Acute and Critical Care

Volume 36 (1); February 2021

Review Articles

Infection
Evolution of COVID-19 management in critical care: review and perspective from a hospital in the United Kingdom: Avinash Kumar Jha, Sudhindra Gurunath Kulkarni; Acute Crit Care. 2021;36(1):1-14. Published online February 26, 2021; DOI: https://doi.org/10.4266/acc.2020.00864

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The unexpected emergence and spread of coronavirus disease 2019 (COVID-19) has been pandemic, with long-lasting effects, and unfortunately, it does not seem to have ended. Integrating advanced planning, strong teamwork, and clinical management have been both essential and rewarding during this time. Understanding the new concepts of this novel disease and accommodating them into clinical practice is an ongoing process, ultimately leading to advanced and highly specific treatment modalities. We conducted a literature review through PubMed, Europe PMC, Scopus, and Google Scholar to incorporate the most updated therapeutic principles. This article provides a concise and panoramic view of the cohort of critically ill patients admitted to the intensive care unit. We conclude that COVID-19 management includes low tidal volume ventilation, early proning, steroids, and a high suspicion for secondary bacterial/fungal infections. Lung ultrasound is emerging as a promising tool in assessing the clinical response. Managing non-clinical factors such as staff burnout, communication/consent issues, and socio-emotional well-being is equally important.

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Feasibility of Ultrasound-Guided, Peripherally Inserted Central Catheter Placement at the Bedside in a Communicable-Disease Isolation Unit
Kyoung Won Yoon, Wongook Wi, Moon Suk Choi, Eunmi Gil, Chi-Min Park, Keesang Yoo
Journal of Personalized Medicine.2023; 13(5): 863. CrossRef
Implementation of an Emergency Department–Embedded Infusion Center for the Administration of Monoclonal Antibody Therapy in Patients With Early COVID-19 Infection
Julie Graham, Christina Ballejos, Danisha Jenkins, Christina Kelley
Journal of Infusion Nursing.2022; 45(1): 41. CrossRef
Editorial: cardiovascular anaesthesiology
Anne D. Cherry, Mark Nelson, Nirvik Pal
Current Opinion in Anaesthesiology.2022; 35(1): 1. CrossRef
Dietetic-Led Nutrition Interventions in Patients with COVID-19 during Intensive Care and Ward-Based Rehabilitation: A Single-Center Observational Study
Ella Terblanche, Jessica Hills, Edie Russell, Rhiannon Lewis, Louise Rose
Nutrients.2022; 14(5): 1062. CrossRef
Mortality of COVID-19 Patients Requiring Extracorporeal Membrane Oxygenation During the Three Epidemic Waves
Christophe Beyls, Pierre Huette, Christophe Viart, Benjamin Mestan, Guillaume Haye, Mathieu Guilbart, Michael Bernasinski, Patricia Besserve, Florent Leviel, Alejandro Witte Pfister, Florence De Dominicis, Vincent Jounieaux, Pascal Berna, Hervé Dupont, Os
ASAIO Journal.2022; 68(12): 1434. CrossRef
Comparison of characteristics and ventilatory course between coronavirus disease 2019 and Middle East respiratory syndrome patients with acute respiratory distress syndrome
Imran Khalid, Romaysaa M Yamani, Maryam Imran, Muhammad Ali Akhtar, Manahil Imran, Rumaan Gul, Tabindeh Jabeen Khalid, Ghassan Y Wali
Acute and Critical Care.2021; 36(3): 223. CrossRef

Epidemiology
Influence of sarcopenia focused on critically ill patients: Belgin Akan; Acute Crit Care. 2021;36(1):15-21. Published online February 2, 2021; DOI: https://doi.org/10.4266/acc.2020.00745

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A systemic review was performed to evaluate the epidemiological, pathophysiological, and clinical features of sarcopenia, the relationship of sarcopenia with critical illness and its impact on mortality, and diagnostic methods and treatment modalities. Generally, in the presence of critical illness, sarcopenia is not included in the treatment approach strategies. An intensivist should be aware that sarcopenia may be present in critically ill patients. Although the main modalities against sarcopenia are early mobilization and nutritional support, they can only prevent its development and may have positive effects on prognosis rather than treating the existing sarcopenia.

