Acute and Critical Care

From articles published in Acute and Critical Care during the past two years (2021 ~ ).

Letter to the editor

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
COVID-19 Critical Illness: A Data-Driven Review
Jennifer C. Ginestra, Oscar J.L. Mitchell, George L. Anesi, Jason D. Christie
Annual Review of Medicine.2022; 73(1): 95. CrossRef
Macklin effect on baseline chest CT scan accurately predicts barotrauma in COVID-19 patients
Gianluca Paternoster, Gianfranco Belmonte, Enrico Scarano, Pietro Rotondo, Diego Palumbo, Alessandro Belletti, Francesco Corradi, Pietro Bertini, Giovanni Landoni, Fabio Guarracino, Alessandro Isirdi, Diego Costanzo, Matteo Romani, Luigi De Simone, Robert
Respiratory Medicine.2022; 197: 106853. CrossRef
Barotrauma and its complications in COVID-19 patients: a retrospective study at tertiary care hospital of Eastern India
Roopak Dubey, Kamal Kumar Sen, Aparajita Mishra
Bulletin of the National Research Centre.2022;[Epub] CrossRef
COVID-19 on Chest CT: Translating Known Microscopic Findings to Imaging Observations
Belinda Dsouza, Kathleen M. Capaccione, Aron Soleiman, Jay Leb, Mary Salvatore
Life.2022; 12(6): 855. CrossRef
Incidence, clinical characteristics and outcome of barotrauma in critically ill patients with COVID-19: a systematic review and meta-analysis
Michele UMBRELLO, Roberto VENCO, Edoardo ANTONUCCI, Sergio CEREGHINI, Clelia FILARDO, Luigi GUGLIELMETTI, Giulia MONTANARI, Stefano MUTTINI
Minerva Anestesiologica.2022;[Epub] CrossRef
Pneumothorax in Critically Ill COVID-19 Patients: Prevalence, Analysis of Risk Factors and Clinical Outcomes
Zeead AlGhamdi, Shaya Y Alqahtani, Khalid AlDajani, Ammar Alsaedi, Omar Al-Rubaish, Abdulmajeed Alharbi, Hatem Elbawab
International Journal of General Medicine.2022; Volume 15: 8249. CrossRef
Barotrauma in Coronavirus Disease 2019 Patients Undergoing Invasive Mechanical Ventilation: A Systematic Literature Review*
Alessandro Belletti, Gabriele Todaro, Gabriele Valsecchi, Rosario Losiggio, Diego Palumbo, Giovanni Landoni, Alberto Zangrillo
Critical Care Medicine.2022; 50(3): 491. CrossRef
Predictors of Pneumothorax/Pneumomediastinum in Mechanically Ventilated COVID-19 Patients
Alessandro Belletti, Diego Palumbo, Alberto Zangrillo, Evgeny V. Fominskiy, Stefano Franchini, Antonio Dell'Acqua, Alessandro Marinosci, Giacomo Monti, Giordano Vitali, Sergio Colombo, Giorgia Guazzarotti, Rosalba Lembo, Nicolò Maimeri, Carolina Faustini,
Journal of Cardiothoracic and Vascular Anesthesia.2021; 35(12): 3642. CrossRef
Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation
Shadi Hamouri, Shaher M Samrah, Omar Albawaih, Zidan Saleh, Mahmoud M Smadi, Ahmad Alhazymeh, Sebawe Syaj
International Journal of General Medicine.2021; Volume 14: 2017. CrossRef
Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation
Kartikeya Rajdev, Alan J. Spanel, Sean McMillan, Shubham Lahan, Brian Boer, Justin Birge, Meilinh Thi
Journal of Intensive Care Medicine.2021; 36(9): 1013. CrossRef
Pneumothorax and barotrauma in invasively ventilated patients with COVID-19
Alessandro Belletti, Giovanni Landoni, Alberto Zangrillo
Respiratory Medicine.2021; 187: 106552. CrossRef
Outcomes of Barotrauma in Critically Ill COVID-19 Patients With Severe Pneumonia
Victor P. Gazivoda, Mudathir Ibrahim, Aaron Kangas-Dick, Arony Sun, Michael Silver, Ory Wiesel
Journal of Intensive Care Medicine.2021; 36(10): 1176. CrossRef

Review Article

Meta-analysis
The efficacy of vitamin C, thiamine, and corticosteroid therapy in adult sepsis patients: a systematic review and meta-analysis: Manoj Kumar Reddy Somagutta, Maria Kezia Lourdes Pormento, Muhammad Adnan Khan, Alaa Hamdan, Namrata Hange, Manish KC, Sukrut Pagad, Molly Sanjay Jain, Sivasthikka Lingarajah, Vishal Sharma, Jaspreet Kaur, Bernard Emuze, Erkan Batti, Obumneme Jude Iloeje; Acute Crit Care. 2021;36(3):185-200. Published online June 30, 2021; DOI: https://doi.org/10.4266/acc.2021.00108

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Abstract PDF Supplementary Material

