Annals of Intensive Care最新文献

{"title":"Efficacy of restrictive versus liberal transfusion strategies in patients with traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.","authors":"Xiang Yuan, Sen Zhang, Jun Wan, Cheng Chen, Peng Wang, Shijie Fan, Yuyang Liu, Jingxian Yang, Jiayi Hou, Qiaoyu You, Xiao Li, Kuilin Li, Ziyan Xiang, Yang Rao, Yu Zhang","doi":"10.1186/s13613-024-01411-1","DOIUrl":"10.1186/s13613-024-01411-1","url":null,"abstract":"<p><strong>Background: </strong>The effects of restrictive versus liberal transfusion strategies in critically ill patients with traumatic brain injury (TBI) and anemia, particularly in adult patients with moderate to severe TBI, remain inconclusive. Therefore, this systematic review and meta-analysis aim to evaluate the comparative impact of restrictive and liberal red blood cell transfusion strategies among critically ill adult patients with moderate to severe TBI.</p><p><strong>Methods: </strong>We conducted a search of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials from their inception through October 20, 2024, to identify randomized controlled trials that compared restrictive (transfusions at a hemoglobin level of ≤ 7 g/dL) and liberal (transfusions at a hemoglobin level of ≤ 9-10 g/dL) transfusion strategies in adult patients with TBI. The primary outcome was mortality, with secondary outcomes including an unfavorable neurological outcome at six months, as determined by the Glasgow Outcome Scale (GOS < 4; or Glasgow Outcome Scale-Extended [GOSE] < 6), and the number of units of packed red blood cells (pRBCs) transfused.</p><p><strong>Results: </strong>Five randomized controlled trials involving 1,528 patients were included in the analysis. The results showed that restrictive transfusion, compared to liberal transfusion, had no impact on mortality (RR 1.00, 95% CI 0.80 to 1.24, I² = 0%) or unfavorable neurological outcome at 6 months (RR 1.06, 95% CI 0.94 to 1.20, I² = 47%). Restrictive transfusion was associated with a reduction in the number of units of pRBCs transfused (MD -2.62, 95% CI -3.33 to -1.90, I² = 63%).</p><p><strong>Conclusion: </strong>In patients with TBI, a restrictive transfusion strategy did not reduce the risk of mortality or unfavorable neurological outcome compared with a liberal transfusion strategy.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"177"},"PeriodicalIF":5.7,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction.","authors":"Jae Wook Jung, Ilmo Kang, Jin Park, Seungjoo Lee, Sang-Beom Jeon","doi":"10.1186/s13613-024-01412-0","DOIUrl":"10.1186/s13613-024-01412-0","url":null,"abstract":"<p><strong>Background: </strong>Malignant middle cerebral artery infarction (MMI) is associated with a high incidence of severe disability and mortality. Decompressive hemicraniectomy has become a recognized treatment that can improve the prognosis for patients if performed within a certain time window. Nevertheless, despite this intervention, a mortality rate of approximately 20-40% persists following the surgery. The trends and clinical implications of intracranial pressure (ICP) in these situations remain unclear. We aimed to investigate whether intracranial pressure (ICP) trends are associated with clinical outcomes in patients undergoing decompressive hemicraniectomy for MMI.</p><p><strong>Methods: </strong>This retrospective cohort study included consecutive patients with MMI who underwent decompressive craniectomy and received ICP monitoring after surgery. Using a linear mixed model, we categorized the patients into ICP increase and decrease groups based on the ICP values obtained over 192 h. We then compared the proportion of 3-month favorable outcomes (modified Rankin Scale of 0-4) and mortality rates between these groups.