Disseminated intravascular coagulation (DIC) is a common complication in sepsis. Since DIC not only promotes organ dysfunction but also is a strong prognostic factor, its diagnosis at the earliest possible tim...
The overall result of the randomized controlled double-blinded trial for polymyxin B-immobilized fiber column on septic shock (EUPHRATES trial) was disappointing. However, post hoc analysis showed benefits for...
Enteral nutrition (EN) can maintain the structure and function of the gastrointestinal mucosa better than parenteral nutrition. In critically ill patients, EN must be discontinued or interrupted, if gastrointe...
Outcomes in emergent patients with suspected infection depend on how quickly clinicians evaluate the patients and start treatment. This study was performed to compare the predictive ability of the quantitative...
Authors: Oi Yasufumi, Naoto Morimura, Aya Shirasawa, Hiroshi Honzawa, Yutaro Oyama, Shoko Niida, Takeru Abe, Shouhei Imaki and Ichiro Takeuchi
Accurate and early identification of infection sites might help to drive crucial decisions regarding the treatment of sepsis. We aimed to determine the clinical and etiological features of infection according ...
Accidental hypothermia is a serious condition that requires immediate and accurate assessment to determine severity and treatment. Currently, accidental hypothermia is evaluated using the Swiss grading system ...
Circulating levels of soluble urokinase plasminogen activation receptor (suPAR) have been proposed as a prognostic biomarker in patients with critical illness and sepsis. However, the origin of suPAR in sepsis...
Authors: Hendrik Gussen, Philipp Hohlstein, Matthias Bartneck, Klaudia Theresa Warzecha, Lukas Buendgens, Tom Luedde, Christian Trautwein, Alexander Koch and Frank Tacke
While understanding of critical illness and delirium continue to evolve, the impact on clinical practice is often unknown and delayed. Our purpose was to provide insight into practice changes by characterizing...
Authors: Gary D. Owen, Joanna L. Stollings, Shayan Rakhit, Li Wang, Chang Yu, Morgan A. Hosay, James W. Stewart, Fernando Frutos-Vivar, Oscar Peñuelas, Andres Esteban, Antonio R. Anzueto, Konstantinos Raymondos, Fernando Rios, Arnaud W. Thille, Marco González, Bin Du…
The study by Ogura et al. investigated the association between the structures of intensive care units (ICUs) affecting patient outcomes. A major limitation of this study is that the types of ICUs had not clear...
Sphingosine 1-phosphate (S1P) is a signaling lipid essential in regulating processes involved in sepsis pathophysiology, including endothelial permeability and vascular tone. Serum S1P is progressively reduced...
Authors: Martin Sebastian Winkler, Konstantin B. Märtz, Axel Nierhaus, Günter Daum, Edzard Schwedhelm, Stefan Kluge and Markus H. Gräler
Early and accurate diagnosis of sepsis is challenging. Although procalcitonin and presepsin have been identified as potential biomarkers to differentiate between sepsis and other non-infectious causes of syste...
Cardiac output measurements may inform diagnosis and provide guidance of therapeutic interventions in patients with hemodynamic instability. The FloTrac™ algorithm uses uncalibrated arterial pressure waveform ...
Authors: Thomas Kaufmann, Ramon P. Clement, Bart Hiemstra, Jaap Jan Vos, Thomas W. L. Scheeren, Frederik Keus and Iwan C. C. van der Horst
Currently, the appropriate method of management of patients with refractory septic shock remains unclear. This study aimed to evaluate the factors associated with response to epinephrine in norepinephrine-refr...
Red blood cell (RBC) transfusions are common procedures performed in the intensive care unit (ICU). However, conservative transfusion approaches have been recommended to avoid RBC transfusions that are not cli...
Authors: Lesley J. J. Soril, Tom W. Noseworthy, Henry T. Stelfox, David A. Zygun and Fiona M. Clement
The gut is hypothesized to be the “motor” of critical illness. Under basal conditions, the gut plays a crucial role in the maintenance of health. However, in critical illness, all elements of the gut are injur...
Catecholamines are commonly used in septic shock but face limitations of their hypo-responsiveness and adverse events due to high dose. Terlipressin is a synthetic vasopressin analog with greater selectivity f...
Authors: Yibing Zhu, Huibin Huang, Xiuming Xi and Bin Du
Nutritional therapy is one of the important treatments in critically ill patients. How to estimate calorie consumption and how to determine an optimal calorie dose are clinical questions of great importance. A...