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High prevalence of pre-existing sarcopenia in critically ill patients with hematologic malignancies admitted to the intensive care unit for sepsis or septic shock
Antoine Herault, Emilie Lévêque, Simon Draye-Carbonnier, Pierre Decazes, Alexandra Zduniak, Romain Modzelewski, Julie Libraire, Najate Achamrah, Anne-Lise Ménard, Pascal Lenain, Nathalie Contentin, Maximilien Grall, Stéphane Leprêtre, Emilie Lemasle, Hélè
Clinical Nutrition ESPEN.2023; 55: 373. CrossRef
Acute Changes in Body Muscle Mass and Fat Depletion in Hospitalized Young Trauma Patients: A Descriptive Retrospective Study
Hassan Al-Thani, Bianca M. Wahlen, Ayman El-Menyar, Mohammad Asim, Lena Ribhi Nassar, Mohamed Nadeem Ahmed, Syed Nabir, Monira Mollazehi, Husham Abdelrahman
Diseases.2023; 11(3): 120. CrossRef
The relationship between body mass index and mortality is not linear in patients requiring venovenous extracorporeal support
Elwin Tham, Stuart Campbell, Heather Hayanga, Jeffrey Ammons, Wei Fang, Penny Sappington, Paul McCarthy, Alper Toker, Vinay Badhwar, J.W. Awori Hayanga
The Journal of Thoracic and Cardiovascular Surgery.2023;[Epub] CrossRef
The importance of sarcopenia in critically ill patients in intensive care units
Sanja Tomanović-Vujadinović
Galenika Medical Journal.2023; 2(8): 25. CrossRef
Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment
I.A. Osuna-Padilla, N.C. Rodríguez-Moguel, S. Rodríguez-Llamazares, C.E. Orsso, C.M. Prado, M.A. Ríos-Ayala, O. Villanueva-Camacho, A. Aguilar-Vargas, L.E. Pensado-Piedra, F. Juárez-Hernández, C.M. Hernández-Cárdenas
Clinical Nutrition.2022; 41(12): 2910. CrossRef
A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults
Bethan Jenkins, Philip C. Calder, Luise V. Marino
Clinical Nutrition ESPEN.2022; 49: 92. CrossRef
The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review
I. Nies, L.L.G.C. Ackermans, M. Poeze, T.J. Blokhuis, Jan A. Ten Bosch
Injury.2022; 53: S23. CrossRef
Intra-Aortic Balloon Pump Placement in the Axillary Artery: Where are We?
Gustavo André Boeing Boros, Claudia Yanet San Martin de Bernoche, Pedro Felipe Gomes Nicz
ABC: Heart Failure & Cardiomyopathy.2022; 2(2): 209. CrossRef
Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan: A nationwide, web-based cross-sectional study
Keishi Nawata, Nobuto Nakanishi, Shigeaki Inoue, Keibun Liu, Masafumi Nozoe, Yuko Ono, Isamu Yamada, Hajime Katsukawa, Joji Kotani, Supat Chupradit
PLOS ONE.2022; 17(11): e0276855. CrossRef
A scoping review considering potential biomarkers or functional measures of gastrointestinal dysfunction and enteral feeding intolerance in critically ill adults
Bethan Jenkins, Philip C. Calder, Luise V. Marino
Clinical Nutrition ESPEN.2022; 52: 331. CrossRef
ICU Acquired Weakness in patients with respiratory failure
Sergei A. Andreichenko, Mikhail V. Bychinin, Dmitriy I. Korshunov, Tatiana V. Klypa
Journal of Clinical Practice.2021; 12(2): 5. CrossRef
Predicting outcome in abdominal sepsis: putting the puzzle together
Catherine S. Reid, Vanessa M. Banz, Joerg C. Schefold, Markus M. Luedi
Journal of Cachexia, Sarcopenia and Muscle.2021; 12(5): 1119. CrossRef
Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission: A retrospective study
Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto
Clinical Nutrition ESPEN.2021; 45: 177. CrossRef

CPR/Resuscitation
Critical emergency medicine and the resuscitative care unit: Maria Mermiri, Georgios Mavrovounis, Dimitrios Chatzis, Ioannis Mpoutsikos, Aristea Tsaroucha, Maria Dova, Zacharoula Angelopoulou, Dimitrios Ragias, Athanasios Chalkias, Ioannis Pantazopoulos; Acute Crit Care. 2021;36(1):22-28. Published online January 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00521

