Disseminated thrombotic process in the microcirculation is considered to be an important cause of multiple organ dysfunction in sepsis. The fundamental purpose of this prothrombotic change was believed to be i...
Abdominal X-rays, the diagnostic method for enteral feeding tube (EFT) positioning, are a source of irradiation for the patients and carry a potential risk of adverse effects. Data related to ultrasound (US)-g...
Authors: Wagner Luis Nedel, Mariana Nunes Ferreira Jost and João Wilney Franco Filho
Nonconvulsive status epilepticus (NCSE) is a diagnosis that is often challenging and one that may progress to refractory NCSE. Ketamine is a noncompetitive N-methyl-d-aspartate antagonist that increasingly has be...
Authors: Michael A. Pizzi, Prasuna Kamireddi, William O. Tatum, Jerry J. Shih, Daniel A. Jackson and William D. Freeman
Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-establ...
Authors: Thomas-Michael Schneider, Tibor Bence and Franz Brettner
Interruption of enteral nutrition (EN) in the intensive care unit (ICU) occurs frequently for various reasons including feeding intolerance and the conduct of diagnostic and therapeutic procedures. However, fe...
Authors: Midori Uozumi, Masamitsu Sanui, Tetsuya Komuro, Yusuke Iizuka, Tadashi Kamio, Hiroshi Koyama, Hideyuki Mouri, Tomoyuki Masuyama, Kazuyuki Ono and Alan Kawarai Lefor
Sepsis is a global healthcare problem, characterized by whole body inflammation in response to microbial infection, which leads to organ dysfunction. It is becoming a frequent complication in hospitalized pati...
Authors: Ashitha L. Vijayan, Vanimaya, Shilpa Ravindran, R. Saikant, S. Lakshmi, R. Kartik and Manoj. G
The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU.
Brain-dead donor organ transplantation has been available to children in Japan since the 2010 revision of the Organ Transplant Law. Of the 50–60 brain-dead donor organ transplants performed annually in Japan, ...
Authors: Nao Nishimura, Mureo Kasahara, Kenji Ishikura and Satoshi Nakagawa
Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend o...
Acute kidney injury (AKI) after cardiac surgery in children with congenital heart disease is a common complication. AKI is also associated with high morbidity and mortality. The Kidney Diseases Improving Globa...
In Japan, nafamostat mesylate (NM) is frequently used as an anticoagulant during continuous renal replacement therapy (CRRT). The dialyzer membrane AN69ST has been reported to adsorb NM and affect the manageme...
Sepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the ...
Authors: F. Teles, W. G. Rodrigues, M. G. T. C. Alves, C. F. T. Albuquerque, S. M. O. Bastos, M. F. A. Mota, E. S. Mota and F. J. L. Silva
The perfusion of splanchnic organs is deeply altered in patients with septic shock. The aim of the study is to identify the predictive factors of septic shock-induced increase of serum lipase and amylase and t...
Authors: Anis Chaari, Karim Abdel Hakim, Nevine Rashed, Kamel Bousselmi, Vipin Kauts, Mahmoud Etman and William Francis Casey
Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (...
Authors: Gabriel Wardi, Arvin R. Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R. Beitler, Matthew Nolan, Daniel Lasoff and Rebecca E. Sell
Sepsis is one of the most significant causes of mortality in intensive care units. It indicates crosstalk between inflammation and coagulation. In this study, we aimed to identify prognostic markers among seps...
Authors: Kota Hoshino, Taisuke Kitamura, Yoshihiko Nakamura, Yuhei Irie, Norihiko Matsumoto, Yasumasa Kawano and Hiroyasu Ishikura
The intensive care unit (ICU) environment exposes patients to noise levels that may result in substantial sleep disruption. There is a need to accurately describe the intensity pattern and source of noise in t...
Authors: Lori J. Delaney, Marian J. Currie, Hsin-Chia Carol Huang, Violeta Lopez, Edward Litton and Frank Van Haren
The efficacy of polymyxin B-immobilized (PMX) fiber column on septic shock is still under debate. Recently, the result from “Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized controlled trial of ...
