Pub Date : 2020-10-01DOI: 10.4103/jtccm.jtccm_7_21
Xin Li, Lu Li, Xiaotong Li, Zhidan zhang, Xiaochun Ma
Background: The prevalence of clinical manifestations in severe patients with COVID-19 was highly variable across region, populations, and assessment methods. We investigated the characteristics in patients with COVID-19 and the risk factors associated with severe cases and progression to severe patients during hospitalization. Methods: In this retrospective, multicenter observational study, we collected the clinical manifestations and laboratory regarding from 125 patients with laboratory-confirmed COVID-19 in Liaoning province, China. The collected COVID-19 patients were divided into two groups, including nonsevere group and severe group which were according to the Chinese national guideline for COVID-19 diagnosis and treatment. Results: One hundred and twenty-five laboratory-confirmed COVID-19 patients from three centralized diagnosis and treatment centers were enrolled. The median age was 44 years old, 68 (54.4%) were male. One hundred and twelve (81.6%) patients were in nonsevere group and 23 (18.4%) were in severe group. The overall hospital mortality is 1.6%. About 34% patients had been to Wuhan, 35.2%patients had contact with confirmed COVID-19 patient in Wuhan. Thirty-five (28%) patients were local and 11 (8.8%) patients had a history of direct contact with wildlife. About 20.8% of the patients had comorbidity, hypertension was the most common comorbidity (14.4%). Four patients changed from nonsevere to severe during hospitalization. Most patients were admitted in January and February (98.4%). The median hospital stay was 16 days (interquartile range [IQR]: 12–21). On admission, fever was the most common symptom (60.8%). Duration from onset symptom to hospitalization was 5 days (IQR, 2–8). Compared with nonsevere group, severe cases were associated with significant increased NE (74.19 ± 13.87 vs. 62.32 ± 12.80, P = 0.001), C-reactive protein (CRP) (33.27 ± 38.60 vs. 15.53 ± 29.35, P = 0.003), D2 (1.52 ± 2.83 vs. 0.44 ± 0.93, P = 0.021), lower lymphocyte count (0.81 ± 0.41 vs. 2.32 ± 6.63, P = 0.042), and lymphocyte percentage (LY%) (15.94 ± 10.47 vs. 28.83 ± 11.66, P < 0.001). Kaletra and Chinese medicine were most widely used, the proportion was 61.6% and 66.4%, respectively. Age (odds ratio [OR] = 1.030, 95% confidence interval [CI], 0.99–1.09; P = 0.042), fever on admission (OR = 5.23, 95% CI, 1.32–20.79; P = 0.019), increased NE (OR = 10.53, 95% CI, 3.55–31.25; P = 0.000), and decreased LY% (OR = 7.72, 95% CI, 2.61–22.83; P = 0.000) were independently associated with the severe COVID-19. Age (OR, 1.12; 95% CI, 1.01–1.23; P = 0.025), myalgia (OR, 30.82; 95% CI, 1.58–600.16; P = 0.024), and CRP (OR = 1.04, 95% CI, 1.004–1.073; P = 0.030) were associated with higher risk of development to severe COVID-19 cases. Conclusions: 1. Identification of individuals at risk for severe COVID-19 after severe acute respiratory syndrome coronavirus 2 infection is important 2. The effects of conventional methods on predicting those patients who will g
{"title":"Clinical Characteristics and Analysis of Factors Associated with Severe COVID-19 Patients in Liaoning, China: A Multicenter Retrospective Study","authors":"Xin Li, Lu Li, Xiaotong Li, Zhidan zhang, Xiaochun Ma","doi":"10.4103/jtccm.jtccm_7_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_7_21","url":null,"abstract":"Background: The prevalence of clinical manifestations in severe patients with COVID-19 was highly variable across region, populations, and assessment methods. We investigated the characteristics in patients with COVID-19 and the risk factors associated with severe cases and progression to severe patients during hospitalization. Methods: In this retrospective, multicenter observational study, we collected the clinical manifestations and laboratory regarding from 125 patients with laboratory-confirmed COVID-19 in Liaoning province, China. The collected COVID-19 patients were divided into two groups, including nonsevere group and severe group which were according to the Chinese national guideline for COVID-19 diagnosis and treatment. Results: One hundred and twenty-five laboratory-confirmed COVID-19 patients from three centralized diagnosis and treatment centers were