Acute kidney injury (AKI) is a serious complication after cardiac surgery, being associated with a high mortality. We assessed three urinary biomarkers, L-type fatty acid-binding protein (L-FABP), neutrophil g...
The Deyo-Charlson Comorbidity Index (DCCI) has low predictive value in the intensive care unit (ICU). Our goal was to determine whether addition of 25-hydroxyvitamin D (25OHD) levels to the DCCI improved 90-da...
Authors: Bisundev Mahato, Tiffany M. N. Otero, Carrie A. Holland, Patrick T. Giguere, Ednan K. Bajwa, Carlos A. Camargo Jr. and Sadeq A. Quraishi
Macrophage migration inhibitory factor (MIF) is known to amplify the immune response in septic animal models. Few clinical data support this pro-inflammatory role in septic patients. Renal replacement therapy ...
Authors: Julia Pohl, Maria Papathanasiou, Martin Heisler, Pia Stock, Malte Kelm, Ulrike B. Hendgen-Cotta, Tienush Rassaf and Peter Luedike
The right heart often receives less attention during echocardiography. The situation is no different in septic shock. We prospectively investigated the echocardiographic indices of the right heart in septic sh...
Alarmins, including high-mobility group box 1 (HMGB-1), can be released from damaged tissues and activated cells as inflammatory mediators. We aimed to evaluate HMGB-1 and mitochondrial DNA dynamics and estima...
This update comprises six important topics under neurocritical care that require reevaluation. For post-cardiac arrest brain injury, the evaluation of the injury and its corresponding therapy, including temper...
Sepsis is associated with coagulation abnormalities, and a high content of intravascular tissue factor (TF) may contribute to the development of multisystem organ failure. Circulating microvesicles (MVs) are i...
Authors: Carolin Trepesch, Ramona Nitzsche, Aenne Glass, Bernd Kreikemeyer, Jochen K. Schubert and Sonja Oehmcke-Hecht
Quality benchmarks are increasingly being used to compare the delivery of healthcare, and may affect reimbursement in the future. The University Health Consortium (UHC) expected probability of mortality (EPM) ...
Authors: Angela K. M. Lipshutz, John R. Feiner, Barbara Grimes and Michael A. Gropper
Late defecation was recently reported to be associated with worse clinical outcomes in critically ill patients. However, more research is needed to examine the causes and clinical significance of late defecati...
Severe cases of traumatic brain injury (TBI) require neurocritical care, the goal being to stabilize hemodynamics and systemic oxygenation to prevent secondary brain injury. It is reported that approximately 4...
Traumatic brain injury (TBI) is recognized as the significant cause of mortality and morbidity in the world. To reduce unfavorable outcome in TBI patients, many researches have made much efforts for the innova...
Protein deficiency is a major problem in critically ill patients. Egg white powder recently became a standard additive for protein supplementation in our unit. However, clinical data are not available to suppo...
Authors: Rungsun Bhurayanontachai and Sunatee Sa-nguansai
Targeted temperature management (TTM) (primarily therapeutic hypothermia (TH)) after out-of-hospital cardiac arrest (OHCA) has been considered effective, especially for adult-witnessed OHCA with a shockable in...
Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery ...
Authors: Anders Winther Voldby and Birgitte Brandstrup
Patient-ventilator asynchrony is a major cause of difficult weaning from mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is reported useful to improve the synchrony in patients with sustain...
The early prediction of neurological outcomes in postcardiac arrest patients treated with therapeutic hypothermia (TH) remains challenging. Amplitude-integrated electroencephalography (aEEG) is a type of quant...
Substantial attention and resources have been directed to improving outcomes of patients with critical illnesses, in particular sepsis, but all recent clinical trials testing various interventions or strategie...
Authors: Alexandre Mebazaa, Pierre François Laterre, James A. Russell, Andreas Bergmann, Luciano Gattinoni, Etienne Gayat, Michael O. Harhay, Oliver Hartmann, Frauke Hein, Anne Louise Kjolbye, Matthieu Legrand, Roger J. Lewis, John C. Marshall, Gernot Marx, Peter Radermacher, Mathias Schroedter…
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is dep...
