Effectiveness and safety of Shenfu injection in septic patients with hypoperfusion: A multi-center, open-label, randomized, controlled trial","authors":"","doi":"10.1016/j.jointm.2024.01.007","DOIUrl":"10.1016/j.jointm.2024.01.007","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the effectiveness and safety of the Shenfu injection (SFI) combined with standard bundle treatment in septic patients with hypoperfusion.</p></div><div><h3>Method</h3><p>This study was a multi-center, randomized, open-label, controlled trial conducted in four teaching hospitals in China. The septic patients with hypoperfusion and traditional Chinese medicine (TCM) syndrome with Yang-Qi deficiency were enrolled from January 2019, through September 2020. Eligible patients were randomly allocated in a 1:1 ratio to either receive 60 mL of SFI infusion per day plus standard treatment (SFI group) or standard bundle treatment alone (control group). The primary outcome was 28-day all-cause mortality. Secondary outcomes were 90-day all-cause mortality time to weaning from mechanical ventilation, time to weaning from vasopressors, time to discharge from the ICU and hospital, and laboratory results after randomization.</p></div><div><h3>Results</h3><p>A total of 188 patients completed the trail. This study revealed that the results of the SFI group and the control groups were not statistically significant in 28-day all-cause mortality (10.6% <em>vs.</em> 20.2%, respectively; <em>P</em>=0.106). The infusion of SFI was associated with a significant reduction in the duration of vasopressor use (median=4.0 days, interquartile range [IQR]: 2.0 days–6.0 days <em>vs</em>. median=5.0 days, IQR: 3.0 days–8.0 days, respectively; <em>P</em>=0.043). Patients in the SFI group had statistically greater reductions in plasma lactate levels compared with those in the control group at the first 12 h (median=1.1 mmol/L, IQR: 0.3–2.0 mmol/L <em>vs</em>. median=0.0 mmol/L, IQR: −0.2 to 0.8 mmol/L, respectively; <em>P</em> &lt;0.001) and 24 h (median=1.4 mmol/L, IQR: 0.3–2.2 mmol/L <em>vs</em>. median=0.4 mmol/L, IQR: −0.4 to 1.6 mmol/L, respectively; <em>P</em>=0.001).</p></div><div><h3>Conclusion</h3><p>SFI plus standard therapy did not significantly decrease 28-day all-cause mortality for septic patients with hypoperfusion and TCM syndrome with Yang-Qi deficiency.</p><p><strong>Trial registration</strong> Chinese Clinical Trial Registry Identifier: ChiCTR1800020435</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 4","pages":"Pages 484-490"},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X24000185/pdfft?md5=ca8ff5897cde33b86419141d8972bb71&pid=1-s2.0-S2667100X24000185-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140785510","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 high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation: A randomized, physiological, crossover study","authors":"Elena Lytra ,&nbsp;Stelios Kokkoris ,&nbsp;Ioannis Poularas ,&nbsp;Dimitrios Filippiadis ,&nbsp;Demosthenes Cokkinos ,&nbsp;Dimitrios Exarhos ,&nbsp;Spyros Zakynthinos ,&nbsp;Christina Routsi","doi":"10.1016/j.jointm.2023.11.008","DOIUrl":"10.1016/j.jointm.2023.11.008","url":null,"abstract":"<div><h3>Background</h3><p>Compared to conventional oxygen devices, high-flow oxygen treatment (HFOT) through the nasal cannulae has demonstrated clinical benefits. Limited data exist on whether such effects are also present in HFOT through tracheostomy. Hence, we aimed to examine the short-term effects of HFOT through tracheostomy on diaphragmatic function and respiratory parameters in tracheostomized patients on prolonged mechanical ventilation.</p></div><div><h3>Methods</h3><p>A randomized, crossover, physiological study was conducted in our ICU between December 2020 and April 2021, in patients with tracheostomy and prolonged mechanical ventilation. The patients underwent a 30-min spontaneous breathing trial (SBT) and received oxygen either via T-piece or by HFOT through tracheostomy, followed by a washout period of 15-min breathing through the T-piece and receipt of 30-min oxygen with the other modality in a randomized crossover manner. At the start and end of each session, blood gasses, breathing frequency (f), and tidal volume (V_T) via a Wright's spirometer were measured, along with diaphragm ultrasonography including diaphragm excursion and diaphragmatic thickening fraction, which expressed the inspiratory muscle effort.