enrolled. The median age was 44 years old, 68 (54.4%) were male. One hundred and twelve (81.6%) patients were in nonsevere group and 23 (18.4%) were in severe group. The overall hospital mortality is 1.6%. About 34% patients had been to Wuhan, 35.2%patients had contact with confirmed COVID-19 patient in Wuhan. Thirty-five (28%) patients were local and 11 (8.8%) patients had a history of direct contact with wildlife. About 20.8% of the patients had comorbidity, hypertension was the most common comorbidity (14.4%). Four patients changed from nonsevere to severe during hospitalization. Most patients were admitted in January and February (98.4%). The median hospital stay was 16 days (interquartile range [IQR]: 12–21). On admission, fever was the most common symptom (60.8%). Duration from onset symptom to hospitalization was 5 days (IQR, 2–8). Compared with nonsevere group, severe cases were associated with significant increased NE (74.19 ± 13.87 vs. 62.32 ± 12.80, P = 0.001), C-reactive protein (CRP) (33.27 ± 38.60 vs. 15.53 ± 29.35, P = 0.003), D2 (1.52 ± 2.83 vs. 0.44 ± 0.93, P = 0.021), lower lymphocyte count (0.81 ± 0.41 vs. 2.32 ± 6.63, P = 0.042), and lymphocyte percentage (LY%) (15.94 ± 10.47 vs. 28.83 ± 11.66, P < 0.001). Kaletra and Chinese medicine were most widely used, the proportion was 61.6% and 66.4%, respectively. Age (odds ratio [OR] = 1.030, 95% confidence interval [CI], 0.99–1.09; P = 0.042), fever on admission (OR = 5.23, 95% CI, 1.32–20.79; P = 0.019), increased NE (OR = 10.53, 95% CI, 3.55–31.25; P = 0.000), and decreased LY% (OR = 7.72, 95% CI, 2.61–22.83; P = 0.000) were independently associated with the severe COVID-19. Age (OR, 1.12; 95% CI, 1.01–1.23; P = 0.025), myalgia (OR, 30.82; 95% CI, 1.58–600.16; P = 0.024), and CRP (OR = 1.04, 95% CI, 1.004–1.073; P = 0.030) were associated with higher risk of development to severe COVID-19 cases. Conclusions: 1. Identification of individuals at risk for severe COVID-19 after severe acute respiratory syndrome coronavirus 2 infection is important 2. The effects of conventional methods on predicting those patients who will g","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"27 1","pages":"90 - 95"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86731844","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 : 2020-10-01DOI: 10.4103/jtccm.jtccm_2_21
Q. Feng, Songmei Jiang, S. Deng, Y. Ai, Q. Peng, Yunan Mo, Lina Zhang
Objective: Postoperative cognitive dysfunction (POCD) and neurologic deficit continues to be an important neuropsychological adverse affecting patients' outcome. We conducted this systematic review to investigate the relationship between regional cerebral oxygen saturation (rSO2) and early POCD in postoperative patients. Materials and Methods: Our search included MEDLINE (PubMed) and Cochrane library, from inception to October 31, 2018. We included studies reporting values of rSO2 at the beginning of and/or during surgery, and the primary outcome was POCD, and excluded articles who do not put postoperative cognitive function as the main observation. Two reviewers assessed the quality of the included articles using the Newcastle-Ottawa Scale and extracted the data. Results: Seven prospective cohort studies that included 532 patients incorporate into this systematic review. About 37.78% (201/532) patients achieved POCD. POCD was associated with significantly lower overall values of rSO2 during surgery compared to the population that did not achieve POCD (mean difference [MD] −1.98; 95% confidence interval [CI] −3.30 to −0.66; P = 0.003). In the subgroup, the lowest rSO2 values intraoperative period were a better predictor of POCD (MD −2.91; 95% CI −4.37 to − 1.46; P < 0.0001) than the mean rSO2 values (MD − 2.94; 95% CI −5.71 to − 0.17; P = 0.04). However, all of two were proved superior to baseline rSO2 values (MD −0.13; 95% CI -1.33 to 1.07; P = 0.83); patients with intraoperative cerebral oxygen <50% are nearly four times more likely to have early POCD (odds ratio = 3.65; 95% CI 1.62–8.23, P = 0.002). Conclusions: Patients with POCD have significantly lower cerebral oxygenation during operation than their counterparts. The lowest rSO2 values intraoperative period and patients with intraoperative cerebral oxygen <50% were a better predictor of POCD.