Sepsis refers to systemic inflammatory response syndrome and organ failure resulting from infection. Inflammatory receptors (e.g., Toll-like receptors and nucleotide oligomerization domain) recognize bacterial...
The term sepsis-associated encephalopathy (SAE) has been applied to animal models, postmortem studies in patients, and severe cases of sepsis. SAE is considered to include all types of brain dysfunction, inclu...
Sepsis is frequently complicated by coagulopathy and, in about 35 % of severe cases, by disseminated intravascular coagulation (DIC). In Japan, aggressive treatment of septic DIC is encouraged using antithromb...
Authors: Kohji Okamoto, Toshihisa Tamura and Yusuke Sawatsubashi
Kidney injury, including acute kidney injury (AKI) and chronic kidney disease (CKD), has become very common in critically ill patients treated in ICUs. Many epidemiological studies have revealed significant as...
Microcirculatory alterations are frequently observed in critically ill patients undergoing major surgery and those who suffer from trauma or sepsis. Despite the need for adequate fluid administration to restor...
The availability of direct oral anticoagulants (DOACs) has caused a paradigm shift in thrombosis management. DOAC profiles do not differ greatly, though they are quite different from that of warfarin, whereas ...
Authors: Masahiro Ieko, Sumiyoshi Naitoh, Mika Yoshida and Nobuhiko Takahashi
Intensive care unit (ICU) scoring systems or prediction models evolved to meet the desire of clinical and administrative leaders to assess the quality of care provided by their ICUs. The Critical Care Informat...
Authors: Raymond Kao, Fran Priestap and Allan Donner
The type of medical review before an adverse event influences patient outcome. Delays in the up-transfer of patients requiring intensive care are associated with higher mortality rates. Timely detection and re...
Authors: Krishnaswamy Sundararajan, Arthas Flabouris and Campbell Thompson
The components of nucleosomes, which contain DNA and histones, are released into the circulation from damaged cells and can promote inflammation. We studied whether the on-admission levels of circulating nucle...
Authors: Anne K. Penttilä, Ari Rouhiainen, Leena Kylänpää, Harri Mustonen, Pauli Puolakkainen, Heikki Rauvala and Heikki Repo
Based on the proven efficacy of lactate in predicting mortality and morbidity in sepsis when measured early in the resuscitative protocol, our group hypothesized that this utility extends later in the course o...
Authors: Jason Chertoff, Michael Chisum, Lauren Simmons, Brent King, Michael Walker and Jorge Lascano
Physiological abnormalities are often observed in patients prior to cardiac arrest. A modified early warning score (MEWS) system was introduced, which aims to detect early abnormalities by grading vital signs,...
We established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including...
The clinical impact of arrhythmias on the continuum of critical illness is unclear, and data in medical intensive care units (ICU) is lacking. In this study, we distinguish between different types of arrhythmi...
Authors: Rodrigo J. Valderrábano, Alejandro Blanco, Eduardo J. Santiago-Rodriguez, Christine Miranda, José Rivera-del Rio del Rio, Juan Ruiz and Robert Hunter
We often administer adrenaline to improve hypotension of patients undergoing systemic inflammation that is not treated with volume resuscitation. The effects of adrenaline on injured lungs during shock status ...
Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectrosco...
Authors: Laura Claverias, Michael Marí, Judith Marín-Corral, Mónica Magret, Sandra Trefler, María Bodí, Antonio García-España, Juan Carlos Yébenes, Sergi Pascual, Joaquim Gea and Alejandro Rodríguez
The management of tracheal tube cuff pressure in patients receiving mechanical ventilation is important for the prevention of ventilator-associated pneumonia. Currently, cuff pressure is intermittently monitor...
Authors: Junichi Michikoshi, Shigekiyo Matsumoto, Hiroshi Miyawaki, Harushi Niu, Katsuhiro Seo, Makoto Yamamoto, Shu-ichi Tokunaga and Takaaki Kitano
Macrophages can differentiate into pro-inflammatory (M1) or anti-inflammatory (M2) phenotypes upon exposure to a pathogen or a cytokine microenvironment. However, M1/M2 macrophage polarization in polymicrobial...