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Abstract PDF

Critical emergency medicine is the medical field concerned with management of critically ill patients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU) overcrowding has a negative impact on patient care and outcome. It has been proposed that implementation of critical care services in the ED can negate this effect. Two main Critical Emergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU” models. The resource intensivist model is based on constant presence of an intensivist in the traditional ED setting, while the ED-ICU model encompasses the notion of a separate ED-based unit, with monitoring and therapeutic capabilities similar to those of an ICU. Critical emergency medicine has the potential to improve patient care and outcome; however, establishment of evidence-based protocols and a multidisciplinary approach in patient management are of major importance.

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Inhaled anaesthetic gas for severe bronchospasm at the emergency department
Osman Adi, Farah Nuradhwa Apoo, Chan Pei Fong, Azma Haryaty Ahmad, Nurul Liana Roslan, Faheem Ahmed Khan, Shahridan Fathil
The American Journal of Emergency Medicine.2024; 75: 179. CrossRef
Patients’ Expectations in Emergency Department at King Abdulaziz University Hospital: A Cross-Sectional Survey-Based Study
Ahmad H Bakhribah, Ghaida A. Eissa, Dania W Alsulami, Marah A Alotaibi, Htoun M Abdulmannan, Imad M Khojah
Cureus.2024;[Epub] CrossRef
The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study
Ahmed Faidh Ramzee, Ayman El-Menyar, Mohammad Asim, Ahad Kanbar, Khalid Ahmed, Bahaa Daoud, Saji Mathradikkal, Ahmad Kloub, Hassan Al-Thani, Sandro Rizoli
World Journal of Emergency Medicine.2023; 14(2): 96. CrossRef
Value of Intensive Nursing Detail Management in Intensive Care Unit Nursing
Yansong Li, Lehong Zhou, Qin Wei, Zhaoqi Dong
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
Effect of Early Low-Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta-analysis
Qidong Jiang, Tao Xu, Dinesh Rokaya
BioMed Research International.2022; 2022: 1. CrossRef
Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model
Elizabeth Powell, Iana Sahadzic, Daniel Najafali, Emilie Berman, Katie Andersen, Leenah Z. Afridi, Zoe Gasparotti, Erin Niles, Jeffrey Rea, Thomas Scalea, Daniel J. Haase, Quincy K. Tran, Edward A. Bittner
Critical Care Research and Practice.2022; 2022: 1. CrossRef

Original Articles

Basic science and research
Feasibility study of incident dark-field video microscope for measuring microcirculatory variables in the mouse dorsal skinfold chamber model: Christine Kang, Ah-Reum Cho, Hyeon Jeong Lee, Hyae Jin Kim, Eun-Jung Kim, Soeun Jeo, Jeong-Min Hong, Daehoan Moon; Acute Crit Care. 2021;36(1):29-36. Published online February 26, 2021; DOI: https://doi.org/10.4266/acc.2020.00969

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Background
Despite the importance of microcirculation in organ function, monitoring microcirculation is not a routine practice. With developments in microscopic technology, incident dark field (IDF) microscopy (Cytocam) has allowed visualization of the microcirculation. Dorsal skinfold chamber (DSC) mouse model has been used to investigate microcirculation physiology. By employing Cytocam-IDF imaging with DSC model to assess microcirculatory alteration in lipopolysaccharide (LPS)-induced endotoxemia, we attempted to validate availability of Cytocam-IDF imaging of microcirculation.
Methods
DSC was implanted in eight BALB/c mice for each group; control and sepsis. Both groups were given 72 hours to recover from surgery. The sepsis group had an additional 24-hour period of recovery post-LPS injection (4 mg/kg). Subsequently, a video of the microcirculation was recorded using Cytocam. Data on microcirculatory variables were obtained. Electron microscopy was implemented using lanthanum fixation to detect endothelial glycocalyx degradation.
Results
The microcirculatory flow index was significantly lower (control, 2.8±0.3; sepsis, 2.1±0.8; P=0.033) and heterogeneity index was considerably higher (control, 0.10±0.15; sepsis, 0.53±0.48; P=0.044) in the sepsis group than in the control group. Electron microscopy revealed glycocalyx demolishment in the sepsis group.
Conclusions
Cytocam showed reliable ability for observing changes in the microcirculation under septic conditions in the DSC model. The convenience and good imaging quality and the automatic analysis software available for Cytocam-IDF imaging, along with the ability to perform real-time in vivo experiments in the DSC model, are expected to be helpful in future microcirculation investigations.

