Journal of Translational Critical Care Medicine最新文献

{"title":"Nephrology rapid response team in the intensive care unit","authors":"J. P. Gómez-Villarreal, Paola Borbolla, R. A. Garza-Treviño, K. Kashani, Gregorio A. Romero-González, L. Rizo-Topete","doi":"10.1097/jtccm-d-23-00015","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00015","url":null,"abstract":"Acute kidney injury (AKI) is a frequent complication in patients admitted to the intensive care unit (ICU), and it is known as an independent factor for adverse outcomes like increased length of hospital stay, the development of chronic kidney disease (CKD), and increased mortality with the associated high cost to healthcare systems. The use of AKI biomarkers and new tools such as point-of-care ultrasonography (POCUS) to perform a hemodynamic and volume status assessment has made it more feasible to detect or predict kidney damage in a very accurate way, thereby avoiding the progression of AKI. The design and implementation of a nephrology rapid response team (NRRT) should be considered to improve patient outcomes and healthcare costs. In this paper, we provide an overview of the implementation of an NRRT.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"138 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141811037","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":"Management of intensive care unit withdrawal syndrome","authors":"Yao Sun, Huiying Zhao","doi":"10.1097/jtccm-d-24-00014","DOIUrl":"https://doi.org/10.1097/jtccm-d-24-00014","url":null,"abstract":"Intensive care unit (ICU) patients frequently develop physical and psychological dependence on analgesic and sedative medications, which can lead to Iatrogenic withdrawal syndrome (IWS) upon discontinuation or tapering. The incidence of IWS in adult ICU patients varies significantly, with reported rates ranging from 12% to 100%. Identified risk factors for IWS include advanced age, obesity, medication dosage, and duration of exposure. The clinical manifestations of IWS are varied and include increased excitability of the central nervous system, gastrointestinal disturbances, and sympathetic nervous system hyperactivity. Preventive and therapeutic strategies for IWS encompass individualized medication regimens, structured withdrawal protocols, and a combination of pharmacological and non-pharmacological interventions. This review emphasizes the critical need for heightened awareness and improved management strategies to mitigate the incidence of IWS in ICU patients.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"19 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141815830","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":"Impaired systemic proteostasis and peripheral immune cell dysfunction in kidney diseases","authors":"Bartolini Desirée, Migni Anna, Russo Roberta, G. Francesco","doi":"10.1097/jtccm-d-23-00016","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00016","url":null,"abstract":"\u0000 Kidney diseases, encompassing a spectrum of either acute or chronic disorders, manifest complex systemic repercussions beyond renal dysfunction. These include a reduced efficacy of tissue proteostasis mechanisms to control protein synthesis, folding, and degradation in both the renal and extra-renal compartments. Emerging research has revealed a pivotal interplay between proteostasis and immune regulation in the pathogenesis of kidney diseases, along with their cardiovascular, immunometabolic, and organ dysfunction symptoms. This review outlines the multifaceted connections between proteostasis dysregulation and immune dysfunction in kidney disease onset and progression. The crosstalk between the proteostasis network and immune cells orchestrates a bidirectional communication that amplifies pathological cascades, exacerbating kidney injury and impairing organ resilience. Furthermore, the article focuses on the implications of systemic proteostasis defects in modulating immune responses in extra-renal tissues underscore the systemic nature of kidney diseases. The disruption of proteostasis mechanisms triggers the release of damage-associated molecular patterns (DAMPs) and inflammatory mediators, perpetuating a state of heightened immune activation, contributing to systemic complications in affected individuals. Understanding the intricate interaction between proteostasis and immune regulation in kidney diseases, including both chronic and acute forms, promises novel therapeutic interventions. Targeting proteostasis pathways to restore cellular homeostasis and modulating immune responses could offer innovative strategies to mitigate renal damage and ameliorate systemic complications associated with kidney diseases. Harnessing this knowledge may also pave the way for the development of more efficient dialysis therapies and interventions with sorbents and hemoperfusion methods, to improve the clinical outcome of the patients.