Authors: Nobuo Watanabe, Yusuke Suzuki, Sadaki Inokuchi and Shigeaki Inoue
Intravenously administered iodine-containing contrast medium (CM) is associated with the development of contrast-induced nephropathy (CIN). Data on the effectiveness of sodium bicarbonate therapy in the preven...
Authors: Nicole Lefel, Loes Janssen, Jos le Noble and Norbert Foudraine
The purposes of the study were to compare serum total cortisol (STC), salivary cortisol (SaC) and calculated free cortisol (cFC) levels at baseline and after the adrenocorticotrophic hormone (ACTH) stimulation...
Authors: Gulsah Elbuken, Zuleyha Karaca, Fatih Tanriverdi, Kursad Unluhizarci, Murat Sungur, Mehmet Doganay and Fahrettin Kelestimur
Severity of illness is an important consideration in making the decision to transfuse as it is the sicker patient that often needs a red cell transfusion. Red blood cell (RBC) transfusions could potentially ha...
Authors: Surender Rajasekaran, Eric Kort, Richard Hackbarth, Alan T. Davis, Dominic Sanfilippo, Robert Fitzgerald, Sandra Zuiderveen, Akunne N. Ndika, Hilary Beauchamp, Anthony Olivero and Nabil Hassan
We hypothesized that activated protein C does not increase in disseminated intravascular coagulation (DIC) after trauma and that the same is true for acute coagulopathy of trauma-shock (ACOTS). Activated prote...
Determination of a patient’s volume status remains challenging. Ultrasound assessments of the inferior vena cava and lung parenchyma have been shown to reflect fluid status when compared to the more traditiona...
Authors: Nawal Salahuddin, Iqbal Hussain, Hakam Alsaidi, Quratulain Shaikh, Mini Joseph, Hassan Hawa and Khalid Maghrabi
Intensive care unit (ICU)-acquired infections are a challenging health problem worldwide, especially when caused by multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment (e.g., bedrail...
Authors: Vincenzo Russotto, Andrea Cortegiani, Santi Maurizio Raineri and Antonino Giarratano
Delirium in intensive care units increases morbidity and mortality risk. The incidence and risk factors of delirium vary among studies. This study therefore aimed to determine the incidence and risk factors of...
Delirium occurs in the intensive care unit and identification is often performed using a validated assessment tool such as the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) patients. The CAM-IC...
Authors: Kimberly J. Terry, Kevin E. Anger and Paul M. Szumita
Molecular amplification techniques are suggested to be a useful adjunct in early detection of pathogens in septic patients. The aim was to study the feasibility of a polymerase chain reaction (PCR) assay compa...
Authors: Runa Plettig, Andreas Nowak, Veronika Balau, Klaus Hahnenkamp and Taras Usichenko
Although fluid resuscitation of patients having acute circulatory failure is essential, avoiding unnecessary administration of fluids in these patients is also important. Fluid responsiveness (FR) is defined a...
Sepsis is a potentially fatal syndrome mediated by an early [e.g., tumor necrosis factor-alpha (TNF-α)] and late [high mobility group box-1 (HMGB-1)] proinflammatory cytokine response to infection. Sepsis-indu...
Authors: Mari Ishida, Masaaki Ueki, Jun Morishita, Masaki Ueno, Shunichi Shiozawa and Nobuhiro Maekawa
Sepsis-induced cardiomyopathy is a reversible myocardial dysfunction that typically resolves in 7–10 days. It is characterized by left ventricular dilatation and depressed ejection fraction. However, many unce...
Traumatic brain injury (TBI) is a major public health problem and a leading cause of death worldwide. A paucity of literature exists on risk factors for mortality in isolated severe TBI, a condition that is di...
Authors: Vijay Krishnamoorthy, Monica S. Vavilala, Brianna Mills and Ali Rowhani-Rahbar