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Sedation with propofol and isoflurane differs in terms of microcirculatory parameters: A randomized animal study using dorsal skinfold chamber mouse model
Christine Kang, Ah-Reum Cho, Haekyu Kim, Jae-Young Kwon, Hyeon Jeong Lee, Eunsoo Kim
Microvascular Research.2024; 153: 104655. CrossRef

CPR/Resuscitation
Is two-dimensional echocardiography better than electrocardiography for predicting patient outcomes after cardiac arrest?: Dong Ki Kim, Yong Soo Cho, Joochan Kim, Byung Kook Lee, Dong Hun Lee, Eujene Jung, Jeong Mi Moon, Byeong Jo Chun; Acute Crit Care. 2021;36(1):37-45. Published online December 21, 2020; DOI: https://doi.org/10.4266/acc.2020.00773

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Background
Coronary artery stenosis increases hospital mortality and leads to poor neurological recovery in cardiac arrest (CA) patients. However, electrocardiography (ECG) cannot fully predict the presence of coronary artery stenosis in CA patients. Hence, we aimed to determine whether regional wall motion abnormality (RWMA), as observed by two-dimensional echocardiography (2DE), predicted patient survival outcomes with greater accuracy than did ST segment elevation (STE) on ECG in CA patients who underwent coronary angiography (CAG) after return of spontaneous circulation.
Methods
This was a retrospective observational study of adult patients with CA of presumed cardiac etiology who underwent CAG at a single tertiary care hospital. We investigated whether RWMA observed on 2DE predicted patient outcomes more accurately than did STE observed on ECG. The primary outcome was incidence of hospital mortality. The secondary outcomes were Glasgow-Pittsburgh Cerebral Performance Category scores measured 6 months after discharge and significant coronary artery stenosis on CAG.
Results
Among the 145 patients, 36 (24.8%) experienced in-hospital death. In multivariable analysis of survival outcomes, only total arrest time (P=0.011) and STE (P=0.035) were significant. The odds ratio (OR) and 95% confidence interval (CI), which were obtained by adjusting the total arrest time for survival outcomes, were significant only for STE (OR, 0.40; 95% CI, 0.17–0.94). The presence of RWMA was not a significant factor.
Conclusions
While STE predicted survival outcomes in adult CA patients, RWMA did not. The decision to perform CAG after CA should include ECG under existing guidelines. The use of RWMA has limited benefits in treatment of this population.

Citations

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Just the Facts: Management of return of spontaneous circulation after out-of-hospital cardiac arrest
Hashim Kareemi, Ariel Hendin, Christian Vaillancourt
Canadian Journal of Emergency Medicine.2023; 25(7): 580. CrossRef

Pulmonary
Development of a prognostic scoring system in patients with pneumonia requiring ventilator care for more than 4 days: a single-center observational study: Yeseul Oh, Yewon Kang, Kwangha Lee; Acute Crit Care. 2021;36(1):46-53. Published online February 17, 2021; DOI: https://doi.org/10.4266/acc.2020.00787

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Background
The aim of the present study was to develop a prognostic model using demographic characteristics, comorbidities, and clinical variables measured on day 4 of mechanical ventilation (MV) for patients with prolonged acute mechanical ventilation (PAMV; MV for >96 hours).
Methods
Data from 437 patients (70.9% male; median age, 68 years) were obtained over a period of 9 years. All patients were diagnosed with pneumonia. Binary logistic regression identified factors predicting mortality at 90 days after the start of MV. A PAMV prognosis score was calculating ß-coefficient values and assigning points to variables.
Results
The overall 90-day mortality rate was 47.1%. Five factors (age ≥65 years, body mass index <18.5 kg/m², hemato-oncologic diseases as comorbidities, requirement for vasopressors on day 4 of MV and requirement for neuromuscular blocking agents on day 4 of MV) were identified as prognostic indicators. Each factor was valued as +1 point, and used to develop a PAMV prognosis score. This score showed acceptable discrimination (area under the receiver operating characteristic curve of 0.695 for mortality, 95% confidence interval 0.650–0.738, p<0.001), and calibration (Hosmer–Lemeshow chi-square=6.331, with df 7 and p=0.502). The cutoff value for predicting mortality based on the maximum Youden index was ≤2 (sensitivity, 87.5%; specificity, 41.3%). For patients with PAMV scores ≤1, 2, 3 and ≥4, the 90-day mortality rates were 29.2%, 45.7%, 67.9%, and 90.9%, respectively (P<0.001).
Conclusions
Our study developed a PAMV prognosis score for predicting 90-day mortality. Further research is needed to validate the utility of this score.