Previous studies have suggested favorable outcomes of hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT) therapy in patients with sepsis. However, similar results have not been duplicated in sequential studies. This meta-analysis aimed to reevaluate the value of HAT treatment in patients with sepsis. Electronic databases were searched up until October 2020 for any studies that compared the effect of HAT versus non-HAT use in patients with sepsis. Data from 15 studies (eight randomized controlled trials [RCTs] and seven cohort studies) involving 67,349 patients were included. The results from the RCTs show no significant benefit of triple therapy on hospital mortality (risk ratio [RR], 0.99; P=0.92; I²=0%); intensive care unit (ICU) mortality (RR, 0.77; P=0.20; I²=58%); ICU length of stay (weighted mean difference [WMD], 0.11; P=0.86; I² =37%) or hospital length of stay (WMD: 0.57; P=0.49; I²=17%), and renal replacement therapy (RR, 0.64; P=0.44; I²=39%). The delta Sequential Organ Failure Assessment (SOFA) score favored treatment after a sensitivity analysis (WMD, –0.72; P=0.01; I²=32%). However, a significant effect was noted for the duration of vasopressor use (WMD, –25.49; P<0.001; I²=46%). The results from cohort studies have also shown no significant benefit of HAT therapy on hospital mortality, ICU mortality, ICU length of stay, length of hospital stay, the delta SOFA score, the use of renal replacement therapy, or vasopressor duration. HAT therapy significantly reduced the duration of vasopressor use and improved the SOFA score but appeared not to have significant benefits in other outcomes for patients with sepsis. Further RCTs can help understand its benefit exclusively.

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Insights Into Thiamine Supplementation in Patients With Septic Shock
Nara Aline Costa, Amanda Gomes Pereira, Clara Sandra Araujo Sugizaki, Nayane Maria Vieira, Leonardo Rufino Garcia, Sérgio Alberto Rupp de Paiva, Leonardo Antonio Mamede Zornoff, Paula Schmidt Azevedo, Bertha Furlan Polegato, Marcos Ferreira Minicucci
Frontiers in Medicine.2022;[Epub] CrossRef
Vitamin C-induced Hemolysis: Meta-summary and Review of Literature
Deven Juneja, Ravi Jain
Indian Journal of Critical Care Medicine.2022; 26(2): 224. CrossRef
Is it time to reconsider the administration of thiamine alone or in combination with vitamin C in critically ill patients? A meta-analysis of clinical trial studies
Nafiseh Shokri-mashhadi, Ali Aliyari, Zahra Hajhashemy, Saeed Saadat, Mohammad Hossein Rouhani
Journal of Intensive Care.2022;[Epub] CrossRef
Parenteral Vitamin C in Patients with Severe Infection: A Systematic Review
Arnav Agarwal, John Basmaji, Shannon M. Fernando, Fang Zhou Ge, Yingqi Xiao, Haseeb Faisal, Kimia Honarmand, Mathieu Hylands, Vincent Lau, Kimberley Lewis, Rachel Couban, François Lamontagne, Neill K. J. Adhikari
NEJM Evidence.2022;[Epub] CrossRef
Unanswered questions on the use of hydrocortisone, ascorbic acid, and thiamine therapy in sepsis and septic shock
David Ragoonanan, Nicolas Tran, Veeshal Modi, Paige Morgan Nickelsen
American Journal of Health-System Pharmacy.2022; 79(19): 1626. CrossRef
Impacts of Corticosteroid Therapy at Acute Stage of Hospital-Onset Clostridioides difficile Infections
Ching-Chi Lee, Jen-Chieh Lee, Chun-Wei Chiu, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung
Infection and Drug Resistance.2022; Volume 15: 5387. CrossRef
The impact of vitamin C-containing treatment on the mortality of patients with sepsis: A systematic review and meta-analysis of randomized controlled trials
Ching-Yi Chen, Chien-Tung Chiu, Ho-Sheng Lee, Chih-Cheng Lai
Journal of Infection and Public Health.2022; 15(12): 1514. CrossRef
Role of high dose vitamin C in management of hospitalised COVID-19 patients: A minireview
Deven Juneja, Anish Gupta, Sahil Kataria, Omender Singh
World Journal of Virology.2022; 11(5): 300. CrossRef
Current role of high dose vitamin C in sepsis management: A concise review
Deven Juneja, Prashant Nasa, Ravi Jain
World Journal of Critical Care Medicine.2022; 11(6): 349. CrossRef
HYDROCORTISONE, ASCORBIC ACID, AND THIAMINE THERAPY DECREASE RENAL OXIDATIVE STRESS AND ACUTE KIDNEY INJURY IN MURINE SEPSIS
John Kim, Allan Stolarski, Qiuyang Zhang, Katherine Wee, Daniel Remick
Shock.2022; 58(5): 426. CrossRef
Early administration of Vitamin C in patients with sepsis or septic shock in emergency departments: A multicenter, double blinded, randomized controlled trial: The C-EASIE trial protocol
Stefanie Vandervelden, Lina Wauters, Jan Breuls, Steffen Fieuws, Philippe Vanhove, Ives Hubloue, Magali Bartiaux, Jacques Creteur, François Stifkens, Koen Monsieurs, Didier Desruelles, Elisa Panada
PLOS ONE.2021; 16(11): e0259699. CrossRef
Hydrocortisone, ascorbic acid, and thiamine (HAT) for sepsis and septic shock: a meta-analysis with sequential trial analysis
Weilan Na, Huili Shen, Yichu Li, Dong Qu
Journal of Intensive Care.2021;[Epub] CrossRef

Original Article

Infection
Sepsis-induced cardiomyopathy is associated with higher mortality rates in patients with sepsis: Balaram Krishna J Hanumanthu, Anika Sasidharan Nair, Adarsh Katamreddy, Jason S Gilbert, Jee Young You, Obiageli Lynda Offor, Ankit Kushwaha, Ankita Krishnan, Marzio Napolitano, Leonidas Palaidimos, Joaquin Morante, Seema S. Tekwani, Suchita Mehta, Aanchal Gupta, Harmeen Goraya, Mengyang Sun, Robert T. Faillace, Perminder Gulani; Acute Crit Care. 2021;36(3):215-222. Published online July 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00234