目的:术后认知功能障碍(POCD)和神经功能缺损仍然是影响患者预后的重要神经心理不良因素。我们进行了这项系统综述,探讨术后患者局部脑氧饱和度(rSO2)与早期POCD的关系。材料和方法:我们的检索包括MEDLINE (PubMed)和Cochrane图书馆,从成立到2018年10月31日。我们纳入了报道手术开始和/或手术期间rSO2值的研究,主要结局为POCD,并排除了未将术后认知功能作为主要观察的文章。两位审稿人使用纽卡斯尔-渥太华量表评估纳入文章的质量并提取数据。结果:7项前瞻性队列研究包括532例患者纳入本系统评价。约37.78%(201/532)患者达到POCD。与未实现POCD的人群相比,POCD与手术期间rSO2的总体值显著降低相关(平均差[MD] - 1.98;95%置信区间[CI]−3.30 ~−0.66;P = 0.003)。在亚组中,术中最低rSO2值是POCD的较好预测指标(MD为- 2.91;95% CI为−4.37 ~−1.46;P < 0.0001)高于rSO2平均值(MD−2.94;95% CI为−5.71 ~−0.17;P = 0.04)。然而,这两种方法均优于基线rSO2值(MD - 0.13;95% CI -1.33 ~ 1.07;P = 0.83);术中脑氧<50%的患者发生早期POCD的可能性高出近4倍(优势比= 3.65;95% ci 1.62-8.23, p = 0.002)。结论:POCD患者术中脑氧合明显低于其他患者。术中最低rSO2值和患者术中脑氧<50%是POCD的较好预测指标。
{"title":"The Relationship Between Perioperative Regional Cerebral Oxygen Saturation and Postoperative Cognitive Dysfunction: A Systematic Review and Meta-Analysis","authors":"Q. Feng, Songmei Jiang, S. Deng, Y. Ai, Q. Peng, Yunan Mo, Lina Zhang","doi":"10.4103/jtccm.jtccm_2_21","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_2_21","url":null,"abstract":"Objective: Postoperative cognitive dysfunction (POCD) and neurologic deficit continues to be an important neuropsychological adverse affecting patients' outcome. We conducted this systematic review to investigate the relationship between regional cerebral oxygen saturation (rSO2) and early POCD in postoperative patients. Materials and Methods: Our search included MEDLINE (PubMed) and Cochrane library, from inception to October 31, 2018. We included studies reporting values of rSO2 at the beginning of and/or during surgery, and the primary outcome was POCD, and excluded articles who do not put postoperative cognitive function as the main observation. Two reviewers assessed the quality of the included articles using the Newcastle-Ottawa Scale and extracted the data. Results: Seven prospective cohort studies that included 532 patients incorporate into this systematic review. About 37.78% (201/532) patients achieved POCD. POCD was associated with significantly lower overall values of rSO2 during surgery compared to the population that did not achieve POCD (mean difference [MD] −1.98; 95% confidence interval [CI] −3.30 to −0.66; P = 0.003). In the subgroup, the lowest rSO2 values intraoperative period were a better predictor of POCD (MD −2.91; 95% CI −4.37 to − 1.46; P < 0.0001) than the mean rSO2 values (MD − 2.94; 95% CI −5.71 to − 0.17; P = 0.04). However, all of two were proved superior to baseline rSO2 values (MD −0.13; 95% CI -1.33 to 1.07; P = 0.83); patients with intraoperative cerebral oxygen <50% are nearly four times more likely to have early POCD (odds ratio = 3.65; 95% CI 1.62–8.23, P = 0.002). Conclusions: Patients with POCD have significantly lower cerebral oxygenation during operation than their counterparts. The lowest rSO2 values intraoperative period and patients with intraoperative cerebral oxygen <50% were a better predictor of POCD.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"43 1","pages":"83 - 89"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85671964","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 : 2020-10-01DOI: 10.4103/jtccm.jtccm_3_20
