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From articles published in Acute and Critical Care during the past two years (2023 ~ ).

Review Article
Infection
Microbial infections in burn patients
Souvik Roy, Preeti Mukherjee, Sutrisha Kundu, Debashrita Majumder, Vivek Raychaudhuri, Lopamudra Choudhury
Acute Crit Care. 2024;39(2):214-225.   Published online May 24, 2024
DOI: https://doi.org/10.4266/acc.2023.01571
  • 18,925 View
  • 884 Download
  • 12 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Polymicrobial infections are the leading causes of complications incurred from injuries that burn patients develop. Such patients admitted to the hospital have a high risk of developing hospital-acquired infections, with longer patient stays leading to increased chances of acquiring such drug-resistant infections. Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Proteus mirabilis are the most common multidrug-resistant (MDR) Gram-negative bacteria identified in burn wound infections (BWIs). BWIs caused by viruses, like Herpes Simplex and Varicella Zoster, and fungi-like Candida spp. appear to occur occasionally. However, the preponderance of infection by opportunistic pathogens is very high in burn patients. Variations in the causative agents of BWIs are due to differences in geographic location and infection control measures. Overall, burn injuries are characterized by elevated serum cytokine levels, systemic immune response, and immunosuppression. Hence, early detection and treatment can accelerate the wound-healing process and reduce the risk of further infections at the site of injury. A multidisciplinary collaboration between burn surgeons and infectious disease specialists is also needed to properly monitor antibiotic resistance in BWI pathogens, help check the super-spread of MDR pathogens, and improve treatment outcomes as a result.

Citations

Citations to this article as recorded by  
  • Postacute Overview of Burn Injuries
    Tuba Sengul, Holly Kirkland-Kyhn, Asiye Gul
    Nursing Clinics of North America.2025; 60(1): 15.     CrossRef
  • Phage treatment of multidrug-resistant bacterial infections in humans, animals, and plants: The current status and future prospects
    Omor Faruk, Zilhas Ahmed Jewel, Sanjoy Bairagi, Mohammad Rasheduzzaman, Hindol Bagchi, Akber Subahan Mahbub Tuha, Imran Hossain, Ayon Bala, Sarafat Ali
    Infectious Medicine.2025; 4(1): 100168.     CrossRef
  • Lavandula dentata leaves as potential natural antibiofilm agents against Pseudomonas aeruginosa
    Maram M. Aboulwafa, Nada M. Mostafa, Fadia S. Youssef, Omayma A. Eldahshan, Abdel Nasser B. Singab
    Scientific Reports.2025;[Epub]     CrossRef
  • Larval zebrafish burn wound infection model reveals conserved innate immune responses against diverse pathogenic fungi
    Nayanna M. Mercado Soto, Adam Horn, Nancy P. Keller, Anna Huttenlocher, Andrew S. Wagner, Gustavo H. Goldman
    mBio.2025;[Epub]     CrossRef
  • Unveiling the potential antibacterial action of acetylcysteine for managing Staphylococcus aureus wound infections: in vitro and in vivo study
    Rehab Ahmed, Engy Elekhnawy
    World Journal of Microbiology and Biotechnology.2025;[Epub]     CrossRef
  • Management and Prevention of Multidrug-Resistant Bacteria in War Casualties
    Diana Isabela Costescu Strachinaru, Céline Ragot, Anke Stoefs, Nicolas Donat, Pierre-Michel François, Peter Vanbrabant, Alexia Verroken, Frédéric Janvier, Patrick Soentjens
    Tropical Medicine and Infectious Disease.2025; 10(5): 128.     CrossRef
  • Comprehensive Management of Severe Burn Injuries: A Multidisciplinary Approach from Resuscitation to Rehabilitation
    Maryum Merchant, Scott B. Hu, Chris Miller, Tamana Ahmadi, Edwin Garcia, Malcolm I. Smith
    Emergency Care and Medicine.2025; 2(2): 26.     CrossRef
  • Contribution of icaADBC genes in biofilm production ability of Staphylococcus aureus clinical isolates collected from hospitalized patients at a burn center in North of Iran
    Mostafa Alibegli, Aliakbar bay, Amirabbas Fazelnejad, Pouria Nourmohammadi Ghezelghaye, Hossein Jafari Soghondikolaei, Hamid Reza Goli
    BMC Microbiology.2025;[Epub]     CrossRef
  • MvfR Shapes Pseudomonas aeruginosa Interactions in Polymicrobial Contexts: Implications for Targeted Quorum-Sensing Inhibition
    Kelsey M. Wheeler, Myung Whan Oh, Julianna Fusco, Aishlinn Mershon, Erin Kim, Antonia De Oliveira, Laurence G. Rahme
    Cells.2025; 14(10): 744.     CrossRef
  • Phloxine B-loaded polymersomes enable eradication of Pseudomonas aeruginosa and Staphylococcus aureus in antimicrobial photodynamic therapy
    Nicola Cusick, Holger Schönherr
    RSC Advances.2025; 15(24): 18815.     CrossRef
  • Enhancing clinical outcomes in burn and surgical intensive care unit patients
    Mahta Moghaddam Ahmadi, Moein Moghaddam Ahmadi
    Burns.2024; 50(8): 2137.     CrossRef
  • Development of a Stringent Ex Vivo-Burned Porcine Skin Wound Model to Screen Topical Antimicrobial Agents
    Ping Chen, Eliza A. Sebastian, S. L. Rajasekhar Karna, Kai P. Leung
    Antibiotics.2024; 13(12): 1159.     CrossRef
  • The SOS Response Activation and the Risk of Antibiotic Resistance Enhancement in Proteus spp. Strains Exposed to Subinhibitory Concentrations of Ciprofloxacin
    Agnieszka Zabłotni, Marek Schmidt, Małgorzata Siwińska
    International Journal of Molecular Sciences.2024; 26(1): 119.     CrossRef
Case Report
Neurosurgery
What should an intensivist know about pneumocephalus and tension pneumocephalus?
Bhushan Sudhakar Wankhade, Maged Mohsen Kamel Beniamein, Zeyad Faoor Alrais, Jyoti Ittoop Mathew, Ghaya Zeyad Alrais
Acute Crit Care. 2023;38(2):244-248.   Published online April 13, 2022
DOI: https://doi.org/10.4266/acc.2021.01102
  • 32,997 View
  • 544 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract PDF
Collection of air in the cranial cavity is called pneumocephalus. Although simple pneumocephalus is a benign condition, accompanying increased intracranial pressure can produce a life-threatening condition comparable to tension pneumothorax, which is termed tension pneumocephalus. We report a case of tension pneumocephalus after drainage of a cerebrospinal fluid hygroma. The tension pneumocephalus was treated with decompression craniotomy, but the patient later died due to the complications related to critical care. Traumatic brain injury and neurosurgical intervention are the most common causes of pneumocephalus. Pneumocephalus and tension pneumocephalus are neurosurgical emergencies, and anesthetics and intensive care management like the use of nitrous oxide during anesthesia and positive pressure ventilation have important implications in their development and progress. Clinically, patients can present with various nonspecific neurological manifestations that are indistinguishable from a those of a primary neurological condition. If the diagnosis is questionable, patients should be investigated using computed tomography of the brain. Immediate neurosurgical consultation with decompression is the treatment of choice.

