CHEST critical care最新文献

{"title":"Epidemiologic Characteristics and Management of Sepsis Among Previously Healthy Patients","authors":"Rachel K. Hechtman MD ,&nbsp;Megan E. Heath PhD ,&nbsp;Jennifer K. Horowitz MA ,&nbsp;Elizabeth McLaughlin MS, RN ,&nbsp;Patricia J. Posa RN, BSN, MSA, CCRN ,&nbsp;John Blamoun MD ,&nbsp;Paul Bozyk MD ,&nbsp;Megan Cahill DO, MBA, FACOEP ,&nbsp;Rania Esteitie MD, FCCP, ATSF ,&nbsp;Kevin Furlong DO ,&nbsp;Namita Jayaprakash MB, BcH BAO, MRCEM ,&nbsp;Jessica Jones PharmD ,&nbsp;Maximiliano Tamae-Kakazu MD ,&nbsp;Joan Nagelkirk MD ,&nbsp;Thomas Pfotenhauer DO ,&nbsp;Derek C. Angus MD, MPH, FRCP ,&nbsp;Scott A. Flanders MD ,&nbsp;Elizabeth S. Munroe MD ,&nbsp;Hallie C. Prescott MD","doi":"10.1016/j.chstcc.2025.100148","DOIUrl":"10.1016/j.chstcc.2025.100148","url":null,"abstract":"<div><h3>Background</h3><div>Most deaths resulting from sepsis occur among patients with advanced age, multiple morbidities, or frailty. It is unclear how many sepsis-related deaths truly are preventable. Previously healthy patients may provide insight into preventable sepsis mortality.</div></div><div><h3>Research Question</h3><div>What are the baseline characteristics, management, and outcomes associated with previously healthy patients with sepsis?</div></div><div><h3>Study Design and Methods</h3><div>This was a retrospective cohort of patients hospitalized for community-onset sepsis at 66 Michigan hospitals (November 2020-January 2024). We developed major and minor criteria to classify patients as previously healthy vs having significant comorbidities. We compared baseline characteristics, management, and outcomes of previously healthy patients vs patients with comorbid sepsis. Physicians reviewed charts of previously healthy patients with in-hospital death to evaluate baseline health status and rate preventability of death.</div></div><div><h3>Results</h3><div>Of 29,688 patients hospitalized for sepsis, 2,963 patients (10.0%) were classified as previously healthy. Previously healthy patients had median age of 53 years, a median of 2 minor comorbidities, and lower in-hospital mortality (5.8% vs 12.7%; <em>P</em> &lt; .01) vs comorbid patients. Delivery of guideline-recommended early sepsis management ranged from 56.8% to 80.9% across individual care practices. Several care practices were less common among previously healthy patients, including lactate measurement (67.5% vs 73.8%; <em>P</em> &lt; .01) and timely antibiotic administration (58.0% vs 66.3%; <em>P</em> &lt; .01), whereas some were more common, including ≥ 30 mL/kg fluid resuscitation (72.4% vs 55.3%; <em>P</em> &lt; .01). Among 48 charts of previously healthy decedents reviewed, 77.1% of patients were deemed to have life expectancy &gt; 5 years without sepsis. Most deaths were judged to be unpreventable because of severity of illness on presentation.</div></div><div><h3>Interpretation</h3><div>We found that 1 in 10 patients with community-onset sepsis was healthy previously. Although gaps in in-hospital management were identified, deaths among previously healthy patients generally were deemed unpreventable with better in-hospital management because of patients seeking treatment too late in the course of sepsis. This study highlights system-level opportunities for better recognition and triage of sepsis before hospitalization.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178325","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":"Mapping the Epidemiologic Features of Endotracheal Tube Obstruction","authors":"Vimal Bhardwaj MD, FNB(Critical Care), EDIC ,&nbsp;Abhishek Samprathi MD, DrNB, EDIC ,&nbsp;Manu M.K. Varma MD, DM ,&nbsp;Kingshuk Saha MSc ,&nbsp;Ross Prager MD ,&nbsp;John Basmaji MD ,&nbsp;Nicolas Orozco MD ,&nbsp;Srirang Ramamoorthy MSc ,&nbsp;Jose Chacko MD, EDIC ,&nbsp;Arjun Alva MD","doi":"10.1016/j.chstcc.2025.100156","DOIUrl":"10.1016/j.chstcc.2025.100156","url":null,"abstract":"<div><h3>Background</h3><div>Endotracheal tube blockages (ETBs) are a common yet often overlooked cause of weaning failure, ventilator dyssynchrony, and hypoxia in the ICU, with limited studies on their prevalence, clinical factors, and outcomes.