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11 Citations

Abstract PDF

Background
Patients with sepsis are at risk for developing sepsis-induced cardiomyopathy (SIC). Previous studies offer inconsistent results regarding the association of SIC and mortality. This study sought to assess whether SIC is linked to mortality in patients with sepsis and to evaluate predictors of the development of SIC.
Methods
In this retrospective study, patients admitted to the medical intensive care unit with a diagnosis of sepsis in the absence of acute coronary syndrome were included. SIC was identified using transthoracic echo and was defined by a new onset decline in left ventricular ejection fraction (LVEF) ≤50%, or ≥10% decline in LVEF compared to baseline in patients with a history of heart failure with reduced ejection fraction. Multivariable logistic regression analysis was performed using the R software program.
Results
Of the 359 patients in the final analysis, 19 (5.3%) had SIC. Eight (42.1%) of the 19 patients in the SIC group and 60 (17.6%) of the 340 patients in the non-SIC group died during hospitalization. SIC was associated with an increased risk for all-cause in-hospital mortality (odds ratio [OR], 4.46; 95% confidence interval [CI], 1.15–18.69; P=0.03). Independent predictors for the development of SIC were albumin level (OR, 0.47; 95% CI, 0.23–0.93; P=0.03) and culture positivity (OR, 8.47; 95% CI, 2.24–55.61; P=0.006). Concomitant right ventricular hypokinesis was noted in 13 (68.4%) of the 19 SIC patients.
Conclusions
SIC was associated with an increased risk for all-cause in-hospital mortality. Low albumin level and culture positivity were independent predictors of SIC.

Citations

Citations to this article as recorded by

Therapeutic Dilemmas in Mixed Septic-Cardiogenic Shock
Daniela Urina Jassir, Antoine H. Chaanine, Sapna Desai, Indranee Rajapreyar, Thierry H. Le Jemtel
The American Journal of Medicine.2023; 136(1): 27. CrossRef
A case of sepsis‐induced cardiomyopathy successfully treated with venoarterial extracorporeal membrane oxygenation
Keigo Sato, Akihiro Naito, Taichi Shiratori, Masahiro Yamamoto, Kenichi Shimane, Manabu Mikami, Mariko Senda, Haruki Kume, Motofumi Suzuki
IJU Case Reports.2023; 6(1): 26. CrossRef
RNF20 deletion causes inflammation in model of sepsis through the NLRP3 activation
Anlong Qi, Yancun Liu, Jianhua Zhai, Yongtao Wang, Wang Li, Tong Wang, Yanfen Chai
Immunopharmacology and Immunotoxicology.2023; : 1. CrossRef
S100a8/a9 contributes to sepsis-induced cardiomyopathy by activating ERK1/2-Drp1-mediated mitochondrial fission and respiratory dysfunction
Feng Wu, Yan-Ting Zhang, Fei Teng, Hui-Hua Li, Shu-Bin Guo
International Immunopharmacology.2023; 115: 109716. CrossRef
Ultrasound in Sepsis and Septic Shock—From Diagnosis to Treatment
Gianluca Tullo, Marcello Candelli, Irene Gasparrini, Sara Micci, Francesco Franceschi
Journal of Clinical Medicine.2023; 12(3): 1185. CrossRef
A novel signature combing cuproptosis- and ferroptosis-related genes in sepsis-induced cardiomyopathy
Juanjuan Song, Kairui Ren, Dexin Zhang, Xinpeng Lv, Lin Sun, Ying Deng, Huadong Zhu
Frontiers in Genetics.2023;[Epub] CrossRef
Protein Phosphatase 2A Improves Cardiac Functional Response to Ischemia and Sepsis
Ulrich Gergs, Tina Jahn, Nico Schulz, Claudia Großmann, Uwe Rueckschloss, Uta Demus, Igor B. Buchwalow, Joachim Neumann
International Journal of Molecular Sciences.2022; 23(9): 4688. CrossRef
Feasibility and discriminatory value of tissue motion annular displacement in sepsis-induced cardiomyopathy: a single-center retrospective observational study
Jieqiong Song, Yao Yao, Shilong Lin, Yizhou He, Duming Zhu, Ming Zhong
Critical Care.2022;[Epub] CrossRef
Sepsis-Induced Cardiomyopathy Reviewed: The Case for Early Consideration of Mechanical Support
Daniel L. Plack, Olivier Royer, Etienne J. Couture, Christoph G.S. Nabzdyk
Journal of Cardiothoracic and Vascular Anesthesia.2022; 36(10): 3916. CrossRef
Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis
Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
Annals of Intensive Care.2022;[Epub] CrossRef
Association of Sepsis-Induced Cardiomyopathy and Mortality: A Systematic Review and Meta-Analysis
Yu-Min Lin, Mei-Chuan Lee, Han Siong Toh, Wei-Ting Chang, Sih-Yao Chen, Fang-Hsiu Kuo, Hsin-Ju Tang, Yi-Ming Hua, Dongmei Wei, Jesus Melgarejo, Zhen-Yu Zhang, Chia-Te Liao
SSRN Electronic Journal .2022;[Epub] CrossRef

Review Article

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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Abstract PDF

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.

