Critical care (Houten, Netherlands)最新文献

{"title":"Respiratory distress observation scales to predict weaning outcome","authors":"M. Decavèle, E. Rozenberg, M. Niérat, J. Mayaux, E. Morawiec, C. Morélot-Panzini, T. Similowski, A. Demoule, M. Dres","doi":"10.1186/s13054-022-04028-7","DOIUrl":"https://doi.org/10.1186/s13054-022-04028-7","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47614966","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":"One-year patient outcomes based on lung morphology in acute respiratory distress syndrome: secondary analysis of LIVE trial","authors":"Florian Blanchard, T. Godet, S. Pons, Natacha Kapandji, M. Jabaudon, V. Degos, L. Borao, A. Bouglé, A. Monsel, E. Futier, J. Constantin, A. James","doi":"10.1186/s13054-022-04036-7","DOIUrl":"https://doi.org/10.1186/s13054-022-04036-7","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48775186","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":"Intermediate-risk pulmonary embolism: echocardiography predictors of clinical deterioration","authors":"A. Weekes, Denise N. Fraga, V. Belyshev, W. Bost, Christopher A. Gardner, Nathaniel S. O’Connell","doi":"10.1186/s13054-022-04030-z","DOIUrl":"https://doi.org/10.1186/s13054-022-04030-z","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43334243","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":"Association of annual hospital septic shock case volume and hospital mortality.","authors":"Yan Chen, Xu-Dong Ma, Xiao-Hui Kang, Si-Fa Gao, Jin-Min Peng, Shan Li, Da-Wei Liu, Xiang Zhou, Li Weng, Bin Du","doi":"10.1186/s13054-022-04035-8","DOIUrl":"10.1186/s13054-022-04035-8","url":null,"abstract":"<p><strong>Background: </strong>The burden of sepsis remains high in China. The relationship between case volume and hospital mortality among patients with septic shock, the most severe complication of sepsis, is unknown in China.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed surveillance data from a national quality improvement program in intensive care units (ICUs) in China in 2020. Association between septic shock case volume and hospital mortality was analyzed using multivariate linear regression and restricted cubic splines.</p><p><strong>Results: </strong>We enrolled a total of 134,046 septic shock cases in ICUs from 1902 hospitals in China during 2020. In this septic shock cohort, the median septic shock volume per hospital was 33 cases (interquartile range 14-76 cases), 41.4% were female, and more than half of the patients were over 61 years old, with average hospital mortality of 21.2%. An increase in case volume was associated with improved survival among septic shock cases. In the linear regression model, the highest quartile of septic shock volume was associated with lower hospital mortality compared with the lowest quartile (β - 0.86; 95% CI - 0.98, - 0.74; p < 0.001). Similar differences were found in hospitals of respective geographic locations and hospital levels. With case volume modeled as a continuous variable in a restricted cubic spline, a lower volume threshold of 40 cases before which a substantial reduction of the hospital mortality rate was observed.</p><p><strong>Conclusions: </strong>The findings suggest that hospitals with higher septic shock case volume have lower hospital mortality in China. Further research is needed to explain the mechanism of this volume-outcome relationship.</p>","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":"161"},"PeriodicalIF":0.0,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9166431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42085463","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":"Comparative incidence of early and late bloodstream and respiratory tract co-infection in patients admitted to ICU with COVID-19 pneumonia versus Influenza A or B pneumonia versus no viral pneumonia: wales multicentre ICU cohort study.","authors":"Manish Pandey,&nbsp;Alexander May,&nbsp;Laura Tan,&nbsp;Harriet Hughes,&nbsp;Jack Parry Jones,&nbsp;Wendy Harrison,&nbsp;Scott Bradburn,&nbsp;Sam Tyrrel,&nbsp;Babu Muthuswamy,&nbsp;Nidhika Berry,&nbsp;Richard Pugh,&nbsp;Daryn Sutton,&nbsp;Andy Campbell,&nbsp;Matthew Morgan","doi":"10.1186/s13054-022-04026-9","DOIUrl":"10.1186/s13054-022-04026-9","url":null,"abstract":"<p><strong>Objective: </strong>The aim is to characterise early and late respiratory and bloodstream co-infection in patients admitted to intensive care units (ICUs) with SARS-CoV-2-related acute hypoxemic respiratory failure (AHRF) needing respiratory support in seven ICUs within Wales, during the first wave of the COVID-19 pandemic. We compare the rate of positivity of different secondary pathogens and their antimicrobial sensitivity in three different patient groups: patients admitted to ICU with COVID-19 pneumonia, Influenza A or B pneumonia, and patients without viral pneumonia.