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Sildenafil for treating patients with COVID-19 and perfusion mismatch: a pilot randomized trial
Mario G. Santamarina, Ignacio Beddings, Felipe Martinez Lomakin, Dominique Boisier Riscal, Mónica Gutiérrez Claveria, Jaime Vidal Marambio, Nicole Retamal Báez, Cristian Pavez Novoa, César Reyes Allende, Paulina Ferreira Perey, Miguel Gutiérrez Torres, Camila Villalobos Mazza, Constanza Vergara Sagredo, Sebastian Ahumada Bermejo, Eduardo Labarca Mellado, Elizabeth Barthel Munchmeyer, Solange Marchant Ramos, Mariano Volpacchio & Jorge Vega
doi : 10.1186/s13054-021-03885-y
Critical Care volume 26, Article number: 1 (2022)
SARS-CoV-2 seems to affect the regulation of pulmonary perfusion. Hypoperfusion in areas of well-aerated lung parenchyma results in a ventilation–perfusion mismatch that can be characterized using subtraction computed tomography angiography (sCTA). This study aims to evaluate the efficacy of oral sildenafil in treating COVID-19 inpatients showing perfusion abnormalities in sCTA.
Mechanical power in pediatric acute respiratory distress syndrome: a PARDIE study
Anoopindar K. Bhalla, Margaret J. Klein, Vicent Modesto I Alapont, Guillaume Emeriaud, Martin C. J. Kneyber, Alberto Medina, Pablo Cruces, Franco Diaz, Muneyuki Takeuchi, Aline B. Maddux, Peter M. Mourani, Cristina Camilo, Benjamin R. White, Nadir Yehya, John Pappachan, Matteo Di Nardo, Steven Shein, Christopher Newth, Robinder Khemani & Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network
doi : 10.1186/s13054-021-03853-6
Critical Care volume 26, Article number: 2 (2022)
Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk for ventilator-induced lung injury than individual ventilator management components. We sought to evaluate if mechanical ventilation management with a high mechanical power is associated with fewer ventilator-free days (VFD) in children with pediatric acute respiratory distress syndrome (PARDS).
Gut microbiota plays a pivotal role in opioid-induced adverse effects in gastrointestinal system
Rongpeng Xu, Liying Miao, Chun Yang & Bin Zhu
doi : 10.1186/s13054-021-03867-0
Critical Care volume 26, Article number: 5 (2022)
Early, biomarker-guided steroid dosing in COVID-19 Pneumonia: a pilot randomized controlled trial
Yewande E. Odeyemi, Sarah J. Chalmers, Erin F. Barreto, Jacob C. Jentzer, Ognjen Gajic & Hemang Yadav
doi : 10.1186/s13054-021-03873-2
Critical Care volume 26, Article number: 9 (2022)
Although corticosteroid administration has been associated with improved outcomes in severe COVID-19 pneumonia, their ideal use remains undefined with a “one size fits all” approach used, irrespective of the individual inflammatory response [1]. Recent studies have highlighted distinct COVID-19 inflammatory phenotypes with differential responses to corticosteroids [2]. Our goal was to assess the feasibility and safety of an individualized, biomarker-guided corticosteroid dosing approach utilizing C-reactive protein (CRP) in patients with pneumonia and acute hypoxemic respiratory failure (AHRF). With the COVID-19 outbreak, a separate COVID-19 trial arm was created, which we report here.
Persistence of live virus in critically ill patients infected with SARS-COV-2: a prospective observational study
Duane J. Funk, Jared Bullard, Sylvan Lother, Gloria Vazquez Grande, Lauren Garnett, Kaylie Doan, Kerry Dust, Anand Kumar, Guillaume Poliquin & Jim Strong
doi : 10.1186/s13054-021-03884-z
Critical Care volume 26, Article number: 10 (2022)
Research on the duration of infectivity of ICU patients with COVID-19 has been sparse. Tests based on Reverse Transcriptase polymerase chain reaction (RT-PCR) detect both live virus and non-infectious viral RNA. We aimed to determine the duration of infectiousness based on viral culture of nasopharyngeal samples of patients with COVID-19.
