Pub Date : 2024-05-31DOI: 10.1101/2024.05.30.24308206
Ruan Vlok, Ravi Shankar, Jamie Cham, Bradley Bridge, Lachlan Donaldson
Introduction Percutaneous Stellate ganglion blockade (PSGB) is an increasingly recognised technique for the management of refractory ventricular arrhythmias (VA). Both ultrasound guided and landmark based techniques have been used to successfully decrease the burden of VA. The role of intra-arrest PSGB remains unknown, however it may represent a cost-effective point of care intervention that can be performed for shockable cardiac arrest.
{"title":"Intra-Arrest Percutaneous Stellate Ganglion Block: A Protocol for a Scoping Review","authors":"Ruan Vlok, Ravi Shankar, Jamie Cham, Bradley Bridge, Lachlan Donaldson","doi":"10.1101/2024.05.30.24308206","DOIUrl":"https://doi.org/10.1101/2024.05.30.24308206","url":null,"abstract":"<strong>Introduction</strong> Percutaneous Stellate ganglion blockade (PSGB) is an increasingly recognised technique for the management of refractory ventricular arrhythmias (VA). Both ultrasound guided and landmark based techniques have been used to successfully decrease the burden of VA. The role of intra-arrest PSGB remains unknown, however it may represent a cost-effective point of care intervention that can be performed for shockable cardiac arrest.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141255912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-29DOI: 10.1101/2024.05.29.24308094
Maj-Brit Nørregaard Kjær, Camilla Rahbek Lysholm Bruun, Anders Granholm, Morten Hylander Møller, Bodil Steen Rasmussen, Camilla Bekker Mortensen, Lone Musaeus Poulsen, Thomas Strøm, Eva Laerkner, Anne Craveiro Brøchner, Trine Haberlandt, Anne-Marie Gellert Bunzel, Louise Stenbryggen Herløv, Anna Holm, Praleene Sivapalan, Stine Estrup, Maria Cronhjort, Anna Schandl, Jon Henrik Laake, Kristin Hofsø, Fredrike Blokzijl, Frederic Keus, Carmen Andrea Pfortmueller, Marlies Ostermann, Jade M Cole, Matt P Wise, Wojciech Szczeklik, Anna Wludarczyk, Tomas Jovaiša, Maurizio Cecconi, Martin Ingi Sigurdsson, Marek Nalos, Johanna Hästbacka, Marja Mäkinen, Naomi Hammond, Edward Litton, Kimberley Haines, Sheila Nainan Myatra, Bharath Kumar Tirupakuzhi Vijayaraghavan, Kavita Yadav, Vivekanand Jha, Balasubramanian Venkatesh, Ingrid Egerod, Anders Perner, Marie O Collet
Purpose Randomised clinical trials should ideally use harmonised outcomes that are important to patients and to facilitate meta-analyses and ensuring generalisability. Core outcome sets for specific subsets of ICU patients exist, e.g., respiratory failure, delirium, and COVID-19, but not for ICU patients in general. Accordingly, we aimed to develop a core outcome set for adult general ICU patients.