</p><p><strong>Design: </strong>Multicentre, retrospective, observational cohort study with rapid microbiology data from Public Health Wales, sharing of clinical and demographic data from seven participating ICUs.</p><p><strong>Setting: </strong>Seven Welsh ICUs participated between 10 March and 31 July 2020. Clinical and demographic data for COVID-19 disease were shared by each participating centres, and microbiology data were extracted from a data repository within Public Health Wales. Comparative data were taken from a cohort of patients without viral pneumonia admitted to ICU during the same period as the COVID-19 cohort (referred to as no viral pneumonia or 'no viral' group), and to a retrospective non-matched cohort of consecutive patients with Influenza A or B admitted to ICUs from 20 November 2017. The comparative data for Influenza pneumonia and no viral pneumonia were taken from one of the seven participating ICUs.</p><p><strong>Participants: </strong>A total of 299 consecutive patients admitted to ICUs with COVID-19 pneumonia were compared with 173 and 48 patients admitted with no viral pneumonia or Influenza A or B pneumonia, respectively.</p><p><strong>Main outcome measures: </strong>Primary outcome was to calculate comparative incidence of early and late co-infection in patients admitted to ICU with COVID-19, Influenza A or B pneumonia and no viral pneumonia. Secondary outcome was to calculate the individual group of early and late co-infection rate on a per-patient and per-sample basis, with their antimicrobial susceptibility and thirdly to ascertain any statistical correlation between clinical and demographic variables with rate of acquiring co-infection following ICU admission.</p><p><strong>Results: </strong>A total of 299 adults (median age 57, M/F 2:1) were included in the COVID-19 ICU cohort. The incidence of respiratory and bloodstream co-infection was 40.5% and 15.1%, respectively. Staphylococcus aureus was the predominant bacterial pathogen within the first 48 h. Gram-negative organisms from Enterobacterales group were predominantly seen after 48 h in COVID-19 cohort. Comparative no viral pneumonia cohort had lower rates of respiratory tract infection and bloodstream infection. The influenza cohort had similar rates respiratory tract infection and bloodstream infection. Mortality in all three groups was similar, and no clinical or demographic v","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":"158"},"PeriodicalIF":0.0,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9160852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49571258","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":"Association between early cumulative fluid balance and successful liberation from invasive ventilation in COVID-19 ARDS patients - insights from the PRoVENT-COVID study: a national, multicenter, observational cohort analysis.","authors":"Sanchit Ahuja, Harm-Jan de Grooth, Frederique Paulus, Fleur L van der Ven, Ary Serpa Neto, Marcus J Schultz, Pieter R Tuinman","doi":"10.1186/s13054-022-04023-y","DOIUrl":"10.1186/s13054-022-04023-y","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence indicates the potential benefits of restricted fluid management in critically ill patients. Evidence lacks on the optimal fluid management strategy for invasively ventilated COVID-19 patients. We hypothesized that the cumulative fluid balance would affect the successful liberation of invasive ventilation in COVID-19 patients with acute respiratory distress syndrome (ARDS).</p><p><strong>Methods: </strong>We analyzed data from the multicenter observational 'PRactice of VENTilation in COVID-19 patients' study. Patients with confirmed COVID-19 and ARDS who required invasive ventilation during the first 3 months of the international outbreak (March 1, 2020, to June 2020) across 22 hospitals in the Netherlands were included. The primary outcome was successful liberation of invasive ventilation, modeled as a function of day 3 cumulative fluid balance using Cox proportional hazards models, using the crude and the adjusted association. Sensitivity analyses without missing data and modeling ARDS severity were performed.</p><p><strong>Results: </strong>Among 650 patients, three groups were identified. Patients in the higher, intermediate, and lower groups had a median cumulative fluid balance of 1.98 L (1.27-7.72 L), 0.78 L (0.26-1.27 L), and - 0.35 L (- 6.52-0.26 L), respectively. Higher day 3 cumulative fluid balance was significantly associated with a lower probability of successful ventilation liberation (adjusted hazard ratio 0.86, 95% CI 0.77-0.95, P = 0.0047). Sensitivity analyses showed similar results.