Citations

Citations to this article as recorded by  
  • A case of cerebrospinal fluid (CSF) leak and pneumocephalus in a 52-year-old with a pituitary adenoma
    Barbara Magid, Lauren Titone, Tyler Wise
    Visual Journal of Emergency Medicine.2025; 38: 102153.     CrossRef
  • A Rare Case of Post-lumbar Discectomy Pneumocephalus: An Anatomically Informed Case Report
    Yasir H Elhassan, Mustafa Alhasan, Yasser S Abdulghani
    Cureus.2025;[Epub]     CrossRef
  • Etiology of Intracranial Pneumocephalus: A Retrospective Comparative Study of Traumatic and Iatrogenic Causes in Emergency Patients
    Mehdi Hekimoğlu, Hıdır Özer
    Medical Records.2025; 7(2): 476.     CrossRef
  • Spontaneous extensive pneumocephalus following frontal sinus defect
    Kaavya Venkatesh, Nitin Mukerji, Devasmitha Venkataraman
    BMJ Case Reports.2025; 18(5): e263987.     CrossRef
  • Sudden-onset, non-traumatic large volume pneumocephalus following presentation of acute bacterial meningitis
    Alexandra Krez, Michael Malinzak, Colby Feeney
    BMJ Case Reports.2024; 17(1): e256194.     CrossRef
  • Fatal postoperative tension pneumocephalus after acute subdural hematoma evacuation: a case report
    Nikolaos Gkantsinikoudis, Panagiotis Monioudis, Elias Antoniades, Vassilios Tsitouras, Ioannis Magras
    International Journal of Neuroscience.2024; : 1.     CrossRef
  • Pro-Con Debate: Air or Saline for Loss-of-Resistance Technique of Interlaminar Epidural Access with Fluoroscopy-Guided Pain Medicine Procedures
    David Hao, Kirk Bonner, Taylor Burnham, Milan P. Stojanovic
    Anesthesia & Analgesia.2024;[Epub]     CrossRef
  • Pneumocephalus After Lumbar Epidural Steroid Injection: A Rare Complication With Spontaneous Resolution
    Yasser Hegazy, Natalie N Balassiano, Ishank Gupta, Roger Stern, Muhammad Ghallab
    Cureus.2024;[Epub]     CrossRef
  • Pneumocephalus; a rare cause of coma
    Elisavet Simoulidou, Vivian Georgopoulou, Panagiotis Kalmoukos, Dimitrios Kouroupis, Nikoleta Moscha, Maria Sidiropoulou, Sofia Chatzimichailidou, Konstantinos Petidis, Athina Pyrpasopoulou
    The American Journal of Emergency Medicine.2023; 68: 215.e1.     CrossRef
  • Pneumocephalus secondary to epidural analgesia: a case report
    Maira Ahmad, Shannay Bellamy, William Ott, Rany Mekhail
    Journal of Medical Case Reports.2023;[Epub]     CrossRef
  • Transnasal Endoscopic Treatment of Tension Pneumocephalus Caused by Posttraumatic or Iatrogenic Ethmoidal Damage
    Goran Latif Omer, Riccardo Maurizi, Beatrice Francavilla, Kareem Rekawt Hama Rashid, Gianluca Velletrani, Hasan Mustafa Salah, Giulia Marzocchella, Mohammed Ibrahim Mohialdeen Gubari, Stefano Di Girolamo, Rong-San Jiang
    Case Reports in Otolaryngology.2023; 2023: 1.     CrossRef
  • Tension pneumocephalus as a complication of surgical evacuation of chronic subdural hematoma: case report and literature review
    Mohammed A. Azab, Ahmed Hazem, Brandon Lucke-Wold
    Exploration of Neuroprotective Therapy.2023; 3(4): 177.     CrossRef
Review Article
Cardiology
Beta-blocker therapy in patients with acute myocardial infarction: not all patients need it
Seung-Jae Joo
Acute Crit Care. 2023;38(3):251-260.   Published online August 31, 2023
DOI: https://doi.org/10.4266/acc.2023.00955
  • 23,292 View
  • 2,717 Download
  • 8 Web of Science
  • 11 Crossref
AbstractAbstract PDF
Most of the evidences for beneficial effects of beta-blockers in patients with acute myocardial infarction (AMI) were from the clinical studies published in the pre-reperfusion era when anti-platelet drugs, statins or inhibitors of renin-angiotensin-aldosterone system which are known to reduce cardiovascular mortality of patients with AMI were not introduced. In the reperfusion era, beta-blockers’ benefit has not been clearly shown except in patients with reduced ejection fraction (EF; ≤40%). In the era of the early reperfusion therapy for AMI, a number of patients with mildly reduced EF (>40%, <50%) or preserved EF (≥50%) become increasing. However, because no randomized clinical trials are available until now, the benefit and the optimal duration of oral treatment with beta-blockers in patients with mildly reduced or preserved EF are questionable. Registry data have not showed the association of oral beta-blocker therapy with decreased mortality in survivors without heart failure or left ventricular systolic dysfunction after AMI. In the Korea Acute Myocardial Infarction Registry-National Institute of Health of in-hospital survivors after AMI, the benefit of beta-blocker therapy at discharge was shown in patients with reduced or mildly reduced EF, but not in those with preserved EF, which provides new information about beta-blocker therapy in patients without reduced EF. However, clinical practice can be changed when the results of appropriate randomized clinical trials are available. Ongoing clinical trials may help to answer the unresolved issues of beta-blocker therapy in patients with AMI.

Citations

Citations to this article as recorded by  
  • Beta-Blockers in Patients With Myocardial Infarction: A Meta-Analysis
    Mushood Ahmed, Areeba Ahsan, Aimen Shafiq, Hasan Ahmad, Raheel Ahmed, Jamal S. Rana, Marat Fudim, Gregg C. Fonarow
    American Journal of Therapeutics.2025;[Epub]     CrossRef
  • Neuroimmune Interactions and Their Role in Immune Cell Trafficking in Cardiovascular Diseases and Cancer
    Yutang Wang, Jack C. Anesi, Indu S. Panicker, Darcy Cook, Prapti Bista, Yan Fang, Ernesto Oqueli
    International Journal of Molecular Sciences.2025; 26(6): 2553.     CrossRef
  • Elevated serum amylase concentrations are associated with worse in-hospital outcomes among patients with acute myocardial infarction
    Marijana Mikacic, Marko Kumric, Iva Rancic Vidic, Duska Glavas, Tina Ticinovic Kurir, Josko Bozic, Josip Andelo Borovac
    BMC Cardiovascular Disorders.2025;[Epub]     CrossRef
  • Cardiac arrhythmia following acute myocardial infarction: a retrospective analysis of 27,648 hospitalized patients in a tertiary heart hospital
    Nidal Asaad, Ayman El-Menyar, Rajvir Singh, Betsy Varughese, Shahul Hameed Khan, Hajar AlBinali, Jassim Al Suwaidi
    Monaldi Archives for Chest Disease.2025;[Epub]     CrossRef
  • Beta-Adrenergic Blockers for Acute Myocardial Infarction: 50 years of Expert Opinions in Cecil Textbook of Medicine
    Peter Manu, Gheorghe-Andrei Dan
    American Journal of Therapeutics.2025; 32(3): e274.     CrossRef
  • Prognostic impact of changes in left ventricular ejection fraction and wall motion score index in patients with myocardial infarction
    Min-Wook Bae, Seong-guen Moon, Kyung-Tae Jung, Won-Ho Kim, Sang-Hyun Park, Jihun Ahn, Jin-Yong Hwang, Seok Kyu Oh, Seung Ho Hur, Myung Ho Jung, Kyu-Sun Lee
    Frontiers in Cardiovascular Medicine.2025;[Epub]     CrossRef
  • In-hospital cardiac arrest after STEMI: prevention strategies and post-arrest care
    Walker Boyd, Wesley Young, Mehmet Yildiz, Timothy D. Henry, Kari Gorder
    Expert Review of Cardiovascular Therapy.2024; 22(8): 379.     CrossRef
  • Association between Inflammation and New-Onset Atrial Fibrillation in Acute Coronary Syndromes
    Ruxandra-Maria Băghină, Simina Crișan, Silvia Luca, Oana Pătru, Mihai-Andrei Lazăr, Cristina Văcărescu, Alina Gabriela Negru, Constantin-Tudor Luca, Dan Gaiță
    Journal of Clinical Medicine.2024; 13(17): 5088.     CrossRef
  • Use of Early Intravenous Beta Blockers in Patients with Acute ST-Segment Elevation Myocardial Infarction Without Heart Failure—Revival or Requiem?
    Azka Latif, Xiaoming Jia
    Cardiovascular Drugs and Therapy.2024; 38(5): 973.     CrossRef
  • Progress in Disease Modeling for Myocardial Infarction and Coronary Artery Disease: Bridging In Vivo and In Vitro Approaches
    Riya Kar, Debabrata Mukhopadhyay, Ramcharan Singh Angom
    Hearts.2024; 5(4): 429.     CrossRef
  • Optimal duration of medical therapy for patients with acute myocardial infarction
    Ki Yung Boo, Seung-Jae Joo, Jae-Geun Lee, Joon-Hyouk Choi, Song-Yi Kim, Geum Ko, Hae Eun Yun, Myung Ho Jeong
    Medicine.2024; 103(48): e40697.     CrossRef
Original Articles
Pulmonary
Factors influencing sleep quality in the intensive care unit: a descriptive pilot study in Korea
Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee
Acute Crit Care. 2023;38(3):278-285.   Published online August 11, 2023
DOI: https://doi.org/10.4266/acc.2023.00514
  • 5,484 View
  • 302 Download
  • 8 Web of Science
  • 11 Crossref
AbstractAbstract PDFSupplementary Material
Background
As sleep disturbances are common in the intensive care unit (ICU), this study assessed the sleep quality in the ICU and identified barriers to sleep.
Methods
Patients admitted to the ICUs of a tertiary hospital between June 2022 and December 2022 who were not mechanically ventilated at enrollment were included. The quality of sleep (QoS) at home was assessed on a visual analog scale as part of an eight-item survey, while the QoS in the ICU was evaluated using the Korean version of the Richards-Campbell Sleep Questionnaire (K-RCSQ). Good QoS was defined by a score of ≥50.
Results
Of the 30 patients in the study, 19 reported a QoS score <50. The Spearman correlation coefficient showed no meaningful relationship between the QoS at home and the overall K-RCSQ QoS score in the ICU (r=0.16, P=0.40). The most common barriers to sleep were physical discomfort (43%), being awoken for procedures (43%), and feeling unwell (37%); environmental factors including noise (30%) and light (13%) were also identified sources of sleep disruption. Physical discomfort (median [interquartile range]: 32 [28.0–38.0] vs. 69 [42.0–80.0], P=0.004), being awoken for procedures (36 [20.0–48.0] vs. 54 [36.0–80.0], P=0.04), and feeling unwell (31 [18.0–42.0] vs. 54 [40.0–76.0], P=0.01) were associated with lower K-RCSQ scores.
Conclusions
In the ICU, physical discomfort, patient care interactions, and feeling unwell were identified as barriers to sleep.