Extracorporeal membrane oxygenation (ECMO) have become more frequently used in daily ICU practice, heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication while on extracorporeal mem...
Authors: Alain Rougé, Felix Pelen, Michel Durand and Carole Schwebel
Decannulation is an essential step towards liberating tracheostomized patients from mechanical ventilation. However, despite its perceived importance, there is no universally accepted protocol for this vital t...
Authors: Ratender Kumar Singh, Sai Saran and Arvind K. Baronia
Patients with water intoxication may develop rhabdomyolysis. Existing studies suggest a relationship between the serum sodium correction rate and rhabdomyolysis. The aim of the present study was to determine t...
Authors: Masahiro Kashiura, Kazuhiro Sugiyama and Yuichi Hamabe
Swift and adequate fluid loading is a cornerstone of septic shock therapy. Yet, careful assessment of volume responsiveness and volume amount during the resuscitation process is a prerequisite. Both overzealou...
Fluid overdose can be harmful in critically ill patients. Since central venous pressure (CVP) is currently considered to be an inappropriate indicator of preload, much attention is being given to predicting fl...
Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, littl...
A crucial step in the transition from mechanical ventilation to extubation is the successful performance of a spontaneous breathing trial (SBT). The American College of Chest Physicians (ACCP) Guidelines recom...
Authors: Chuan Jiang, Antonio Esquinas and Bushra Mina
Since the withdrawal of recombinant-activated protein C, the anticoagulant therapy for sepsis was taken no notice. For instance, the international sepsis guidelines did not share a space for this therapy. Howe...
Septic shock remains challenging to intensive care units worldwide, despite recent documented improvement in mortality over the years. Multiple new therapies have been attempted without success in large clinic...
The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respirator...
Patients in intensive care units (ICU) are often diagnosed with postoperative delirium; the duration of which has a relevant negative impact on various clinical outcomes. Recent research found a potentially im...
Authors: Mira John, E. Wesley Ely, Dorothee Halfkann, Julika Schoen, Beate Sedemund-Adib, Stefan Klotz, Finn Radtke, Sebastian Stehr and Michael Hueppe
Intracranial hemorrhage (ICH) is a recognized complication of adults treated with extracorporeal membrane oxygenation (ECMO) and is associated with increased morbidity and mortality. However, the predictors of...
Authors: Alexander Fletcher Sandersjöö, Jiri Bartek Jr., Eric Peter Thelin, Anders Eriksson, Adrian Elmi-Terander, Mikael Broman and Bo-Michael Bellander
Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and othe...
Authors: Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco and Claudio Ronco
This prospective study compared clinical characteristics and prognosis between primary (P) and secondary (S) acute gastrointestinal injury (AGI) (P-AGI)/(S-AGI) in critically ill patients.
Authors: Dong Zhang, Rao Fu, Yanhua Li, Hongyan Li, Yuting Li and Hongxiang Li
Endothelin 1 (ET-1) is a strong vasoconstrictor, which is involved in inflammation and reduced tissue perfusion. C-terminal proendothelin-1 (CT-proET-1) is the stable circulating precursor protein of ET-1. We ...
Authors: Lukas Buendgens, Eray Yagmur, Jan Bruensing, Ulf Herbers, Christer Baeck, Christian Trautwein, Alexander Koch and Frank Tacke
Monitoring of tissue perfusion is an essential step in the management of acute circulatory failure. The presence of cellular dysfunction has been a basic component of shock definition even in the absence of hy...
Authors: Ahmed Hasanin, Ahmed Mukhtar and Heba Nassar
The Third International Consensus Definitions for Sepsis and Septic Shock has recently defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunct...
Authors: Frank Anthony Rasulo, Giuseppe Bellelli, Eugene Wesley Ely, Alessandro Morandi, Pratik Pandharipande and Nicola Latronico
Despite recent advances in medical care, mortality due to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains high. Fluid resuscitation and vasopr...
Authors: Takeshi Suzuki, Yuta Suzuki, Jun Okuda, Takuya Kurazumi, Tomohiro Suhara, Tomomi Ueda, Hiromasa Nagata and Hiroshi Morisaki
Fulminant meningococcal sepsis, characterized by overwhelming innate immune activation, mostly affects young people and causes high mortality. This study aimed to investigate the effect of targeting two key mo...