Invasive pulmonary aspergillosis among intubated patients with SARS-CoV-2 or influenza pneumonia: a European multicenter comparative cohort study
Anahita Rouzé, Elise Lemaitre, Ignacio Martin-Loeches, Pedro Povoa, Emili Diaz, Rémy Nyga, Antoni Torres, Matthieu Metzelard, Damien Du Cheyron, Fabien Lambiotte, Fabienne Tamion, Marie Labruyere, Claire Boulle Geronimi, Charles-Edouard Luyt, Martine Nyunga, Olivier Pouly, Arnaud W. Thille, Bruno Megarbane, Anastasia Saade, Eleni Magira, Jean-François Llitjos, Iliana Ioannidou, Alexandre Pierre, Jean Reignier, Denis Garot, Louis Kreitmann, Jean-Luc Baudel, Guillaume Voiriot, Gaëtan Plantefeve, Elise Morawiec, Pierre Asfar, Alexandre Boyer, Armand Mekontso-Dessap, Demosthenes Makris, Christophe Vinsonneau, Pierre-Edouard Floch, Clémence Marois, Adrian Ceccato, Antonio Artigas, Alexandre Gaudet, David Nora, Marjorie Cornu, Alain Duhamel, Julien Labreuche, Saad Nseir & the coVAPid study group
doi : 10.1186/s13054-021-03874-1
Critical Care volume 26, Article number: 11 (2022)
Recent multicenter studies identified COVID-19 as a risk factor for invasive pulmonary aspergillosis (IPA). However, no large multicenter study has compared the incidence of IPA between COVID-19 and influenza patients.
Respiratory effects of lung recruitment maneuvers depend on the recruitment-to-inflation ratio in patients with COVID-19-related acute respiratory distress syndrome
Yoann Zerbib, Alexis Lambour, Julien Maizel, Loay Kontar, Bertrand De Cagny, Thierry Soupison, Thomas Bradier, Michel Slama & Clément Brault
doi : 10.1186/s13054-021-03876-z
Critical Care volume 26, Article number: 12 (2022)
In the context of acute respiratory distress syndrome (ARDS), the response to lung recruitment maneuvers (LRMs) varies considerably from one patient to another and so is difficult to predict. The aim of the study was to determine whether or not the recruitment-to-inflation (R/I) ratio could differentiate between patients according to the change in lung mechanics during the LRM.
Vitamin C for???5 days is associated with decreased hospital mortality in sepsis subgroups: a nationwide cohort study
Sun-Young Jung, Min-Taek Lee, Moon Seong Baek & Won-Young Kim
doi : 10.1186/s13054-021-03872-3
Critical Care volume 26, Article number: 3 (2022)
Previous randomized trials of vitamin C, hydrocortisone, and thiamine on sepsis were limited by short-term vitamin C administration, heterogeneous populations, and the failure to evaluate each component’s effect. The purpose of this study was to determine whether vitamin C alone for???5 days or in combination with corticosteroids and/or thiamine was associated with decreased mortality across the sepsis population and subpopulation.
Prone positioning during venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome: a pooled individual patient data analysis
Marco Giani, Emanuele Rezoagli, Christophe Guervilly, Jonathan Rilinger, Thibault Duburcq, Matthieu Petit, Laura Textoris, Bruno Garcia, Tobias Wengenmayer, Giacomo Grasselli, Antonio Pesenti, Alain Combes, Giuseppe Foti, Matthieu Schmidt & EuroPronECMO Investigators
doi : 10.1186/s13054-021-03879-w
Critical Care volume 26, Article number: 8 (2022)
Prone positioning (PP) reduces mortality of patients with acute respiratory distress syndrome (ARDS). The potential benefit of prone positioning maneuvers during venovenous extracorporeal membrane oxygenation (ECMO) is unknown. The aim of this study was to evaluate the association between the use of prone positioning during extracorporeal support and ICU mortality in a pooled population of patients from previous European cohort studies.