Citations

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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
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

Original Articles

Pulmonary
Diaphragm ultrasound as a better predictor of successful extubation from mechanical ventilation than rapid shallow breathing index: Mohammad Jhahidul Alam, Simanta Roy, Mohammad Azmain Iktidar, Fahmida Khatun Padma, Khairul Islam Nipun, Sreshtha Chowdhury, Ranjan Kumar Nath, Harun-Or Rashid; Acute Crit Care. 2022;37(1):94-100. Published online January 11, 2022; DOI: https://doi.org/10.4266/acc.2021.01354

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Abstract PDF

Background
In 3%–19% of patients, reintubation is needed 48–72 hours following extubation, which increases intensive care unit (ICU) morbidity, mortality, and expenses. Extubation failure is frequently caused by diaphragm dysfunction. Ultrasonography can be used to determine the mobility and thickness of the diaphragm. This study looked at the role of diaphragm excursion (DE) and thickening fraction in predicting successful extubation from mechanical ventilation.
Methods
Thirty-one patients were extubated with the advice of an ICU consultant using the ICU weaning regimen and diaphragm ultrasonography was performed. Ultrasound DE and thickening fraction were measured three times: at the commencement of the t-piece experiment, at 10 minutes, and immediately before extubation. All patients' parameters were monitored for 48 hours after extubation. Rapid shallow breathing index (RSBI) was also measured at the same time.
Results
Successful extubation was significantly correlated with DE (P=0.01). Receiver curve analysis for DE to predict successful extubation revealed good properties (area under the curve [AUC], 0.83; P<0.001); sensitivity, 77.8%; specificity, 84.6%, positive predictive value (PPV), 87.5%; negative predictive value (NPV), 73.3% while cut-off value, 11.43 mm. Diaphragm thickening fraction (DTF) also revealed moderate curve properties (AUC, 0.69; P=0.06); sensitivity, 61.1%; specificity, 84.6%; PPV, 87.5%; NPV, 61.1% with cut-off value 22.33% although former one was slightly better. RSBI could not reach good receiver operating characteristic value at cut-off points 100 b/min/L (AUC, 0.58; P=0.47); sensitivity, 66.7%; specificity, 53.8%; PPV, 66.7%; NPV, 53.8%).
Conclusions
To decrease the rate of reintubation, DE and DTF are better indicators of successful extubation. DE outperforms DTF.

Citations

Citations to this article as recorded by

Ultrasonographic Assessment of Diaphragmatic Function and Its Clinical Application in the Management of Patients with Acute Respiratory Failure
Marina Saad, Stefano Pini, Fiammetta Danzo, Francesca Mandurino Mirizzi, Carmine Arena, Francesco Tursi, Dejan Radovanovic, Pierachille Santus
Diagnostics.2023; 13(3): 411. CrossRef
The ratio of respiratory rate to diaphragm thickening fraction for predicting extubation success
Dararat Eksombatchai, Chalermwut Sukkratok, Yuda Sutherasan, Detajin Junhasavasdikul, Pongdhep Theerawit
BMC Pulmonary Medicine.2023;[Epub] CrossRef
Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation: a systematic review and meta-analysis
Henry M. Parada-Gereda, Adriana L. Tibaduiza, Alejandro Rico-Mendoza, Daniel Molano-Franco, Victor H. Nieto, Wanderley A. Arias-Ortiz, Purificación Perez-Terán, Joan R. Masclans
Critical Care.2023;[Epub] CrossRef
Role of diaphragm ultrasound in weaning mechanically ventilated patients: A prospective observational study
Ravi Saravanan, Krishnamurthy Nivedita, Krishnamoorthy Karthik, Rajagopalan Venkatraman
Indian Journal of Anaesthesia.2022; 66(8): 591. CrossRef
The role of diaphragmatic thickness measurement in weaning prediction and its comparison with rapid shallow breathing index: a single-center experience
Lokesh Kumar Lalwani, Manjunath B Govindagoudar, Pawan Kumar Singh, Mukesh Sharma, Dhruva Chaudhry
Acute and Critical Care.2022; 37(3): 347. CrossRef
Diaphragm ultrasound in weaning from mechanical ventilation: a last step to predict successful extubation?
Domenica Di Costanzo, Mariano Mazza, Antonio Esquinas
Acute and Critical Care.2022; 37(4): 681. CrossRef
Sonographic assessment of diaphragmatic thickening and excursion as predictors of weaning success in the intensive care unit: A prospective observational study
Amandeep Kaur, Shruti Sharma, VikramP Singh, MRavi Krishna, ParshotamL Gautam, Gagandeep Singh
Indian Journal of Anaesthesia.2022; 66(11): 776. CrossRef
Comparison of assessment of diaphragm function using speckle tracking between patients with successful and failed weaning: a multicentre, observational, pilot study
Qiancheng Xu, Xiao Yang, Yan Qian, Chang Hu, Weihua Lu, Shuhan Cai, Bo Hu, Jianguo Li
BMC Pulmonary Medicine.2022;[Epub] CrossRef
Ultrasonographic assessment of diaphragmatic function in preterm infants on non-invasive neurally adjusted ventilatory assist (NIV-NAVA) compared to nasal intermittent positive-pressure ventilation (NIPPV): a prospective observational study
Mohamed Elkhouli, Liran Tamir-Hostovsky, Jenna Ibrahim, Nehad Nasef, Adel Mohamed
European Journal of Pediatrics.2022; 182(2): 731. CrossRef

Nursing
Challenges of the patient transition process from the intensive care unit: a qualitative study: Kobra Ghorbanzadeh, Abbas Ebadi, Mohammadali Hosseini, Sadat Seyed Bagher Madah, Hamidreza Khankeh; Acute Crit Care. 2021;36(2):133-142. Published online January 28, 2021; DOI: https://doi.org/10.4266/acc.2020.00626