</p><p><strong>Results: </strong>Of 112 MMI patients who underwent decompressive hemicraniectomy, 66 (58.9%) received invasive ICP monitoring. ICP monitoring was performed for a median of 146.5 h (IQR 72.5-181.8). Among the 66 patients, 37 (56.1%) were in the ICP increase group, and 29 (43.9%) were in the ICP decrease group. During the monitoring period, the initial monitored ICP and peak ICP did not significantly differ between the ICP increase and decrease groups. However, the ICP trend was significantly different between the two groups (P < 0.001). In multivariable logistic regression analyses, the ICP increase group had a significantly lower proportion of 3-month favorable outcomes compared to the ICP decrease group (adjusted OR 0.11; 95% CI, 0.01-0.59; P = 0.019), and significantly higher mortality in the intensive care unit (adjusted OR 6.98; 95% CI, 1.37-54.6; P = 0.031).</p><p><strong>Conclusions: </strong>In MMI patients, continuous ICP monitoring could be useful for detecting those with an increasing ICP trend that may be associated with unfavorable clinical outcomes.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"176"},"PeriodicalIF":5.7,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early reduction in gut microbiota diversity in critically ill patients is associated with mortality.","authors":"Hannah Wozniak, Nadia Gaïa, Vladimir Lazarevic, Christophe Le Terrier, Tal Sarah Beckmann, Eleonora Balzani, Martin Urner, Jérôme Pugin, Jacques Schrenzel, Claudia-Paula Heidegger","doi":"10.1186/s13613-024-01407-x","DOIUrl":"10.1186/s13613-024-01407-x","url":null,"abstract":"<p><strong>Background: </strong>Critical illness is associated with an altered gut microbiota, yet its association with poor outcomes remains unclear. This study evaluates the early gut microbiota diversity changes in intensive care unit patients and its association with mortality. Additionally, it explores fecal pH as a potential biomarker for these changes.</p><p><strong>Methods: </strong>In this prospective observational cohort study, fecal samples were collected at two time points: S1, the first stool passed upon intensive care unit admission, and S2, the first stool passed at least 24 h after S1. Full-length 16S rRNA gene sequencing was performed for gut microbiota analysis, with α-diversity measured using the Shannon index. Bayesian joint models were used to estimate the association between time-varying changes in gut microbiota diversity and 60-day mortality, as well as the association between daily changes in stool pH and in diversity.</p><p><strong>Results: </strong>Twenty-four of 96 patients overall died during follow-up. Daily Shannon index decreased on average by -0.1 points [95% Credible Intervals (CrI) -0.20 to -0.10]. Every point decrease in Shannon index was associated with a 1.99-fold increase in the hazard of death (95% CrI, 1.04 to 4.51). Time-varying fecal pH levels were not associated with changes in Shannon index.</p><p><strong>Conclusions: </strong>Gut microbiota diversity decreased over time, associated with increased mortality. Fecal pH is an unreliable marker of gut microbiota change. Future studies on gut microbiota and related biomarkers should focus on the initial days in the intensive care unit to detect and mitigate a decline in gut microbiota diversity.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"174"},"PeriodicalIF":5.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eadyn's predictive potential: expanding horizons in vasopressor weaning and hemodynamic management.","authors":"Jorge Iván Alvarado-Sánchez, Sergio Salazar-Ruiz, Juan Daniel Caicedo-Ruiz, Yenny Rocío Cárdenas-Bolívar, Fredy Leonardo Carreño-Hernández, Andrés Felipe Mora-Salamanca, Carlos Santacruz-Herrera","doi":"10.1186/s13613-024-01413-z","DOIUrl":"10.1186/s13613-024-01413-z","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"173"},"PeriodicalIF":5.