L. Moscote-Salazar, Tariq Janjua, W. Florez-Perdomo, E. García-Ballestas, A. Amit
Luis Rafael Moscote‐Salazar1,2, Tariq Janjua3, William A. Florez‐Perdomo2,4, Ezequiel Garcia‐Ballestas1,2, Agrawal Amit5 1Center of Biomedical Research, Faculty of Medicine, University of Cartagena, 2Department of Neurocritical Care, Latinamerican Council of Neurocritical Care, Cartagena, 4Department of Medicine, Soutcolombian University, Neiva, Colombia; 3Neurocritical Care, Critical Care Unit, Regions Hospitals, Saint Paul, Minnesota, USA; 5Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
Luis Rafael Moscote‐salazar1,2, Tariq janju3, William A. Florez‐Perdomo2,4, Ezequiel Garcia‐ballestas1,2, Agrawal Amit5 1卡塔赫纳大学医学院生物医学研究中心,2卡塔赫纳拉丁美洲神经危重症护理委员会神经危重症护理部,4南哥伦比亚大学医学部,内瓦,哥伦比亚;3美国明尼苏达州圣保罗地区医院重症监护病房神经危重症护理;5印度中央邦博帕尔全印度医学科学研究所神经外科
{"title":"Heart Rate Variability: A Potential Noninvasive Biomarker in Viral Sepsis by COVID19 Infection","authors":"L. Moscote-Salazar, Tariq Janjua, W. Florez-Perdomo, E. García-Ballestas, A. Amit","doi":"10.4103/jtccm.jtccm_3_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_3_20","url":null,"abstract":"Luis Rafael Moscote‐Salazar1,2, Tariq Janjua3, William A. Florez‐Perdomo2,4, Ezequiel Garcia‐Ballestas1,2, Agrawal Amit5 1Center of Biomedical Research, Faculty of Medicine, University of Cartagena, 2Department of Neurocritical Care, Latinamerican Council of Neurocritical Care, Cartagena, 4Department of Medicine, Soutcolombian University, Neiva, Colombia; 3Neurocritical Care, Critical Care Unit, Regions Hospitals, Saint Paul, Minnesota, USA; 5Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"26 1","pages":"67 - 68"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91074281","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 : 2020-07-01DOI: 10.4103/jtccm.jtccm_16_20
Ying Shi, Tingting Wang, X. Zuo
Many patients suffer from multiple organ dysfunction syndrome (MODS), which represents a dominant cause of death in the intensive care unit. Current theories about the mechanisms of MODS include inflammation, dysregulated immune response, reduced cellular oxygen utilization, cytopathic hypoxia, and apoptosis. Moreover, an increasing number of studies have shown that endoplasmic reticulum stress (ERS) is related to organ dysfunction. The endoplasmic reticulum is an organelle that is responsible for secretion and membrane protein synthesis and assembly as well as some other physiological activities. Under certain conditions, the homeostasis of ER can be lost, causing the accumulation of unfolded or misfolded protein, which is termed as ERS. During ERS, unfolded protein response (UPR) is activated. Once UPR fails to rebuilt cellular homeostasis, cell function will be impaired and apoptosis will be induced. To better understand the relationship between ERS and severe diseases, we summarize the current research in the context of ERS and UPR signaling associated with various organ dysfunction and severe diseases, including acute lung injury, hepatic injury, heart failure, hemorrhagic shock with multiple organ dysfunction, sepsis, and some other diseases. We also discuss ERS or UPR as a novel therapeutic target and their future directions.