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9 Citations

Abstract PDF

Background
The transition of patients from the intensive care unit (ICU) to the general ward is challenging. This study aimed to explain the challenges that patients face during the transition process.
Methods
In this qualitative research of conventional content analysis, data collection was conducted between February 2018 and July 2019 in educational hospitals. After obtaining informed consent, purposive sampling was performed with 22 nurses, intensive care physicians, anesthesiologists, and patients and their families using in-depth semi-structured interviews until data saturation.
Results
The content analysis yielded three main themes in the challenges patients face during the transition process from the ICU: mixed feelings regarding transition (happiness/hope, worry/uncertainty, abandonment); care break (different atmosphere, the difference between the program and the quality of care, assigning care to the patient and family, and care culture and beliefs); and search for support and information (ineffective communication, self-care capacity of patient and family, ineffective and disrupted training, and weak follow-up programs), which inflicts care shock in the patients.
Conclusions
The results showed that patients and their families were in a state of care shock during the ICU transition process and were sometimes disconcerted. It is necessary to design and implement care models according to the needs and challenges patients face during the transition period from ICU (patient-centered), based on the evidence available, and after considering the field of medicine and the accessibility of care in the country. The transition process can be improved and enhanced by obtaining knowledge about ICU care and related challenges as well as organizing a learning environment.

Citations

Citations to this article as recorded by

A Quality Improvement Project to Decrease Suboptimal Patient Transfers between Two Neonatal Units
Kiane A. Douglas, Chinonye Eriobu, Ann Sanderson, Dmitry Tumin, Uduak S. Akpan
Pediatric Quality & Safety.2023; 8(1): e635. CrossRef
Family caregivers' experiences and needs of transitional care during the transfer from intensive care unit to a general ward: A qualitative study
Yuxin Zhan, Jiaohua Yu, Yi Chen, Yufang Liu, Yingyue Wang, Yali Wan, Suyun Li
Journal of Nursing Management.2022; 30(2): 592. CrossRef
Co-development of a transitions in care bundle for patient transitions from the intensive care unit: a mixed-methods analysis of a stakeholder consensus meeting
Brianna K. Rosgen, Kara M. Plotnikoff, Karla D. Krewulak, Anmol Shahid, Laura Hernandez, Bonnie G. Sept, Jeanna Morrissey, Kristin Robertson, Nancy Fraser, Daniel J. Niven, Sharon E. Straus, Jeanna Parsons Leigh, Henry T. Stelfox, Kirsten M. Fiest
BMC Health Services Research.2022;[Epub] 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
Factors Influencing the Decision-making of Healthcare Providers Regarding the Transition of Patients from the Intensive Care Unit to the General Ward in Iran: A Qualitative Study
Vahid Adiban, Kobra Ghorbanzadeh, Abbas Ebadi, Mohammadali Hosseini, Sadat Seyed Bagher Maddah, Hamidreza Khankeh, Maryam Khoshbakht Pishkhani
Indian Journal of Critical Care Medicine.2022; 26(5): 566. CrossRef
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Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin
Revista Gaúcha de Enfermagem.2022;[Epub] CrossRef
Validation of manual to complement the transition of care at discharge from intensive care
Martina Zucchetti, Isis Marques Severo, Isabel Cristina Echer, Daniela dos Santos Marona Borba, Carmen Lucia Silva Nectoux, Karina de Oliveira Azzolin
Revista Gaúcha de Enfermagem.2022;[Epub] CrossRef
Transición de la fase aguda a la rehabilitación del paciente crítico
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Salud, Ciencia y Tecnología.2022; 2(S1): 303. CrossRef
Improve Communicating Uncertainty in Intensive Care Unit With Patient and Family (ICU-PF)
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Review Articles

Infection
Identification and infection control of carbapenem-resistant Enterobacterales in intensive care units: Jongyoun Yi, Kye-Hyung Kim; Acute Crit Care. 2021;36(3):175-184. Published online August 12, 2021; DOI: https://doi.org/10.4266/acc.2021.00409

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Infections with multidrug-resistant organisms among patients in intensive care units (ICUs) are associated with high mortality. Among multidrug-resistant organisms, carbapenem-resistant Enterobacterales (CRE) harbor important pathogens for healthcare-associated infections, including pneumonia, bacteremia, and urinary tract infections. Risk factors for CRE colonization include underlying comorbid conditions, prior antibiotics exposure, prior use of healthcare facilities, device use, and longer ICU stay. The mortality rate due to invasive CRE infection is 22%–49%, and CRE colonization is associated with an approximately 10-fold increased risk of CRE infection. Infection control measures include hand hygiene, contact precautions, minimizing the use of devices, and environmental control. Additionally, implementing active surveillance of CRE carriage should be considered in ICU settings.

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International Journal of Environmental Research and Public Health.2023; 20(3): 1960. CrossRef
Epidemiology and prevention of hospital-acquired carbapenem-resistant Enterobacterales infection in hospitalized patients, Northeast Ethiopia
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American Journal of Infection Control.2022; 50(10): 1145. CrossRef
Clinical Risk Factors and Microbiological and Intestinal Characteristics of Carbapenemase-Producing Enterobacteriaceae Colonization and Subsequent Infection
Wenli Yuan, Jiali Xu, Lin Guo, Yonghong Chen, Jinyi Gu, Huan Zhang, Chenghang Yang, Qiuping Yang, Shuwen Deng, Longlong Zhang, Qiongfang Deng, Zi Wang, Bin Ling, Deyao Deng, Arryn Craney, Rafael Vignoli
Microbiology Spectrum.2022;[Epub] CrossRef

