Pub Date : 2024-11-04DOI: 10.1007/s00134-024-07711-1
Michael C Reade, David Liu
{"title":"The nature of clinical research: even a clear answer gives rise to many other questions.","authors":"Michael C Reade, David Liu","doi":"10.1007/s00134-024-07711-1","DOIUrl":"https://doi.org/10.1007/s00134-024-07711-1","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-04DOI: 10.1007/s00134-024-07709-9
Matteo Marzaroli, Alberto Zangrillo, Giacomo Monti
{"title":"Optimizing meropenem infusion: the importance of concentration and stability.","authors":"Matteo Marzaroli, Alberto Zangrillo, Giacomo Monti","doi":"10.1007/s00134-024-07709-9","DOIUrl":"https://doi.org/10.1007/s00134-024-07709-9","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Should we abandon the CAM-ICU and practice \"humanizing care\" for all patients?","authors":"Dimitri Gusmao-Flores, Mariana Luz, Bruna Brandao Barreto","doi":"10.1007/s00134-024-07624-z","DOIUrl":"10.1007/s00134-024-07624-z","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-09-16DOI: 10.1007/s00134-024-07646-7
Geoffrey J Wigmore, Adam M Deane, Jeffrey J Presneill, Rinaldo Bellomo
{"title":"Human albumin solution for on-pump cardiac surgery: benefit or burden? Author's reply.","authors":"Geoffrey J Wigmore, Adam M Deane, Jeffrey J Presneill, Rinaldo Bellomo","doi":"10.1007/s00134-024-07646-7","DOIUrl":"10.1007/s00134-024-07646-7","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-20DOI: 10.1007/s00134-024-07601-6
Siyao Zeng, Yue Li, Zhipeng Yao, Junbo Zheng, Hongliang Wang
{"title":"Potential reevaluation needed for the meta-analysis of high-pressure recruitment maneuvers in the 2023 ESICM guidelines on acute respiratory distress syndrome.","authors":"Siyao Zeng, Yue Li, Zhipeng Yao, Junbo Zheng, Hongliang Wang","doi":"10.1007/s00134-024-07601-6","DOIUrl":"10.1007/s00134-024-07601-6","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-09-02DOI: 10.1007/s00134-024-07609-y
Ryan Ruiyang Ling, Mallikarjuna Ponnapa Reddy, Ashwin Subramaniam, Benjamin Moran, Kollengode Ramanathan, Mahesh Ramanan, Aidan Burrell, David Pilcher, Kiran Shekar
Purpose: Acute hypoxaemic respiratory failure (AHRF) is a common reason for intensive care unit (ICU) admission. However, patient characteristics, outcomes, and trends over time are unclear. We describe the epidemiology and outcomes of patients with AHRF over time.
Methods: In this binational, registry-based study from 2005 to 2022, we included all adults admitted to an Australian or New Zealand ICU with an arterial blood gas within the first 24 h of ICU stay. AHRF was defined as a partial pressure of oxygen/inspired oxygen ratio (PaO2/FiO2) ≤ 300. The primary outcome was adjusted in-hospital mortality, categorised based on PaO2/FiO2 (mild: 200-300, moderate: 100-200, and severe < 100, and non-linearly). We investigated how adjusted mortality evolved based on temporal trends (by year of admission), sex, age, admission diagnosis and the receipt of mechanical ventilation.
Results: Of 1,560,221 patients, 826,106 (52.9%) were admitted with or developed AHRF within the first 24 h of ICU stay. Of these 826,106 patients, 51.4% had mild, 39.3% had moderate, and 9.3% had severe AHRF. Compared to patients without AHRF (5.3%), patients with mild (8%), moderate (14.2%) and severe (29.9%) AHRF had higher in-hospital mortality rates. As PaO2/FiO2 ratio decreased, adjusted in-hospital mortality progressively increased, particularly below an inflection point at a PaO2/FiO2 ratio of 200. The adjusted in-hospital mortality for all patients decreased over time (13.3% in 2005 to 8.2% in 2022), and this trend was similar in patients with and without AHRF.
Conclusion: The healthcare burden due to AHRF may be larger than expected, and mortality rates remain high in severe AHRF. Although mortality has decreased over time, this may reflect improvements in ICU care in general, rather than specifically in AHRF. More research is required to earlier identify AHRF and stratify these patients at risk of deterioration early, and to validate our findings.