Elevated plasma Galectin-3 is associated with major adverse kidney events and death after ICU admission
L. Boutin, M. Legrand, M. Sadoune, A. Mebazaa, E. Gayat, C. E. Chadjichristos & F. Dépret
doi : 10.1186/s13054-021-03878-x
Critical Care volume 26, Article number: 13 (2022)
Galectin-3 (Gal-3) is a proinflammatory and profibrotic protein especially overexpressed after Acute Kidney Injury (AKI). The early renal prognostic value of Gal-3 after AKI in critically ill patients remains unexplored. The objective was to evaluate the prognostic value of plasma level of Gal-3 for Major Adverse Kidney Events (MAKE) and mortality 30 days after ICU admission across AKI stages.
Biomarkers for sepsis: more than just fever and leukocytosis—a narrative review
Tatiana Barichello, Jaqueline S. Generoso, Mervyn Singer & Felipe Dal-Pizzol
doi : 10.1186/s13054-021-03862-5
Critical Care volume 26, Article number: 14 (2022)
A biomarker describes a measurable indicator of a patient's clinical condition that can be measured accurately and reproducibly. Biomarkers offer utility for diagnosis, prognosis, early disease recognition, risk stratification, appropriate treatment (theranostics), and trial enrichment for patients with sepsis or suspected sepsis. In this narrative review, we aim to answer the question, "Do biomarkers in patients with sepsis or septic shock predict mortality, multiple organ dysfunction syndrome (MODS), or organ dysfunction?" We also discuss the role of pro- and anti-inflammatory biomarkers and biomarkers associated with intestinal permeability, endothelial injury, organ dysfunction, blood–brain barrier (BBB) breakdown, brain injury, and short and long-term mortality. For sepsis, a range of biomarkers is identified, including fluid phase pattern recognition molecules (PRMs), complement system, cytokines, chemokines, damage-associated molecular patterns (DAMPs), non-coding RNAs, miRNAs, cell membrane receptors, cell proteins, metabolites, and soluble receptors. We also provide an overview of immune response biomarkers that can help identify or differentiate between systemic inflammatory response syndrome (SIRS), sepsis, septic shock, and sepsis-associated encephalopathy. However, significant work is needed to identify the optimal combinations of biomarkers that can augment diagnosis, treatment, and good patient outcomes.
Association between unmet medication needs after hospital discharge and readmission or death among acute respiratory failure survivors: the addressing post-intensive care syndrome (APICS-01) multicenter prospective cohort study
Samuel M. Brown, Victor D. Dinglas, Narjes Akhlaghi, Somnath Bose, Valerie Banner-Goodspeed, Sarah Beesley, Danielle Groat, Tom Greene, Ramona O. Hopkins, Mustafa Mir-Kasimov, Carla M. Sevin, Alison E. Turnbull, James C. Jackson & Dale M. Needham for the APICS-01 Study Team
doi : 10.1186/s13054-021-03848-3
Critical Care volume 26, Article number: 6 (2022)
Survivors of acute respiratory failure (ARF) commonly experience long-lasting physical, cognitive, and/or mental health impairments. Unmet medication needs occurring immediately after hospital discharge may have an important effect on subsequent recovery.