Neurosurgery
Brain-lung interaction: a vicious cycle in traumatic brain injury: Ariana Alejandra Chacón-Aponte, Érika Andrea Durán-Vargas, Jaime Adolfo Arévalo-Carrillo, Iván David Lozada-Martínez, Maria Paz Bolaño-Romero, Luis Rafael Moscote-Salazar, Pedro Grille, Tariq Janjua; Acute Crit Care. 2022;37(1):35-44. Published online February 11, 2022; DOI: https://doi.org/10.4266/acc.2021.01193

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The brain-lung interaction can seriously affect patients with traumatic brain injury, triggering a vicious cycle that worsens patient prognosis. Although the mechanisms of the interaction are not fully elucidated, several hypotheses, notably the “blast injury” theory or “double hit” model, have been proposed and constitute the basis of its development and progression. The brain and lungs strongly interact via complex pathways from the brain to the lungs but also from the lungs to the brain. The main pulmonary disorders that occur after brain injuries are neurogenic pulmonary edema, acute respiratory distress syndrome, and ventilator-associated pneumonia, and the principal brain disorders after lung injuries include brain hypoxia and intracranial hypertension. All of these conditions are key considerations for management therapies after traumatic brain injury and need exceptional case-by-case monitoring to avoid neurological or pulmonary complications. This review aims to describe the history, pathophysiology, risk factors, characteristics, and complications of brain-lung and lung-brain interactions and the impact of different old and recent modalities of treatment in the context of traumatic brain injury.

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Indian Journal of Neurotrauma.2023;[Epub] CrossRef
The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury
Mabrouk Bahloul, Karama Bouchaala, Najeh Baccouche, Kamilia Chtara, Hedi Chelly, Mounir Bouaziz
Acute and Critical Care.2022; 37(2): 266. CrossRef
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Original Articles

Infection
Nosocomial meningitis in intensive care: a 10-year retrospective study and literature review: Sofia R. Valdoleiros, Cristina Torrão, Laura S. Freitas, Diana Mano, Celina Gonçalves, Carla Teixeira; Acute Crit Care. 2022;37(1):61-70. Published online January 26, 2022; DOI: https://doi.org/10.4266/acc.2021.01151

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Background
Nosocomial meningitis is a medical emergency that requires early diagnosis, prompt initiation of therapy, and frequent admission to the intensive care unit (ICU). Methods: A retrospective study was conducted in adult patients diagnosed with nosocomial meningitis who required admission to the ICU between April 2010 and March 2020. Meningitis/ventriculitis and intracranial infection were defined according to Centers for Disease Control and Prevention guidelines. Results: An incidence of 0.75% of nosocomial meningitis was observed among 70 patients. The mean patient age was 59 years and 34% were ≥65 years. Twenty-two percent of patients were in an immunocompromised state. A clear predisposing factor for nosocomial meningitis (traumatic brain injury, basal skull fracture, brain hemorrhage, central nervous system [CNS] invasive procedure or device) was present in 93% of patients. Fever was the most frequent clinical feature. A microbiological agent was identified in 30% of cases, of which 27% were bacteria, with a predominance of Gram-negative over Gram-positive. Complications developed in 47% of cases, 24% of patients were discharged with a Glasgow coma scale <14, and 37% died. There were no clear clinical predictors of complications. Advanced age (≥65 years old) and the presence of complications were associated with higher hospital mortality. Conclusions: Nosocomial meningitis in critical care has a low incidence rate but high mortality and morbidity. In critical care patients with CNS-related risk factors, a high level of suspicion for meningitis is warranted, but diagnosis can be hindered by several confounding factors.

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Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland
Sakke Niemelä, Laura Lempinen, Eliisa Löyttyniemi, Jarmo Oksi, Jussi Jero
BMC Infectious Diseases.2023;[Epub] CrossRef
Bacterial meningitis in children with an abnormal craniocerebral structure
Jiali Pan, Wei Xu, Wenliang Song, Tao Zhang
Frontiers in Pediatrics.2023;[Epub] CrossRef
Fieber in der Intensivmedizin
Jan-Hendrik Naendrup, Boris Böll, Jorge Garcia Borrega
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Rayan Fawaz, Mathilde Schmitt, Philémon Robert, Nathan Beucler, Jean-Marc Delmas, Nicolas Desse, Aurore Sellier, Arnaud Dagain
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Pulmonary
Airway pressure release ventilation in mechanically ventilated patients with COVID-19: a multicenter observational study: John S. Zorbas, Kwok M. Ho, Edward Litton, Bradley Wibrow, Edward Fysh, Matthew H. Anstey; Acute Crit Care. 2021;36(2):143-150. Published online May 4, 2021; DOI: https://doi.org/10.4266/acc.2021.00017

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Abstract PDF

Background
Evidence prior to the coronavirus disease 2019 (COVID-19) pandemic suggested that, compared with conventional ventilation strategies, airway pressure release ventilation (APRV) can improve oxygenation and reduce mortality in patients with acute respiratory distress syndrome. We aimed to assess the association between APRV use and clinical outcomes among adult patients receiving mechanical ventilation for COVID-19 and hypothesized that APRV use would be associated with improved survival compared with conventional ventilation.
Methods
A total of 25 patients with COVID-19 pneumonitis was admitted to intensive care units (ICUs) for invasive ventilation in Perth, Western Australia, between February and May 2020. Eleven of these patients received APRV. The primary outcome was survival to day 90. Secondary outcomes were ventilation-free survival days to day 90, mechanical complications from ventilation, and number of days ventilated.
Results
Patients who received APRV had a lower probability of survival than did those on other forms of ventilation (hazard ratio, 0.17; 95% confidence interval, 0.03–0.89; P=0.036). This finding was independent of indices of severity of illness to predict the use of APRV. Patients who received APRV also had fewer ventilator-free survival days up to 90 days after initiation of ventilation compared to patients who did not receive APRV, and survivors who received APRV had fewer ventilator-free days than survivors who received other forms of ventilation. There were no differences in mechanical complications according to mode of ventilation.
Conclusions
Based on the findings of this study, we urge caution with the use of APRV in COVID-19.