Citations

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Ability of the modified NUTRIC score to predict mortality in patients requiring short-term versus prolonged acute mechanical ventilation: a retrospective cohort study
Wanho Yoo, Hyojin Jang, Hayoung Seong, Saerom Kim, Soo Han Kim, Eun-Jung Jo, Jung Seop Eom, Kwangha Lee
Therapeutic Advances in Respiratory Disease.2024;[Epub] CrossRef
Association between mechanical power and intensive care unit mortality in Korean patients under pressure-controlled ventilation
Jae Kyeom Sim, Sang-Min Lee, Hyung Koo Kang, Kyung Chan Kim, Young Sam Kim, Yun Seong Kim, Won-Yeon Lee, Sunghoon Park, So Young Park, Ju-Hee Park, Yun Su Sim, Kwangha Lee, Yeon Joo Lee, Jin Hwa Lee, Heung Bum Lee, Chae-Man Lim, Won-Il Choi, Ji Young Hong
Acute and Critical Care.2024; 39(1): 91. CrossRef

Pulmonary
Effectiveness of online versus in-person structured training program on arterial blood gas, electrolytes, and ventilatory management of critically ill patients: Gaurav Jain, Bhavna Gupta, Priyanka Gupta, Sagarika Panda, Sameer Sharma, Shalinee Rao; Acute Crit Care. 2021;36(1):54-61. Published online February 2, 2021; DOI: https://doi.org/10.4266/acc.2020.00759

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Background
Due to the risk of viral transmission during in-person training, a shift toward online platforms is imperative in the current pandemic. Therefore, we compared the effectiveness of an in-person interactive course with a structurally similar online course designed to improve cognitive skills among clinical health professionals in arterial blood gas analysis, management of electrolyte imbalances, and approaches to mechanical ventilation in critically ill patients.
Methods
In an observational, outcome assessor-blinded, cohort trial, group A included participants enrolled prospectively in an online course, while group B included those who took part in an in-person course (retrospective arm). The primary objective was comparison of cognitive skills through a pre and post-test questionnaire. Statistical analysis was performed using Student t-test.
Results
In total, 435 participants were analyzed in group A, while 99 participants were evaluated in group B. The mean pre-test score was 9.48±2.75 and 10.76±2.42, while the mean post-test score was 11.94±1.90 (passing rate, 64.6%) and 12.53±1.63 (passing rate, 73.3%) in groups A and B, respectively. Group B scored significantly higher in both pre-test (P=0.001) and post-test evaluations (P=0.004). The improvement in post-test score was significantly greater (P=0.001) in group A (2.46±2.22) compared to group B (1.77±1.76). The medical specialties fared better in group B, while surgical specialties scored higher in group A. The pre-test vs. post-test scores exhibited a moderate correlation in both groups (P<0.001). The feedback survey showed a Likert score >3.5 for most points in both groups.
Conclusions
The online teaching module exhibited a significant benefit in terms of participant sensitization and knowledge sharing.

Citations

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Health Care Simulation as a Training Tool for Epidemic Management
Marcia A. Corvetto, Fernando R. Altermatt, Francisca Belmar, Eliana Escudero
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2023; 18(6): 382. CrossRef

Pediatric
Abstract to publication conversion in pediatric critical care medicine in Pakistan: Anwarul Haque, Mohammad Shahzad, Humaira Jurair, Naveed Ur Rehman Siddiqui, Sidra Ishaque, Qalab Abbas; Acute Crit Care. 2021;36(1):62-66. Published online February 5, 2021; DOI: https://doi.org/10.4266/acc.2020.00780