Citations

Citations to this article as recorded by  
  • Effects of nursing interventions applied at night on sleep quality and sleep effort of patients in the intensive care unit
    Aynur Bahar, Mina Güner Muşluoğlu, Hilal Uygur
    Psychology, Health & Medicine.2025; : 1.     CrossRef
  • Impact of Noninvasive Ventilation on Quality of Sleep among Patients Admitted to the Critical Care Unit
    Margiben T Bhatt, Aiswarya Kunjappan, Madhura M Reddy, Samruddha S Prabhu, Vani Lakshmi R
    Indian Journal of Critical Care Medicine.2025; 29(5): 424.     CrossRef
  • Sleep Quality and Its Associated Factors among Adult Patients Admitted in the Intensive Care Units of Public Hospitals in Addis Ababa, Ethiopia
    Taye Mezgebu Ashine, Birehanu Melaku Kassaye, Asefu Woldestadik, Kasie Gebeyehu Tiruneh, Tadesse Sahle Adeba, Edmialem Getahun Mesfin, Tamrat Alate Woldeyohannis, Asaminew Habtamu Sane
    SAGE Open Nursing.2025;[Epub]     CrossRef
  • Factors Predicting Sleep Quality in Sepsis Survivors: A Cross-Sectional Study
    Kewalin Pongsuwun, Wimolrat Puwarawuttipanit, Ruttanaporn Kongkar, Yong Rongrungruang
    Pacific Rim International Journal of Nursing Research.2025; 29(3): 619.     CrossRef
  • Quieting the ICU: Pathway to Recovery, by Enhancing Sleep through Non Pharmacological Intervention: A Comparative Analysis
    Shivakumar Shivanna, Swapna Mandala Babu, Deepak CP
    Indian Journal of Critical Care Medicine.2025; 29(S1): S198.     CrossRef
  • Comparing single-patient and multi-patient room intensive care units: a multicenter cohort study on architectural differences and clinical significance in South Korea
    Daun Jeong, Donghyoun Lee, Kyoung Won Yoon, Hyo Jin Kim, Sun Young Choi, Chi-Min Park
    Acute and Critical Care.2025; 40(2): 160.     CrossRef
  • Could fever dreams influence sleep in intensive care units?
    Jeng Swen Ng, Sheryn Tan, Sanjana Santhosh, Brandon Stretton, Joshua Kovoor, Aashray Gupta, Stephen Bacchi
    Acute and Critical Care.2024; 39(2): 327.     CrossRef
  • Effects of ICU diaries on psychological disorders and sleep quality in critically ill patients and their family members: A systematic review and meta-analysis
    Wenjie Huang, Yang Gao, Lingjun Zhou, Xiaojuan Xiao, Hong Xu, Lizhou Lu, Jinhao Deng, Juan Wu
    Sleep Medicine.2024; 122: 84.     CrossRef
  • Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review
    Issa M. Hweidi, Omar H. Jebreel, Hossam N. Alhawatmeh, Mohamad I. Jarrah, Awwad A. Abu‐Awwad, Mohammed I. Hweidi
    Journal of Clinical Nursing.2024; 33(12): 4528.     CrossRef
  • Nursing Sleep Promotion in Intensive Care Unit
    Orlando Fernandes, Válter Gonçalves, Leonardo Ribeiro, Elsa Sousa, Michelle Viríssimo, Abel Viveiros, Ana Alves
    European Journal of Theoretical and Applied Sciences.2024; 2(6): 238.     CrossRef
  • Different nursing interventions on sleep quality among critically ill patients: A systematic review and network meta-analysis
    Daijin Huang, Yumei Li, Jing Ye, Chang Liu, Dongyan Shen, Yunhui Lv
    Medicine.2023; 102(52): e36298.     CrossRef
Pulmonary
Characteristics and outcomes of patients with chronic obstructive pulmonary disease admitted to the intensive care unit due to acute hypercapnic respiratory failure
Türkay Akbaş, Harun Güneş
Acute Crit Care. 2023;38(1):49-56.   Published online February 27, 2023
DOI: https://doi.org/10.4266/acc.2022.01011
  • 6,122 View
  • 291 Download
  • 10 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Background
The study aimed to describe the clinical course, outcomes, and prognostic factors of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure.
Methods
This retrospective study involved patients with acute hypercapnic respiratory failure due to COPD of any cause admitted to the intensive care unit (ICU) for non-invasive or invasive mechanical ventilation (IMV) support between December 2015 and February 2020.
Results
One hundred patients were evaluated. The main causes of acute hypercapnic respiratory failure were bronchitis, pneumonia, and heart failure. The patients’ mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 23.0±7.2, and their IMV rate was 43%. ICU, in-hospital, and 90-day mortality rates were 21%, 29%, and 39%, respectively. Non-survivors had more pneumonia, shock within the first 24 hours of admission, IMV, vasopressor use, and renal replacement therapy, along with higher APACHE II scores, lower admission albumin levels and PaO2/ FiO2 ratios, and longer ICU and hospital stays than survivors. Logistic regression analysis identified APACHE II score (odds ratio [OR], 1.157; 95% confidence interval [CI], 1.017–1.317; P=0.026), admission PaO2/FiO2 ratio (OR, 0.989; 95% CI, 0.978–0.999; P=0.046), and vasopressor use (OR, 8.827; 95% CI, 1.650–47.215; P=0.011) as predictors of ICU mortality. APACHE II score (OR, 1.099; 95% CI, 1.021–1.182; P=0.011) and admission albumin level (OR, 0.169; 95% CI, 0.056–0.514; P=0.002) emerged as predictors of 90-day mortality.
Conclusions
APACHE II scores, the PaO2/FiO2 ratio, vasopressor use, and albumin levels are significant short-term mortality predictors in severely ill COPD patients with acute hypercapnic respiratory failure.

