Articles

The application of anticoagulant therapy to sepsis

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...

Authors: Jecko Thachil and Toshiaki Iba

The role of contact system in septic shock: the next target? An overview of the current evidence

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...

Authors: Henrique Nicola

Complex effects of high-flow nasal cannula therapy on hemodynamics in the pediatric patient after cardiac surgery

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...

Authors: Yu Inata and Muneyuki Takeuchi

Acetylcholinesterase and butyrylcholinesterase in cardiosurgical patients with postoperative delirium

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

Association between recurrence of acute kidney injury and mortality in intensive care unit patients with severe sepsis

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

Predictors of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation: an observational cohort study

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

Comparison of the clinical characteristics and prognosis of primary versus secondary acute gastrointestinal injury in critically ill patients

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

C-terminal proendothelin-1 (CT-proET-1) is associated with organ failure and predicts mortality in critically ill patients

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

Perfusion indices revisited

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

Are you Ernest Shackleton, the polar explorer? Refining the criteria for delirium and brain dysfunction in sepsis

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

Sepsis-induced cardiac dysfunction and β-adrenergic blockade therapy for sepsis

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

Combined inhibition of C5 and CD14 efficiently attenuated the inflammatory response in a porcine model of meningococcal sepsis

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

The relationship between cerebral regional oxygen saturation during extracorporeal cardiopulmonary resuscitation and the neurological outcome in a retrospective analysis of 16 cases

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 ...

Authors: Naoki Ehara, Tomoya Hirose, Tadahiko Shiozaki, Akinori Wakai, Tetsuro Nishimura, Nobuto Mori, Mitsuo Ohnishi, Daikai Sadamitsu and Takeshi Shimazu

Prolonged direct hemoperfusion using a polymyxin B immobilized fiber cartridge provides sustained circulatory stabilization in patients with septic shock: a retrospective observational before-after study

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

Long-term cognitive outcomes among unselected ventilated and non-ventilated ICU patients

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

Risk factors and prognosis of pain events during mechanical ventilation: a retrospective study

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

Psychological rumination and recovery from work in intensive care professionals: associations with stress, burnout, depression and health

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

Echocardiography for patients undergoing extracorporeal cardiopulmonary resuscitation: a primer for intensive care physicians

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...

Authors: Zhongheng Zhang

Pathophysiology of trauma-induced coagulopathy: disseminated intravascular coagulation with the fibrinolytic phenotype

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...

Authors: Mineji Hayakawa

The impact of changes in intensive care organization on patient outcome and cost-effectiveness—a narrative review

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

Effect of extracorporeal cytokine removal on vascular barrier function in a septic shock patient

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

Permissive hypotension/hypotensive resuscitation and restricted/controlled resuscitation in patients with severe trauma

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

Monitoring the coagulation status of trauma patients with viscoelastic devices

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

Acute traumatic coagulopathy and trauma-induced coagulopathy: an overview

Hemorrhage is the most important contributing factor of acute-phase mortality in trauma patients. Previously, traumatologists and investigators identified iatrogenic and resuscitation-associated causes of coag...

Authors: Shigeki Kushimoto, Daisuke Kudo and Yu Kawazoe

Tranexamic acid and trauma-induced coagulopathy

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

Damage control resuscitation: a practical approach for severely hemorrhagic patients and its effects on trauma surgery

Coagulopathy observed in trauma patients was thought to be a resuscitation-associated phenomenon. The replacement of lost and consumed coagulation factors was the mainstay in the resuscitation of hemorrhagic s...

Authors: Yasumitsu Mizobata

Dynamics of fibrinogen in acute phases of trauma

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...

Authors: Mineji Hayakawa

Trauma-induced coagulopathy and critical bleeding: the role of plasma and platelet transfusion

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...

Authors: Hiroyasu Ishikura and Taisuke Kitamura

Comments to Role of upper airway ultrasound in airway management

Tracheal ultrasound can be an alternative diagnostic tool in airway management, besides traditional confirmatory methods such as capnography and auscultation. The standard image is a hyperechoic air–mucosa (A–...

Authors: Wan-Ching Lien

Hemodynamic effects of electrical muscle stimulation in the prophylaxis of deep vein thrombosis for intensive care unit patients: a randomized trial

Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimula...

Authors: Masahiro Ojima, Ryosuke Takegawa, Tomoya Hirose, Mitsuo Ohnishi, Tadahiko Shiozaki and Takeshi Shimazu

Decreasing skeletal muscle as a risk factor for mortality in elderly patients with sepsis: a retrospective cohort study

Older patients account for the majority of patients with sepsis. The objective of this study was to determine if decreased skeletal muscle mass is associated with outcomes in elderly patients with sepsis.

Authors: Keita Shibahashi, Kazuhiro Sugiyama, Masahiro Kashiura and Yuichi Hamabe

Does the combination use of two pain assessment tools have a synergistic effect?

Pain management is a very important aspect in the intensive care unit (ICU), as adequate pain control has been shown to be associated with better clinical outcomes in critically ill patients. A Numerical Ratin...

Authors: Takeshi Suzuki

Heat stroke with bimodal rhabdomyolysis: a case report and review of the literature

Severe heat stroke tends to be complicated with rhabdomyolysis, especially in patients with exertional heat stroke. Rhabdomyolysis usually occurs in the acute phase of heat stroke. We herein report a case of h...

Authors: Toshihiko Yoshizawa, Kazuhiko Omori, Ikuto Takeuchi, Yuto Miyoshi, Hiroshi Kido, Etsuhisa Takahashi, Kei Jitsuiki, Kouhei Ishikawa, Hiromichi Ohsaka, Manabu Sugita and Youichi Yanagawa

Why is prone positioning so unpopular?