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Background
To determine the rate of conversion of abstracts presented at conferences into full-text articles published in peer-reviewed journals in the field of pediatric critical care medicine (PCCM) in a developing country.
Methods
We retrospectively reviewed PCCM abstracts from Pakistan presented at national and international pediatric and critical care conferences over 10 years (January 2010 to March 2020). Data included abstract characteristics, such as presentation (poster/oral), presenter (fellow/resident), time of meeting (month and year), type of meeting, study design and topic; and publication characteristics, such as journal name, time (month and year) and first author. The primary outcome was publication rate of PCCM abstracts presented in meetings and time (months) from presentation to publication.
Results
A total of 79 PCCM abstracts were presented in 20 meetings during the study period. There were 65 poster presentations (82.28%), of which 63 (79.74%) were presented at international critical care conferences and all presenters were PCCM fellows. In total, 64 (81%) abstracts were descriptive observational studies (retrospective: 50, 63.29%) and prospective (14, 17.72%). Only one was an interventional randomized controlled trial. The publication rate of PCCM abstracts was 63.3% (50/79) and the mean time to publication was 12.39±13.61 months. The publication rate was significantly correlated to the year of publication (P<0.001).
Conclusions
The PCCM abstract publication rate and mean time from presentation to publication was 63.3% and 12.39±13.61 months, respectively, in a developing country.

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From Concept to Publication
Aaron W. Calhoun, Isabel T. Gross, Leah B. Mallory, Lindsay N. Shepard, Mark D. Adler, Tensing Maa, Marc A. Auerbach, Adam Cheng, David O. Kessler, Travis M. Whitfill, Jonathan P. Duff
Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare.2022; 17(6): 385. CrossRef

Case Reports

CPR/Resuscitation
Successful resuscitation of refractory ventricular fibrillation with double sequence defibrillation: SungJoon Park, Jung-Youn Kim, Young-Duck Cho, Eusun Lee, Bosun Shim, Young-Hoon Yoon; Acute Crit Care. 2021;36(1):67-69. Published online October 21, 2020; DOI: https://doi.org/10.4266/acc.2020.00122

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Abstract PDF

In cardiac arrest, if the initial rhythm is ventricular fibrillation (VF) or pulseless ventricular tachycardia, the survival rates are high and good neurologic outcomes are expected. However, the mortality rate increases when refractory ventricular fibrillation (RVF) occurs. We report a case of RVF that was successfully resuscitated with double sequence defibrillation (DSD). A 51-year-old man visited the emergency department with chest pain. The initial electrocardiography showed markedly elevated ST-segment on V1–V5 leads, and VF arrest occurred. Although 10 defibrillations were administered over 20 minutes, there was no response. Two rounds of DSD were performed by placing additional pads on the patient’s anterior-posterior areas and sequentially applying the maximum energy setting. The patient returned to spontaneous circulation and was discharged with cerebral performance category 1 after 14 days of hospital admission. Therefore, DSD could be an option for treatment and termination of RVF.

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Keep shocking: Double sequential defibrillation for refractory ventricular fibrillation
Ahmed Kamal Mohamed, Mohamed Shakaib Nayaz, Ali Nawaz, Carl B Kapadia
The American Journal of Emergency Medicine.2023; 63: 178.e5. CrossRef

Cardiology
A successfully treated case of primary purulent pericarditis complicated by cardiac tamponade and pneumopericardium: Jong Wook Beom, Yeekyoung Ko, Ki Yung Boo, Jae-Geun Lee, Joon Hyouk Choi, Seung-Jae Joo, Ji Hwan Moon, Su Wan Kim, Song-Yi Kim; Acute Crit Care. 2021;36(1):70-74. Published online October 12, 2020; DOI: https://doi.org/10.4266/acc.2020.00234

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Abstract PDF

Acute pericarditis is caused by various factors, but purulent pericarditis is rare. Primary purulent pericarditis in immunocompetent hosts is very rare in the modern antibiotics era. We report a successfully treated case of primary purulent pericarditis complicated with cardiac tamponade and pneumopericardium in an immunocompetent host. A 69-year-old female was referred from another hospital because of pleuritic chest pain with a large amount of pericardial effusion. She was diagnosed with acute pericarditis accompanied by cardiac tamponade. We performed emergency pericardiocentesis, with drainage of 360 ml of bloody pericardial fluid. The culture grew Streptococcus anginosus, confirming the diagnosis of acute purulent pericarditis. We performed pericardiostomy because cardiomegaly and pneumopericardium were aggravated after removal of the pericardial drainage catheter. The patient received antibiotics for a total of 23 days intravenously and was discharged with oral antibiotic therapy. Purulent pericarditis is one of the rare forms of pericarditis and is lifethreatening. A multimodality approach is required for proper diagnosis and treatment of this disease.