{"title":"A core outcome set for adult general ICU patients","authors":"Maj-Brit Nørregaard Kjær, Camilla Rahbek Lysholm Bruun, Anders Granholm, Morten Hylander Møller, Bodil Steen Rasmussen, Camilla Bekker Mortensen, Lone Musaeus Poulsen, Thomas Strøm, Eva Laerkner, Anne Craveiro Brøchner, Trine Haberlandt, Anne-Marie Gellert Bunzel, Louise Stenbryggen Herløv, Anna Holm, Praleene Sivapalan, Stine Estrup, Maria Cronhjort, Anna Schandl, Jon Henrik Laake, Kristin Hofsø, Fredrike Blokzijl, Frederic Keus, Carmen Andrea Pfortmueller, Marlies Ostermann, Jade M Cole, Matt P Wise, Wojciech Szczeklik, Anna Wludarczyk, Tomas Jovaiša, Maurizio Cecconi, Martin Ingi Sigurdsson, Marek Nalos, Johanna Hästbacka, Marja Mäkinen, Naomi Hammond, Edward Litton, Kimberley Haines, Sheila Nainan Myatra, Bharath Kumar Tirupakuzhi Vijayaraghavan, Kavita Yadav, Vivekanand Jha, Balasubramanian Venkatesh, Ingrid Egerod, Anders Perner, Marie O Collet","doi":"10.1101/2024.05.29.24308094","DOIUrl":"https://doi.org/10.1101/2024.05.29.24308094","url":null,"abstract":"<strong>Purpose</strong> Randomised clinical trials should ideally use harmonised outcomes that are important to patients and to facilitate meta-analyses and ensuring generalisability. Core outcome sets for specific subsets of ICU patients exist, e.g., respiratory failure, delirium, and COVID-19, but not for ICU patients in general. Accordingly, we aimed to develop a core outcome set for adult general ICU patients.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141188847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1101/2024.05.06.24306959
Inyoung Choi, Qi Long, Emily Getzen
Electronic health records offer great promise for early disease detection, treatment evaluation, information discovery, and other important facets of precision health. Clinical notes, in particular, may contain nuanced information about a patient’s condition, treatment plans, and history that structured data may not capture. As a result, and with advancements in natural language processing, clinical notes have been increasingly used in supervised prediction models. To predict long-term outcomes such as chronic disease and mortality, it is often advantageous to leverage data occurring at multiple time points in a patient’s history. However, these data are often collected at irregular time intervals and varying frequencies, thus posing an analytical challenge. Here, we propose the use of large language models (LLMs) for robust temporal harmonization of clinical notes across multiple visits. We compare multiple state-of-the-art LLMs in their ability to generate useful information during time gaps, and evaluate performance in supervised deep learning models for clinical prediction.
{"title":"Filling the gaps: leveraging large language models for temporal harmonization of clinical text across multiple medical visits for clinical prediction","authors":"Inyoung Choi, Qi Long, Emily Getzen","doi":"10.1101/2024.05.06.24306959","DOIUrl":"https://doi.org/10.1101/2024.05.06.24306959","url":null,"abstract":"Electronic health records offer great promise for early disease detection, treatment evaluation, information discovery, and other important facets of precision health. Clinical notes, in particular, may contain nuanced information about a patient’s condition, treatment plans, and history that structured data may not capture. As a result, and with advancements in natural language processing, clinical notes have been increasingly used in supervised prediction models. To predict long-term outcomes such as chronic disease and mortality, it is often advantageous to leverage data occurring at multiple time points in a patient’s history. However, these data are often collected at irregular time intervals and varying frequencies, thus posing an analytical challenge. Here, we propose the use of large language models (LLMs) for robust temporal harmonization of clinical notes across multiple visits. We compare multiple state-of-the-art LLMs in their ability to generate useful information during time gaps, and evaluate performance in supervised deep learning models for clinical prediction.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140935378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1101/2024.05.04.24306709
Kevin M. Grudzinski, Samuel Fenske, Richard G. Wunderink, Catherine A. Gao, NU SCRIPT Study Investigators
Background Pneumonia is the leading cause of infectious deaths and the most common infection identified in ICU patients. Assessment of bronchoalveolar lavage fluid (BALF) cellularity can aid in pneumonia diagnosis. Low percentages (<50%) of BALF neutrophils have a high negative predictive value for bacterial pneumonia in a general medical ICU population, but unclear operating characteristics in patients with immunocompromise and neutropenia remain unknown.