Citations

Citations to this article as recorded by  
  • Breaking new ground: machine learning enhances survival forecasts in hypercapnic respiratory failure
    Zhongxiang Liu, Bingqing Zuo, Jianyang Lin, Zhixiao Sun, Hang Hu, Yuan Yin, Shuanying Yang
    Frontiers in Medicine.2025;[Epub]     CrossRef
  • Efficacy and safety of medroxyprogesterone acetate on noninvasive ventilation -treated exacerbated COPD patients: a double-blind randomized clinical trial
    Mohsen Gholinataj Jelodar, Mohammadreza Malek-Ahmadi, Adeleh Sahebnasagh, Farhad Mohammadi, Fatemeh Saghafi
    BMC Pulmonary Medicine.2025;[Epub]     CrossRef
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    Michele Vitacca, Massimiliano Beccaria, Luca Bianchi, Paolo Ceruti, Maurizio Marvisi, Monia Betti, Michela Bezzi, Francesco Tursi
    Multidisciplinary Respiratory Medicine.2025;[Epub]     CrossRef
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    Ye Zhang, Hao Chen, Shiyu Hu, Chengshui Chen, Wenyu Chen
    Respiratory Medicine.2025; 245: 108188.     CrossRef
  • Antibiotics in COPD exacerbations requiring mechanical ventilation: a dogma to be re-evaluated
    Sebastian Osorio-Rico, Daniel Perez-Marin, John Cardeño-Sanchez
    Internal and Emergency Medicine.2024; 19(5): 1505.     CrossRef
  • Opportunities and perspectives of small molecular phosphodiesterase inhibitors in neurodegenerative diseases
    Qi Li, Qinghong Liao, Shulei Qi, He Huang, Siyu He, Weiping Lyu, Jinxin Liang, Huan Qin, Zimeng Cheng, Fan Yu, Xue Dong, Ziming Wang, Lingfei Han, Yantao Han
    European Journal of Medicinal Chemistry.2024; 271: 116386.     CrossRef
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    Wenjie Sun, Yeshan Li, Shuxin Tan
    International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1303.     CrossRef
  • Value of diaphragmatic ultrasound parameters in assessing weaning outcomes and survival in ventilator-dependent intensive care unit patients
    Liuhua Pan
    American Journal of Translational Research.2024; 16(12): 7830.     CrossRef
  • COPD Exacerbation: Why It Is Important to Avoid ICU Admission
    Irene Prediletto, Gilda Giancotti, Stefano Nava
    Journal of Clinical Medicine.2023; 12(10): 3369.     CrossRef
Case Report
Pulmonary
A fatal case report of invasive pulmonary aspergillosis and mucormycosis coinfection in an immunocompetent patient with coronavirus disease 2019 in Korea
Jin Hyoung Kim, Misung Kim, Soyeoun Lim, Sun Young Park, Yangjin Jegal, Taehoon Lee, Byung Ju Kang
Acute Crit Care. 2023;38(3):382-388.   Published online June 27, 2022
DOI: https://doi.org/10.4266/acc.2021.01340
  • 4,865 View
  • 133 Download
  • 7 Web of Science
  • 9 Crossref
AbstractAbstract PDF
Systemic glucocorticoid treatment is highly recommended in critically ill coronavirus disease 2019 (COVID-19) patients. However, secondary fungal infections are of concern in such patients. Here, we describe the first case of COVID-19-associated invasive pulmonary aspergillosis (CAPA) and COVID-19-associated mucormycosis (CAM) coinfection in a COVID-19 positive immunocompetent patient in Korea. A 69-year-old man was admitted to our hospital with COVID-19 pneumonia. He had no underlying comorbidities and was not taking medications. He received remdesivir, dexamethasone, and antibiotic therapy under mechanical ventilation. Although his condition improved temporarily, multiple cavities were observed on chest computed tomography, and Aspergillus fumigatus was cultured from tracheal aspiration culture. He was diagnosed with probable CAPA and received voriconazole therapy. However, his condition was not significantly improved despite having received voriconazole therapy for 4 weeks. After release from COVID-19 quarantine, he underwent bronchoscopy examination and was then finally diagnosed with CAPA and CAM coinfection on bronchoscopic biopsy. Antifungal treatment was changed to liposomal amphotericin B. However, his progress deteriorated, and he died 4 months after admission. This case highlights that clinical suspicion and active checkups are required to diagnose secondary fungal infections in immunocompetent COVID-19 patients who receive concurrent glucocorticoid therapy.

Citations

Citations to this article as recorded by  
  • Incidence and Temporal Dynamics of Combined Infections in SARS-CoV-2-Infected Patients With Risk Factors for Severe Complications
    Sin Young Ham, Seungjae Lee, Min-Kyung Kim, Jaehyun Jeon, Eunyoung Lee, Subin Kim, Jae-Phil Choi, Hee-Chang Jang, Sang-Won Park
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Mucormycosis coinfection in patients with proven aspergillosis
    Hyeon Mu Jang, Ji Yeun Kim, Joon Seon Song, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Ho Choi, Sang-Oh Lee, Yang Soo Kim, Sung-Han Kim
    Medical Mycology.2025;[Epub]     CrossRef
  • Mixed Aspergillosis and Mucormycosis Infections in Patients with COVID-19: Case Series and Literature Review
    Elahe Sasani, Farzad Pakdel, Sadegh Khodavaisy, Mohammadreza Salehi, Amir Salami, Marjan Sohrabi, Pouyan Aminishakiba, Iman Amirafzali, Arezoo Salami Khaneshan
    Mycopathologia.2024;[Epub]     CrossRef
  • Prevalence of co‐existent COVID‐19‐associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID‐19‐associated pulmonary mucormycosis (CAPM)
    Valliappan Muthu, Ritesh Agarwal, Shivaprakash Mandya Rudramurthy, Deepak Thangaraju, Manoj Radhakishan Shevkani, Atul K. Patel, Prakash Srinivas Shastri, Ashwini Tayade, Sudhir Bhandari, Vishwanath Gella, Jayanthi Savio, Surabhi Madan, Vinaykumar Hallur,
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    Sang Hyun Ra, Ji Yeun Kim, Joon Seon Song, Hyeon Mu Jang, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Sung-Han Kim
    Medical Mycology.2024;[Epub]     CrossRef
  • Successful treatment of mixed pulmonary Aspergillus and Mucor infection using intrabronchial amphotericin B infusion: a case report and literature review
    Fei-Xiang Ling, Dong-Ming Qu, Ye-Quan Lu, Rou Li, Lei Zhao
    BMC Pulmonary Medicine.2024;[Epub]     CrossRef
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    Sang Hwan Lee, Yun Jin Kim, Jaehoon Oh, Hyunggoo Kang, Kyung Hun Yoo, Byuk Sung Ko, Tae Ho Lim, Bo-Guen Kim, Hyun Lee, Sang-Heon Kim, Jang Won Sohn, Ho Joo Yoon, Hayoung Choi, Yongil Cho, Dong Won Park
    Frontiers in Medicine.2024;[Epub]     CrossRef
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    Jason Murray, Zhen A. Lu, Karin Miller, Alex Meadows, Marissa Totten, Sean X. Zhang
    Journal of Fungi.2023; 9(3): 357.     CrossRef
  • COVID-19 and Fungal infections: a double debacle
    Sara Mina, Hajar Yaakoub, Cédric Annweiler, Vincent Dubée, Nicolas Papon
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Review Articles
Basic science and research
Sex or gender differences in treatment outcomes of sepsis and septic shock
Seung Yeon Min, Ho Jin Yong, Dohhyung Kim
Acute Crit Care. 2024;39(2):207-213.   Published online May 24, 2024
DOI: https://doi.org/10.4266/acc.2024.00591
  • 6,716 View
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AbstractAbstract PDF
Gender disparities in intensive care unit (ICU) treatment approaches and outcomes are evident. However, clinicians often pay little attention to the importance of biological sex and sociocultural gender in their treatment courses. Previous studies have reported that differences between sexes or genders can significantly affect the manifestation of diseases, diagnosis, clinicians' treatment decisions, scope of treatment, and treatment outcomes in the intensive care field. In addition, numerous reports have suggested that immunomodulatory effects of sex hormones and differences in gene expression from X chromosomes between genders might play a significant role in treatment outcomes of various diseases. However, results from clinical studies are conflicting. Recently, the need for customized treatment based on physical, physiological, and genetic differences between females and males and sociocultural characteristics of society have been increasingly emphasized. However, interest in and research into this field are remarkably lacking in Asian countries, including South Korea. Through this review, we hope to enhance our awareness of the importance of sex and gender in intensive care treatment and research by briefly summarizing several principal issues, mainly focusing on sex and sex hormone-based outcomes in patients admitted to the ICU with sepsis and septic shock.