Authors: Bernt C. Hellerud, Hilde L. Orrem, Knut Dybwik, Søren E. Pischke, Andreas Baratt-Due, Albert Castellheim, Hilde Fure, Grethe Bergseth, Dorte Christiansen, Miles A. Nunn, Terje Espevik, Corinna Lau, Petter Brandtzæg, Erik W. Nielsen and Tom E. Mollnes
In recent years, the measurement of cerebral regional oxygen saturation (rSO2) during resuscitation has attracted attention. The objective of this study was to clarify the relationship between the serial changes ...
Direct hemoperfusion therapy with polymyxin B immobilized fiber cartridges (PMX-DHP) is widely used for septic shock in Japan and parts of Europe. Although this treatment is usually administered for 2 h, the o...
Authors: Kyohei Miyamoto, Yu Kawazoe and Seiya Kato
Cognitive dysfunction is an important long-term complication of critical illness associated with reduced quality of life, increase in healthcare costs, and institutionalization. Delirium, an acute form of brai...
Authors: José Raimundo A. de Azevedo, Widlani Sousa Montenegro, Djane Pereira Rodrigues, Suellen C. de C. Souza, Vanessa F. S. Araujo, Margareth Pereira de Paula, Patricia H. C. P. Prazeres, Adenilde da Luz Leitão and Adriana V. N. Mendonça
Pain assessment is highly recommended in patients receiving mechanical ventilation. However, pain intensity and its impact on outcomes in these patients remain obscure. We collected the results of routine pain...
Authors: Ayahiro Yamashita, Masaki Yamasaki, Hiroki Matsuyama and Fumimasa Amaya
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At t...
The work demands of critical care can be a major cause of stress in intensive care unit (ICU) professionals and lead to poor health outcomes. In the process of recovery from work, psychological rumination is c...
Authors: Tushna Vandevala, Louisa Pavey, Olga Chelidoni, Nai-Feng Chang, Ben Creagh-Brown and Anna Cox
In severe trauma patients, coagulopathy is frequently observed in the acute phase of trauma. Trauma-induced coagulopathy is coagulopathy caused by the trauma itself. The pathophysiology of trauma-induced coagu...
The mortality rate of critically ill patients is high and the cost of the intensive (ICU) department is among the highest within the health-care industry. The cost will continue to increase because of the agin...
Authors: Alexander F. van der Sluijs, Eline R. van Slobbe-Bijlsma, Stephen E. Chick, Margreeth B. Vroom, Dave A. Dongelmans and Alexander P. J. Vlaar
Sepsis and septic shock are major healthcare problems, affecting millions of individuals around the world each year. Pathophysiologically, septic multiple organ dysfunction (MOD) is a life-threatening conditio...
Authors: Sascha David, Kristina Thamm, Bernhard M. W. Schmidt, Christine S. Falk and Jan T. Kielstein
Coagulopathy is a physiological response to massive bleeding that frequently occurs after severe trauma and is an independent predictive factor for mortality. Therefore, it is very important to grasp the coagu...
Authors: Yuichiro Sakamoto, Hiroyuki Koami and Toru Miike
Achieving a balance between organ perfusion and hemostasis is critical for optimal fluid resuscitation in patients with severe trauma. The concept of “permissive hypotension” refers to managing trauma patients...
Authors: Daisuke Kudo, Yoshitaro Yoshida and Shigeki Kushimoto
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly ...
Authors: Takeshi Nishida, Takahiro Kinoshita and Kazuma Yamakawa
Fibrinogen is a unique precursor of fibrin and cannot be compensated for by other coagulation factors. If plasma fibrinogen concentrations are insufficient, hemostatic clots cannot be formed with the appropria...
Hemorrhage is responsible for 30 to 40% of all trauma-related mortality. Among adult trauma patients, 94% of hemorrhage-related deaths occur within 24 h and approximately 60% of these deaths within 3 h of hosp...
