Jakub Fronczek, Kamil Polok, Dylan W. de Lange, Christian Jung, Michael Beil, Andrew Rhodes, Jesper Fj?lner, Jacek G?rka, Finn H. Andersen, Antonio Artigas, Maurizio Cecconi, Steffen Christensen, Michael Joannidis, Susannah Leaver, Brian Marsh, Alessandro Morandi, Rui Moreno, Sandra Oeyen, Christina Agvald-?hman, Bernardo Bollen Pinto, Joerg C. Schefold, Andreas Valentin, Sten Walther, Ximena Watson, Tilemachos Zafeiridis, Sigal Sviri, Peter Vernon van Heerden, Hans Flaatten, Bertrand Guidet & Wojciech Szczeklik, for the VIP1 & VIP2 study group-Show fewer authors
doi : 10.1186/s13054-021-03632-3
Critical Care volume 25, Article number: 231 (2021)
The Clinical Frailty Scale (CFS) is frequently used to measure frailty in critically ill adults. There is wide variation in the approach to analysing the relationship between the CFS score and mortality after admission to the ICU. This study aimed to evaluate the influence of modelling approach on the association between the CFS score and short-term mortality and quantify the prognostic value of frailty in this context.
Yupei Li, Luojia Jiang, Tao Song, Yiran Wang & Baihai Su
doi : 10.1186/s13054-021-03637-y
Critical Care volume 25, Article number: 232 (2021)
Paulo Eugênio Silva, Jo?o Luiz Quaglioti Durigan & Nicolas Babault
doi : 10.1186/s13054-021-03636-z
Critical Care volume 25, Article number: 233 (2021)
Runzhi Huang, Tong Meng, Qiongfang Zha, Kebin Cheng, Xin Zhou, Junhua Zheng, Dingyu Zhang & Ruilin Liu
doi : 10.1186/s13054-021-03661-y
Critical Care volume 25, Article number: 234 (2021)
The coronavirus disease 2019 (COVID-19) has induced a worldwide epidemiological event with a high infectivity and mortality. However, the predicting biomarkers and their potential mechanism in the progression of COVID-19 are not well known.
Mar?a Mart?nez-Mart?nez, Erika P. Plata-Menchaca, Francesc X. Nuvials, Oriol Roca & Ricard Ferrer
doi : 10.1186/s13054-021-03654-x
Critical Care volume 25, Article number: 235 (2021)
Maria C. Barbosa-Silva, Maiara N. Lima, Denise Battaglini, Chiara Robba, Paolo Pelosi, Patricia R. M. Rocco & Tatiana Maron-Gutierrez
doi : 10.1186/s13054-021-03659-6
Critical Care volume 25, Article number: 236 (2021)
Infectious diseases may affect brain function and cause encephalopathy even when the pathogen does not directly infect the central nervous system, known as infectious disease-associated encephalopathy. The systemic inflammatory process may result in neuroinflammation, with glial cell activation and increased levels of cytokines, reduced neurotrophic factors, blood–brain barrier dysfunction, neurotransmitter metabolism imbalances, and neurotoxicity, and behavioral and cognitive impairments often occur in the late course. Even though infectious disease-associated encephalopathies may cause devastating neurologic and cognitive deficits, the concept of infectious disease-associated encephalopathies is still under-investigated; knowledge of the underlying mechanisms, which may be distinct from those of encephalopathies of non-infectious cause, is still limited. In this review, we focus on the pathophysiology of encephalopathies associated with peripheral (sepsis, malaria, influenza, and COVID-19), emerging therapeutic strategies, and the role of neuroinflammation.
Roeland F. Stolk, Henk J. van Leeuwen, Matthijs Kox, Marcel van Borren, Hans de Boer & Peter Pickkers
doi : 10.1186/s13054-021-03664-9
Critical Care volume 25, Article number: 237 (2021)
Matthieu Schmidt, Christoph Fisser, Gennaro Martucci, Darryl Abrams, Thomas Frapard, Konstantin Popugaev, Antonio Arcadipane, Bianca Bromberger, Giovanni Lino, Alexis Serra, Sacha Rozencwajg, Matthias Lubnow, Sergey Petrikov, Thomas Mueller, Alain Combes, Tài Pham & Daniel Brodie for the International ECMO Network (ECMONet)
doi : 10.1186/s13054-021-03649-8
Critical Care volume 25, Article number: 238 (2021)
Current practices regarding tracheostomy in patients treated with extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome are unknown. Our objectives were to assess the prevalence and the association between the timing of tracheostomy (during or after ECMO weaning) and related complications, sedative, and analgesic use.