Differentiating sepsis from the systemic inflammatory response syndrome (SIRS) in critical care patients is challenging, especially before serious organ damage is evident, and with variable clinical presentati...
Authors: Bert K. Lopansri, Russell R. Miller III, John P. Burke, Mitchell Levy, Steven Opal, Richard E. Rothman, Franco R. D’Alessio, Venkataramana K. Sidhaye, Robert Balk, Jared A. Greenberg, Mark Yoder, Gourang P. Patel, Emily Gilbert, Majid Afshar, Jorge P. Parada, Greg S. Martin…
Guidelines for grading diastolic dysfunction poorly categorize septic patients. We compared how well the American Society of Echocardiography (ASE) 2009 and 2016 definitions and a simplified definition categor...
Authors: Michael J. Lanspa, Troy D. Olsen, Emily L. Wilson, Mary Louise Leguyader, Eliotte L. Hirshberg, Jeffrey L. Anderson, Samuel M. Brown and Colin K. Grissom
One of the main pathophysiological manifestations during the acute phase of sepsis is massive production of proinflammatory mediators. Clinical trials involving direct suppression of inflammatory mediators to ...
Authors: Ken Kuwajima, Kyungho Chang, Ai Furuta, Masahiko Bougaki, Kanji Uchida, Shigehito Sawamura and Yoshitsugu Yamada
For patients treated with extracorporeal membrane oxygenation (ECMO), employing a well-coordinated, multidisciplinary team specializing in ECMO has reportedly been effective in delivering better clinical outco...
Authors: Atthasit Komindr, Ryuzo Abe, Yoshihisa Tateishi, Yuka Takahashi, Jun Goto, Keita Wada, Yutaka Furukawa, Atsushi Sugiura, Taro Imaeda, Natsumi Suga, Noriyuki Hattori and Shigeto Oda
Management of fluid therapy in an intensive care unit (ICU) tends to be volume restriction after initial fluid resuscitation, since it has been the consensus that volume overload is associated with complicatio...
Authors: Kenichiro Morisawa, Shigeki Fujitani and Yasuhiko Taira
This review is a “Pro-Con” discussion about the optimal fluid volume in critically ill patients in the intensive care unit (ICU). This article argues that fluids should be aggressively managed in critically il...
Although it has been reported that high hospital patient volume results in survival and cost benefits for several diseases, it is uncertain whether this association is applicable in burn care.
We have read the study about the association between high red blood cell distribution width and higher ward mortality after intensive care unit discharge. The study increases the evidence that RDW may be a mar...
Authors: Tiago Antonio Tonietto, Marcio Manozzo Boniatti, Thiago Costa Lisboa, Marina Verçoza Viana and Gustavo Adolpho Moreira Faulhaber
To determine if real-time compression feedback using a non-automated hand-held device improves patient outcomes from in-hospital cardiac arrest (IHCA).
Authors: Reza Goharani, Amir Vahedian-Azimi, Behrooz Farzanegan, Farshid R. Bashar, Mohammadreza Hajiesmaeili, Seyedpouzhia Shojaei, Seyed J. Madani, Keivan Gohari-Moghaddam, Sevak Hatamian, Seyed M. M. Mosavinasab, Masoum Khoshfetrat, Mohammad A. Khabiri Khatir and Andrew C. Miller
Mechanical ventilation can initiate ventilator-associated lung injury (VALI) and contribute to the development of multiple organ dysfunction. Although a lung protective strategy limiting both tidal volume and ...
Mechanically ventilated patients often develop muscle weakness post-intensive care admission. Current evidence suggests that early mobilisation of these patients can be an effective intervention in improving t...
Authors: Catherine Clarissa, Lisa Salisbury, Sheila Rodgers and Susanne Kean
Heat stroke induces coagulofibrinolytic activation, which leads to life-threatening disseminated intravascular coagulation (DIC). However, treatment strategies for DIC in heat stroke have not yet been establis...
Authors: Hironori Matsumoto, Jun Takeba, Kensuke Umakoshi, Yuki Nakabayashi, Naoki Moriyama, Suguru Annen, Muneaki Ohshita, Satoshi Kikuchi, Norio Sato and Mayuki Aibiki
Despite the evidence for calibrated cardiac monitored devices to determine fluid responsiveness, there is minimal evidence that the use of cardiac output monitor devices leads to an overall change in IV fluid ...