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive assessment and progression of health status during neurorehabilitation in survivors of critical illness: a prospective cohort study.","authors":"Marion Egger, Melanie Finsterhölzl, Daria Farabegoli, Franziska Wippenbeck, Maria Schlutt, Friedemann Müller, Volker Huge, Klaus Jahn, Jeannine Bergmann","doi":"10.1186/s13613-024-01396-x","DOIUrl":"10.1186/s13613-024-01396-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Critical illness survivors frequently suffer from long-term impairments, often described as post-intensive care syndrome (PICS). PICS encompasses physical, cognitive, and mental impairments. Additionally, the term intensive care unit (ICU)-acquired weakness (ICUAW) was coined for muscle weakness after critical illness. Research on the progression and outcome of individuals affected by PICS and ICUAW is scant. Thus we aimed to assess the health status and its progression during neurorehabilitation in critically ill patients using comprehensive outcome measures, describe the prevalence of PICS, and evaluate factors associated with rehabilitation outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients with mixed reasons for critical illness who received ≥ 5 days of mechanical ventilation on the ICU and who were admitted to neurorehabilitation, were eligible to be included in this prospective cohort study. A number of outcomes (patient-reported, clinician-reported, and performance) were assessed after discharge from the ICU (V1) and shortly before discharge from inpatient neurorehabilitation (V2). The prevalence of PICS, defined as having at least one impairment in any PICS dimension), was calculated at V1 and V2. Multiple logistic regressions were conducted to identify factors associated with rehabilitation outcome (poor outcome = modified Rankin Scale &gt; 2) and ICUAW at V2 (MRC sum score &lt; 48).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In total, 250 critical illness survivors (62 ± 14 years, 34% female, median stay on ICU 55 days, median inpatient rehabilitation 65 days) were included. 11 participants (4.4%) died before V2. All outcomes improved significantly during rehabilitation except sensory impairment and pain. PICS was present in 96% at V1 and in 85% at V2, whereby mainly the physical domain (V1: 87%, V2: 66%; ICUAW with MRC sum score &lt; 48) and the cognitive domain (V1:65%, V2:55%; Montreal Cognitive Assessment &lt; 26) were affected. Mental impairment was lower (V1:48%, V2:29%; Hospital Anxiety and Depression Scale &gt; 7), but still affected a considerable number of participants. Accordingly, health-related quality of life was rather low at discharge (0.64 ± 0.28, index value of EQ-5D-5L). MRC sum score at V1, duration of mechanical ventilation, and female gender were significantly associated with a poor rehabilitation outcome. Grip strength in % of reference at V1, age, female gender, and comorbidities were significantly associated with persistent ICUAW at discharge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Despite significant improvements during rehabilitation, survivors after critical illness experience a substantial burden of PICS and ICUAW at discharge from rehabilitation care. Survivors of critical illness require long-term follow-up, supportive structures, and tailored long-term multi-disciplinary therapies even after intensive rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;German Clinical Trials Register, DRKS000217","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"175"},"PeriodicalIF":5.7,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eadyn's Beacon: Illuminating Vasopressor management strategies.","authors":"Rogério da Hora Passos, Sávio Sérgio Ferreira Custódio, Tomas de Azevedo Rodrigues, Igor Dovorake Lourenço, Bruno de Arruda Bravim, Thiago Domingos Correa","doi":"10.1186/s13613-024-01410-2","DOIUrl":"10.1186/s13613-024-01410-2","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"172"},"PeriodicalIF":5.7,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High flow nasal cannula and low level continuous positive airway pressure have different physiological effects during de novo acute hypoxemic respiratory failure.","authors":"Samuel Tuffet, Mohamed Ahmed Boujelben, Anne-Fleur Haudebourg, Tommaso Maraffi, François Perier, Pascale Labedade, Elsa Moncomble, Ségolène Gendreau, Matthieu Lacheny, Emmanuel Vivier, Armand Mekontso-Dessap, Guillaume Carteaux","doi":"10.1186/s13613-024-01408-w","DOIUrl":"10.1186/s13613-024-01408-w","url":null,"abstract":"<p><strong>Background: </strong>Large tidal volumes during de novo acute hypoxemic respiratory failure (AHRF) may promote patient self-inflicted lung injury. Tidal volume assessment under high flow nasal cannula (HFNC) is not routinely feasible at the bedside. Our objective was to determine whether tidal volume during low-level continuous positive airway pressure (CPAP) could predict tidal volume during HFNC and to compare the physiological effects of HFNC and low-level CPAP.