</div></div><div><h3>Research Question</h3><div>What are the incidence, risk factors, and associated clinical and ventilator factors of ETBs in ventilated patients in the ICU?</div></div><div><h3>Study Design and Methods</h3><div>We assessed 369 endotracheal tubes (ETTs) of mechanically ventilated patients after extubation. This prospective observational study was conducted at the tertiary cardiothoracic ICUs (CICUs) and medical ICUs (MICUs) of Narayana Health City, Bengaluru, India. Tubes were inspected visually and were cut at the point of maximum blockage, and cross-sectional images captured with a 12-megapixel camera were analyzed for ETB percentage using the SketchAndCalc algorithm.</div></div><div><h3>Results</h3><div>Of the 369 ETTs assessed, ETBs were categorized as showing low (0%-9%), moderate (10%-49%), and severe (&gt; 50%) occlusion. In the CICU, severe ETBs was observed in &lt; 2% of patients, compared with 4% of patients in the MICU, whereas moderate ETBs were present in 27.9% of patients in the CICU and 16.5% of patients in the MICU. On univariable analysis, suction type (β = 9.62 [95% CI, 5.27-13.98]; <em>P</em> &lt; .01), peak pressure (P_peak; β = 1.73 [95% CI, 1.38-2.08]; <em>P</em> &lt; .01), coagulopathy (β = 9.42 [95% CI, 4.22-14.62]; <em>P</em> &lt; .01), and ICU type (β = 9.62 [95% CI, 5.28-13.96]; <em>P</em> &lt; .01) were statistically significant. Multivariable regression analysis showed only P_peak (β = 1.65 [95% CI, 1.28-2.02]; <em>P</em> &lt; .01), coagulopathy (β = 8.02 [95% CI, 3.26-12.79]; <em>P</em> &lt; .01) and larger number of days receiving invasive mechanical ventilation (β = 0.02 [95% CI, 0.01-0.03]; <em>P</em> &lt; .01) to be significant factors associated with ETB percentage.</div></div><div><h3>Interpretation</h3><div>Moderate ETB was more prevalent in patients in the ICU, with significant factors including coagulopathy, closed suction practice, and mechanical ventilation duration. P_peak alarms lacked clinical impact, despite statistical significance.</div></div><div><h3>Clinical Trial Registry</h3><div>Clinical Trial Registry-India; No.: CTRI/2023/10/058184; URL: <span><span>www.ctri.nic.in</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166512","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":"Post-Intensive Care Rehabilitation","authors":"Laura Allum MRes ,&nbsp;Louise Rose PhD","doi":"10.1016/j.chstcc.2025.100154","DOIUrl":"10.1016/j.chstcc.2025.100154","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124181","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":"Lessons From Gattinoni","authors":"Andrea Castellví-Font MD ,&nbsp;Tai Pham MD, PhD ,&nbsp;Bhakti Patel MD ,&nbsp;Eddy Fan MD, PhD","doi":"10.1016/j.chstcc.2025.100153","DOIUrl":"10.1016/j.chstcc.2025.100153","url":null,"abstract":"<div><div>Professor Luciano Gattinoni’s contributions to critical care medicine transformed the management of ARDS and mechanical ventilation, shaping the foundation of modern intensive care. Among his landmark achievements, the so-called baby lung concept redefined ARDS as a condition characterized by reduced functional lung volume, rather than lung stiffness, leading to the development of lung-protective ventilation strategies that prioritize minimizing ventilator-induced lung injury. His work on positive end-expiratory pressure advanced the understanding of lung aeration, atelectasis, and recruitment, highlighting the role of CT imaging in respiratory research. His research on prone positioning elucidated its physiologic benefits and demonstrated its lifesaving potential for patients with severe ARDS, culminating in its widespread adoption. Additionally, his work on mechanical power provided a unifying framework for assessing ventilator-induced lung injury risk, although challenges in its bedside application remain. Through his relentless pursuit of integrating respiratory physiology into clinical practice, Professor Gattinoni inspired generations of clinicians and researchers, leaving an indelible legacy that continues to guide advancements in critical care worldwide.