</p></div><div><h3>Results</h3><p>Eleven patients were enrolled in whom 19 sessions were uneventfully completed; eight patients were studied twice on two different days with alternate sessions; and three patients were studied once. Patients were randomly assigned to start the SBT with a T-piece (<em>n</em>=10 sessions) or with HFOT (<em>n</em>=9 sessions). With HFOT, V_T and minute ventilation (V_E) significantly increased during SBT (from [465±119] mL to [549±134] mL, <em>P</em> &lt;0.001 and from [12.4±4.3] L/min to [13.1±4.2] L/min, <em>P</em> &lt;0.05, respectively), but they did not change significantly during SBT with T-piece (from [495±132] mL to [461±123] mL and from [12.8±4.4] mL to [12.0±4.4] mL, respectively); f/V_T decreased during HFOT (from [64±31] breaths/(min∙L) to [49±24] breaths/(min∙L), <em>P</em> &lt;0.001), but it did not change significantly during SBT with T-piece (from [59±28] breaths/(min∙L) to [64±33] breaths/(min∙L)); partial pressure of arterial oxygen increased during HFOT (from [99±39] mmHg to [132±48] mmHg, <em>P</em> &lt;0.001), but it decreased during SBT with T-piece (from [124±50] mmHg to [83±22] mmHg, <em>P</em> &lt;0.01). In addition, with HFOT, diaphragmatic excursion increased (from [12.9±3.3] mm to [15.7±4.4] mm, <em>P</em> &lt;0.001), but it did not change significantly during SBT with T-piece (from [13.4±3.3] mm to [13.6±3.3] mm). The diaphragmatic thickening fraction did not change during SBT either with T-piece or with HFOT.</p></div><div><h3>Conclusion</h3><p>In patients with prolonged mechanical ventilation, HFOT through tracheostomy compared with T-piece improves ventilation, pattern of breathing, and oxygenation without increasing the i","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 2","pages":"Pages 202-208"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000956/pdfft?md5=41cb94554c920133228b5df3638f7f08&pid=1-s2.0-S2667100X23000956-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395706","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":"Clinical practice guidelines for nutritional assessment and monitoring of adult ICU patients in China","authors":"Xiangdong Guan ,&nbsp;Dechang Chen ,&nbsp;Yuan Xu (Chinese Society of Critical Care Medicine)","doi":"10.1016/j.jointm.2023.12.002","DOIUrl":"10.1016/j.jointm.2023.12.002","url":null,"abstract":"<div><p>The Chinese Society of Critical Care Medicine (CSCCM) has developed clinical practice guidelines for nutrition assessment and monitoring for patients in adult intensive care units (ICUs) in China. This guideline focuses on nutrition evaluation and metabolic monitoring to achieve optimal and personalized nutrition therapy for critically ill patients. This guideline was developed by experts in critical care medicine and evidence-based medicine methodology and was developed after a thorough review of the system and a summary of relevant trials or studies published from 2000 to July 2023. A total of 18 recommendations were formed and consensus was reached through discussions and reviews by expert groups in critical care medicine, parenteral and enteral nutrition, and surgery. The recommendations are based on currently available evidence and cover several key fields, including screening and assessment, evaluation and assessment of enteral feeding intolerance, metabolic and nutritional measurement and monitoring during nutrition therapy, and organ function evaluation related to nutrition supply. Each question was analyzed according to the Population, Intervention, Comparison, and Outcome (PICO) principle. In addition, interpretations were provided for four questions that did not reach a consensus but may have potential clinical and research value. The plan is to update this nutrition assessment and monitoring guideline using the international guideline update method within 3–5 years.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 2","pages":"Pages 137-159"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23001081/pdfft?md5=c543e5107fc60c2b9c473644c4af05b1&pid=1-s2.0-S2667100X23001081-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139886357","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":"Optimal strategy for treatment of sepsis based on the host inflammatory reaction and immune response","authors":"Hui Zhang,&nbsp;Ning Dong,&nbsp;Yongming Yao","doi":"10.1016/j.jointm.2023.10.002","DOIUrl":"10.1016/j.jointm.2023.10.002","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 2","pages":"Pages 175-180"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000828/pdfft?md5=51a4ca6d4802a577a702eb2db1948d7a&pid=1-s2.0-S2667100X23000828-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305694","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}