Journal of intensive medicine最新文献

{"title":"Latest Updates and Challenges in infections in intensive care medicine","authors":"Jordi Rello","doi":"10.1016/j.jointm.2023.11.001","DOIUrl":"10.1016/j.jointm.2023.11.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000865/pdfft?md5=32f6b43c3f87f94ee2d3feffd9e99be9&pid=1-s2.0-S2667100X23000865-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138625870","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":"Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future","authors":"Darragh O'Reilly ,&nbsp;Jennifer McGrath ,&nbsp;Ignacio Martin-Loeches","doi":"10.1016/j.jointm.2023.10.001","DOIUrl":"10.1016/j.jointm.2023.10.001","url":null,"abstract":"<div><p>Sepsis remains a major challenge internationally for healthcare systems. Its incidence is rising due to poor public awareness and delays in its recognition and subsequent management. In sepsis, mortality increases with every hour left untreated. Artificial intelligence (AI) is transforming worldwide healthcare delivery at present. This review has outlined how AI can augment strategies to address this global disease burden. AI and machine learning (ML) algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional methods. Our review highlights how these models can predict the risk of sepsis and organ failure even before it occurs. This gives providers additional time to plan and execute treatment plans, thereby avoiding increasing complications associated with delayed diagnosis of sepsis. The potential for cost savings with AI implementation is also discussed, including improving workflow efficiencies, reducing administrative costs, and improving healthcare outcomes. Despite these advantages, clinicians have been slow to adopt AI into clinical practice. Some of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical use. Furthermore, the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such technologies. Finally, we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 34-45"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000816/pdfft?md5=f14061017e65ccf19b8b13fe0858f566&pid=1-s2.0-S2667100X23000816-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139299750","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":"Erratum to “Relationship between PaO2/FiO2 and delirium in intensive care: A cross-sectional study” [Journal of Intensive Medicine volume 3 (2023) 73–78.]","authors":"Fang Gong ,&nbsp;Yuhang Ai ,&nbsp;Lina Zhang ,&nbsp;Qianyi Peng ,&nbsp;Quan Zhou ,&nbsp;Chunmei Gui","doi":"10.1016/j.jointm.2023.12.001","DOIUrl":"10.1016/j.jointm.2023.12.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Page 136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000919/pdfft?md5=a9c5afc9c253ae201649920356452ae3&pid=1-s2.0-S2667100X23000919-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139192641","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":"Extracorporeal membrane oxygenation in adult patients with sepsis and septic shock: Why, how, when, and for whom","authors":"Hongling Zhang ,&nbsp;Youdong Xu ,&nbsp;Xin Huang ,&nbsp;Shunyin Yang ,&nbsp;Ruiting Li ,&nbsp;Yongran Wu ,&nbsp;Xiaojing Zou ,&nbsp;Yuan Yu ,&nbsp;You Shang","doi":"10.1016/j.jointm.2023.07.001","DOIUrl":"10.1016/j.jointm.2023.07.001","url":null,"abstract":"<div><p>Sepsis and septic shock remain the leading causes of death in intensive care units. Some patients with sepsis fail to respond to routine treatment and rapidly progress to refractory respiratory and circulatory failure, necessitating extracorporeal membrane oxygenation (ECMO). However, the role of ECMO in adult patients with sepsis has not been fully established. According to existing studies, ECMO may be a viable salvage therapy in carefully selected adult patients with sepsis. The choice of venovenous, venoarterial, or hybrid ECMO modes is primarily determined by the patient's oxygenation and hemodynamics (distributive shock with preserved cardiac output, septic cardiomyopathy (left, right, or biventricular heart failure), or right ventricular failure caused by acute respiratory distress syndrome). Veno-venous ECMO can be used in patients with sepsis and severe acute respiratory distress syndrome when conventional mechanical ventilation fails, and early application of veno-arterial ECMO in patients with sepsis-induced refractory cardiogenic shock may be critical in improving their chances of survival. When ECMO is indicated, the choice of an appropriate mode and determination of the optimal timing of initiation and weaning are critical, particularly in an experienced ECMO center. Furthermore, some special issues, such as ECMO flow, anticoagulation, and antibiotic therapy, should be noted during the management of ECMO support.