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090599","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":"Response","authors":"Tessa A. Mulder MD ,&nbsp;Linda Becude MD ,&nbsp;Jorge E. Lopez Matta MD ,&nbsp;Wilbert B. van den Hout PhD ,&nbsp;David J. van Westerloo MD, PhD ,&nbsp;Martijn P. Bauer MD, PhD","doi":"10.1016/j.chstcc.2025.100152","DOIUrl":"10.1016/j.chstcc.2025.100152","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943174","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":"The SONIC CENTRAL Study Does Not See the Forest for the Trees","authors":"Yonatan Y. Greenstein MD, FCCP,&nbsp;Keith Guevarra DO, FCCP","doi":"10.1016/j.chstcc.2025.100151","DOIUrl":"10.1016/j.chstcc.2025.100151","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100151"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943113","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":"High Respiratory Effort During Invasive Pressure Support Ventilation","authors":"Anis Chaba MD ,&nbsp;Joanna W.Y. Chow MBBS ,&nbsp;Atthaphong Phongphithakchai MD ,&nbsp;Wisam Al-Bassam MD ,&nbsp;Fumitaka Yanase PhD ,&nbsp;Zachary O’Brien MBBS ,&nbsp;Glenn Eastwood PhD ,&nbsp;Ahmad Bassam MD ,&nbsp;Stefanos Hadzakis MD ,&nbsp;Sofia Spano MD ,&nbsp;Akinori Maeda MD ,&nbsp;Lucinda Roberts MD ,&nbsp;Rinaldo Bellomo PhD ,&nbsp;Ary Serpa Neto PhD","doi":"10.1016/j.chstcc.2025.100147","DOIUrl":"10.1016/j.chstcc.2025.100147","url":null,"abstract":"<div><h3>Background</h3><div>High respiratory effort may be common in invasively ventilated patients receiving pressure support ventilation, but its epidemiologic characteristics are unclear.</div></div><div><h3>Research Question</h3><div>What are the epidemiologic characteristics of high respiratory efforts in critically ill patients, does agreement exist between high respiratory drive and high respiratory effort, what are clinician responses during such events, and what is the relationship between those with clinical parameters and outcomes?</div></div><div><h3>Study Design and Methods</h3><div>This clinician-masked, prospective, observational study in 2 centers measured the drop in airway pressure during the first 100 ms of an inspiratory effort with an occluded airway (P_0.1), a validated noninvasive measure of respiratory drive, in patients receiving pressure support ventilation for &gt; 24 hours. We also measured estimated respiratory muscle pressure (_eP_musc), a validated surrogate of inspiratory effort. We measured _eP_musc and P_0.1 twice daily.</div></div><div><h3>Results</h3><div>Of 528 ventilated patients, 80 patients received pressure support ventilation for &gt; 24 hours. Among them, 33 patients (41%) exhibited high respiratory effort, which was more common in COVID-19 ARDS, with 19 of such patients (58%) reached the predefined threshold vs 14 patients (27%) in the non-COVID-19 cohort (OR, 5.0; 95% CI, 1.9-14.9; <em>P</em> = .001). Moreover, 36% of P_0.1 values were ≥ 4 cm H₂O, indicating high respiratory drive. Moderate agreement was found between _eP_musc and P_0.1 measurements (intraclass correlation coefficient, 0.65), suggesting significant discrepancies between those 2 parameters. Clinician-directed management based on usual clinical observations (but masked to P_0.1 and _eP_musc) rarely changed in the presence of high respiratory effort. Higher _eP_musc and its concomitant elevation with P_0.1 were associated with worse blood gas parameters and respiratory mechanics. A concomitant elevation of both _eP_musc and P_0.1 was associated independently with a decreased likelihood of being alive and ventilator-free up to day 28 (OR, 0.26; 95% CI, 0.06-0.87; <em>P</em> = .037).