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Airway Pressure Release Ventilation for Acute Respiratory Failure Due to Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Ashraf Roshdy, Ahmad Samy Elsayed, Ahmad Sabry Saleh
Journal of Intensive Care Medicine.2023; 38(2): 160. CrossRef
Techniques for Oxygenation and Ventilation in Coronavirus Disease 2019
Guy A. Richards, Oliver Smith
Seminars in Respiratory and Critical Care Medicine.2023; 44(01): 091. CrossRef
Does airway pressure release ventilation offer new hope for treating acute respiratory distress syndrome?
Jiangli Cheng, Aijia Ma, Meiling Dong, Yongfang Zhou, Bo Wang, Yang Xue, Peng Wang, Jing Yang, Yan Kang
Journal of Intensive Medicine.2022; 2(4): 241. CrossRef
Early spontaneous breathing for acute respiratory distress syndrome in individuals with COVID-19
Friedrich Hohmann, Lisa Wedekind, Felicitas Grundeis, Steffen Dickel, Johannes Frank, Martin Golinski, Mirko Griesel, Clemens Grimm, Cindy Herchenhahn, Andre Kramer, Maria-Inti Metzendorf, Onnen Moerer, Nancy Olbrich, Volker Thieme, Astrid Vieler, Falk Fi
Cochrane Database of Systematic Reviews.2022;[Epub] CrossRef
Respiratory system mechanics, gas exchange, and outcomes in mechanically ventilated patients with COVID-19-related acute respiratory distress syndrome: a systematic review and meta-analysis
Mallikarjuna Ponnapa Reddy, Ashwin Subramaniam, Clara Chua, Ryan Ruiyang Ling, Christopher Anstey, Kollengode Ramanathan, Arthur S Slutsky, Kiran Shekar
The Lancet Respiratory Medicine.2022; 10(12): 1178. 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

Review Article

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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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

Guideline

Pharmacology
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit: Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha; Acute Crit Care. 2022;37(1):1-25. Published online February 28, 2022; DOI: https://doi.org/10.4266/acc.2022.00094; Correction in: Acute Crit Care 2023;38(1):149

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Abstract PDF

We revised and expanded the “2010 Guideline for the Use of Sedatives and Analgesics in the Adult Intensive Care Unit (ICU).” We revised the 2010 Guideline based mainly on the 2018 “Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) in Adult Patients in the ICU,” which was an updated 2013 pain, agitation, and delirium guideline with the inclusion of two additional topics (rehabilitation/mobility and sleep). Since it was not possible to hold face-to-face meetings of panels due to the coronavirus disease 2019 (COVID-19) pandemic, all discussions took place via virtual conference platforms and e-mail with the participation of all panelists. All authors drafted the recommendations, and all panelists discussed and revised the recommendations several times. The quality of evidence for each recommendation was classified as high (level A), moderate (level B), or low/very low (level C), and all panelists voted on the quality level of each recommendation. The participating panelists had no conflicts of interest on related topics. The development of this guideline was independent of any industry funding. The Pain, Agitation/Sedation, Delirium, Immobility (rehabilitation/mobilization), and Sleep Disturbance panels issued 42 recommendations (level A, 6; level B, 18; and level C, 18). The 2021 clinical practice guideline provides up-to-date information on how to prevent and manage pain, agitation/sedation, delirium, immobility, and sleep disturbance in adult ICU patients. We believe that these guidelines can provide an integrated method for clinicians to manage PADIS in adult ICU patients.

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Original Articles

Neurology
Association of natural light exposure and delirium according to the presence or absence of windows in the intensive care unit: Hyo Jin Lee, Eunhye Bae, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2021;36(4):332-341. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00556

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Background
Patients in the intensive care unit (ICU) have increased risks of delirium, which is associated with worse outcomes. As pharmacologic treatments for delirium are ineffective, prevention is important. Nonpharmacologic preventive strategies include exposure to natural light and restoring circadian rhythm. We investigated the effect of exposure to natural light through windows on delirium in the ICU.
Methods
This retrospective cohort study assessed all patients admitted to the medical ICU of a university-affiliated hospital between January and June 2020 for eligibility. The ICU included 12 isolation rooms, six with and six without windows. Patients with ICU stays of >48 hours were included and were divided into groups based on their admission to a single room with (window group) or without windows (windowless group). The primary outcome was the cumulative incidence of delirium. The secondary outcomes were the numbers of delirium- and mechanical ventilation-free days, ICU and hospital length of stay, and in-ICU and 28-day mortalities.
Results
Of the 150 included patients (window group: 83 [55.3%]; windowless group: 67 [44.7%]), the cumulative incidence of delirium was significantly lower in the window group than in the windowless group (21.7% vs. 43.3%; relative risk, 1.996; 95% confidence interval [CI], 1.220–3.265). Other secondary outcomes did not differ between groups. Admission to a room with a window was independently associated with a decreased risk of delirium (adjusted odds ratio, 0.318; 95% CI, 0.125–0.805).
Conclusions
Exposure to natural light through windows was associated with a lower incidence of delirium in the ICU.