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 62-72"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000488/pdfft?md5=62ca2f57cb6c1f160dbd7674e91a4148&pid=1-s2.0-S2667100X23000488-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135149900","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":"Diagnosis and management of malaria in the intensive care unit","authors":"George Akafity ,&nbsp;Nicholas Kumi ,&nbsp;Joyce Ashong","doi":"10.1016/j.jointm.2023.09.002","DOIUrl":"10.1016/j.jointm.2023.09.002","url":null,"abstract":"<div><p>Malaria is responsible for approximately three-quarters of a million deaths in humans globally each year. Most of the morbidity and mortality reported are from Sub-Saharan Africa and Asia, where the disease is endemic. In non-endemic areas, malaria is the most common cause of imported infection and is associated with significant mortality despite recent advancements and investments in elimination programs. Severe malaria often requires intensive care unit admission and can be complicated by cerebral malaria, respiratory distress, acute kidney injury, bleeding complications, and co-infection. Intensive care management includes prompt diagnosis and early initiation of effective antimalarial therapy, recognition of complications, and appropriate supportive care. However, the lack of diagnostic capacities due to limited advances in equipment, personnel, and infrastructure presents a challenge to the effective diagnosis and management of malaria. This article reviews the clinical classification, diagnosis, and management of malaria as relevant to critical care clinicians, highlighting the role of diagnostic capacity, treatment options, and supportive care.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 3-15"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000762/pdfft?md5=2860522cdf0d44281a0709b9905a404f&pid=1-s2.0-S2667100X23000762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135410965","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":"Establishment of a rat model of severe spontaneous intracerebral hemorrhage","authors":"Shuixiang Deng ,&nbsp;Shengjie Feng ,&nbsp;Yuewen Xin ,&nbsp;Yu He ,&nbsp;Yao Wang ,&nbsp;Mi Tian ,&nbsp;Ye Gong","doi":"10.1016/j.jointm.2023.08.007","DOIUrl":"10.1016/j.jointm.2023.08.007","url":null,"abstract":"<div><h3>Background</h3><p>Severe intracerebral hemorrhage (ICH) is the most devastating subtype of stroke resulting in high mortality and disability. At present, the development of targeted treatments to minimize the high morbidity and mortality is limited partly due to the lack of a severe ICH animal model. In this study, we aimed to establish an accurate severe ICH model in rats and examine the pathological and physiological changes associated with ICH.</p></div><div><h3>Methods</h3><p>A rat model of severe ICH model was established by intrastriatal injection of autologous blood using different blood volumes (ICH 100 µL group, ICH 130 µL group, ICH 160 µL group, ICH 170 µL group, and ICH 180 µL group). The mortality was assessed during the 28-day post-ICH period. Short- and long-term neurological deficits were evaluated using the Longa method, foot fault, falling latency, and Morris water maze tests. Brain water content, hematoma volume, hemoglobin content, and magnetic resonance imaging were assessed to determine the extent of brain injury. Immunofluorescence staining was conducted to examine microglial activation and neuronal apoptosis. Hematoxylin and eosin (H&amp;E) staining, lung water content, and western blotting were used to assess lung injury following ICH.