{"title":"Endoplasmic Reticulum Stress and Critical Care Medicine","authors":"Ying Shi, Tingting Wang, X. Zuo","doi":"10.4103/jtccm.jtccm_16_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_16_20","url":null,"abstract":"Many patients suffer from multiple organ dysfunction syndrome (MODS), which represents a dominant cause of death in the intensive care unit. Current theories about the mechanisms of MODS include inflammation, dysregulated immune response, reduced cellular oxygen utilization, cytopathic hypoxia, and apoptosis. Moreover, an increasing number of studies have shown that endoplasmic reticulum stress (ERS) is related to organ dysfunction. The endoplasmic reticulum is an organelle that is responsible for secretion and membrane protein synthesis and assembly as well as some other physiological activities. Under certain conditions, the homeostasis of ER can be lost, causing the accumulation of unfolded or misfolded protein, which is termed as ERS. During ERS, unfolded protein response (UPR) is activated. Once UPR fails to rebuilt cellular homeostasis, cell function will be impaired and apoptosis will be induced. To better understand the relationship between ERS and severe diseases, we summarize the current research in the context of ERS and UPR signaling associated with various organ dysfunction and severe diseases, including acute lung injury, hepatic injury, heart failure, hemorrhagic shock with multiple organ dysfunction, sepsis, and some other diseases. We also discuss ERS or UPR as a novel therapeutic target and their future directions.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"13 1","pages":"54 - 63"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72880515","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 : 2020-07-01DOI: 10.4103/jtccm.jtccm_5_20
Willie Perdomo, H. Ucrós, L. Moscote-Salazar
{"title":"D Vitamin, Coronavirus, and Neurological Injuries","authors":"Willie Perdomo, H. Ucrós, L. Moscote-Salazar","doi":"10.4103/jtccm.jtccm_5_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_5_20","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"1 1","pages":"64 - 65"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81003200","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 : 2020-07-01DOI: 10.4103/jtccm.jtccm_10_20
P. Honore, A. Mugisha, L. Kugener, S. Redant, R. Attou, A. Gallerani, D. Bels
{"title":"Patients Admitted to the Intensive Care Unit Should Receive Central Venous Pressure Monitoring: We Should Personalize Our Approach","authors":"P. Honore, A. Mugisha, L. Kugener, S. Redant, R. Attou, A. Gallerani, D. Bels","doi":"10.4103/jtccm.jtccm_10_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_10_20","url":null,"abstract":"","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"4 1","pages":"66 - 66"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88221501","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 : 2020-07-01DOI: 10.4103/jtccm.jtccm_18_20
L. Moscote-Salazar, Tariq Janjua, Pilar Bosque-Varela, A. Agrawal
Luis Rafael Moscote‐Salazar1,2, Tariq Janjua3, Pilar Bosque‐Varela1, Amit Agrawal4 1Neurology, Paracelsus Medical University, Salzburg, Austria; 2Department of Neurosurgery, Center of Biomedical Research (CIB), University of Cartagena, Cartagena de Indias, Colombia; 3Neurology, Regions Hospital, Saint Paul, MN, USA; 4Neurology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
Luis Rafael Moscote‐salazar1,2, Tariq Janjua3, Pilar Bosque‐Varela1, Amit agrawal11神经病学,奥地利萨尔茨堡Paracelsus医科大学;2卡塔赫纳大学生物医学研究中心神经外科,哥伦比亚卡塔赫纳;3美国明尼苏达州圣保罗地区医院神经内科;4印度中央邦博帕尔全印度医学科学研究所神经病学
{"title":"Cerebral Venous Thrombosis in Air Travelers during COVID-19 Times: Is the Risk Higher?","authors":"L. Moscote-Salazar, Tariq Janjua, Pilar Bosque-Varela, A. Agrawal","doi":"10.4103/jtccm.jtccm_18_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_18_20","url":null,"abstract":"Luis Rafael Moscote‐Salazar1,2, Tariq Janjua3, Pilar Bosque‐Varela1, Amit Agrawal4 1Neurology, Paracelsus Medical University, Salzburg, Austria; 2Department of Neurosurgery, Center of Biomedical Research (CIB), University of Cartagena, Cartagena de Indias, Colombia; 3Neurology, Regions Hospital, Saint Paul, MN, USA; 4Neurology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"105 1","pages":"47 - 48"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80609193","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 : 2020-07-01DOI: 10.4103/jtccm.jtccm_27_20