Caroline Hauw-Berlemont, Charlotte Salmon Gandonnière, Florence Boissier, Nadia Aissaoui, Laetitia Bodet-Contentin, Muriel Sarah Fartoukh, Mercedes Jourdain, Julien Le Marec, Fabienne Tamion, Olfa Hamzaoui, Cécile Aubron on behalf of the FEMMIR (Femme Médecins en Médecine Intensive Réanimation) Group for the French Intensive Care Society
doi : 10.1186/s13054-021-03657-8
Critical Care volume 25, Article number: 239 (2021)
Marie Smedberg, Johan Helleberg, ?ke Norberg, Inga Tj?der, Olav Rooyackers & Jan Wernerman
doi : 10.1186/s13054-021-03640-3
Critical Care volume 25, Article number: 240 (2021)
A plasma glutamine concentration outside the normal range at Intensive Care Unit (ICU) admission has been reported to be associated with an increased mortality rate. Whereas hypoglutaminemia has been frequently reported, the number of patients with hyperglutaminemia has so far been quite few. Therefore, the association between hyperglutaminemia and mortality outcomes was studied in a prospective, observational study.
Quentin de Roux, Marie Renaudier, Wulfran Bougouin, Johanna Boccara, Vincent Fihman, Raphaël Lepeule, Chamsedine Cherait, Antonio Fiore, François Hemery, Jean-Winoc Decousser, Olivier Langeron & Nicolas Mongardon
doi : 10.1186/s13054-021-03658-7
Critical Care volume 25, Article number: 241 (2021)
Bloodstream infections (BSIs) are frequent on veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Performing routine blood cultures (BCs) may identify early paucisymptomatic BSIs. We investigated the contribution of systematic daily BCs to detect BSIs on V-A ECMO.
Heyan Wang & Hangyong He
doi : 10.1186/s13054-021-03663-w
Critical Care volume 25, Article number: 242 (2021)
Penglin Ma, Jingtao Liu, Feng Shen, Xuelian Liao, Ming Xiu, Heling Zhao, Mingyan Zhao, Jing Xie, Peng Wang, Man Huang, Tong Li, Meili Duan, Kejian Qian, Yue Peng, Feihu Zhou, Xin Xin, Xianyao Wan, ZongYu Wang, Shusheng Li, Jianwei Han, Zhenliang Li, Guolei Ding, Qun Deng, Jicheng Zhang, Yue Zhu, Wenjing Ma, Jingwen Wang, Yan Kang & Zhongheng Zhang -Show fewer authors
doi : 10.1186/s13054-021-03682-7
Critical Care volume 25, Article number: 243 (2021)
Septic shock comprises a heterogeneous population, and individualized resuscitation strategy is of vital importance. The study aimed to identify subclasses of septic shock with non-supervised learning algorithms, so as to tailor resuscitation strategy for each class.
Jasmin Khateeb, Yuchong Li & Haibo Zhang
doi : 10.1186/s13054-021-03662-x
Critical Care volume 25, Article number: 244 (2021)
The major variant of concerns (VOCs) have shared mutations in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike proteins, mostly on the S1 unit and resulted in higher transmissibility rate and affect viral virulence and clinical outcome. The spike protein mutations and other non-structural protein mutations in the VOCs may lead to escape approved vaccinations in certain extend. We will discuss these VOC mutations and discuss the need for combination therapeutic strategies targeting viral cycle and immune host responses.
Mohamed Hassene Khalil, Adel Sekma, Wafa Zhani, Asma Zorgati, Houda Ben Soltane, Semir Nouira on behalf of the GREAT Network
doi : 10.1186/s13054-021-03683-6
Critical Care volume 25, Article number: 245 (2021)
Ryan Ruiyang Ling, Kollengode Ramanathan, Wynne Hsing Poon, Chuen Seng Tan, Nicolas Brechot, Daniel Brodie, Alain Combes & Graeme MacLaren
doi : 10.1186/s13054-021-03668-5
Critical Care volume 25, Article number: 246 (2021)
While recommended by international societal guidelines in the paediatric population, the use of venoarterial extracorporeal membrane oxygenation (VA ECMO) as mechanical circulatory support for refractory septic shock in adults is controversial. We aimed to characterise the outcomes of adults with septic shock requiring VA ECMO, and identify factors associated with survival.