Recent studies have shown acute respiratory distress syndrome (ARDS) to be underdiagnosed and inadequately treated, as evidenced by underutilization of low-tidal volume ventilation. Despite a proven survival b...

Authors: Jason Chertoff

Nicotine replacement therapy for agitation and delirium management in the intensive care unit: a systematic review of the literature

Active smokers are prevalent within the intensive care setting and place a significant burden on healthcare systems. Nicotine withdrawal due to forced abstinence on admission may contribute to increased agitat...

Authors: Melanie Kowalski, Andrew A. Udy, Hayden J. McRobbie and Michael J. Dooley

Accuracy of Critical Care Pain Observation Tool and Behavioral Pain Scale to assess pain in critically ill conscious and unconscious patients: prospective, observational study

Critically ill patients admitted to intensive care unit (ICU) may suffer from different painful stimuli, but the assessment of pain is difficult because most of them are almost sedated and unable to self-repor...

Authors: Paolo Severgnini, Paolo Pelosi, Elena Contino, Elisa Serafinelli, Raffaele Novario and Maurizio Chiaranda

Perspective on optimizing clinical trials in critical care: how to puzzle out recurrent failures

Critical care is a complex field of medicine, especially because of its diversity and unpredictability. Mortality rates of the diseases are usually high and patients are critically ill, admitted in emergency, ...

Authors: Bruno François, Marc Clavel, Philippe Vignon and Pierre-François Laterre

Current rehabilitation practices in intensive care units: a preliminary survey by the Japanese Society of Education for Physicians and Trainees in Intensive Care (JSEPTIC) Clinical Trial Group

We conducted an internet survey targeting healthcare providers in intensive care units (ICUs) in Japan and received 318 responses. Eighteen percent of respondents replied that full-time physical therapists (PT...

Authors: Shunsuke Taito, Masamitsu Sanui, Hideto Yasuda, Nobuaki Shime and Alan Kawarai Lefor

Validity of the Richmond Agitation-Sedation Scale (RASS) in critically ill children

The Richmond Agitation-Sedation Scale (RASS) is a single tool that is intuitive, is easy to use, and includes both agitation and sedation. The RASS has never been formally validated for pediatric populations. ...

Authors: Abigail Glicksman Kerson, Rebecca DeMaria, Elizabeth Mauer, Christine Joyce, Linda M. Gerber, Bruce M. Greenwald, Gabrielle Silver and Chani Traube

Initial central venous pressure could be a prognostic marker for hemodynamic improvement of polymyxin B direct hemoperfusion: a retrospective cohort study

Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estima...

Authors: Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita and Masako Deguchi

Fluid responsiveness prediction using Vigileo FloTrac measured cardiac output changes during passive leg raise test

Passive leg raising (PLR) is a so called self-volume challenge used to test for fluid responsiveness. Changes in cardiac output (CO) or stroke volume (SV) measured during PLR are used to predict the need for s...

Authors: Anton Krige, Martin Bland and Thomas Fanshawe

Augmented renal clearance in Japanese intensive care unit patients: a prospective study

Augmented renal clearance (ARC) of circulating solutes and drugs has been recently often reported in intensive care unit (ICU) patients. However, only few studies on ARC have been reported in Japan. The aims o...

Authors: Yasumasa Kawano, Shinichi Morimoto, Yoshito Izutani, Kentaro Muranishi, Hironari Kaneyama, Kota Hoshino, Takeshi Nishida and Hiroyasu Ishikura

Retraction Note: Brain injury following cardiac arrest: pathophysiology for neurocritical care

Authors: Hiroyuki Uchino, Yukihiko Ogihara, Hidekimi Fukui, Miyuki Chijiiwa, Shusuke Sekine, Naomi Hara and Eskil Elmér

Erratum to: Comments to: Risk factors for late defecation and its association with the outcomes of critically ill patients: a retrospective observational study

Authors: Dominique Prat and Benjamin Sztrymf

Glycocalyx and its involvement in clinical pathophysiologies

Vascular hyperpermeability is a frequent intractable feature involved in a wide range of diseases in the intensive care unit. The glycocalyx (GCX) seemingly plays a key role to control vascular permeability. T...

Authors: Akira Ushiyama, Hanae Kataoka and Takehiko Iijima

Light irradiation for treatment of acute carbon monoxide poisoning: an experimental study

Because treatment modalities for carbon monoxide (CO) poisoning, especially normobaric oxygen and hyperbaric oxygen therapies, have limited effects and hyperbaric oxygen is not available at the scene where tre...

Authors: Taku Tanaka, Takeshi Kashimura, Marii Ise, Brandon D. Lohman and Yasuhiko Taira

Lung ultrasound—a primary survey of the acutely dyspneic patient

There has been an explosion of knowledge and application of clinical lung ultrasound (LUS) in the last decade. LUS has important applications in the ambulatory, emergency, and critical care settings and its de...

Authors: Francis Chun Yue Lee

An overview of point-of-care ultrasound for soft tissue and musculoskeletal applications in the emergency department

The skin, soft tissue, and most parts of the musculoskeletal system are relatively superficial anatomical structures and ideal targets for ultrasound examination in the emergency departments. Soft tissue and m...

Authors: Kuo-Chih Chen, Aming Chor-Ming Lin, Chee-Fah Chong and Tzong-Luen Wang

Overview of point-of-care abdominal ultrasound in emergency and critical care

Point-of-care abdominal ultrasound (US), which is performed by clinicians at bedside, is increasingly being used to evaluate clinical manifestations, to facilitate accurate diagnoses, and to assist procedures ...

Authors: Toru Kameda and Nobuyuki Taniguchi

Role of upper airway ultrasound in airway management

Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enabl...

Authors: Adi Osman and Kok Meng Sum