Comparison between meropenem and ceftolozane/tazobactam: possible influence of CRRT
Patrick M. Honore, Sebastien Redant, Thierry Preseau, Sofie Moorthamers, Keitiane Kaefer, Leonel Barreto Gutierrez, Rachid Attou, Andrea Gallerani, Willem Boer & David De Bels
doi : 10.1186/s13054-021-03837-6
Critical Care volume 26, Article number: 15 (2022)
Impact of exposure time in awake prone positioning on clinical outcomes of patients with COVID-19-related acute respiratory failure treated with high-flow nasal oxygen: a multicenter cohort study
Mariano Esperatti, Marina Busico, Nora Angélica Fuentes, Adrian Gallardo, Javier Osatnik, Alejandra Vitali, Elizabeth Gisele Wasinger, Matías Olmos, Jorgelina Quintana, Santiago Nicolas Saavedra, Ana Inés Lagazio, Facundo Juan Andrada, Hiromi Kakisu, Nahuel Esteban Romano, Agustin Matarrese, Mariela Adriana Mogadouro, Giuliana Mast, Claudia Navarro Moreno, Greta Dennise Rebaza Niquin, Veronica Barbaresi, Alejandro Bruhn Cruz, Bruno Leonel Ferreyro, Antoni Torres & Argentine Collaborative Group on High Flow and Prone Positioning
doi : 10.1186/s13054-021-03881-2
Critical Care volume 26, Article number: 16 (2022)
In patients with COVID-19-related acute respiratory failure (ARF), awake prone positioning (AW-PP) reduces the need for intubation in patients treated with high-flow nasal oxygen (HFNO). However, the effects of different exposure times on clinical outcomes remain unclear. We evaluated the effect of AW-PP on the risk of endotracheal intubation and in-hospital mortality in patients with COVID-19-related ARF treated with HFNO and analyzed the effects of different exposure times to AW-PP.
Hyperoxemia in postsurgical sepsis/septic shock patients is associated with reduced mortality
Marta Martín-Fernández, María Heredia-Rodríguez, Irene González-Jiménez, Mario Lorenzo-López, Estefanía Gómez-Pesquera, Rodrigo Poves-Álvarez, F. Javier Álvarez, Pablo Jorge-Monjas, Juan Beltrán-DeHeredia, Eduardo Gutiérrez-Abejón, Francisco Herrera-Gómez, Gabriella Guzzo, Esther Gómez-Sánchez, Álvaro Tamayo-Velasco, Rocío Aller, Paolo Pelosi, Jesús Villar & Eduardo Tamayo
doi : 10.1186/s13054-021-03875-0
Critical Care volume 26, Article number: 4 (2022)
Despite growing interest in treatment strategies that limit oxygen exposure in ICU patients, no studies have compared conservative oxygen with standard oxygen in postsurgical patients with sepsis/septic shock, although there are indications that it may improve outcomes. It has been proven that high partial pressure of oxygen in arterial blood (PaO2) reduces the rate of surgical-wound infections and mortality in patients under major surgery. The aim of this study is to examine whether PaO2 is associated with risk of death in adult patients with sepsis/septic shock after major surgery.
Choosing the right reference cohort for assessing outcome of venovenous ECMO
Alexander Supady, Paul M. Biever, Dawid L. Staudacher & Tobias Wengenmayer
doi : 10.1186/s13054-021-03880-3
Critical Care volume 26, Article number: 17 (2022)
Impact of time to intubation on mortality and pulmonary sequelae in critically ill patients with COVID-19: a prospective cohort study
Jessica González, Iván D. Benítez, David de Gonzalo-Calvo, Gerard Torres, Jordi de Batlle, Silvia Gómez, Anna Moncusí-Moix, Paola Carmona, Sally Santisteve, Aida Monge, Clara Gort-Paniello, María Zuil, Ramón Cabo-Gambín, Carlos Manzano Senra, José Javier Vengoechea Aragoncillo, Rafaela Vaca, Olga Minguez, María Aguilar, Ricard Ferrer, Adrián Ceccato, Laia Fernández, Ana Motos, Jordi Riera, Rosario Menéndez, Darío Garcia-Gasulla, Oscar Peñuelas, Gonzalo Labarca, Jesús Caballero, Carme Barberà, Antoni Torres, Ferran Barbé on behalf of CIBERESUCICOVID Project (COV20/00110, ISCIII)
doi : 10.1186/s13054-021-03882-1
Critical Care volume 26, Article number: 18 (2022)
We evaluated whether the time between first respiratory support and intubation of patients receiving invasive mechanical ventilation (IMV) due to COVID-19 was associated with mortality or pulmonary sequelae.