Tommaso Pettenuzzo, Annalisa Boscolo, Alessandro De Cassai, Nicol? Sella, Francesco Zarantonello, Paolo Persona, Laura Pasin, Giovanni Landoni & Paolo Navalesi
doi : 10.1186/s13054-021-03669-4
Critical Care volume 25, Article number: 247 (2021)
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the association of higher positive end-expiratory pressure (PEEP), as opposed to lower PEEP, with hospital mortality in adult intensive care unit (ICU) patients undergoing invasive mechanical ventilation for reasons other than acute respiratory distress syndrome (ARDS).
François Beloncle, Antoine Studer, Valérie Seegers, Jean-Christophe Richard, Christophe Desprez, Nicolas Fage, Hamid Merdji, Bertrand Pavlovsky, Julie Helms, Sibylle Cunat, Satar Mortaza, Julien Demiselle, Laurent Brochard, Alain Mercat & Ferhat Meziani
doi : 10.1186/s13054-021-03665-8
Critical Care volume 25, Article number: 248 (2021)
Differences in physiology of ARDS have been described between COVID-19 and non-COVID-19 patients. This study aimed to compare initial values and longitudinal changes in respiratory system compliance (CRS), oxygenation parameters and ventilatory ratio (VR) in patients with COVID-19 and non-COVID-19 pulmonary ARDS matched on oxygenation.
Arthur Orieux, Pierre Khan, Renaud Prevel, Didier Gruson, Sébastien Rubin & Alexandre Boyer
doi : 10.1186/s13054-021-03666-7
Critical Care volume 25, Article number: 249 (2021)
Paolo Pelosi, Lorenzo Ball, Carmen S. V. Barbas, Rinaldo Bellomo, Karen E. A. Burns, Sharon Einav, Luciano Gattinoni, John G. Laffey, John J. Marini, Sheila N. Myatra, Marcus J. Schultz, Jean Louis Teboul & Patricia R. M. Rocco
doi : 10.1186/s13054-021-03686-3
Critical Care volume 25, Article number: 250 (2021)
A personalized mechanical ventilation approach for patients with adult respiratory distress syndrome (ARDS) based on lung physiology and morphology, ARDS etiology, lung imaging, and biological phenotypes may improve ventilation practice and outcome. However, additional research is warranted before personalized mechanical ventilation strategies can be applied at the bedside. Ventilatory parameters should be titrated based on close monitoring of targeted physiologic variables and individualized goals. Although low tidal volume (VT) is a standard of care, further individualization of VT may necessitate the evaluation of lung volume reserve (e.g., inspiratory capacity). Low driving pressures provide a target for clinicians to adjust VT and possibly to optimize positive end-expiratory pressure (PEEP), while maintaining plateau pressures below safety thresholds. Esophageal pressure monitoring allows estimation of transpulmonary pressure, but its use requires technical skill and correct physiologic interpretation for clinical application at the bedside. Mechanical power considers ventilatory parameters as a whole in the optimization of ventilation setting, but further studies are necessary to assess its clinical relevance. The identification of recruitability in patients with ARDS is essential to titrate and individualize PEEP. To define gas-exchange targets for individual patients, clinicians should consider issues related to oxygen transport and dead space. In this review, we discuss the rationale for personalized approaches to mechanical ventilation for patients with ARDS, the role of lung imaging, phenotype identification, physiologically based individualized approaches to ventilation, and a future research agenda.
Renata ?ern? Pa??zkov?, Ji?ina Mart?nkov?, Eduard Havel, Petr ?afr?nek, Milan Ka?ka, David Astapenko, Jan Bezou?ka, Jaroslav Chl?dek & Vladim?r ?ern?
doi : 10.1186/s13054-021-03680-9
Critical Care volume 25, Article number: 251 (2021)
Meropenem dosing for septic critically patients is difficult due to pathophysiological changes associated with sepsis as well as supportive symptomatic therapies. A prospective single-center study assessed whether fluid retention alters meropenem pharmacokinetics and the achievement of the pharmacokinetic/pharmacodynamic (PK/PD) targets for efficacy.