</p><p><strong>Methods: </strong>Prospective, single-center study including 29 de novo AHRF patients treated with HFNC (50 to 60 L.min^- 1). Patients were monitored using electrical impedance tomography during HFNC then CPAP at 4 cmH₂O. Tidal volume during HFNC was calculated based on tidal impedance variation. The ability of tidal volume under low-level CPAP to predict tidal volume under HFNC was explored using Bland-Altman analysis. CPAP and HFNC were compared in terms of tidal volume, minute ventilation, respiratory comfort, dyspnea, oxygenation, ventilation distribution, end-expiratory lung volume, thoraco-abdominal asynchrony and recruitment.</p><p><strong>Results: </strong>Under HFNC, patients had a tidal volume of 6.6 (5.9-8.7) mL.kg^- 1 PBW. 20 (69%) patients exhibited a tidal volume between 4 and 8 mL.kg^- 1 PBW, while in 5 (17%) patients it exceeded 9 mL.kg^- 1 PBW. Tidal volume under CPAP was higher (9.4 (8.3-11) mL.kg^- 1 PBW, p < 0.001). Tidal volumes under CPAP and under HFNC were modestly correlated (Spearman r = 0.50, p = 0.005). Bland-Altman analysis showed a bias of 2.4 mL.kg^- 1, with limits of agreement ranging from - 1.1 mL.kg^- 1to 5.9 mL.kg^- 1. Nevertheless, a larger (> 11.5 mL.kg^- 1 PBW ) tidal volume under low-level CPAP predicted a larger (> 9 mL.kg^- 1 PBW ) tidal volume under HFNC with 80% sensitivity and 96% specificity. Low-level CPAP was associated with increased minute ventilation, end-expiratory lung volume, and oxygenation as compared to HFNC. It decreased signs of respiratory distress in the most severe patients but was associated with lower comfort compared to HFNC.</p><p><strong>Conclusion: </strong>Among ICU patients with de novo AHRF, tidal volume under HFNC was mostly protective. Tidal volume during CPAP at 4 cmH₂O did not predict tidal volume during HFNC. Such low-level CPAP was associated with increased tidal volume, minute ventilation, end-expiratory volume, and oxygenation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT03919331. Registration date: 2019-03-26.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"171"},"PeriodicalIF":5.7,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alteplase in COVID-19 severe hypoxemic respiratory failure: the TRISTARDS multicenter randomized trial.","authors":"Giovanni Landoni, Pratima Chowdary, Ferhat Meziani, Jacques Creteur, Nicolas De Schryver, Johann Motsch, Ingrid Henrichmoeller, Alain Pagès, Nuala Peter, Thierry Danays, Markus A Weigand","doi":"10.1186/s13613-024-01386-z","DOIUrl":"10.1186/s13613-024-01386-z","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary intravascular thrombus formation has been widely observed in patients with respiratory failure, for example, in patients with SARS-CoV-2 infection (COVID-19). The aim of this study was to evaluate the efficacy/safety of alteplase thrombolysis in COVID-19 severe hypoxemic respiratory failure. In this multicenter, open-label study, patients were randomized to receive alteplase (low- or high-dose) over 5 days plus standard of care (SOC), or SOC alone. The primary endpoint was time to clinical improvement (≥ 2-point decrease on WHO Clinical Progression Scale, or hospital discharge) up to Day 28. Secondary endpoints included all-cause mortality at Day 28, treatment failure at Day 28 and change in arterial oxygen partial pressure/fractional inspired oxygen (PaO₂/FiO₂) ratio at Day 6 versus baseline.