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283302","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":"Effect of Vasopressors and Vasodilators on Kidney Medulla Oxygenation","authors":"Patrick M Honore, Sydney Blackman, Emily Perriens, Ilann Oueslati, Christophe Al-Sammour, David Vidal Bankier, Maha Bendoumou, Maya Ramos-Prieto, P. Bulpa, Arnaud Robert, Gauthier Nendumba, O. Vornicu, Patrick Evrard, A. Dincq, Isabelle Michaux","doi":"10.1097/jtccm-d-23-00011","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00011","url":null,"abstract":"\u0000 This narrative review provides a comprehensive summary of research findings up to 2023 regarding the impact of vasopressors and vasodilators on medullary oxygenation during cardiopulmonary bypass and septic shock. It encompasses a thorough evaluation of all current vasopressors and vasodilators. Among vasodilators, levosimendan demonstrates superior efficacy, particularly in cases of heart failure following cardiac surgery. In the context of hypotension during such procedures, vasopressin emerges as the most effective vasopressor. In cases of hypotensive septic shock, both vasopressin and angiotensin II appear to be superior in preserving medullary oxygenation. However, it is imperative to emphasize the need for more robust data and randomized controlled human trials to validate these initial findings. Currently, it would be premature to offer definitive clinical recommendations on this matter.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"40 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279188","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":"Therapeutic plasma exchange in critical illness","authors":"R. Koniman, Manish Kaushik","doi":"10.1097/jtccm-d-23-00010","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00010","url":null,"abstract":"\u0000 Therapeutic plasma exchange (TPE) is widely used for various diseases, particularly in critically ill patients. Most of these indications rely mainly on the removal of pathological molecules in the plasma by TPE. TPE is also used to replace missing plasma components in some diseases. However, there are emerging data on the use of TPE in novel indications because of its potential immunomodulatory effects. This review discusses the techniques of TPE, key considerations when prescribing TPE, indications for TPE in critically ill patients, emerging developments and knowledge gaps in this field.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"103 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018808","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":"Crush syndrome-related acute kidney injury in earthquake victims","authors":"G. Ramírez-Guerrero, Vicente Torres-Cifuentes","doi":"10.1097/jtccm-d-23-00008","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00008","url":null,"abstract":"\u0000 Natural disasters are unpredictable and thousands of people are affected yearly. Currently, this risk persists, given the large population living in risk areas prone to suffering another seismic event. Generally, on-site mortality is high and occurs immediately from massive trauma or asphyxia. After surviving the first event, extricated patients are at risk of developing crush syndrome caused by direct physical trauma and compression of the human body with lesions in different tissues. This could lead to several systemic complications, including acute kidney injury (AKI), sepsis, acute respiratory distress syndrome, bleeding, hypovolemic shock, arrhythmias, electrolyte disturbances and disseminated intravascular coagulation. Hence, AKI in this scenario can occur due to many causes, such as rhabdomyolysis, direct renal trauma, hypovolemia and hemodynamic alterations. The most important measure to reduce crush syndrome mortality and prevent the development of crush syndrome-related AKI in disaster situations is the immediate start of treatment. Nevertheless, despite optimal therapy delivery, these previous efforts might not suffice the development and progression of AKI, consequently, the indication of extracorporeal blood purification techniques. This narrative review provides a focused overview of crush syndrome-related AKI, including etiology, mechanisms, diagnosis, current treatment, removal of myoglobin and their limitations.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139026515","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":"Validation of peritoneal neutrophil gelatinase-associated lipocalin as a biomarker for peritonitis: A comparison between laboratory-base method and rapid stick test","authors":"Niccolò Morisi, G. Virzì, José David Gonzàlez Barajas, Bladimir Diaz-Villavicencio, S. M. Manani, M. Zanella","doi":"10.1097/jtccm-d-23-00006","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00006","url":null,"abstract":"Neutrophil gelatinase-associated lipocalin (NGAL) is a multifunctional protein with roles beyond biomarker status, influencing critical processes. This study aimed to assess dipstick test for NGAL (NGALds), a novel dipstick test, against the established laboratory-based NGAL (NGALlab) method for early peritonitis detection, focusing on peritoneal fluid analysis to provide a rapid and cost-effective diagnostic tool for peritonitis management. Conducted at San Bortolo Hospital, Italy, this retrospective study collected samples from suspected or confirmed peritonitis cases between May 1, 2021, and December 31, 2021. Samples included peritoneal dialysate effluents (PDE) and underwent white blood cell counts, NGALds, NGALlab, and effluent culture. The study analyzed 27 peritonitis cases, involving 133 PDE samples from 22 patients. NGALds exhibited a strong correlation (Rs = 0.732, P < 0.05) with NGALlab, particularly for medium to high-risk peritonitis cases, with a 98% accuracy rate. NGALds effectively aligns with NGALlab for peritonitis diagnosis, offering a valuable diagnostic tool, particularly suitable for point-of-care and resource-limited healthcare settings. Further research should investigate its correlation with neutrophil levels in PDE, solidifying NGALds as an accessible and efficient resource for peritonitis management.