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Surgery
Early detection and assessment of intensive care unit-acquired weakness: a comprehensive review
Hanan Elkalawy, Pavan Sekhar, Wael Abosena
Acute Crit Care. 2023;38(4):409-424.   Published online November 30, 2023
DOI: https://doi.org/10.4266/acc.2023.00703
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AbstractAbstract PDF
Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.

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  • Advancing Nutritional Care Through Bioelectrical Impedance Analysis in Critical Patients
    Ana Maria Dumitriu, Cristian Cobilinschi, Bogdan Dumitriu, Sebastian Vâlcea, Raluca Ungureanu, Angela Popa, Rǎzvan Ene, Radu Țincu, Ioana Marina Grințescu, Liliana Mirea
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    Chen Xin, Yubiao Gai, Lili Wei, Yanqiu Wang, Yuhong Luo, Binru Han
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    Yanyang Zhang, Jinfu Ma, Qing Zhao, Hui Liu
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Original Article
Nursing
Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan
Khaldoun Mohammad Hamdan, Ahmad M. Al-Bashaireh, Mohammad Al-Dalahmeh, Ahmad Rajeh Saifan, Maha Alkaid Albqoor, Abeer M. Shaheen
Acute Crit Care. 2023;38(4):469-478.   Published online November 28, 2023
DOI: https://doi.org/10.4266/acc.2023.00430
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AbstractAbstract PDF
Background
There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods
A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results
We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions
ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

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  • Core competency in palliative care among intensive care unit nurses: A latent profile analysis
    Qin Guan, Xiaoling Zhu, Zhipeng Xue, Mengyun Peng
    Nursing in Critical Care.2025;[Epub]     CrossRef
  • Knowledge, attitudes, and self-efficacy regarding palliative care among Palestinian nurses in intensive care units
    Bilal Awad, Ahmad Batran, Malakeh Z. Malak, Ahmad Ayed, Anas Shehadeh, Bahaa Alassoud, Moath Abu Ejheisheh
    BMC Nursing.2025;[Epub]     CrossRef
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    Ayman Mohamed El‐Ashry, Sameh Eltyebani, Shimmaa Mohamed Elsayed, Mahmoud Abdelwahab Khedr, Mona Metwally El‐Sayed, Mohamed Adel Ghoneam, Haitham Mokhtar Mohamed Abdallah
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    Mona Ibrahim Hebeshy, Darcy Copeland
    Journal of Palliative Care.2025;[Epub]     CrossRef
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    Fırat Demir, Cansu Polat Dünya, İlknur Özkan
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    Saeedeh Rafiee, Ismail Azizi-Fini, Zahra-Sadat Banihashemi, Safoura Yadollahi
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Review Article
Cardiology
Left ventricle unloading during veno-arterial extracorporeal membrane oxygenation: review with updated evidence
Yongwhan Lim, Min Chul Kim, In-Seok Jeong
Acute Crit Care. 2024;39(4):473-487.   Published online November 18, 2024
DOI: https://doi.org/10.4266/acc.2024.00801
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AbstractAbstract PDF
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is widely used to treat medically refractory cardiogenic shock and cardiac arrest, and its usage has increased exponentially over time. Although VA-ECMO has many advantages over other mechanical circulatory supports, it has the unavoidable disadvantage of increasing retrograde arterial flow in the afterload, which causes left ventricular (LV) overload and can lead to undesirable consequences during VA-ECMO treatment. Weak or no antegrade flow without sufficient opening of the aortic valve increases the LV end-diastolic pressure, and that can cause refractory pulmonary edema, blood stagnation, thrombosis, and refractory ventricular arrhythmia. This hemodynamic change is also related to an increase in myocardial energy consumption and poor recovery, making LV unloading an essential management issue during VA-ECMO treatment. The principal factors in effective LV unloading are its timing, indications, and modalities. In this article, we review why LV unloading is required, when it is indicated, and how it can be achieved.

Citations

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  • Routine Left Ventricular Unloading During Venoarterial Extracorporeal Membrane Oxygenation—A Therapeutic Conundrum
    Alice Bottussi, Jacopo D'Andria Ursoleo, Enrica Piazza, Edoardo Mongardini, Fabrizio Monaco
    Journal of Cardiothoracic and Vascular Anesthesia.2025; 39(3): 860.     CrossRef
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    Sang Yoon Kim, Hyoung Woo Chang, Jae Hang Lee, Jae Hyun Jeon, Yoohwa Hwang, Hwan Hee Park, Dong Jung Kim
    Medicina.2025; 61(4): 552.     CrossRef
  • Left Heart Venting or Unloading Strategies for VA-ECMO Patients: Indications, Timing, and Techniques: A Narrative Review
    YeongEun Jo, Jiae Seong, Hwa-Jin Cho, Do Wan Kim, Yongwhan Lim, Yang Hyun Cho, Seunghwan Song, Min Chul Kim, Inseok Jeong
    Journal of Cardiovascular Intervention.2025;[Epub]     CrossRef
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    Yongwhan Lim, Min Chul Kim, Seok Oh, Joon Ho Ahn, Seung Hun Lee, Dae Young Hyun, Kyung Hoon Cho, Doo Sun Sim, Young Joon Hong, Juhan Kim, Youngkeun Ahn
    Journal of Cardiovascular Intervention.2025;[Epub]     CrossRef
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    Jihyuk Chung, Su Yong Kim, Juhyun Lee, Yang Hyun Cho
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Original Article
Cardiology
Risk factors for cannula-associated arterial thrombosis following extracorporeal membrane oxygenation support: a retrospective study
Ngan Hoang Kim Trieu, Xuan Thi Phan, Linh Thanh Tran, Huy Minh Pham, Dai Quang Huynh, Tuan Manh Nguyen, Anh Tuan Mai, Quan Quoc Minh Du, Bach Xuan Nguyen, Thao Thi Ngoc Pham
Acute Crit Care. 2023;38(3):315-324.   Published online August 23, 2023
DOI: https://doi.org/10.4266/acc.2023.00500
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AbstractAbstract PDF
Background
Hemostatic dysfunction during extracorporeal membrane oxygenation (ECMO) due to blood-circuit interaction and the consequences of shear stress imposed by flow rates lead to rapid coagulation cascade and thrombus formation in the ECMO system and blood vessels. We aimed to identify the incidence and risk factors for cannula-associated arterial thrombosis (CaAT) post-decannulation.
Methods
A retrospective study of patients undergoing arterial cannula removal following ECMO was performed. We evaluated the incidence of CaAT and compared the characteristics, ECMO machine parameters, cannula sizes, number of blood products transfused during ECMO, and daily hemostasis parameters in patients with and without CaAT. Multivariate analysis identified the risk factors for CaAT.
Results
Forty-seven patients requiring venoarterial ECMO (VA-ECMO) or hybrid methods were recruited for thrombosis screening. The median Sequential Organ Failure Assessment score was 11 (interquartile range, 8–13). CaAT occurred in 29 patients (61.7%), with thrombosis in the superficial femoral artery accounting for 51.7% of cases. The rate of limb ischemia complications in the CaAT group was 17.2%. Multivariate analysis determined that the ECMO flow rate–body surface area (BSA) ratio (100 ml/min/m2) was an independent factor for CaAT, with an odds ratio of 0.79 (95% confidence interval, 0.66–0.95; P=0.014).
Conclusions
We found that the incidence of CaAT was 61.7% following successful decannulation from VA-ECMO or hybrid modes, and the ECMO flow rate–BSA ratio was an independent risk factor for CaAT. We suggest screening for arterial thrombosis following VA-ECMO, and further research is needed to determine the risks and benefits of such screening.

