Pub Date : 2025-07-01DOI: 10.1016/j.jointm.2025.03.003
Sergio Lassola , Eleonora Balzani , Silvia De Rosa , Marta Turella , Giacomo Bellani
{"title":"Free flow Helmet continuous positive airway pressure: The devil is in the “valve's” details!","authors":"Sergio Lassola , Eleonora Balzani , Silvia De Rosa , Marta Turella , Giacomo Bellani","doi":"10.1016/j.jointm.2025.03.003","DOIUrl":"10.1016/j.jointm.2025.03.003","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 219-221"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522612","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 : 2025-07-01DOI: 10.1016/j.jointm.2024.12.003
Jean-Pierre Frat , Sylvain Le Pape
In patients with hypoxemic acute respiratory failure (ARF), the first-line treatment is oxygen therapy, which may include the administration of high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), or continuous positive airway pressure (CPAP). In addition to improving oxygenation, HFNO and NIV reduce the work of breathing as compared to standard oxygen, while CPAP does not. However, tolerance to NIV and CPAP is clinically challenging, resulting in treatment interruption in 10 %–20 % of cases. Compared to standard oxygen, HFNO has been shown to reduce the risk of intubation, while the benefits of NIV or CPAP, even when delivered via a helmet, require further evaluation. Although evidence for the efficacy of HFNO in reducing mortality remains inconclusive, HFNO has emerged as the reference treatment and is recommended for patients with hypoxemic ARF given its benefit in reducing the risk of intubation.
{"title":"High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Pro","authors":"Jean-Pierre Frat , Sylvain Le Pape","doi":"10.1016/j.jointm.2024.12.003","DOIUrl":"10.1016/j.jointm.2024.12.003","url":null,"abstract":"<div><div>In patients with hypoxemic acute respiratory failure (ARF), the first-line treatment is oxygen therapy, which may include the administration of high-flow nasal oxygen (HFNO), noninvasive ventilation (NIV), or continuous positive airway pressure (CPAP). In addition to improving oxygenation, HFNO and NIV reduce the work of breathing as compared to standard oxygen, while CPAP does not. However, tolerance to NIV and CPAP is clinically challenging, resulting in treatment interruption in 10 %–20 % of cases. Compared to standard oxygen, HFNO has been shown to reduce the risk of intubation, while the benefits of NIV or CPAP, even when delivered via a helmet, require further evaluation. Although evidence for the efficacy of HFNO in reducing mortality remains inconclusive, HFNO has emerged as the reference treatment and is recommended for patients with hypoxemic ARF given its benefit in reducing the risk of intubation.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 222-229"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522355","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 : 2025-07-01DOI: 10.1016/j.jointm.2025.03.001
Jiajia Ren , Xiaoming Gao , Jueheng Liu , Mingzhu Liu , Aihui Dai , Chuchu Zhang , Guorong Deng , Xi Xu , Ruohan Li , Jiamei Li , Gang Wang
{"title":"The association of blood eosinophil levels with sepsis and mortality risk: An observational and Mendelian Randomization Study","authors":"Jiajia Ren , Xiaoming Gao , Jueheng Liu , Mingzhu Liu , Aihui Dai , Chuchu Zhang , Guorong Deng , Xi Xu , Ruohan Li , Jiamei Li , Gang Wang","doi":"10.1016/j.jointm.2025.03.001","DOIUrl":"10.1016/j.jointm.2025.03.001","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 292-294"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522365","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 : 2025-07-01DOI: 10.1016/j.jointm.2024.12.009
Yanxia Huang , Mei Meng , Xiaojun Pan , Sheng Zhang, Lidi Zhang, Jiao Liu, Dechang Chen
Background
Family presence is essential in reducing delirium and promoting early recovery of patients in the intensive care unit (ICU). This study was conducted through a questionnaire survey to examine the current visitation policies of ICUs in China and explore flexible visitation options.
Methods
Two versions of independently developed questionnaire, informed by relevant literature, was distributed in two versions: a medical staff questionnaire and a family questionnaire. The survey was administered online and conducted anonymously, with participants completing it after scanning a two-dimensional bar code. Data were collected from January 2020 to June 2020. We accessed the difference between the two groups were compared and the association between factors associated with family satisfaction were assessed.
Results
A total of 1200 hospitals across 30 provinces participated, yielding 16,359 valid responses (13,483 from medical staff and 2876 from family members). Currently, 90.5 % of the ICUs allow once-daily visitation, whereas only 1.2 % permit unrestricted visitation. Family care was allowed in 15.0 % of the ICUs at the end of the patient's life, and 30.3 % allowed flexible visitation for rehabilitation exercises. Among medical staff, 73.9 % of doctors and 58.7 % of nurses supported flexible visitation when rehabilitation exercises are needed. In addition, 73.3 % of family members were willing to help with rehabilitation exercises, and 77.3 % were satisfied with the existing visitation policies.
Conclusions
Most ICUs in mainland of China enforce restrictive visitation policies, most medical staff and family members accept. Moreover, flexible visitation policies for rehabilitation purposes may be increasingly acceptable in the future.