</div></div><div><h3>Interpretation</h3><div>In this study, many critical care patients receiving invasive pressure support ventilation exhibited high respiratory efforts. In these patients, adjustments to ventilator settings were uncommon, despite association with worse clinical parameters and outcomes.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100147"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144146831","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":"The Semiawake Exit","authors":"Abigail Chua MD, MPH ,&nbsp;James Richard Mattson MD ,&nbsp;Ewa Rakowski MD ,&nbsp;Hailey Capuano RN ,&nbsp;Sahar Ahmad MD","doi":"10.1016/j.chstcc.2025.100149","DOIUrl":"10.1016/j.chstcc.2025.100149","url":null,"abstract":"","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100149"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070638","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":"Longitudinal Respiratory Subphenotypes and Differences in Response to Positive End-Expiratory Pressure and Fio2 Ventilation Strategy in COVID-19 ARDS","authors":"Robin L. Goossen MD ,&nbsp;Daan F.L. Filippini MD ,&nbsp;Relin van Vliet MD ,&nbsp;Laura A. Buiteman-Kruizinga RN, PhD ,&nbsp;Markus W. Hollmann MD, PhD ,&nbsp;Sheila N. Myatra MD ,&nbsp;Ary Serpa Neto MD, PhD ,&nbsp;Peter E. Spronk MD, PhD ,&nbsp;Meta C.E. van der Woude MD, PhD ,&nbsp;Marcus J. Schultz MD, PhD ,&nbsp;David M.P. van Meenen MD, PhD ,&nbsp;Frederique Paulus PhD ,&nbsp;Lieuwe D.J. Bos MD, PhD ,&nbsp;Practice of Ventilation and Adjunctive Therapies in ICU Patients With COVID-19 Investigators","doi":"10.1016/j.chstcc.2025.100145","DOIUrl":"10.1016/j.chstcc.2025.100145","url":null,"abstract":"<div><h3>Background</h3><div>In patients with ARDS, positive end-expiratory pressure (PEEP) titration remains a challenge and recommendations are not in agreement. In mechanically ventilated patients with COVID-19, subphenotypes based on different respiratory trajectories have been identified, but their heterogeneity in response to PEEP/F<span>io</span>₂ strategy remains understudied.</div></div><div><h3>Research Question</h3><div>Can these previously determined subphenotypes be detected early in the course of mechanical ventilation, and do these subphenotypes moderate the association between PEEP and F<span>io</span>₂ ventilation strategy and mortality?</div></div><div><h3>Study Design and Methods</h3><div>Retrospective analysis of invasively ventilated patients with COVID-19. Patients were categorized into 2 treatment groups: high PEEP/low F<span>io</span>₂ strategy and low PEEP/high F<span>io</span>₂ strategy. To replicate previously described longitudinal respiratory subphenotypes, hereafter named the <em>low-power</em> or <em>high-power</em> subphenotype, a prediction model was created. The primary outcome was the interaction between PEEP/F<span>io</span>₂ strategy and subphenotype, with mortality as the dependent variable.</div></div><div><h3>Results</h3><div>Of the 1,464 patients included in this analysis, 361 patients (25%) were allocated into the high PEEP/low F<span>io</span>₂ strategy and 1,103 patients (75%) were allocated into the low PEEP/high F<span>io</span>₂ strategy. A prediction model consisting of respiratory data of the first 2 days of invasive ventilation (area under the receiver operating characteristics curve, 0.88) assigned 908 patients (62%) to the low-power subphenotype and 556 patients (38%) to the high-power subphenotype. The high-power subphenotype was characterized by higher minute volume, mechanical power, ventilatory ratio, and driving pressure. The association between PEEP/F<span>io</span>₂ ventilation strategy and ICU mortality was moderated by the subphenotype (<em>P = .