{"title":"Epidemiology of acute hypoxaemic respiratory failure in Australian and New Zealand intensive care units during 2005-2022. A binational, registry-based study.","authors":"Ryan Ruiyang Ling, Mallikarjuna Ponnapa Reddy, Ashwin Subramaniam, Benjamin Moran, Kollengode Ramanathan, Mahesh Ramanan, Aidan Burrell, David Pilcher, Kiran Shekar","doi":"10.1007/s00134-024-07609-y","DOIUrl":"10.1007/s00134-024-07609-y","url":null,"abstract":"<p><strong>Purpose: </strong>Acute hypoxaemic respiratory failure (AHRF) is a common reason for intensive care unit (ICU) admission. However, patient characteristics, outcomes, and trends over time are unclear. We describe the epidemiology and outcomes of patients with AHRF over time.</p><p><strong>Methods: </strong>In this binational, registry-based study from 2005 to 2022, we included all adults admitted to an Australian or New Zealand ICU with an arterial blood gas within the first 24 h of ICU stay. AHRF was defined as a partial pressure of oxygen/inspired oxygen ratio (PaO<sub>2</sub>/FiO<sub>2</sub>) ≤ 300. The primary outcome was adjusted in-hospital mortality, categorised based on PaO<sub>2</sub>/FiO<sub>2</sub> (mild: 200-300, moderate: 100-200, and severe < 100, and non-linearly). We investigated how adjusted mortality evolved based on temporal trends (by year of admission), sex, age, admission diagnosis and the receipt of mechanical ventilation.</p><p><strong>Results: </strong>Of 1,560,221 patients, 826,106 (52.9%) were admitted with or developed AHRF within the first 24 h of ICU stay. Of these 826,106 patients, 51.4% had mild, 39.3% had moderate, and 9.3% had severe AHRF. Compared to patients without AHRF (5.3%), patients with mild (8%), moderate (14.2%) and severe (29.9%) AHRF had higher in-hospital mortality rates. As PaO<sub>2</sub>/FiO<sub>2</sub> ratio decreased, adjusted in-hospital mortality progressively increased, particularly below an inflection point at a PaO<sub>2</sub>/FiO<sub>2</sub> ratio of 200. The adjusted in-hospital mortality for all patients decreased over time (13.3% in 2005 to 8.2% in 2022), and this trend was similar in patients with and without AHRF.</p><p><strong>Conclusion: </strong>The healthcare burden due to AHRF may be larger than expected, and mortality rates remain high in severe AHRF. Although mortality has decreased over time, this may reflect improvements in ICU care in general, rather than specifically in AHRF. More research is required to earlier identify AHRF and stratify these patients at risk of deterioration early, and to validate our findings.</p>","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-12DOI: 10.1007/s00134-024-07581-7
Sylvain Diop, Roman Mounier
{"title":"Seeking the optimal PaO<sub>2</sub> in the critically ill, are we looking toward the right target?","authors":"Sylvain Diop, Roman Mounier","doi":"10.1007/s00134-024-07581-7","DOIUrl":"10.1007/s00134-024-07581-7","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-08-28DOI: 10.1007/s00134-024-07617-y
Frederik M Nielsen, Thomas L Klitgaard, Morten H Møller, Olav L Schjørring, Bodil S Rasmussen
{"title":"Seeking the optimal PaO<sub>2</sub> in the critically ill, are we looking toward the right target? Authors' reply.","authors":"Frederik M Nielsen, Thomas L Klitgaard, Morten H Møller, Olav L Schjørring, Bodil S Rasmussen","doi":"10.1007/s00134-024-07617-y","DOIUrl":"10.1007/s00134-024-07617-y","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142080248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01Epub Date: 2024-09-04DOI: 10.1007/s00134-024-07605-2
Yonathan Freund, Marta Cancella de Abreu, Ben Bloom
{"title":"Effect of the 1-h bundle on mortality in patients with suspected sepsis in the emergency department: faster is better for the sicker ones! Author's reply.","authors":"Yonathan Freund, Marta Cancella de Abreu, Ben Bloom","doi":"10.1007/s00134-024-07605-2","DOIUrl":"10.1007/s00134-024-07605-2","url":null,"abstract":"","PeriodicalId":13665,"journal":{"name":"Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":27.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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