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Four Decades of Intensive Care Unit Design Evolution and Thoughts for the Future
Neil A. Halpern, Elizabeth Scruth, Michelle Rausen, Diana Anderson
Critical Care Clinics.2023; 39(3): 577. CrossRef
2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit
Yijun Seo, Hak-Jae Lee, Eun Jin Ha, Tae Sun Ha
Acute and Critical Care.2022; 37(1): 1. CrossRef
Post-acute delirium of COVID-19 infection: Report of two cases
Dai-Chun Chi, Chih-Pang Chu, TienWei Yang, Hu-Ming Chang
Taiwanese Journal of Psychiatry.2022; 36(1): 44. CrossRef
The future of intensive care: delirium should no longer be an issue
Katarzyna Kotfis, Irene van Diem-Zaal, Shawniqua Williams Roberson, Marek Sietnicki, Mark van den Boogaard, Yahya Shehabi, E. Wesley Ely
Critical Care.2022;[Epub] CrossRef
The effects of hypomagnesemia on delirium in middle-aged and older adult patients admitted to medical intensive care units
Joong-Yub Kim, Hyo Jin Lee, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee, Tae Yun Park
Acute and Critical Care.2022; 37(3): 407. CrossRef

Pulmonary
The Mount Sinai Hospital Institute for critical care medicine response to the COVID-19 pandemic: Jennifer Wang, Evan Leibner, Jaime B. Hyman, Sanam Ahmed, Joshua Hamburger, Jean Hsieh, Neha Dangayach, Pranai Tandon, Umesh Gidwani, Andrew Leibowitz, Roopa Kohli-Seth; Acute Crit Care. 2021;36(3):201-207. Published online August 10, 2021; DOI: https://doi.org/10.4266/acc.2021.00402

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Background
The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of critically ill patients. This was especially true in New York City. We present a roadmap for hospitals and healthcare systems to prepare for a Pandemic.
Methods
This was a retrospective review of how Mount Sinai Hospital (MSH) was able to rapidly prepare to handle the pandemic. MSH, the largest academic hospital within the Mount Sinai Health System, rapidly expanded the intensive care unit (ICU) bed capacity, including creating new ICU beds, expanded the workforce, and created guidelines.
Results
MSH a 1,139-bed quaternary care academic referral hospital with 104 ICU beds expanded to 1,453 beds (27.5% increase) with 235 ICU beds (126% increase) during the pandemic peak in the first week of April 2020. From March to June 2020, with follow-up through October 2020, MSH admitted 2,591 COVID-19-positive patients, 614 to ICUs. Most admitted patients received noninvasive support including a non-rebreather mask, high flow nasal cannula, and noninvasive positive pressure ventilation. Among ICU patients, 68.4% (n=420) received mechanical ventilation; among the admitted ICU patients, 42.8% (n=263) died, and 47.8% (n=294) were discharged alive.
Conclusions
Flexible bed management initiatives; teamwork across multiple disciplines; and development and implementation of guidelines were critical accommodating the surge of critically ill patients. Non-ICU services and staff were deployed to augment the critical care work force and open new critical care units. This approach to rapidly expand bed availability and staffing across the system helped provide the best care for the patients and saved lives.

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Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl
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Emily Stone, Louis B. Irving, Katrina O. Tonga, Bruce Thompson
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Sherrie Wang, MaKenzie Chambers, Kelsey Martin, Grace Gilbert, Pietro M. Gentile, Rock Hwang, Rakesh Mashru, Kenneth W. Graf, Henry J. Dolch
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Pulmonary
Comparison of high-flow nasal oxygen therapy and noninvasive ventilation in COVID-19 patients: a systematic review and meta-analysis: Glenardi Glenardi, Febie Chriestya, Bambang J Oetoro, Ghea Mangkuliguna, Natalia Natalia; Acute Crit Care. 2022;37(1):71-83. Published online February 22, 2022; DOI: https://doi.org/10.4266/acc.2021.01326

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Abstract PDF Supplementary Material

Background
Acute respiratory failure (ARF) is a major adverse event commonly encountered in severe coronavirus disease 2019 (COVID-19). Although noninvasive mechanical ventilation (NIV) has long been used in the management of ARF, it has several adverse events which may cause patient discomfort and lead to treatment complication. Recently, high-flow nasal cannula (HFNC) has the potential to be an alternative for NIV in adults with ARF, including COVID-19 patients. The objective was to investigate the efficacy of HFNC compared to NIV in COVID-19 patients. Methods: This meta-analysis was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Literature search was carried out in electronic databases for relevant articles published prior to June 2021. The protocol used in this study has been registered in International Prospective Register of Systematic Reviews (CRD42020225186). Results: Although the success rate of NIV is higher compared to HFNC (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16–0.97; P=0.04), this study showed that the mortality in the NIV group is also significantly higher compared to HFNC group (OR, 0.49; 95% CI, 0.39–0.63; P<0.001). Moreover, this study also demonstrated that there was no significant difference in intubation rates between the two groups (OR, 1.35; 95% CI, 0.86–2.11; P=0.19). Conclusions: Patients treated with HFNC showed better outcomes compared to NIV for ARF due to COVID-19. Therefore, HFNC should be considered prior to NIV in COVID-19–associated ARF. However, further studies with larger sample sizes are still needed to better elucidate the benefit of HFNC in COVID-19 patients.

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Scott Weerasuriya, Savvas Vlachos, Ahmed Bobo, Namitha Birur Jayaprabhu, Lauren Matthews, Adam R Blackstock, Victoria Metaxa
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