Protein intake and outcome of critically ill patients: analysis of a large international database using piece-wise exponential additive mixed models
Wolfgang H. Hartl, Philipp Kopper, Andreas Bender, Fabian Scheipl, Andrew G. Day, Gunnar Elke & Helmut Küchenhoff
doi : 10.1186/s13054-021-03870-5
Critical Care volume 26, Article number: 7 (2022)
Proteins are an essential part of medical nutrition therapy in critically ill patients. Guidelines almost universally recommend a high protein intake without robust evidence supporting its use.
Time-to-antibiotics and clinical outcomes in patients with sepsis and septic shock: a prospective nationwide multicenter cohort study
Yunjoo Im, Danbee Kang, Ryoung-Eun Ko, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Soo Jin Na, Chi Ryang Chung, Mi Hyeon Park, Dong Kyu Oh, Chae-Man Lim, Gee Young Suh on behalf of the Korean Sepsis Alliance (KSA) investigators
doi : 10.1186/s13054-021-03883-0
Critical Care volume 26, Article number: 19 (2022)
Timely administration of antibiotics is one of the most important interventions in reducing mortality in sepsis. However, administering antibiotics within a strict time threshold in all patients suspected with sepsis will require huge amount of effort and resources and may increase the risk of unintentional exposure to broad-spectrum antibiotics in patients without infection with its consequences. Thus, controversy still exists on whether clinicians should target different time-to-antibiotics thresholds for patients with sepsis versus septic shock.
Value of variation of end-tidal carbon dioxide for predicting fluid responsiveness during the passive leg raising test in patients with mechanical ventilation: a systematic review and meta-analysis
Haijun Huang, Chenxia Wu, Qinkang Shen, Yixin Fang & Hua Xu
doi : 10.1186/s13054-022-03890-9
Critical Care volume 26, Article number: 20 (2022)
The ability of end-tidal carbon dioxide (?EtCO2) for predicting fluid responsiveness has been extensively studied with conflicting results. This meta-analysis aimed to explore the value of ?EtCO2 for predicting fluid responsiveness during the passive leg raising (PLR) test in patients with mechanical ventilation.
The prognostic utility of protein C as a biomarker for adult sepsis: a systematic review and meta-analysis
Vanessa Catenacci, Fatima Sheikh, Kush Patel & Alison E. Fox-Robichaud
doi : 10.1186/s13054-022-03889-2
Critical Care volume 26, Article number: 21 (2022)
Sepsis, the dysregulated host response to infection, triggers abnormal pro-coagulant and pro-inflammatory host responses. Limitations in early disease intervention highlight the need for effective diagnostic and prognostic biomarkers. Protein C’s role as an anticoagulant and anti-inflammatory molecule makes it an appealing target for sepsis biomarker studies. This meta-analysis aims to assess the diagnostic and prognostic value of protein C (PC) as a biomarker for adult sepsis.
Correction to: Vital-sign circadian rhythms in patients prior to discharge from an ICU: a retrospective observational analysis of routinely recorded physiological data
Shaun Davidson, Mauricio Villarroel, Mirae Harford, Eoin Finnegan, Joao Jorge, Duncan Young, Peter Watkinson & Lionel Tarassenko
doi : 10.1186/s13054-022-03887-4
Critical Care volume 26, Article number: 22 (2022)
Omega-6 sparing effects of parenteral lipid emulsions—an updated systematic review and meta-analysis on clinical outcomes in critically ill patients
Quirin Notz, Zheng-Yii Lee, Johannes Menger, Gunnar Elke, Aileen Hill, Peter Kranke, Daniel Roeder, Christopher Lotz, Patrick Meybohm, Daren K. Heyland & Christian Stoppe
doi : 10.1186/s13054-022-03896-3
Critical Care volume 26, Article number: 23 (2022)
Parenteral lipid emulsions in critical care are traditionally based on soybean oil (SO) and rich in pro-inflammatory omega-6 fatty acids (FAs). Parenteral nutrition (PN) strategies with the aim of reducing omega-6 FAs may potentially decrease the morbidity and mortality in critically ill patients.