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139209844","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":"Identification of ferroptosis-related genes in acute kidney injury by bioinformatic analysis","authors":"Jianfeng Ye, Yun Cen, Man Li, Wanjie Gu, Xuehao Lu, Fengzhi Zhao, Bowen Shi, Jun Xu, Haiyan Yin","doi":"10.1097/jtccm-d-23-00005","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00005","url":null,"abstract":"Acute kidney injury (AKI) is a rapid decline in renal function characterized by a decrease in glomerular filtration rate in a short period. Ferroptosis affects the development of various kidney diseases. Therefore, searching for genes related to ferroptosis is crucial for understanding the occurrence and development of AKI. We obtained data from 18 samples (8 with acute kidney injury and 10 non-pathological tissue) in GSE53769 and 48 samples (39 with acute kidney injury and 9 non-pathological tissue) in GSE139061. We obtained differentially expressed genes (DEGs) of AKI/Control samples from both two datasets and intersected them with known ferroptosis-related genes (FRGs) to obtain ferroptosis-related DEGs (FRDEGs). GO annotation, KEGG pathway analysis, and GSEA analysis were conducted on the FRDEGs to understand their enriched biological functions and pathways. Next, we constructed the protein-protein interaction (PPI) network. A total of 312 genes were obtained, which were abnormally expressed in both two datasets. After intersecting with known FRGs, 14 FRDEGs were obtained, namely ACSF2, ADIPOR1, ARF6, ATF3, ATF6, DPEP1, FH, GLRX5, MIOX, NAP1L1, NDRG1, PPARA, SPHK1, YY1AP1. The results of the immune infiltration analysis showed that multiple gene expressions among 14 genes are correlated with immune cell infiltration. Fourteen ferroptosis genes (ACSF2, ADIPOR1, ARF6, ATF3, ATF6, DPEP1, FH, GLRX5, MIOX, NAP1L1, NDRG1, PPARA, SPHK1, YY1AP1) are involved in the occurrence and development of AKI, among which NDRG1 might be the core functional gene, and PPARA is expected to become the most effective therapeutic target gene.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139212053","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":"Evaluation of the Real-time Teleradiology Consultation System in the Emergency Department","authors":"U. Gulacti, Kasım Turgut, İ. Aydın, Erdal Yavuz, Ebru Arslan, F. Aksoy, Mustafa Gurbuz, Burak Erten, O. Ozcan","doi":"10.1097/jtccm-d-23-00002","DOIUrl":"https://doi.org/10.1097/jtccm-d-23-00002","url":null,"abstract":"\u0000 \u0000 \u0000 Teleradiology involves the transmission of all radiological images to a radiologist in a remote location to ensure an accurate diagnosis. Although various teleradiology systems exist, there is not a fully accepted real-time interactive teleradiology system yet. In this study, we analyzed “the teleradiology consultation system which includes a real-time and instant messaging program (Skype®)” established in an emergency department.\u0000 \u0000 \u0000 \u0000 The consultations requested from the teleradiology system implemented in the emergency department (ED) of a Medical Faculty Training and Research Hospital were evaluated between January 2018 and June 2018 retrospectively.\u0000 \u0000 \u0000 \u0000 A total of 18,284 teleconsultations were included in the study. The mean age of the patients who required teleconsultation was 40.6 ± 24.8 years (range: 0–109 years) and 10,069 (55.1%) were male. And 17,079 (93.4%) computed tomography (CT) was consulted. The majority of CT scans were cranial CT (n = 7113, 41.6%) and upper-lower abdominal CT (n = 5436, 31.8%). And 1205 magnetic resonance imaging (MRIs) (6.6%) were consulted. The majority of MRIs were diffusion MRIs (n = 975, 80.9%). The mean evaluation time of radiological imaging was 66.3 minutes. In 7238 (39.6%) of all consultations, a problem or a demand was reported via interactive communication by radiologists or emergency physicians. They are as follows; the desire to speed up delayed reports (33.0%, n = 2388), problems related to radiological images (32.0%, n = 2316); demand for correction of delay problems from health system technicians (11.6%, n = 839), incomplete reporting (6.6%, n = 477), demand for the acceleration of reports of critical patients (6.4%, n = 463), request for re-evaluation of radiological images (5.2%, n = 376), the demand for additional clinical information of the radiology doctor (2.0%, n = 144), asking radiology doctor the statements in the report or to request for disclosure of findings (1.1%, n = 78), the other reasons (2.0%, n = 144). All of these problems were answered with real-time interviews and solved. Conclusion: The teleradiology system is important in health institutions where there is no 7/24 radiologist.\u0000 \u0000 \u0000 \u0000 This study showed that the establishment of a teleradiology consultation system integrated with a messaging service in the ED might provide real-time and immediate resolution of the occurring problems.\u0000","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85767230","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":"Immune Dysregulation during and after COVID-19: “Tomorrow Never Dies” Situation","authors":"S. Patil, Swati V. Patil, G. Gondhali, S. Toshniwal","doi":"10.1097/jtccm-d-22-00024","DOIUrl":"https://doi.org/10.1097/jtccm-d-22-00024","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75446831","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}