</p></div><div><h3>Results</h3><p>The mortality of ICH rats increased significantly with an increase in autologous blood injection. The 28-day mortality in the 100 µL, 130 µL, 160 µL, 170 µL, and 180 µL ICH groups were 5%, 20%, 40%, 75%, and 100%, respectively. A significantly higher 28-day mortality was observed in the ICH 160 µL group compared to the ICH 100 µL group. The ICH 160 µL group exhibited significantly increased neurological deficits, brain edema, hematoma volume, and hemoglobin content compared to the sham group. Compared with the sham operation group, the activation of microglia and neuronal death in ICH 160 µL rats increased. The use of H&amp;E staining and western blotting demonstrated that disruption of the intra-alveolar structure, alveolar edema, and infiltration of inflammatory cells and cytokines into the lung tissue were more severe in the ICH 160 µL group than the sham group.</p></div><div><h3>Conclusions</h3><p>A severe ICH model in rats was successfully established using an injection of autologous blood at a volume of 160 µL. This model may provide a valuable tool to examine the pathological mechanisms and potential therapeutic interventions of severe ICH.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 108-117"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000774/pdfft?md5=b7ae42fe68d068f91ffce1d0b51991fd&pid=1-s2.0-S2667100X23000774-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305440","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":"Prediction of mechanical ventilation outcome by early abdominal-visceral-blood-flow-and-function score in critically ill patients after cardiopulmonary bypass in the ICU: A prospective observational study","authors":"Chaofu Yue ,&nbsp;Longxiang Su ,&nbsp;Jun Wang ,&nbsp;Na Cui ,&nbsp;Yuankai Zhou ,&nbsp;Wei Cheng ,&nbsp;Bo Tang ,&nbsp;Xi Rui ,&nbsp;Huaiwu He ,&nbsp;Yun Long","doi":"10.1016/j.jointm.2023.09.001","DOIUrl":"10.1016/j.jointm.2023.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Abdominal organs are important organs that sense and respond to ischemia and hypoxia, but there are few evaluation methods.We use ultrasonography to evaluate abdominal organ function and blood flow in patients with mechanical ventilation (MV) after cardiopulmonary bypass and to obtain a semiquantitative score for abdominal organ function and blood flow.</p></div><div><h3>Methods</h3><p>Patients with cardiopulmonary bypass in the Critical Care Department of Peking Union Medical College Hospital in China from March to July 2021 were enrolled in this prospective observational study. The correlation of the abdominal-visceral-blood-flow-and-function score (AVBFS) with the duration of MV, number of days spent in the intensive care unit (ICU), acute physiology and chronic health evaluation II (APACHE-II), sequential organ failure assessment (SOFA), lactate, epinephrine, and norepinephrine use was analyzed, and the results were used to assess the predictive value of the receiver operating characteristic curve (ROC) regression analysis score for the duration of MV.</p></div><div><h3>Results</h3><p>Of the 92 patients who underwent cardiopulmonary bypass, 41 were finally included. The AVBFS were significantly correlated with the duration of MV, number of days spent in the ICU, APACHE-II score, SOFA score, and norepinephrine use time. The AVBFS in a group of patients using ventilators ≥36 h were significantly higher than those obtained for a group of patients using ventilators &lt;36 h (<em>P</em> &lt;0.05). The evaluation results for the AVBFS at 0-12 h after ICU admission were as follows: area under the ROC curve (AUC)=0.876 (95% confidence interval [CI]: 0.767 to 0.984), cut-off value=2.5, specificity=0.842, and sensitivity=0.773.</p></div><div><h3>Conclusions</h3><p>Abdominal visceral organ function and blood perfusion can be used to evaluate gastrointestinal function. It is related to early and late extubation after cardiac surgery.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 101-107"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000622/pdfft?md5=a1bd1d979a9db0c011de5701ee6d0165&pid=1-s2.0-S2667100X23000622-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135849442","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":"Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection","authors":"Marie Dejonckheere ,&nbsp;Massimo Antonelli ,&nbsp;Kostoula Arvaniti ,&nbsp;Koen Blot ,&nbsp;Ben CreaghBrown ,&nbsp;Dylan W. de Lange ,&nbsp;Jan De Waele ,&nbsp;Mieke Deschepper ,&nbsp;Yalim Dikmen ,&nbsp;George Dimopoulos ,&nbsp;Christian Eckmann ,&nbsp;Guy Francois ,&nbsp;Massimo Girardis ,&nbsp;Despoina Koulenti ,&nbsp;Sonia Labeau ,&nbsp;Jeffrey Lipman ,&nbsp;Fernando Lipovestky ,&nbsp;Emilio Maseda ,&nbsp;Philippe Montravers ,&nbsp;Adam Mikstacki ,&nbsp;Stijn