</p><p><strong>Results: </strong>Sixty-nine patients were randomized to alteplase (low- or high-dose) and 35 to SOC; 65% were on high-flow oxygen or non-invasive ventilation at baseline. Median time to clinical improvement was 25 days in the alteplase group and > 28 days (median not reached) in the SOC group. All-cause mortality was 8/69 (12%) versus 10/35 (29%) in the alteplase versus SOC groups, respectively (unadjusted risk difference [RD], - 17% [95% confidence interval (CI) - 34 to 0], p = 0.047; adjusted RD, - 16% [95% CI - 31 to 1], p = 0.058). The PaO₂/FiO₂ ratio (mean [standard deviation]) increased by + 30 (84) mmHg in the alteplase group and decreased by - 12 (59) mmHg in the SOC group (adjusted mean difference vs. SOC, p = 0.052). Differences were greater in patients receiving high-dose alteplase, and in those not receiving invasive ventilation. Eighteen patients (26.1%) in the alteplase group discontinued treatment due to adverse events. Major bleeding was more frequent with alteplase than with SOC (9 vs. 0 patients); no bleeding was fatal. The study closed early due to insufficient patient recruitment.</p><p><strong>Conclusion: </strong>Alteplase was not associated with faster clinical recovery from COVID-19 severe hypoxemic respiratory failure. A numerical difference in survival and PaO₂/FiO₂ ratio was observed, particularly in patients not receiving invasive ventilation. These exploratory findings merit further investigation in larger patient cohorts that are adequately powered to confirm the hypotheses generated in this study regarding the impact of alteplase on treatment outcomes. Trial registration ClinicalTrials.gov: NCT04640194 (November 23, 2020); https://clinicaltrials.gov/study/NCT04640194 (early discontinuation due to insufficient patient recruitment).</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"170"},"PeriodicalIF":5.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angiopoietin-2 as a prognostic biomarker in septic adult patients: a systemic review and meta-analysis.","authors":"Mengke Zhuo, Sifeng Fu, Yawen Chi, Xinghua Li, Sirui Li, Xiaochun Ma, Xu Li","doi":"10.1186/s13613-024-01393-0","DOIUrl":"10.1186/s13613-024-01393-0","url":null,"abstract":"<p><strong>Background: </strong>The impairment of endothelial function represents a key pathophysiological mechanism in the development of sepsis. This research aimed to evaluate the prognostic significance of angiopoietin-2 (Ang-2), an endothelial biomarker, in predicting mortality in sepsis patients.</p><p><strong>Methods: </strong>Chinese and English studies were systematically retrieved in PubMed, Cochrane Library, Embase, WanFang, CNKI, CQVIP, and CBM databases up to July 16, 2023. We conducted a study selection established upon predefined inclusion and exclusion criteria and used the Newcastle-Ottawa scale (NOS) to assess its quality. We extracted available data from the included studies for data analysis.</p><p><strong>Results: </strong>The final inclusion comprised 33 studies with 4703 participants. According to the NOS, one study was of medium quality, while the rest were of high quality. In comparison to survivors, the levels of Ang-2 in non-survivors were markedly elevated [standardized mean difference (SMD) = 1.08, 95% confidence intervals (CI) 0.68-1.49, P < 0.001], and the same results were also observed in the subgroup that met sepsis 3.0 diagnosis criteria (SMD = 0.63, 95% CI 0.11-1.14, P = 0.017). The results comparing Ang-2 levels between non-survivors and survivors were independent of duration of follow-up, sample sources, type of study, and region. Ang-2 was a risk factor for mortality [odds ratios (OR) = 1.16, 95% CI 1.09-1.23, P < 0.001]. Ang-2 was demonstrated to be able to predict mortality in septic adult patients [area under the curve (AUC) = 0.76, 95% CI 0.70-0.82, P < 0.001].</p><p><strong>Conclusions: </strong>Ang-2 level was positively correlated with risk of death in sepsis patients. Ang-2 might be a useful and valuable biomarker for predicting mortality in septic adult patients.</p>","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"169"},"PeriodicalIF":5.7,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Severe bleeding events among critically ill patients with hematological malignancies.","authors":"Nathan D Nielsen, Jean-Marc Tadié, Raphaël Clere-Jehl","doi":"10.1186/s13613-024-01401-3","DOIUrl":"10.1186/s13613-024-01401-3","url":null,"abstract":"","PeriodicalId":7966,"journal":{"name":"Annals of Intensive Care","volume":"14 1","pages":"168"},"PeriodicalIF":8.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}