Critical care (Houten, Netherlands)最新文献

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Volunteerism during humanitarian crises: a practical guide 人道主义危机中的志愿服务:实用指南

Critical care (Houten, Netherlands)

Pub Date : 2022-04-19 DOI: 10.1186/s13054-022-03984-4

H. Bailey, L. Kaplan

引用次数: 3

Transcranial Doppler as a screening test to exclude intracranial hypertension in brain-injured patients: the IMPRESSIT-2 prospective multicenter international study 经颅多普勒筛查排除脑损伤患者颅内高压：IMPRESSIT-2前瞻性多中心国际研究

Critical care (Houten, Netherlands)

Pub Date : 2022-04-15 DOI: 10.1186/s13054-022-03978-2

Frank A. Rasulo, S. Calza, C. Robba, F. Taccone, D. Biasucci, R. Badenes, Simone Piva, D. Savo, G. Citerio, J. Dibu, Francesco Curto, Martina Merciadri, Paolo Gritti, P. Fassini, Soojin Park, M. Lamperti, P. Bouzat, Paolo Malacarne, A. Chieregato, R. Bertuetti, R. Aspide, A. Cantoni, V. McCredie, Lucrezia Guadrini, N. Latronico

引用次数: 23

High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial 高流量鼻插管与常规氧疗治疗COPD急性加重期轻度高碳酸血症的多中心随机对照试验

Critical care (Houten, Netherlands)

Pub Date : 2022-04-15 DOI: 10.1186/s13054-022-03973-7

J. Xia, S. Gu, Wei Lei, Jihua Zhang, Hui Wei, Chaoling Liu, Han Zhang, Rongli Lu, Liqiong Zhang, Mingyan Jiang, Chao Hu, Zhenshun Cheng, Chaojie Wei, Yusheng Chen, Feng-ju Lu, Min Chen, Hong Bi, Hui Liu, C. Yan, H. Teng, Yang Yang, Chen Liang, Yanlei Ge, P. Hou, Jialin Liu, Weiwei Gao, Yi Zhang, Yingying Feng, Cheng Tao, Xu Huang, P. Pan, Hong Luo, Chunmei Yun, Q. Zhan

引用次数: 15

Closed-loop oxygen control improves oxygen therapy in acute hypoxemic respiratory failure patients under high flow nasal oxygen: a randomized cross-over study (the HILOOP study) 高流量鼻吸氧下急性低氧血症性呼吸衰竭患者闭环氧控制改善氧治疗:一项随机交叉研究(HILOOP研究)

Critical care (Houten, Netherlands)

Pub Date : 2022-04-14 DOI: 10.1186/s13054-022-03970-w

O. Roca, Oriol Caritg, M. Santafé, Francisco-Javier Ramos, A. Pacheco, M. García-de-Acilu, R. Ferrer, M. Schultz, J. Ricard

引用次数: 4

Serum IL-17 levels are higher in critically ill patients with AKI and associated with worse outcomes AKI危重患者的血清IL-17水平较高，并与较差的预后相关

Critical care (Houten, Netherlands)

Pub Date : 2022-04-14 DOI: 10.1186/s13054-022-03976-4

J. Collett, Victor Ortiz-Soriano, Xilong Li, Alexander H. Flannery, R. Toto, O. Moe, D. Basile, Javier A. Neyra

引用次数: 3

Derivation and performance of an end-of-life practice score aimed at interpreting worldwide treatment-limiting decisions in the critically ill 推导和性能的生命结束实践得分旨在解释世界范围内的治疗限制的决定在危重疾病

Critical care (Houten, Netherlands)

Pub Date : 2022-04-13 DOI: 10.1186/s13054-022-03971-9

S. Mentzelopoulos, Su-Chuan Chen, J. Nates, J. Kruser, C. Hartog, A. Michalsen, N. Efstathiou, G. Joynt, S. Lobo, A. Avidan, C. Sprung, Wesley Erwin J. O. Mervyn Charles Victoria Myrick C. John Ely Kompanje Mer Feldman Metaxa Shinall Myburgh Vr, W. Ely, E. Kompanje, M. Mer, C. Feldman, V. Metaxa, Myrick C. Shinall, J. Myburgh, C. Vrettou

引用次数: 3

Gut bacteriobiota and mycobiota are both associated with Day-28 mortality among critically ill patients 肠道菌群和真菌群都与危重病人第28天的死亡率有关

Critical care (Houten, Netherlands)

Pub Date : 2022-04-13 DOI: 10.1186/s13054-022-03980-8

R. Prével, R. Enaud, A. Orieux, Adrian Camino, P. Berger, A. Boyer, L. Delhaes, D. Gruson

引用次数: 7

External validation of the 2020 ERC/ESICM prognostication strategy algorithm after cardiac arrest 心脏骤停后2020 ERC/ESICM预测策略算法的外部验证

Critical care (Houten, Netherlands)

Pub Date : 2022-04-11 DOI: 10.1186/s13054-022-03954-w

C. Youn, K. Park, S. Kim, B. Lee, T. Cronberg, S. Oh, K. Jeung, I. Cho, S. Choi

引用次数: 12

A novel Vascular Leak Index identifies sepsis patients with a higher risk for in-hospital death and fluid accumulation. 一种新的血管泄漏指数识别脓毒症患者在院内死亡和液体积聚的风险较高

Critical care (Houten, Netherlands)

Pub Date : 2022-04-11 DOI: 10.1186/s13054-022-03968-4

Jay Chandra, Miguel A Armengol de la Hoz, Gwendolyn Lee, Alexandria Lee, Patrick Thoral, Paul Elbers, Hyung-Chul Lee, John S Munger, Leo Anthony Celi, David A Kaufman

Purpose: Sepsis is a leading cause of morbidity and mortality worldwide and is characterized by vascular leak. Treatment for sepsis, specifically intravenous fluids, may worsen deterioration in the context of vascular leak. We therefore sought to quantify vascular leak in sepsis patients to guide fluid resuscitation.