Citations

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  • Machine learning‐based prediction of bleeding risk in extracorporeal membrane oxygenation patients using transfusion as a surrogate marker
    Tadashi Kamio, Masaru Ikegami, Megumi Mizuno, Seiichiro Ishii, Hayato Tajima, Yoshihito Machida, Kiyomitsu Fukaguchi
    Transfusion.2025;[Epub]     CrossRef
  • Peripheral VA-ECMO: from Evolving Indications to Perioperative Implications
    Ngan Hoang Kim Trieu, Huy Minh Pham, Dai Quang Huynh, Linh Thanh Tran, Ngoc Tu Nguyen, Anh Tuan Mai, Thao Thi Ngoc Pham
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    Kha Minh Nguyen, Hai Phuong Nguyen Tran, Vi Tuong Dang, Sy Van Hoang, Josip Andelo Borovac, Dmitry Duplyakov, Chiara De Biase, Pok-Tin Tang
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    J. Ajouri, N. Abdal-Daem, V. Scriba, A. A. Peivandi, R. M. Muellenbach, Y. D. Sagban, T. A. Sagban
    Gefässchirurgie.2024; 29(7): 410.     CrossRef
  • Assessment of percutaneous closure for decannulation of veno-arterial extracorporeal membrane oxygenation: A retrospective study
    Diana Martins-Fernandes, João Rocha-Neves, Ana Rita Ferreira, Hélio Martins, Sérgio Gaião, José Artur Paiva
    The Journal of Vascular Access.2024;[Epub]     CrossRef
Review Article
Trauma
Mobilization phases in traumatic brain injury
Tommy Alfandy Nazwar, Ivan Triangto, Gutama Arya Pringga, Farhad Bal’afif, Donny Wisnu Wardana
Acute Crit Care. 2023;38(3):261-270.   Published online August 1, 2023
DOI: https://doi.org/10.4266/acc.2023.00640
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AbstractAbstract PDF
Mobilization in traumatic brain injury (TBI) have shown the improvement of length of stay, infection, long term weakness, and disability. Primary damage as a result of trauma’s direct effect (skull fracture, hematoma, contusion, laceration, and nerve damage) and secondary damage caused by trauma’s indirect effect (microvasculature damage and pro-inflammatory cytokine) result in reduced tissue perfusion & edema. These can be facilitated through mobilization, but several precautions must be recognized as mobilization itself may further deteriorate patient’s condition. Very few studies have discussed in detail regarding mobilizing patients in TBI cases. Therefore, the scope of this review covers the detail of physiological effects, guideline, precautions, and technique of mobilization in patients with TBI.

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  • Reversing Persistent PTEN Activation after Traumatic Brain Injury Fuels Long‐Term Axonal Regeneration via Akt/mTORC1 Signaling Cascade
    Ziyu Shi, Leilei Mao, Shuning Chen, Zhuoying Du, Jiakun Xiang, Minghong Shi, Yana Wang, Yuqing Wang, Xingdong Chen, Zhi‐Xiang Xu, Yanqin Gao
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    Yoo Jin Choo, Jun Sung Moon, Gun Woo Lee, Wook-Tae Park, Min Cheol Chang
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    Jordana de Paula Magalhães, Sheridan Ayessa Ferreira de Brito, Merrill Landers, Aline Alvim Scianni, Poliana do Amaral Yamaguchi Benfica, Carolina Luisa de Almeida Soares, Christina Danielli Coelho de Morais Faria, Anne E. Martin
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    Matthijs F Wouda, Espen I Bengtson, Ellen Høyer, Alhed P Wesche, Vivien Jørgensen
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    André Hagedorn, Helge Haberl, Michael Adamzik, Alexander Wolf, Matthias Unterberg
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Original Articles
Trauma
Comparison of admission GCS score to admission GCS-P and FOUR scores for prediction of outcomes among patients with traumatic brain injury in the intensive care unit in India
Nishant Agrawal, Shivakumar S Iyer, Vishwanath Patil, Sampada Kulkarni, Jignesh N Shah, Prashant Jedge
Acute Crit Care. 2023;38(2):226-233.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2023.00570
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AbstractAbstract PDF
Background
This study aimed to determine the predictive power of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale Pupil (GCS-P) score in determining outcomes for traumatic brain injury (TBI) patients. The Glasgow Outcome Scale (GOS) was used to evaluate patients at 1 month and 6 months after the injury.
Methods
We conducted a 15-month prospective observational study. It included 50 TBI patients admitted to the ICU who met our inclusion criteria. We used Pearson’s correlation coefficient to relate coma scales and outcome measures. The predictive value of these scales was determined using the receiver operating characteristic (ROC) curve, calculating the area under the curve with a 99% confidence interval. All hypotheses were two-tailed, and significance was defined as P<0.01.
Results
In the present study, the GCS-P and FOUR scores among all patients on admission as well as in the subset of patients who were mechanically ventilated were statistically significant and strongly correlated with patient outcomes. The correlation coefficient of the GCS score compared to GCS-P and FOUR scores was higher and statistically significant. The areas under the ROC curve for the GCS, GCS-P, and FOUR scores and the number of computed tomography abnormalities were 0.912, 0.905, 0.937, and 0.324, respectively.
Conclusions
The GCS, GCS-P, and FOUR scores are all excellent predictors with a strong positive linear correlation with final outcome prediction. In particular, the GCS score has the best correlation with final outcome.