K. Kang, Nagel' Li, Yang Gao, Xue Du, Xinyu Zhang, Mingsheng Zhao, Kaijiang Yu
Liver injury is one of the most common critical clinical illnesses and is one of the manifestations of multiple organ dysfunction induced by sepsis. The liver plays a central role in the development of sepsis. The role of the liver in removing bacteria and regulating immune inflammation is crucial, and the liver is the target of sepsis-related injuries. However, the mechanism of liver injury in sepsis is still not clear. This review discusses the pathophysiology, clinical manifestations, and treatment of sepsis-related liver injury. Liver injury, pathophysiological mechanism, sepsis, sepsis-related liver injury
{"title":"Research Progress on Sepsis-Related Liver Injury","authors":"K. Kang, Nagel' Li, Yang Gao, Xue Du, Xinyu Zhang, Mingsheng Zhao, Kaijiang Yu","doi":"10.4103/jtccm.jtccm_27_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_27_20","url":null,"abstract":"Liver injury is one of the most common critical clinical illnesses and is one of the manifestations of multiple organ dysfunction induced by sepsis. The liver plays a central role in the development of sepsis. The role of the liver in removing bacteria and regulating immune inflammation is crucial, and the liver is the target of sepsis-related injuries. However, the mechanism of liver injury in sepsis is still not clear. This review discusses the pathophysiology, clinical manifestations, and treatment of sepsis-related liver injury. Liver injury, pathophysiological mechanism, sepsis, sepsis-related liver injury","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"12 1","pages":"49 - 53"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79136512","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 : 2020-05-11DOI: 10.4103/2665-9190.329042
L. Su, Jiahao Zhang, Nanhui Jiang, Jie Yang, Li He, Qin-jing Xie, Rong Huang, Fang Liu, Ying Feng, K. Kashani, Q. Lu, Zhongyi Sun, Z. Peng
ABSTRACT Background: The effect of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) on the coronavirus disease 2019 (COVID-19) remains controversial from clinic evidence. Objectives: The objectives of this study were to report the major characteristics and clinical outcomes of COVID-19 patients treated with ACEIs and ARBs and compare the different effects of the two drugs for outcomes of COVID-19 patients. Methods: This is a retrospective, two-center case series of 198 consecutive COVID-19 patients with a history of hypertension. Results: Among 198 patients, 58 (29.3%) and 16 (8.1%) were on ARB and ACEI, respectively. Patients who were on ARB or ACEI/ARB had a significantly lower rate of severe illness and acute respiratory distress syndrome (ARDS) when compared with patients treated with ACEI alone or not receiving RAAS blocker (P < 0.05). The Kaplan–Meier survival curve showed that patients with ARB in their antihypertensive regimen had a trend toward a higher survival rate when compared with individuals without ARB (adjusted hazard ratio, 0.27; 95% confidence interval [CI], 0.07–1.02; P = 0.054). The occurrence rates of severe illness, ARDS, and death were similar in the two groups regardless of receiving ACEI. The Cox regression analyses showed a better survival in the ARB group than the ACEI group (adjusted hazard ratio, 0.03; 95% CI, 0.00–0.58; P = 0.02). Conclusions: Our data may provide that some evidence of using ARB, but not ACEI, was associated with a reduced rate of severe illness and ARDS, indicating their potential protective impact in COVID-19. Further large sample sizes and multiethnic populations are warranted to confirm our findings.