Blot","doi":"10.1016/j.jointm.2023.06.004","DOIUrl":"10.1016/j.jointm.2023.06.004","url":null,"abstract":"<div><h3>Background</h3><p>The <em>AbSeS</em>-classification defines specific phenotypes of patients with intra-abdominal infection based on the (1) setting of infection onset (community-acquired, early onset, or late-onset hospital-acquired), (2) presence or absence of either localized or diffuse peritonitis, and (3) severity of disease expression (infection, sepsis, or septic shock). This classification system demonstrated reliable risk stratification in intensive care unit (ICU) patients with intra-abdominal infection. This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the <em>AbSeS</em>-classification and mortality.</p></div><div><h3>Methods</h3><p>This was a secondary analysis of an international observational study (“<em>AbSeS</em>”) investigating ICU patients with intra-abdominal infection. Only patients with pancreatic infection were included in this analysis (<em>n</em>=165). Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU. Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio (OR) and 95% confidence interval (CI).</p></div><div><h3>Results</h3><p>The overall mortality was 35.2% (<em>n</em>=58). The independent risk factors for mortality included older age (OR=1.03, 95% CI: 1.0 to 1.1 <em>P</em>=0.023), localized peritonitis (OR=4.4, 95% CI: 1.4 to 13.9 <em>P</em>=0.011), and persistent signs of inflammation at day 7 (OR=9.5, 95% CI: 3.8 to 23.9, <em>P</em>&lt;0.001) or after the implementation of additional source control interventions within the first week (OR=4.0, 95% CI: 1.3 to 12.2, <em>P</em>=0.013)<em>.</em> Gram-negative bacteria were most frequently isolated (<em>n</em>=58, 49.2%) without clinically relevant differences in microbial etiology between survivors and non-survivors.</p></div><div><h3>Conclusions</h3><p>In pancreatic infection, a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome. In this limited series, essentials of the <em>AbSeS</em>-classification, such as the setting of infection onset, diffuse peritonitis, and severity of disease expression, were not associated with an increased mortality risk.</p><p><span>ClinicalTrials.gov</span><svg><path></path></svg> number: NCT03270345</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 81-93"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000464/pdfft?md5=957a1e420dab278bdb27bcd76a75f85a&pid=1-s2.0-S2667100X23000464-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43769514","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":"Infectious causes of fever of unknown origin in developing countries: An international ID-IRI study","authors":"Hakan Erdem ,&nbsp;Jaffar A. Al-Tawfiq ,&nbsp;Maha Abid ,&nbsp;Wissal Ben Yahia ,&nbsp;George Akafity ,&nbsp;Manar Ezzelarab Ramadan ,&nbsp;Fatma Amer ,&nbsp;Amani El-Kholy ,&nbsp;Atousa Hakamifard ,&nbsp;Bilal Ahmad Rahimi ,&nbsp;Farouq Dayyab ,&nbsp;Hulya Caskurlu ,&nbsp;Reham Khedr ,&nbsp;Muhammad Tahir ,&nbsp;Lysien Zambrano ,&nbsp;Mumtaz Ali Khan ,&nbsp;Aun Raza ,&nbsp;Nagwa Mostafa El-Sayed ,&nbsp;Magdalena Baymakova ,&nbsp;Aysun Yalci ,&nbsp;Aamer Ikram","doi":"10.1016/j.jointm.2023.07.004","DOIUrl":"10.1016/j.jointm.2023.07.004","url":null,"abstract":"<div><h3>Background</h3><p>Fever of unknown origin (FUO) in developing countries is an important dilemma and further research is needed to elucidate the infectious causes of FUO.</p></div><div><h3>Methods</h3><p>A multi-center study for infectious causes of FUO in lower middle-income countries (LMIC) and low-income countries (LIC) was conducted between January 1, 2018 and January 1, 2023. In total, 15 participating centers from seven different countries provided the data, which were collected through the Infectious Diseases-International Research Initiative platform. Only adult patients with confirmed infection as the cause of FUO were included in the study. The severity parameters were quick Sequential Organ Failure Assessment (qSOFA) ≥2, intensive care unit (ICU) admission, vasopressor use, and invasive mechanical ventilation (IMV).