Citations

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  • Development of a Novel Neurological Score Combining GCS and FOUR Scales for Assessment of Neurosurgical Patients with Traumatic Brain Injury: GCS-FOUR Scale
    Ali Ansari, Sina Zoghi, Amirabbas Khoshbooei, Mohammad Amin Mosayebi, Maryam Feili, Omid Yousefi, Amin Niakan, Seyed Amin Kouhpayeh, Reza Taheri, Hosseinali Khalili
    World Neurosurgery.2024; 182: e866.     CrossRef
  • Comparison of Glasgow Coma Scale Full Outline of UnResponsiveness and Glasgow Coma Scale: Pupils Score for Predicting Outcome in Patients with Traumatic Brain Injury
    Indu Kapoor, Hemanshu Prabhakar, Arvind Chaturvedi, Charu Mahajan, Abraham L Chawnchhim, Tej P Sinha
    Indian Journal of Critical Care Medicine.2024; 28(3): 256.     CrossRef
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    Baojie Mao, Lichao Ling, Yuhang Pan, Rui Zhang, Wanning Zheng, Yanfei Shen, Wei Lu, Yuning Lu, Shanhu Xu, Jiong Wu, Ming Wang, Shu Wan
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    Shiyi Zuo, Yuting Feng, Juan Sun, Guofang Liu, Hanxu Cai, Xiaolong Zhang, Zhian Hu, Yong Liu, Zhongxiang Yao
    Geriatric Nursing.2024; 59: 498.     CrossRef
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    Molly Wart, Thomas H. Edwards, Julie A. Rizzo, Geoffrey W. Peitz, Armi Pigott, Jonathan M. Levine, Nicholas D. Jeffery
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Epidemiology
Risk factors for hospital mortality in intensive care unit survivors: a retrospective cohort study
Luiza Gabriella Antonio e Silva, Claudia Maria Dantas de Maio Carrilho, Thalita Bento Talizin, Lucienne Tibery Queiroz Cardoso, Edson Lopes Lavado, Cintia Magalhães Carvalho Grion
Acute Crit Care. 2023;38(1):68-75.   Published online February 27, 2023
DOI: https://doi.org/10.4266/acc.2022.01375
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AbstractAbstract PDF
Background
Deaths can occur after a patient has survived treatment for a serious illness in an intensive care unit (ICU). Mortality rates after leaving the ICU can be considered indicators of health care quality. This study aims to describe risk factors and mortality of surviving patients discharged from an ICU in a university hospital.
Methods
Retrospective cohort study carried out from January 2017 to December 2018. Data on age, sex, length of hospital stay, diagnosis on admission to the ICU, hospital discharge outcome, presence of infection, and Simplified Acute Physiology Score (SAPS) III prognostic score were collected. Infected patients were considered as those being treated for an infection on discharge from the ICU. Patients were divided into survivors and non-survivors on leaving the hospital. The association between the studied variables was performed using the logistic regression model.
Results
A total of 1,025 patients who survived hospitalization in the ICU were analyzed, of which 212 (20.7%) died after leaving the ICU. When separating the groups of survivors and non-survivors according to hospital outcome, the median age was higher among non-survivors. Longer hospital stays and higher SAPS III values were observed among non-survivors. In the logistic regression, the variables age, length of hospital stay, SAPS III, presence of infection, and readmission to the ICU were associated with hospital mortality.
Conclusions
Infection on ICU discharge, ICU readmission, age, length of hospital stay, and SAPS III increased risk of death in ICU survivors.

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    Michelle Carmen Paulus, Imre Willemijn Kehinde Kouw, Yente Florine Niké Boelens, Anoek Jacqueline Hubertine Hermans, Bert Strookappe, Arthur Raymond Hubert van Zanten
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    Kyung Hun Yoo, Juncheol Lee, Jaehoon Oh, Nayeon Choi, Tae Ho Lim, Hyunggoo Kang, Byuk Sung Ko, Yongil Cho
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    O. I. Butranova, S. K. Zyryanov, A. A. Gorbacheva, G A. Putsman
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    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Escore para Avaliação de Prognóstico em Pacientes com Endocardite Infecciosa
    Alfredo José Mansur
    Arquivos Brasileiros de Cardiologia.2023;[Epub]     CrossRef
Gastroenterology
The diagnostic accuracy of ultrasonography over manual aspiration for gastric reserve volume estimation in critically ill patients
Rahul Sharma, Ravi Kant Dogra, Jyoti Pathania, Arti Sharma
Acute Crit Care. 2023;38(1):134-141.   Published online February 22, 2023
DOI: https://doi.org/10.4266/acc.2022.00955
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AbstractAbstract PDF
Background
Although gastric reserve volume (GRV) is a surrogate marker of gastrointestinal dysfunction and feeding intolerance, there is ambiguity in its estimation due to problems associated with its measurement. Introduction of point-of-care ultrasound as a tool for anesthetists kindled interest in its use for GRV estimation.
Methods
In this prospective observational study, we recruited 57 critically ill patients and analyzed 586 samples of GRV obtained by both ultrasonography (USG) and manual aspiration.
Results
The analysis showed that USG-guided GRV was significantly correlated (r=0.788, P<0.001) and in positive agreement with manual aspiration based on Bland-Altman plot, with a mean difference of 8.50±14.84 (95% confidence interval, 7.389–9.798). The upper and lower limits of agreement were 37.7 and –20.5, respectively, within the ±1.96 standard deviation (P<0.001). The respective sensitivity and positive predictive value, specificity and negative predictive value, and area under the curve of USG for feeding intolerance were 66.67%, 98.15%, and 0.82%, with 96.49% diagnostic accuracy.
Conclusions
Ultrasonographic estimation of GRV was positively, significantly correlated and in agreement with the manual aspiration method and estimated feeding intolerance earlier. Routine use of gastric USG could avoid clinical situations where feeding status is unclear and there is high risk of aspiration and could become a standard practice of critical care.

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  • Assessing gastrointestinal system dysfunction in intensive care
    Kaspar F. Bachmann, Varsha M. Asrani, Annika Reintam Blaser
    Current Opinion in Critical Care.2025; 31(2): 172.     CrossRef
  • Correlación de volumen residual gástrico medido y ultrasonido gástrico para identificar intolerancia gástrica en pacientes neurocríticos con nutrición enteral en la unidad de cuidados intensivos
    Mauricio Pérez-Macías, Roxana Vázquez-Ramírez, Marcela Pinedo-Lechuga
    Medicina Crítica.2024; 38(2): 102.     CrossRef
  • Is pre-extubation fasting in ICU justified? Insights from a prospective observational study using gastric ultrasound
    Mohd Saif Khan, Barun Ram, Amit Kumar, Kamel Bousselmi, Priyesh Kumar, Dumini Soren, Priyanka Shrivastava, Naveen Kumar
    Trends in Anaesthesia and Critical Care.2024; 58: 101497.     CrossRef
  • Early initiation of gastric tube feeding: ultrasound assessment. A prospective interventional study
    Islam M. Elbardan, Ahmed A. Alla Ossman, Nada El Kayal, Assem A. ElRazek Abd-Rabih
    Research and Opinion in Anesthesia & Intensive Care.2024; 11(4): 270.     CrossRef
  • Gastrointestinal function in critically ill patients
    Annika Reintam Blaser, Kaspar F. Bachmann, Adam M. Deane
    Current Opinion in Clinical Nutrition & Metabolic Care.2023; 26(5): 463.     CrossRef
Review Article
Pulmonary
Beyond survival: understanding post-intensive care syndrome
Lovish Gupta, Maazen Naduthra Subair, Jaskaran Munjal, Bhupinder Singh, Vasu Bansal, Vasu Gupta, Rohit Jain
Acute Crit Care. 2024;39(2):226-233.   Published online May 24, 2024
DOI: https://doi.org/10.4266/acc.2023.01158
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AbstractAbstract PDF
Post-intensive care syndrome (PICS) refers to persistent or new onset physical, mental, and neurocognitive complications that can occur following a stay in the intensive care unit. PICS encompasses muscle weakness; neuropathy; cognitive deficits including memory, executive, and attention impairments; post-traumatic stress disorder; and other mood disorders. PICS can last long after hospital admission and can cause significant physical, emotional, and financial stress for patients and their families. Several modifiable risk factors, such as duration of sepsis, delirium, and mechanical ventilation, are associated with PICS. However, due to limited awareness about PICS, these factors are often overlooked. The objective of this paper is to highlight the pathophysiology, clinical features, diagnostic methods, and available preventive and treatment options for PICS.