</em>03), with high PEEP/low F<span>io</span>₂ ventilation being associated with lower mortality in the low-power subphenotype (OR, 0.46; 95% CI, 0.31-0.67; <em>P &lt; .</em>001) and not in the high-power subphenotype (OR, 0.85; 95% CI, 0.57-1.28; <em>P = .</em>44).</div></div><div><h3>Interpretation</h3><div>In this study, high PEEP/low F<span>io</span>₂ ventilation was associated with improved mortality only in one of the subphenotypes, suggesting that such subphenotypes influence heterogeneity of PEEP and F<span>io</span>₂ effect and should be considered in personalized ventilation strategies.</div></div><div><h3>Clinical Trial Registry</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>; No.: NCT05954351; URL: <span><span>www.clinicaltrials.gov</span><svg><path></path></svg></span></div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166487","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 Central Nervous System-Related Biomarkers With Hospital Delirium in Patients With Respiratory Failure in the ICU","authors":"Andrew T. Pham MD ,&nbsp;Ryan A. Peterson PhD ,&nbsp;Suzanne Slaughter MS ,&nbsp;Morgan Martin BS ,&nbsp;Joseph A. Hippensteel MD ,&nbsp;Ellen L. Burnham MD","doi":"10.1016/j.chstcc.2025.100143","DOIUrl":"10.1016/j.chstcc.2025.100143","url":null,"abstract":"<div><h3>Background</h3><div>Delirium commonly occurs in critical illness and is associated with significant morbidity and mortality. Although risk reduction measures can mitigate the risk of delirium, identifying patients in whom delirium will develop remains clinically challenging.</div></div><div><h3>Research Question</h3><div>In critically ill patients with respiratory failure, are central nervous system (CNS)-related biomarkers measured at admission associated with delirium diagnosis?</div></div><div><h3>Study Design and Methods</h3><div>We performed a secondary analysis of a cohort of patients with respiratory failure in the medical ICU enrolled at a single medical center. Using serum collected at ICU admission, we measured CNS-related biomarkers including brain-derived neurotrophic factor (BDNF), chitinase-3-like protein 1, glial fibrillary acidic protein, neurofilament light chain (NF-L), neurogranin, S100 calcium-binding protein B, and triggering receptor expressed on myeloid cells 2 via a multiplex immunoassay. The primary outcome was diagnosis of in-hospital delirium, defined using validated methods. Associations between individual biomarkers and delirium diagnosis were examined using multivariable logistic regressions, adjusting for factors known to predispose and precipitate delirium. Secondary outcomes included in-hospital mortality, ventilator-free days, ICU-free days, and hospital-free days.</div></div><div><h3>Results</h3><div>Serum biomarkers were measured in 100 patients. Delirium occurred in 73% of the cohort. Patients with vs without delirium did not differ significantly in terms of age, sex, comorbidities, severity of illness, or unhealthy alcohol use. After adjustment, NF-L was associated positively with delirium diagnosis (adjusted OR, 1.86; 95% CI, 1.09-3.43), whereas BDNF was associated negatively with delirium (adjusted OR, 0.43; 95% CI, 0.15-0.82). No associations were found between other measured biomarkers and delirium diagnosis. NF-L levels were associated negatively with ICU-free and hospital-free days.</div></div><div><h3>Interpretation</h3><div>Our results indicate that CNS-related biomarkers measured at ICU admission are associated with delirium diagnosis in critically ill patients. Prospective investigations are necessary to validate the role of these biomarkers in predicting delirium.</div></div>","PeriodicalId":93934,"journal":{"name":"CHEST critical care","volume":"3 2","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070637","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}