Authors: Timothy G. Scully, Robert Grealy, Anthony S. McLean and Sam R. Orde
Right ventricular (RV) dysfunction is a known risk factor for increased mortality in cardiac surgery. However, the association between RV performance and ICU morbidity is largely unknown.
Authors: Inge T. Bootsma, Thomas W. L. Scheeren, Fellery de Lange, Johannes Haenen, Piet W. Boonstra and E. Christaan Boerma
Based on promising results over the past 10 years, the method of extracorporeal membrane oxygenation (ECMO) has developed from being used as a ‘rescue therapy’ to become an accepted treatment option for patien...
Authors: Norbert Banjas, Hans-Bernd Hopf, Ernst Hanisch, Benjamin Friedrichson, Julia Fichte and Alexander Buia
In patients with aneurysmal subarachnoid hemorrhage (SAH), an association between hypocapnia and poor clinical outcomes has been reported. However, the optimal arterial carbon dioxide tension (PaCO2) remains unkn...
Authors: Shota Yokoyama, Toru Hifumi, Tomoya Okazaki, Takahisa Noma, Kenya Kawakita, Takashi Tamiya, Tetsuo Minamino and Yasuhiro Kuroda
The western Japan rainstorm disaster on July 6, 2018, was one of the most serious natural catastrophes in Japan, excluding earthquake events. Its main characteristics were severe and widespread flooding and la...
Authors: Shinichiro Ohshimo, Takuma Sadamori and Nobuaki Shime
Data regarding trends of muscle loss on ultrasonography (USG) and its relationship with various outcomes among critically ill patients is limited. This study aimed to describe the trends of loss of muscle thic...
Physical rehabilitation (PR) interventions in the intensive care unit (ICU) can improve patients’ functional outcomes, yet systematic reviews identified discordant effects and poor reporting. We conducted a sc...
Authors: Julie C. Reid, Janelle Unger, Devin McCaskell, Laura Childerhose, David J. Zorko and Michelle E. Kho
Nuclear histone proteins are released into the extracellular space during sepsis and act as major mediators of death. However, circulating histone levels have not been precisely quantified.
The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 suggested against the use of the early goal-directed therapy (EGDT) in patients with septic shock. This recommendation w...
We have read the case report about a decompression sickness that was unresponsive to hyperbaric oxygen treatment in your journal. Presented case is intriguing; however, we think there are some contradictive is...
It is interesting to find that Japanese clinicians continue to hesitate to change their practice even after accumulating evidence for the inefficacy of high-dose corticosteroid for ARDS in the Letters to the E...
A recombinant form of antithrombin (AT), called AT gamma, is being developed as an alternative to AT derived from human plasma. To compare the efficacy and safety of AT gamma to plasma-derived AT (pAT), we con...
High red blood cell distribution width (RDW) is associated with worse outcome in diverse scenarios, including in critical illness. The Sabadell score (SS) predicts in-hospital survival after ICU discharge. We ...
Authors: Rafael Fernandez, Silvia Cano, Ignacio Catalan, Olga Rubio, Carles Subira, Jaume Masclans, Gina Rognoni, Lara Ventura, Caroline Macharete, Len Winfield and Josep Mª. Alcoverro
It is not clear whether vasopressin versus norepinephrine changed mortality in clinical practice in the Vasopressin and Septic Shock Trial (VASST) coordinating center hospital after VASST was published. We tes...
Authors: James A. Russell, Hugh Wellman and Keith R. Walley
Sepsis biomarker panels that provide diagnostic and prognostic discrimination in sepsis patients would be transformative to patient care. We assessed the mortality prediction and diagnostic discriminatory accu...
Authors: Christopher Duplessis, Michael Gregory, Kenneth Frey, Matthew Bell, Luu Truong, Kevin Schully, James Lawler, Raymond J. Langley, Stephen F. Kingsmore, Christopher W. Woods, Emanuel P. Rivers, Anja K. Jaehne, Eugenia B. Quackenbush, Vance G. Fowler, Ephraim L. Tsalik and Danielle Clark
The optimal level of glycemic control in ICU patients has been the subject of intense investigation over the last 20 years. A pivotal study (the NICE-SUGAR study) involving more than 6,000 patients has establi...
This review is for Con side of “Pro-Con debate” on the optimal target of blood glucose levels in patients with chronic hyperglycemia (e.g. premorbid HbA1c level > 7%). Currently, international guideline recomm...