{"title":"Neutrophil percentages in bronchoalveolar lavage fluid: Implications for diagnosing bacterial pneumonia in patients with immunocompromise and neutropenia","authors":"Kevin M. Grudzinski, Samuel Fenske, Richard G. Wunderink, Catherine A. Gao, NU SCRIPT Study Investigators","doi":"10.1101/2024.05.04.24306709","DOIUrl":"https://doi.org/10.1101/2024.05.04.24306709","url":null,"abstract":"<strong>Background</strong> Pneumonia is the leading cause of infectious deaths and the most common infection identified in ICU patients. Assessment of bronchoalveolar lavage fluid (BALF) cellularity can aid in pneumonia diagnosis. Low percentages (<50%) of BALF neutrophils have a high negative predictive value for bacterial pneumonia in a general medical ICU population, but unclear operating characteristics in patients with immunocompromise and neutropenia remain unknown.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140935310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1101/2024.05.01.24306267
Ingrid Didriksson, Attila Frigyesi, Martin Spångfors, Märta Leffler, Anton Reepalu, Anna Nilsson, Martin Annborn, Anna Lybeck, Hans Friberg, Gisela Lilja
Background Long-term outcomes after critical COVID-19 have not been sufficiently studied. This study aimed to describe changes in functional outcome and health-related quality of life (HRQoL) assessed at 3 and 12 months in a cohort of critically ill COVID-19 survivors. A secondary aim was to investigate factors associated with good functional outcome and HRQoL at 12 months.
{"title":"Factors influencing long-term recovery in critically ill COVID-19 survivors: A prospective multicentre cohort study","authors":"Ingrid Didriksson, Attila Frigyesi, Martin Spångfors, Märta Leffler, Anton Reepalu, Anna Nilsson, Martin Annborn, Anna Lybeck, Hans Friberg, Gisela Lilja","doi":"10.1101/2024.05.01.24306267","DOIUrl":"https://doi.org/10.1101/2024.05.01.24306267","url":null,"abstract":"<strong>Background</strong> Long-term outcomes after critical COVID-19 have not been sufficiently studied. This study aimed to describe changes in functional outcome and health-related quality of life (HRQoL) assessed at 3 and 12 months in a cohort of critically ill COVID-19 survivors. A secondary aim was to investigate factors associated with good functional outcome and HRQoL at 12 months.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140888782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-26DOI: 10.1101/2024.04.25.24306345
Hazem Koozi, Jonas Engström, Martin Spångfors, Hans Friberg, Attila Frigyesi
Purpose Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin upon ICU admission as a predictor of AKI, renal replacement therapy (RRT), and 30-day mortality.
{"title":"Plasma endostatin is an early creatinine independent predictor of acute kidney injury and need for renal replacement therapy in critical care","authors":"Hazem Koozi, Jonas Engström, Martin Spångfors, Hans Friberg, Attila Frigyesi","doi":"10.1101/2024.04.25.24306345","DOIUrl":"https://doi.org/10.1101/2024.04.25.24306345","url":null,"abstract":"<strong>Purpose</strong> Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin upon ICU admission as a predictor of AKI, renal replacement therapy (RRT), and 30-day mortality.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140809405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-14DOI: 10.1101/2024.04.13.24305714
Marcus Fredriksson Sundbom, Hannah Langelotz, Helena Nyström, Roman A’roch, Michael Haney
Objective To examine if atrial fibrillation at the time of emergency transport to tertiary care hospital by air ambulance is associated with increased mortality risk.
目的 研究通过空中急救车紧急送往三级医院时的心房颤动是否与死亡风险增加有关。
{"title":"Atrial fibrillation and mortality in critically ill patients undergoing emergent fixed-wing air ambulance transport: a retrospective cohort study","authors":"Marcus Fredriksson Sundbom, Hannah Langelotz, Helena Nyström, Roman A’roch, Michael Haney","doi":"10.1101/2024.04.13.24305714","DOIUrl":"https://doi.org/10.1101/2024.04.13.24305714","url":null,"abstract":"<strong>Objective</strong> To examine if atrial fibrillation at the time of emergency transport to tertiary care hospital by air ambulance is associated with increased mortality risk.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"181 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140613154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-10DOI: 10.1101/2024.04.08.24305484
Héctor Rodríguez-Pérez, Laura Ciuffreda, Tamara Hernández-Beeftink, Beatriz Guillen-Guio, David Domínguez, Almudena Corrales, Elena Espinosa, Julia Alcoba-Florez, Jose M. Lorenzo-Salazar, Rafaela González-Montelongo, Jesús Villar, Carlos Flores
Background Previous metabarcoding studies based on 16S rRNA sequencing in patients with extrapulmonary sepsis have found early pulmonary dysbiosis associated with a poor prognosis. To further discern this association, here we aimed to better characterize the pulmonary bacterial communities in these patients by leveraging metagenomics and to evaluate if the presence of antibiotic resistance genes (ARGs) could explain the higher mortality of the patients.