</p><p><strong>Conclusions: </strong>In a cohort of invasively ventilated patients with COVID-19 and ARDS, a higher cumulative fluid balance was associated with a longer ventilation duration, indicating that restricted fluid management in these patients may be beneficial. Trial registration Clinicaltrials.gov ( NCT04346342 ); Date of registration: April 15, 2020.</p>","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":"157"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9157033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46756546","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":"Prone positioning improves ventilation-perfusion matching assessed by electrical impedance tomography in patients with ARDS: a prospective physiological study.","authors":"Yu-Xian Wang, Ming Zhong, Min-Hui Dong, Jie-Qiong Song, Yi-Jun Zheng, Wei Wu, Jia-le Tao, Ling Zhu, Xin Zheng","doi":"10.1186/s13054-022-04021-0","DOIUrl":"10.1186/s13054-022-04021-0","url":null,"abstract":"<p><strong>Background: </strong>The physiological effects of prone ventilation in ARDS patients have been discussed for a long time but have not been fully elucidated. Electrical impedance tomography (EIT) has emerged as a tool for bedside monitoring of pulmonary ventilation and perfusion, allowing the opportunity to obtain data. This study aimed to investigate the effect of prone positioning (PP) on ventilation-perfusion matching by contrast-enhanced EIT in patients with ARDS.</p><p><strong>Design: </strong>Monocenter prospective physiologic study.</p><p><strong>Setting: </strong>University medical ICU.</p><p><strong>Patients: </strong>Ten mechanically ventilated ARDS patients who underwent PP.</p><p><strong>Interventions: </strong>We performed EIT evaluation at the initiation of PP, 3 h after PP initiation and the end of PP during the first PP session.</p><p><strong>Measurements and main results: </strong>The regional distribution of ventilation and perfusion was analyzed based on EIT images and compared to the clinical variables regarding respiratory and hemodynamic status. Prolonged prone ventilation improved oxygenation in the ARDS patients. Based on EIT measurements, the distribution of ventilation was homogenized and dorsal lung ventilation was significantly improved by PP administration, while the effect of PP on lung perfusion was relatively mild, with increased dorsal lung perfusion observed. The ventilation-perfusion matched region was found to increase and correlate with the increased PaO₂/FiO₂ by PP, which was attributed mainly to reduced shunt in the lung.</p><p><strong>Conclusions: </strong>Prolonged prone ventilation increased dorsal ventilation and perfusion, which resulted in improved ventilation-perfusion matching and oxygenation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT04725227. Registered on 25 January 2021.</p>","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":"154"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9137443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47104423","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":"Effect of abdominal weight training with and without cough machine assistance on lung function in the patients with prolonged mechanical ventilation: a randomized trial","authors":"Tsai-Yi Hung, Wen-Lan Wu, H. Kuo, Shih-Feng Liu, Chia-Ling Chang, Hui-Chuan Chang, Yuh-Chyn Tsai, Jui-Fang Liu","doi":"10.1186/s13054-022-04012-1","DOIUrl":"https://doi.org/10.1186/s13054-022-04012-1","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43421646","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":"Venous return and mean systemic filling pressure: physiology and clinical applications","authors":"R. Persichini, Christopher Lai, J. Teboul, Imane Adda, L. Guérin, X. Monnet","doi":"10.1186/s13054-022-04024-x","DOIUrl":"https://doi.org/10.1186/s13054-022-04024-x","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44476802","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":"Evolving outcomes of extracorporeal membrane oxygenation during the first 2 years of the COVID-19 pandemic: a systematic review and meta-analysis","authors":"R. R. Ling, K. Ramanathan, J. Sim, S. N. Wong, Ying-Chen Chen, F. Amin, S. Fernando, B. Rochwerg, E. Fan, R. Barbaro, G. MacLaren, K. Shekar, D. Brodie","doi":"10.1186/s13054-022-04011-2","DOIUrl":"https://doi.org/10.1186/s13054-022-04011-2","url":null,"abstract":"","PeriodicalId":92888,"journal":{"name":"Critical care (Houten, Netherlands)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45649076","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}