Association between hospital and ICU structural factors and patient outcomes in China: a secondary analysis of the National Clinical Improvement System Data in 2019
Zhen Li, Xudong Ma, Sifa Gao, Qi Li, Hongbo Luo, Jianhua Sun, Wei Du, Longxiang Su, Lu Wang, Qing Zhang, Zunzhu Li, Xiang Zhou, Dawei Liu on behalf of China National Critical Care Quality Control Center Group
doi : 10.1186/s13054-022-03892-7
Critical Care volume 26, Article number: 24 (2022)
Hospital and ICU structural factors are key factors affecting the quality of care as well as ICU patient outcomes. However, the data from China are scarce. This study was designed to investigate how differences in patient outcomes are associated with differences in hospital and ICU structure variables in China throughout 2019.
Vitamin C improves microvascular reactivity and peripheral tissue perfusion in septic shock patients
Jean-Rémi Lavillegrand, Lisa Raia, Tomas Urbina, Geoffroy Hariri, Paul Gabarre, Vincent Bonny, Naïke Bigé, Jean-Luc Baudel, Arnaud Bruneel, Thierry Dupre, Bertrand Guidet, Eric Maury & Hafid Ait-Oufella
doi : 10.1186/s13054-022-03891-8
Critical Care volume 26, Article number: 25 (2022)
Vitamin C has potential protective effects through antioxidant and anti-inflammatory properties. However, the effect of vitamin C supplementation on microvascular function and peripheral tissue perfusion in human sepsis remains unknown. We aimed to determine vitamin C effect on microvascular endothelial dysfunction and peripheral tissue perfusion in septic shock patients.
Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial
Patrice Rosengrave, Emma Spencer, Jonathan Williman, Jan Mehrtens, Stacey Morgan, Tara Doyle, Kymbalee Van Der Heyden, Anna Morris, Geoff Shaw & Anitra C. Carr
doi : 10.1186/s13054-022-03900-w
Critical Care volume 26, Article number: 26 (2022)
Intravenous vitamin C administration in septic shock may have a sparing effect on vasopressor requirements, and vitamin C’s enzyme cofactor functions provide a mechanistic rationale. Our study aimed to determine the effect of intravenous vitamin C administration on vasopressor requirements and other outcomes in patients with septic shock.
Severe necrotizing soft-tissue infection-associated mortality: Have a look at the computed tomography!
Sébastien Tanaka, Michael Thy, Ralph Khoury, Alexy Tran-Dinh, Antoine Khalil & Philippe Montravers
doi : 10.1186/s13054-022-03898-1
Critical Care volume 26, Article number: 27 (2022)
Effects of prone and lateral positioning alternate in high-flow nasal cannula patients with severe COVID-19
Yang Chong, Chuanchuan Nan, Wenjing Mu, Changsong Wang, Mingyan Zhao & Kaijiang Yu
doi : 10.1186/s13054-022-03897-2
Critical Care volume 26, Article number: 28 (2022)
Immune effects of PI3K/Akt/HIF-1?-regulated glycolysis in polymorphonuclear neutrophils during sepsis
Tingting Pan, Shaoqiong Sun, Yang Chen, Rui Tian, Erzhen Chen, Ruoming Tan, Xiaoli Wang, Zhaojun Liu, Jialin Liu & Hongping Qu
doi : 10.1186/s13054-022-03893-6
Critical Care volume 26, Article number: 29 (2022)
Effective removal of pathogenic bacteria is key to improving the prognosis of sepsis. Polymorphonuclear neutrophils (PMNs) are the most important components of innate cellular immunity and play vital roles in clearing pathogenic bacteria. However, the metabolic characteristics and immunomodulatory pathways of PMNs during sepsis have not been investigated. In the present study, we explored the immune metabolism characteristics of PMNs and the mechanism by which neutrophilic glycolysis is regulated during sepsis.