Chloë Goossens, Ruben Weckx, Sarah Derde, Sarah Vander Perre, Inge Derese, Paul P. Van Veldhoven, Bart Ghesquière, Greet Van den Berghe & Lies Langouche
doi : 10.1186/s13054-021-03688-1
Critical Care volume 25, Article number: 252 (2021)
Muscle weakness is a complication of critical illness which hampers recovery. In critically ill mice, supplementation with the ketone body 3-hydroxybutyrate has been shown to improve muscle force and to normalize illness-induced hypocholesterolemia. We hypothesized that altered cholesterol homeostasis is involved in development of critical illness-induced muscle weakness and that this pathway can be affected by 3-hydroxybutyrate.
Ogilvie Thom, Kym Roberts, Susan Devine, Peter A. Leggat & Richard C. Franklin
doi : 10.1186/s13054-021-03687-2
Critical Care volume 25, Article number: 253 (2021)
Drowning is a cause of significant global mortality. The mechanism of injury involves inhalation of water, lung injury and hypoxia. This systematic review addressed the following question: In drowning patients with lung injury, what is the evidence from primary studies regarding treatment strategies and subsequent patient outcomes?
Ronny Munoz-Acuna, Akiva Leibowitz, Margaret Hayes & Somnath Bose
doi : 10.1186/s13054-021-03691-6
Critical Care volume 25, Article number: 254 (2021)
Folke Sj?berg, Lotti Orwelius, Michelle Chew, S?ren Berg & Sten Walther
doi : 10.1186/s13054-021-03635-0
Critical Care volume 25, Article number: 255 (2021)
Alexandra Schou, Jesper M?lgaard, Lars Willy Andersen, S?ren Holm & Marc S?rensen
doi : 10.1186/s13054-021-03689-0
Critical Care volume 25, Article number: 256 (2021)
During 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges. After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.
Laura Drikite, Jonathan P. Bedford, Liam O’Bryan, Tatjana Petrinic, Kim Rajappan, James Doidge, David A. Harrison, Kathryn M. Rowan, Paul R. Mouncey, Duncan Young, Peter J. Watkinson & Mark Corbett
doi : 10.1186/s13054-021-03684-5
Critical Care volume 25, Article number: 257 (2021)
New-onset atrial fibrillation (NOAF) in patients treated on an intensive care unit (ICU) is common and associated with significant morbidity and mortality. We undertook a systematic scoping review to summarise comparative evidence to inform NOAF management for patients admitted to ICU.
Natalia A. Tsareva, Sergey N. Avdeev, Djuro Kosanovic, Ralph Theo Schermuly, Natalia V. Trushenko & Galina V. Nekludova
doi : 10.1186/s13054-021-03690-7
Critical Care volume 25, Article number: 258 (2021)
Patrick M. Honore, Sebastien Redant, Thierry Preseau, Sofie Moorthamers, Keitiane Kaefer, Leonel Barreto Gutierrez, Rachid Attou, Andrea Gallerani & David De Bels
doi : 10.1186/s13054-021-03655-w
Critical Care volume 25, Article number: 259 (2021)
Zheng-Yii Lee, Cindy Sing Ling Yap, M. Shahnaz Hasan, Julia Patrick Engkasan, Mohd Yusof Barakatun-Nisak, Andrew G. Day, Jayshil J. Patel & Daren K. Heyland
doi : 10.1186/s13054-021-03693-4
Critical Care volume 25, Article number: 260 (2021)
The optimal protein dose in critical illness is unknown. We aim to conduct a systematic review of randomized controlled trials (RCTs) to compare the effect of higher versus lower protein delivery (with similar energy delivery between groups) on clinical and patient-centered outcomes in critically ill patients.
Christophe Le Terrier, Marco Vinetti, Paul Bonjean, Régine Richard, Bruno Jarrige, Bertrand Pons, Benjamin Madeux, Pascale Piednoir, Fanny Ardisson, Elain Elie, Frédéric Martino, Marc Valette, Edouard Ollier, Sébastien Breurec, Michel Carles & Guillaume Thiéry
doi : 10.1186/s13054-021-03660-z
Critical Care volume 25, Article number: 261 (2021)
High-level antibiotic consumption plays a critical role in the selection and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in the ICU. Implementation of a stewardship program including a restrictive antibiotic policy was evaluated with respect to ESBL-E acquisition (carriage and infection).