Methods: We performed a retrospective cohort study of sepsis patients in four ICU databases in North America, Europe, and Asia. We developed an intuitive vascular leak index (VLI) and explored the relationship between VLI and in-hospital death and fluid balance using generalized additive models (GAM).

Results: Using a GAM, we found that increased VLI is associated with an increased risk of in-hospital death. Patients with a VLI in the highest quartile (Q4), across the four datasets, had a 1.61-2.31 times increased odds of dying in the hospital compared to patients with a VLI in the lowest quartile (Q1). VLI Q2 and Q3 were also associated with increased odds of dying. The relationship between VLI, treated as a continuous variable, and in-hospital death and fluid balance was statistically significant in the three datasets with large sample sizes. Specifically, we observed that as VLI increased, there was increase in the risk for in-hospital death and 36-84 h fluid balance.

Conclusions: Our VLI identifies groups of patients who may be at higher risk for in-hospital death or for fluid accumulation. This relationship persisted in models developed to control for severity of illness and chronic comorbidities.

目的：败血症是全球发病和死亡的主要原因，其特点是血管渗漏。脓毒症治疗，特别是静脉输液，可能会加重血管渗漏情况下的病情恶化。因此，我们试图量化败血症患者的血管渗漏情况，以指导液体复苏：我们对北美、欧洲和亚洲四个重症监护室数据库中的败血症患者进行了回顾性队列研究。我们制定了直观的血管渗漏指数（VLI），并使用广义相加模型（GAM）探讨了血管渗漏指数与院内死亡和液体平衡之间的关系：使用广义加和模型，我们发现血管渗漏指数增加与院内死亡风险增加有关。在四个数据集中，与 VLI 处于最低四分位数（Q1）的患者相比，VLI 处于最高四分位数（Q4）的患者的院内死亡几率增加了 1.61-2.31 倍。VLI Q2 和 Q3 也与死亡几率增加有关。在样本量较大的三个数据集中，VLI（作为连续变量）与院内死亡和体液平衡之间的关系具有统计学意义。具体来说，我们观察到，随着 VLI 的增加，院内死亡和 36-84 小时体液平衡的风险也随之增加：结论：我们的 VLI 能识别出院内死亡或体液积聚风险较高的患者群体。这种关系在控制病情严重程度和慢性并发症的模型中依然存在。

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引用次数: 0

Plasma disappearance rate of albumin when infused as a 20% solution. 20%溶液输注时白蛋白的血浆消失率

Critical care (Houten, Netherlands)

Pub Date : 2022-04-11 DOI: 10.1186/s13054-022-03979-1

Markus Zdolsek, Patrick Y Wuethrich, Michaela Gunnström, Joachim H Zdolsek, Emma Hasselgren, Christian M Beilstein, Dominique Engel, Robert G Hahn

Background: The transcapillary leakage of albumin is increased by inflammation and major surgery, but whether exogenous albumin also disappears faster is unclear.

Methods: An intravenous infusion of 3 mL/kg of 20% albumin was given over 30 min to 70 subjects consisting of 15 healthy volunteers, 15 post-burn patients, 15 patients who underwent surgery with minor bleeding, 10 who underwent surgery with major bleeding (mean, 1.1 L) and 15 postoperative patients. Blood Hb and plasma albumin were measured on 15 occasions over 5 h. The rate of albumin disappearance from the plasma was quantitated with population kinetic methodology and reported as the half-life (T_1/2).

Results: No differences were observed for T_1/2 between volunteers, post-burn patients, patients who underwent surgery with minor bleeding and postoperative patients. The T_1/2 averaged 16.2 h, which corresponds to 3.8% of the amount infused per h. Two groups showed plasma concentrations of C-reactive protein of approximately 60 mg/L and still had a similarly long T_1/2 for albumin. By contrast, patients undergoing surgery associated with major hemorrhage had a shorter T_1/2, corresponding to 15% of the infused albumin per h. In addition, our analyses show that the T_1/2 differ greatly depending on whether the calculations consider plasma volume changes and blood losses.

Conclusion: The disappearance rate of the albumin in 20% preparations was low in volunteers, in patients with moderately severe inflammation, and in postoperative patients.

背景：炎症和大手术会增加白蛋白的跨毛细血管渗漏，但外源性白蛋白是否也会加速消失尚不清楚：方法：给 70 名受试者静脉输注 3 mL/kg 20% 的白蛋白 30 分钟，其中包括 15 名健康志愿者、15 名烧伤后患者、15 名手术轻微出血患者、10 名手术大出血患者（平均 1.1 L）和 15 名术后患者。采用群体动力学方法对白蛋白从血浆中消失的速度进行量化，并以半衰期（T1/2）进行报告：结果：志愿者、烧伤后患者、有轻微出血的手术患者和术后患者的 T1/2 无差异。有两组患者的血浆中 C 反应蛋白浓度约为 60 毫克/升，但白蛋白的半衰期（T1/2）也同样较长。相比之下，接受大出血手术的患者的 T1/2 较短，相当于每小时输注白蛋白量的 15%。此外，我们的分析表明，T1/2 的差异很大，取决于计算时是否考虑了血浆容量变化和失血量：在志愿者、中度严重炎症患者和术后患者中，20%制剂中白蛋白的消失率较低。

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引用次数: 0

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