{"title":"Tracheal aspirate metagenomics reveals association of antibiotic resistance with non-pulmonary sepsis mortality","authors":"Héctor Rodríguez-Pérez, Laura Ciuffreda, Tamara Hernández-Beeftink, Beatriz Guillen-Guio, David Domínguez, Almudena Corrales, Elena Espinosa, Julia Alcoba-Florez, Jose M. Lorenzo-Salazar, Rafaela González-Montelongo, Jesús Villar, Carlos Flores","doi":"10.1101/2024.04.08.24305484","DOIUrl":"https://doi.org/10.1101/2024.04.08.24305484","url":null,"abstract":"<strong>Background</strong> Previous metabarcoding studies based on 16S rRNA sequencing in patients with extrapulmonary sepsis have found early pulmonary dysbiosis associated with a poor prognosis. To further discern this association, here we aimed to better characterize the pulmonary bacterial communities in these patients by leveraging metagenomics and to evaluate if the presence of antibiotic resistance genes (ARGs) could explain the higher mortality of the patients.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140600996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.1101/2024.04.04.24305205
Katherine M. Winner, Rishi Chanderraj, Ying He, Mark Nuppnau, Robert J. Woods, Michael Heung, Jennifer A. Schaub, Michael W. Sjoding, Robert P. Dickson
Overview We here share a pre-registered analytic plan for a matched case-control study nested in a retrospective cohort of hospitalized patients with suspected sepsis. We will compare gut microbiota (measured near the time of admission) among patients with sepsis who do and do not develop sepsis-induced acute kidney injury.
{"title":"Preregistered analytic plan: the gut microbiome and acute kidney injury in sepsis","authors":"Katherine M. Winner, Rishi Chanderraj, Ying He, Mark Nuppnau, Robert J. Woods, Michael Heung, Jennifer A. Schaub, Michael W. Sjoding, Robert P. Dickson","doi":"10.1101/2024.04.04.24305205","DOIUrl":"https://doi.org/10.1101/2024.04.04.24305205","url":null,"abstract":"<strong>Overview</strong> We here share a pre-registered analytic plan for a matched case-control study nested in a retrospective cohort of hospitalized patients with suspected sepsis. We will compare gut microbiota (measured near the time of admission) among patients with sepsis who do and do not develop sepsis-induced acute kidney injury.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.1101/2024.04.04.24305330
Sarah L. Walker, Federico Angriman, Lisa Burry, Leo Anthony Celi, Kirsten M. Fiest, Judy Gichoya, Alistair Johnson, Kuan Liu, Sangeeta Mehta, Georgiana Roman-Sarita, Laleh Seyyed-Kalantari, Thanh-Giang T. Vu, Elizabeth L. Whitlock, George Tomlinson, Christopher J. Yarnell
Rationale Intravenous sedation is an important tool for managing invasively ventilated patients, yet excess sedation is harmful, and dosing could be influenced by implicit bias.
理由 静脉镇静是管理有创通气患者的重要工具，但过度镇静是有害的，而且剂量可能受到隐性偏见的影响。
{"title":"Association between sex and race and ethnicity and intravenous sedation use in patients receiving invasive ventilation","authors":"Sarah L. Walker, Federico Angriman, Lisa Burry, Leo Anthony Celi, Kirsten M. Fiest, Judy Gichoya, Alistair Johnson, Kuan Liu, Sangeeta Mehta, Georgiana Roman-Sarita, Laleh Seyyed-Kalantari, Thanh-Giang T. Vu, Elizabeth L. Whitlock, George Tomlinson, Christopher J. Yarnell","doi":"10.1101/2024.04.04.24305330","DOIUrl":"https://doi.org/10.1101/2024.04.04.24305330","url":null,"abstract":"<strong>Rationale</strong> Intravenous sedation is an important tool for managing invasively ventilated patients, yet excess sedation is harmful, and dosing could be influenced by implicit bias.","PeriodicalId":501249,"journal":{"name":"medRxiv - Intensive Care and Critical Care Medicine","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140601107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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