Corticosteroids as risk factor for COVID-19-associated pulmonary aspergillosis in intensive care patients
Rasmus Leistner, Lisa Schroeter, Thomas Adam, Denis Poddubnyy, Miriam Stegemann, Britta Siegmund, Friederike Maechler, Christine Geffers, Frank Schwab, Petra Gastmeier, Sascha Treskatsch, Stefan Angermair & Thomas Schneider
doi : 10.1186/s13054-022-03902-8
Critical Care volume 26, Article number: 30 (2022)
Corticosteroids, in particular dexamethasone, are one of the primary treatment options for critically ill COVID-19 patients. However, there are a growing number of cases that involve COVID-19-associated pulmonary aspergillosis (CAPA), and it is unclear whether dexamethasone represents a risk factor for CAPA. Our aim was to investigate a possible association of the recommended dexamethasone therapy with a risk of CAPA.
Effects of positive end-expiratory pressure on lung ultrasound patterns and their correlation with intracranial pressure in mechanically ventilated brain injured patients
Chiara Robba, Lorenzo Ball, Denise Battaglini, Francesca Iannuzzi, Iole Brunetti, Pietro Fiaschi, Gianluigi Zona, Fabio Silvio Taccone, Antonio Messina, Silvia Mongodi & Paolo Pelosi
doi : 10.1186/s13054-022-03903-7
Critical Care volume 26, Article number: 31 (2022)
The effects of positive end-expiratory pressure (PEEP) on lung ultrasound (LUS) patterns, and their relationship with intracranial pressure (ICP) in brain injured patients have not been completely clarified. The primary aim of this study was to assess the effect of two levels of PEEP (5 and 15 cmH2O) on global (LUStot) and regional (anterior, lateral, and posterior areas) LUS scores and their correlation with changes of invasive ICP. Secondary aims included: the evaluation of the effect of PEEP on respiratory mechanics, arterial partial pressure of carbon dioxide (PaCO2) and hemodynamics; the correlation between changes in ICP and LUS as well as respiratory parameters; the identification of factors at baseline as potential predictors of ICP response to higher PEEP.
Timing of inspiratory muscle activity detected from airway pressure and flow during pressure support ventilation: the waveform method
Francesco Mojoli, Marco Pozzi, Anita Orlando, Isabella M. Bianchi, Eric Arisi, Giorgio A. Iotti, Antonio Braschi & Laurent Brochard
doi : 10.1186/s13054-022-03895-4
Critical Care volume 26, Article number: 32 (2022)
Whether respiratory efforts and their timing can be reliably detected during pressure support ventilation using standard ventilator waveforms is unclear. This would give the opportunity to assess and improve patient–ventilator interaction without the need of special equipment.
Endotheliopathy is associated with slower liberation from mechanical ventilation: a cohort study
Martin Schønemann-Lund, Theis S. Itenov, Johan E. Larsson, Birgitte Lindegaard, Pär I. Johansson & Morten H. Bestle
doi : 10.1186/s13054-021-03877-y
Critical Care volume 26, Article number: 33 (2022)
Endotheliopathy is suggested as pivotal pathophysiology of sepsis and trauma-associated organ failure, but its role in acute respiratory failure is not yet determined. We investigated if endotheliopathy biomarkers at ICU admission are associated with illness severity and clinical outcomes in patients with acute respiratory failure requiring mechanical ventilation.