{"title":"Nationwide survey on ICU visiting policies in Mainland of China: Current practices and perspectives","authors":"Yanxia Huang , Mei Meng , Xiaojun Pan , Sheng Zhang, Lidi Zhang, Jiao Liu, Dechang Chen","doi":"10.1016/j.jointm.2024.12.009","DOIUrl":"10.1016/j.jointm.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Family presence is essential in reducing delirium and promoting early recovery of patients in the intensive care unit (ICU). This study was conducted through a questionnaire survey to examine the current visitation policies of ICUs in China and explore flexible visitation options.</div></div><div><h3>Methods</h3><div>Two versions of independently developed questionnaire, informed by relevant literature, was distributed in two versions: a medical staff questionnaire and a family questionnaire. The survey was administered online and conducted anonymously, with participants completing it after scanning a two-dimensional bar code. Data were collected from January 2020 to June 2020. We accessed the difference between the two groups were compared and the association between factors associated with family satisfaction were assessed.</div></div><div><h3>Results</h3><div>A total of 1200 hospitals across 30 provinces participated, yielding 16,359 valid responses (13,483 from medical staff and 2876 from family members). Currently, 90.5 % of the ICUs allow once-daily visitation, whereas only 1.2 % permit unrestricted visitation. Family care was allowed in 15.0 % of the ICUs at the end of the patient's life, and 30.3 % allowed flexible visitation for rehabilitation exercises. Among medical staff, 73.9 % of doctors and 58.7 % of nurses supported flexible visitation when rehabilitation exercises are needed. In addition, 73.3 % of family members were willing to help with rehabilitation exercises, and 77.3 % were satisfied with the existing visitation policies.</div></div><div><h3>Conclusions</h3><div>Most ICUs in mainland of China enforce restrictive visitation policies, most medical staff and family members accept. Moreover, flexible visitation policies for rehabilitation purposes may be increasingly acceptable in the future.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 269-275"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522362","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 : 2025-07-01DOI: 10.1016/j.jointm.2025.03.004
Craig M. Coopersmith
{"title":"Future directions in sepsis research","authors":"Craig M. Coopersmith","doi":"10.1016/j.jointm.2025.03.004","DOIUrl":"10.1016/j.jointm.2025.03.004","url":null,"abstract":"","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 211-213"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522456","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 : 2025-07-01DOI: 10.1016/j.jointm.2025.01.001
Guillaume Carteaux , Anne-Fleur Haudebourg
De novo acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical objective in this population. Noninvasive ventilation (NIV) has been proposed as a potential alternative to invasive ventilation in AHRF. However, no clear clinical benefit has been consistently demonstrated to date. The lack of definitive evidence has left experts unable to provide recommendations for the use of NIV in AHRF. Several factors may account for the inconsistencies in the literature and merit further investigation. Identifying early predictive criteria for NIV failure could be essential in determining which patients are most likely to benefit from this intervention. In addition, the approach to NIV settings may require reconsideration, particularly regarding the level of assistance. Efforts to reduce tidal volume, while aiming to minimize ventilator-induced lung injury, may have inadvertently resulted in insufficient support, amplifying the harmful effects of excessive inspiratory effort. The choice of interface may also significantly influence the physiological effects and outcomes and warrants further exploration. Finally, the frugal nature of noninvasive techniques makes them well-suited for the universal management of AHRF, regardless of constraints. This highlights the need for future developments aimed at optimizing oxygen and energy efficiency, enhancing the ease of use and robustness of NIV devices, and evaluating the effectiveness of NIV under high-constraint conditions, such as in low- and middle-income countries. This review addresses these critical questions.
{"title":"Noninvasive ventilation in acute hypoxemic respiratory failure: What is the future?","authors":"Guillaume Carteaux , Anne-Fleur Haudebourg","doi":"10.1016/j.jointm.2025.01.001","DOIUrl":"10.1016/j.jointm.2025.01.001","url":null,"abstract":"<div><div><em>De novo</em> acute hypoxemic respiratory failure (AHRF) remains one of the leading causes of intensive care unit (ICU) admission and is still associated with high rates of intubation and mortality. Developing effective strategies to prevent intubation and its associated complications remains a critical objective in this population. Noninvasive ventilation (NIV) has been proposed as a potential alternative to invasive ventilation in AHRF. However, no clear clinical benefit has been consistently demonstrated to date. The lack of definitive evidence has left experts unable to provide recommendations for the use of NIV in AHRF. Several factors may account for the inconsistencies in the literature and merit further investigation. Identifying early predictive criteria for NIV failure could be essential in determining which patients are most likely to benefit from this intervention. In addition, the approach to NIV settings may require reconsideration, particularly regarding the level of assistance. Efforts to reduce tidal volume, while aiming to minimize ventilator-induced lung injury, may have inadvertently resulted in insufficient support, amplifying the harmful effects of excessive inspiratory effort. The choice of interface may also significantly influence the physiological effects and outcomes and warrants further exploration. Finally, the frugal nature of noninvasive techniques makes them well-suited for the universal management of AHRF, regardless of constraints. This highlights the need for future developments aimed at optimizing oxygen and energy efficiency, enhancing the ease of use and robustness of NIV devices, and evaluating the effectiveness of NIV under high-constraint conditions, such as in low- and middle-income countries. This review addresses these critical questions.</div></div>","PeriodicalId":73799,"journal":{"name":"Journal of intensive medicine","volume":"5 3","pages":"Pages 237-245"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522357","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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