</p></div><div><h3>Results</h3><p>A total of 160 patients with infectious FUO were included in the study. Overall, 148 (92.5%) patients had community-acquired infections and 12 (7.5%) had hospital-acquired infections. The most common infectious syndromes were tuberculosis (TB) (<em>n</em>=27, 16.9%), infective endocarditis (<em>n</em>=25, 15.6%), malaria (<em>n</em>=21, 13.1%), brucellosis (<em>n</em>=15, 9.4%), and typhoid fever (<em>n</em>=9, 5.6%). <em>Plasmodium falciparum, Mycobacterium tuberculosis</em>, Brucellae, <em>Staphylococcus aureus, Salmonella typhi</em>, and Rickettsiae were the leading infectious agents in this study. A total of 56 (35.0%) cases had invasive procedures for diagnosis. The mean qSOFA score was 0.76±0.94 {median (interquartile range [IQR]): 0 (0–1)}. ICU admission (<em>n</em>=26, 16.2%), vasopressor use (<em>n</em>=14, 8.8%), and IMV (<em>n</em>=10, 6.3%) were not rare. Overall, 38 (23.8%) patients had at least one of the severity parameters. The mortality rate was 15 (9.4%), and the mortality was attributable to the infection causing FUO in 12 (7.5%) patients.</p></div><div><h3>Conclusions</h3><p>In LMIC and LIC, tuberculosis and cardiac infections were the most severe and the leading infections causing FUO.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 94-100"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X2300052X/pdfft?md5=79d66c8257d8eb540fae2f6137b867ac&pid=1-s2.0-S2667100X2300052X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588727","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":"Correlation analysis between lung ultrasound scores and pulmonary arterial systolic pressure in patients with acute heart failure admitted to the emergency intensive care unit","authors":"Ping Xu ,&nbsp;Basma Nasr ,&nbsp;Liang Li ,&nbsp;Wenbin Huang ,&nbsp;Wei Liu ,&nbsp;Xuelian Wang","doi":"10.1016/j.jointm.2023.08.005","DOIUrl":"10.1016/j.jointm.2023.08.005","url":null,"abstract":"<div><h3>Background</h3><p>No convenient, inexpensive, and non-invasive screening tools exist to identify pulmonary hypertension (PH) - left heart disease (LHD) patients during the early stages of the disease course. This study investigated whether different methods of lung ultrasound (LUS) could be used for the initial investigation of PH-LHD.</p></div><div><h3>Methods</h3><p>This was a single-center prospective observational study which was performed in the Zigong Fourth People's Hospital. We consecutively enrolled patients with heart failure (HF) admitted to the emergency intensive care unit from January 2018 to May 2020. Transthoracic echocardiography and LUS were performed within 24 h before discharge. We used the Spearman coefficient for correlation analysis between ultrasound scores and pulmonary arterial systolic pressure (PASP). Bland-Altman plots were generated to inspect possible bias, and receiver operating characteristic (ROC) curves were calculated to assess the relationship between ultrasound scores and an intermediate and high echocardiographic probability of PH-LHD.</p></div><div><h3>Results</h3><p>Seventy-one patients were enrolled in this study, with an overall median age of 79 (interquartile range: 71.5–84.0) years. Among the 71 patients, 36 (50.7%) cases were male, and 26 (36.6%) had an intermediate and high echocardiographic probability of PH. All four LUS scores in patients with an intermediate and high probability of PH were significantly higher than in patients with a low probability of PH (<em>P</em> &lt;0.05). The correlation coefficient (<em>r</em>) between different LUS scoring methods and PASP was moderate for the 6-zone (<em>r</em>=0.455, <em>P</em> &lt;0.001), 8-zone (<em>r</em>=0.385, <em>P</em>=0.001), 12-zone (<em>r</em>=0.587, <em>P</em> &lt;0.001), and 28-zone (<em>r</em>=0.535, <em>P</em> &lt;0.001) methods. In Bland-Altman plots, each of the four LUS scoring methods had a good agreement with PASP (<em>P</em> &lt;0.001). The 8-zone and 12-zone methods showed moderately accurate discriminative values in differentiating patients with an intermediate and high echocardiographic probability of PH (<em>P</em> &lt;0.05).</p></div><div><h3>Conclusions</h3><p>LUS is a readily available, inexpensive, and risk-free method that moderately correlates with PASP. LUS is a potential screening tool used for the initial investigation of PH-LHD, especially in emergencies or critical care settings.</p></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"4 1","pages":"Pages 125-132"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667100X23000610/pdfft?md5=05308cabe3f59c464e740611e2c9f297&pid=1-s2.0-S2667100X23000610-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136008179","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}