{"title":"Differential Effects of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on COVID-19","authors":"L. Su, Jiahao Zhang, Nanhui Jiang, Jie Yang, Li He, Qin-jing Xie, Rong Huang, Fang Liu, Ying Feng, K. Kashani, Q. Lu, Zhongyi Sun, Z. Peng","doi":"10.4103/2665-9190.329042","DOIUrl":"https://doi.org/10.4103/2665-9190.329042","url":null,"abstract":"ABSTRACT Background: The effect of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) on the coronavirus disease 2019 (COVID-19) remains controversial from clinic evidence. Objectives: The objectives of this study were to report the major characteristics and clinical outcomes of COVID-19 patients treated with ACEIs and ARBs and compare the different effects of the two drugs for outcomes of COVID-19 patients. Methods: This is a retrospective, two-center case series of 198 consecutive COVID-19 patients with a history of hypertension. Results: Among 198 patients, 58 (29.3%) and 16 (8.1%) were on ARB and ACEI, respectively. Patients who were on ARB or ACEI/ARB had a significantly lower rate of severe illness and acute respiratory distress syndrome (ARDS) when compared with patients treated with ACEI alone or not receiving RAAS blocker (P < 0.05). The Kaplan–Meier survival curve showed that patients with ARB in their antihypertensive regimen had a trend toward a higher survival rate when compared with individuals without ARB (adjusted hazard ratio, 0.27; 95% confidence interval [CI], 0.07–1.02; P = 0.054). The occurrence rates of severe illness, ARDS, and death were similar in the two groups regardless of receiving ACEI. The Cox regression analyses showed a better survival in the ARB group than the ACEI group (adjusted hazard ratio, 0.03; 95% CI, 0.00–0.58; P = 0.02). Conclusions: Our data may provide that some evidence of using ARB, but not ACEI, was associated with a reduced rate of severe illness and ARDS, indicating their potential protective impact in COVID-19. Further large sample sizes and multiethnic populations are warranted to confirm our findings.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"60 1","pages":"1 - 7"},"PeriodicalIF":0.0,"publicationDate":"2020-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73162035","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 : 2020-04-01DOI: 10.4103/jtccm.jtccm_29_20
Yue Li, Zhipeng Yao, Tong Li, Hongliang Wang
Introduction: The importance of blood ammonia detection and nonhepatic hyperammonemia (NHH) in the treatment and prognosis of patients has been neglected clinically. The purpose of this study was to evaluate the etiology, diagnosis, treatment, and prognosis of NHH in intensive care unit adults in Heilongjiang province, China. To solve this problem, we designed a provincial-level survey of severe adult NHH, including its etiology, risk factors, incidence, prognosis, and treatment strategies. Methods: The present study refers to a cross-sectional survey of the whole province, involving five cities in Heilongjiang province. All patients who met the inclusion criteria were eligible to apply to participate in the study, which included baseline demographics, clinical presentation, and follow-up related to diagnosis and treatment. Results: The total number of patients to be recruited in this study was estimated to reach 759. All patients who met the inclusion criteria were eligible to apply to participate in the study, which included baseline demographics, clinical presentation, and follow-up related to diagnosis and treatment. Conclusion: This study is expected to provide a theoretical basis for the development of more scientific and standardized NHH diagnosis and treatment methods. Ethics and Dissemination: Ethical approval was obtained from the ethics committee of The Second Affiliated Hospital of Harbin Medical University (registration number KY2019-184). The findings of this review will be communicated through peer-reviewed publications and scientific presentations. Trial Registration Number: ChiCTR1900026632.
{"title":"A Cross-Sectional Survey on Nonhepatic Hyperglycemia in Intensive Care Unit, Heilongjiang Province, China","authors":"Yue Li, Zhipeng Yao, Tong Li, Hongliang Wang","doi":"10.4103/jtccm.jtccm_29_20","DOIUrl":"https://doi.org/10.4103/jtccm.jtccm_29_20","url":null,"abstract":"Introduction: The importance of blood ammonia detection and nonhepatic hyperammonemia (NHH) in the treatment and prognosis of patients has been neglected clinically. The purpose of this study was to evaluate the etiology, diagnosis, treatment, and prognosis of NHH in intensive care unit adults in Heilongjiang province, China. To solve this problem, we designed a provincial-level survey of severe adult NHH, including its etiology, risk factors, incidence, prognosis, and treatment strategies. Methods: The present study refers to a cross-sectional survey of the whole province, involving five cities in Heilongjiang province. All patients who met the inclusion criteria were eligible to apply to participate in the study, which included baseline demographics, clinical presentation, and follow-up related to diagnosis and treatment. Results: The total number of patients to be recruited in this study was estimated to reach 759. All patients who met the inclusion criteria were eligible to apply to participate in the study, which included baseline demographics, clinical presentation, and follow-up related to diagnosis and treatment. Conclusion: This study is expected to provide a theoretical basis for the development of more scientific and standardized NHH diagnosis and treatment methods. Ethics and Dissemination: Ethical approval was obtained from the ethics committee of The Second Affiliated Hospital of Harbin Medical University (registration number KY2019-184). The findings of this review will be communicated through peer-reviewed publications and scientific presentations. Trial Registration Number: ChiCTR1900026632.","PeriodicalId":93326,"journal":{"name":"Journal of Translational Critical Care Medicine","volume":"7 1","pages":"36 - 40"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78813487","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}