Daniel Andrea Hofmaenner, Pedro David Wendel Garcia , Christoph Camille Ganter, Silvio D. Brugger, Philipp Karl Buehler & Sascha David
doi : 10.1186/s13054-021-03696-1
Critical Care volume 25, Article number: 262 (2021)
Annalisa Boscolo, Nicol? Sella, Giulia Lorenzoni, Tommaso Pettenuzzo, Laura Pasin, Chiara Pretto, Martina Tocco, Enrico Tamburini, Alessandro De Cassai, Paolo Rosi, Enrico Polati, Katia Donadello, Leonardo Gottin, Silvia De Rosa, Fabio Baratto, Fabio Toffoletto, V. Marco Ranieri, Dario Gregori, Paolo Navalesi & COVID-19 VENETO ICU Network
doi : 10.1186/s13054-021-03667-6
Critical Care volume 25, Article number: 263 (2021)
Pathophysiological features of coronavirus disease 2019-associated acute respiratory distress syndrome (COVID-19 ARDS) were indicated to be somewhat different from those described in nonCOVID-19 ARDS, because of relatively preserved compliance of the respiratory system despite marked hypoxemia. We aim ascertaining whether respiratory system static compliance (Crs), driving pressure (DP), and tidal volume normalized for ideal body weight (VT/kg IBW) at the 1st day of controlled mechanical ventilation are associated with intensive care unit (ICU) mortality in COVID-19 ARDS.
John J. Marini & Luciano Gattinoni
doi : 10.1186/s13054-021-03700-8
Critical Care volume 25, Article number: 264 (2021)
As exemplified by prone positioning, regional variations of lung and chest wall properties provide possibilities for modifying transpulmonary pressures and suggest that clinical interventions related to the judicious application of external pressure may yield benefit. Recent observations made in late-phase patients with severe ARDS caused by COVID-19 (C-ARDS) have revealed unexpected mechanical responses to local chest wall compressions over the sternum and abdomen in the supine position that challenge the clinician’s assumptions and conventional bedside approaches to lung protection. These findings appear to open avenues for mechanism-defining research investigation with possible therapeutic implications for all forms and stages of ARDS.
Matthew F. Barhight, Delphine Nelson, Thomas Moran, Jessica Christiano & L. Nelson Sanchez-Pinto
doi : 10.1186/s13054-021-03705-3
Critical Care volume 25, Article number: 266 (2021)
Hyperchloremia and chloride load have been associated with worse clinical outcomes in critically ill patients. We sought to evaluate the electrolyte profile and clinical outcomes associated with a unit-wide transition from saline to balanced fluids for resuscitation and maintenance fluids in a pediatric intensive care unit (PICU).
Mathias Van Singer, Thomas Brahier, Marie-Josée Brochu Vez, Hélène Gerhard Donnet, Olivier Hugli & Noémie Boillat-Blanco
doi : 10.1186/s13054-021-03704-4
Critical Care volume 25, Article number: 267 (2021)
Gianmaria Cammarota, Teresa Esposito, Danila Azzolina, Roberto Cosentini, Francesco Menzella, Stefano Aliberti, Andrea Coppadoro, Giacomo Bellani, Giuseppe Foti, Giacomo Grasselli, Maurizio Cecconi, Antonio Pesenti, Michele Vitacca, Tom Lawton, V. Marco Ranieri, Sandro Luigi Di Domenico, Onofrio Resta, Antonio Gidaro, Antonella Potalivo, Giuseppe Nardi, Claudia Brusasco, Simonetta Tesoro, Paolo Navalesi, Rosanna Vaschetto & Edoardo De Robertis
doi : 10.1186/s13054-021-03697-0
Critical Care volume 25, Article number: 268 (2021)
Noninvasive respiratory support (NIRS) has been diffusely employed outside the intensive care unit (ICU) to face the high request of ventilatory support due to the massive influx of patients with acute respiratory failure (ARF) caused by coronavirus-19 disease (COVID-19). We sought to summarize the evidence on clinically relevant outcomes in COVID-19 patients supported by NIV outside the ICU.
Jan Bakker, James M. Horowitz, Jackie Hagedorn, Sam Kozloff, David Kaufman & Ricardo Castro
doi : 10.1186/s13054-021-03699-y
Critical Care volume 25, Article number: 269 (2021)
Matthieu Koszutski, Mathieu Mattei, Juan Pablo Maureira, Antoine Kimmoun & Bruno Levy
doi : 10.1186/s13054-021-03703-5
Critical Care volume 25, Article number: 270 (2021)
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