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A Rare Case of Primary Purulent Pericarditis Caused by Streptococcus constellatus
Medeinė Kapačinskaitė, Dovilė Gabartaitė, Agnė Šatrauskienė, Ieva Sakaitė, Vytė Valerija Maneikienė, Aleksejus Zorinas, Vilius Janušauskas
Medicina.2023; 59(1): 159. CrossRef
The Clinical View on Streptococcus anginosus Group – Opportunistic Pathogens Coming Out of Hiding
Magdalena Pilarczyk-Zurek, Izabela Sitkiewicz, Joanna Koziel
Frontiers in Microbiology.2022;[Epub] CrossRef
The effects of pneumopericardium during epicardial catheter ablation after dry pericardiocentesis on patients with ventricular arrhythmia
Qingyong Chen, Bosen Yang, Zhenggang Lai, Wen Yue, Qing Yang
Journal of Interventional Cardiac Electrophysiology.2022; 66(2): 373. CrossRef

Image in Critical Care

Pulmonary
Pneumothorax and pulmonary air leaks as ventilator-induced injuries in COVID-19: Gabriele Martelli, Ivo Tiberio; Acute Crit Care. 2021;36(1):75-77. Published online January 13, 2021; DOI: https://doi.org/10.4266/acc.2020.00955

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Letters to the editor

Pulmonary
Retrieval of a tracheobronchial blood clot with a Yankauer suction catheter in complete airway obstruction: Sharad Kaushik, Gaurav Jain, Namrata Gupta, Lokesh Kumar Saini, Girish Sindhwani; Acute Crit Care. 2021;36(1):78-80. Published online January 13, 2021; DOI: https://doi.org/10.4266/acc.2020.00675

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PDF Supplementary Material

Citations

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Determining Obstruction in Endotracheal Tubes Using Physical Respiratory Signals
Hyunkyoo Kang, Jin-Kyung Park, Jinsu An, Jeong-Han Yi, Hyung-Sik Kim
Applied Sciences.2023; 13(7): 4183. CrossRef

Pulmonary
Pneumothorax rate in intubated patients with COVID-19: Kathleen M. Capaccione, Belinda D’souza, Jay Leb, Lyndon Luk, Jimmy Duong, Wei-Yann Tsai, Ben Navot, Shifali Dumeer, Ahmed Mohammed, Mary M. Salvatore; Acute Crit Care. 2021;36(1):81-84. Published online December 21, 2020; DOI: https://doi.org/10.4266/acc.2020.00689

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Incidence and Outcome of Pneumomediastinum in Non-ICU Hospitalized COVID-19 Patients*
Moises Muley, Panaiotis Finamore, Claudio Pedone, Domenico Paolo Emanuele Margiotta, Emanuele Gilardi, Federica Sambuco, Antonio De Vincentis, Umberto Vespasiani-Gentilucci, Francesco Travaglino, Raffaele Antonelli-Incalzi
Critical Care Medicine.2023; 51(1): 47. CrossRef
The Macklin effect closely correlates with pneumomediastinum in acutely ill intubated patients with COVID-19 infection
Valerie Maccarrone, Connie Liou, Belinda D'souza, Mary M. Salvatore, Jay Leb, Alessandro Belletti, Diego Palumbo, Giovanni Landoni, Kathleen M. Capaccione
Clinical Imaging.2023; 97: 50. CrossRef
High incidence of barotrauma in patients admitted with COVID-19 to ICU and associated mortality in rural Appalachia: An observational study
Sunil Sharma, Varun Badami, Edward Rojas, Rahul Sangani, Kyle Chapman, Carlo Avalon, Austin King, Sijin Wen, Samuele Ceruti
PLOS ONE.2023; 18(3): e0282735. CrossRef
Ventilator management and risk of air leak syndrome in patients with SARS-CoV-2 pneumonia: a single-center, retrospective, observational study
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