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    Noa van der Knaap, Simona Klinkhammer, Alida A. Postma, Johanna M.A. Visser-Meily, Janneke Horn, Caroline M. van Heugten, Paulien H.M. Voorter, Merel M. van der Thiel, Gerhard S. Drenthen, Walter H. Backes, Frank van Rosmalen, Susanne van Santen, Bas C.T.
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    A. Despoti, I. Patsaki, A. Alexandropoulou, E. Magkouti, D. Tzoumi, N. Leventakis, G. Roussou, Α. Papathanasiou, N. Dimitriadi, P. Presvelou, S. Nanas, E. Karatzanos
    Applied Neuropsychology: Adult.2025; : 1.     CrossRef
  • Prevalence of Post-intensive care syndrome among intensive care unit-survivors and its association with intensive care unit length of stay: Systematic review and meta-analysis
    Temesgen Ayenew, Menberu Gete, Mihretie Gedfew, Addisu Getie, Abebe Dilie Afenigus, Afework Edmealem, Haile Amha, Girma Alem, Bekele Getenet Tiruneh, Mengistu Abebe Messelu, Ramya Iyadurai
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    Haohua Shi, Yufang Su, Chunyan Pan
    Frontiers in Psychiatry.2025;[Epub]     CrossRef
Guideline
Pulmonary
Liberation from mechanical ventilation in critically ill patients: Korean Society of Critical Care Medicine Clinical Practice Guidelines
Tae Sun Ha, Dong Kyu Oh, Hak-Jae Lee, Youjin Chang, In Seok Jeong, Yun Su Sim, Suk-Kyung Hong, Sunghoon Park, Gee Young Suh, So Young Park
Acute Crit Care. 2024;39(1):1-23.   Published online February 28, 2024
DOI: https://doi.org/10.4266/acc.2024.00052
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AbstractAbstract PDFSupplementary Material
Background
Successful liberation from mechanical ventilation is one of the most crucial processes in critical care because it is the first step by which a respiratory failure patient begins to transition out of the intensive care unit and return to their own life. Therefore, when devising appropriate strategies for removing mechanical ventilation, it is essential to consider not only the individual experiences of healthcare professionals, but also scientific and systematic approaches. Recently, numerous studies have investigated methods and tools for identifying when mechanically ventilated patients are ready to breathe on their own. The Korean Society of Critical Care Medicine therefore provides these recommendations to clinicians about liberation from the ventilator.
Methods
Meta-analyses and comprehensive syntheses were used to thoroughly review, compile, and summarize the complete body of relevant evidence. All studies were meticulously assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method, and the outcomes were presented succinctly as evidence profiles. Those evidence syntheses were discussed by a multidisciplinary committee of experts in mechanical ventilation, who then developed and approved recommendations.
Results
Recommendations for nine PICO (population, intervention, comparator, and outcome) questions about ventilator liberation are presented in this document. This guideline includes seven conditional recommendations, one expert consensus recommendation, and one conditional deferred recommendation.
Conclusions
We developed these clinical guidelines for mechanical ventilation liberation to provide meaningful recommendations. These guidelines reflect the best treatment for patients seeking liberation from mechanical ventilation.

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  • Comparison of programmed sedation care with conventional care in patients receiving mechanical ventilation for acute respiratory failure
    Jiantang Wang, Yuntao Li, Yujuan Han, Xinyu Yuan
    Irish Journal of Medical Science (1971 -).2025; 194(1): 289.     CrossRef
  • Clinical predictors of extubation failure in postoperative critically ill patients: a post-hoc analysis of a multicenter prospective observational study
    Jun Hattori, Aiko Tanaka, Junko Kosaka, Osamu Hirao, Nana Furushima, Yuichi Maki, Daijiro Kabata, Akinori Uchiyama, Moritoki Egi, Hiroshi Morimatsu, Satoshi Mizobuchi, Yoshifumi Kotake, Ayumi Shintani, Yukiko Koyama, Takeshi Yoshida, Yuji Fujino
    BMC Anesthesiology.2025;[Epub]     CrossRef
  • Comparison of High Versus Low Positive End-Expiratory Pressure in Mechanically Ventilated Patients With Acute Heart Failure: Rationale and Design of the HELP-AHF Trial
    Junho Hyun, In-Cheol Kim, Ah-ram Kim, Hee Jeong Lee, Sang Eun Lee, Sung-Cheol Yun, Min-Seok Kim
    International Journal of Heart Failure.2025; 7(2): 79.     CrossRef
  • RELAÇÃO DA FORÇA MUSCULAR PERIFÉRICA COM O DESMAME DA VENTILAÇÃO MECÂNICA
    Débora Rillary Duarte Filho, Gabriella Schultz Malagute, Luciana Ferreira Rihs, Priscila Corrêa Cavalcanti
    Revista Saúde Dos Vales.2024;[Epub]     CrossRef
Original Articles
Cardiology
Diagnostic accuracy of left ventricular outflow tract velocity time integral versus inferior vena cava collapsibility index in predicting post-induction hypotension during general anesthesia: an observational study
Vibhuti Sharma, Arti Sharma, Arvind Sethi, Jyoti Pathania
Acute Crit Care. 2024;39(1):117-126.   Published online February 23, 2024
DOI: https://doi.org/10.4266/acc.2023.00913
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AbstractAbstract PDF
Background
Point of care ultrasound (POCUS) is being explored for dynamic measurements like inferior vena cava collapsibility index (IVC-CI) and left ventricular outflow tract velocity time integral (LVOT-VTI) to guide anesthesiologists in predicting fluid responsiveness in the preoperative period and in treating post-induction hypotension (PIH) with varying accuracy.
Methods
In this prospective, observational study on included 100 adult patients undergoing elective surgery under general anesthesia, the LVOT-VTI and IVC-CI measurements were performed in the preoperative room 15 minutes prior to surgery, and PIH was measured for 20 minutes in the post-induction period.
Results
The incidence of PIH was 24%. The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the two techniques at 95% confidence interval was 0.613, 30.4%, 93.3%, 58.3%, 81.4%, 73.6% for IVC-CI and 0.853, 83.3%, 80.3%, 57.1%, 93.8%, 77.4% for LVOT-VTI, respectively. In multivariate analysis, the cutoff value for IVC-CI was >51.5 and for LVOT-VTI it was ≤17.45 for predicting PIH with odd ratio [OR] of 8.491 (P=0.025) for IVCCI and OR of 17.427 (P<0.001) for LVOT. LVOT-VTI assessment was possible in all the patients, while 10% of patients were having poor window for IVC measurements.
Conclusions
We recommend the use of POCUS using LVOT-VTI or IVC-CI to predict PIH, to decrease the morbidity of patients undergoing surgery. Out of these, we recommend LVOT-VTI measurements as it has showed a better diagnostic accuracy (77.4%) with no failure rate.

Citations

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  • Left Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value
    Frank L. Dini, Valentina Barletta, Piercarlo Ballo, Giovanni Cioffi, Nicola Riccardo Pugliese, Andrea Rossi, Gani Bajraktari, Stefano Ghio, Michael Y. Henein
    Echocardiography.2025;[Epub]     CrossRef
  • Perioperative Focused Transthoracic Echocardiogram Evaluations for Elderly Hip Fractures: A Narrative Review of Literature and Recommendations
    Michael Armaneous, John Bouz, Tiffany Ding, Christopher Baker, Alina Kim, Avoumia Mourkus, Charles Schoepflin, Justin Calvert
    A&A Practice.2025; 19(3): e01944.     CrossRef
  • The Use of the Perfusion Index to Predict Post-Induction Hypotension in Patients Undergoing General Anesthesia: A Systematic Review and Meta-Analysis
    Kuo-Chuan Hung, Shu-Wei Liao, Chia-Li Kao, Yen-Ta Huang, Jheng-Yan Wu, Yao-Tsung Lin, Chien-Ming Lin, Chien-Hung Lin, I-Wen Chen
    Diagnostics.2024; 14(16): 1769.     CrossRef
  • Where the Postanesthesia Care Unit and Intensive Care Unit Meet
    Mary Rose Gaylor, David N. Hager, Kathleen Tyson
    Critical Care Clinics.2024; 40(3): 523.     CrossRef
Meta-analysis
Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study in South Korea
Moon Seong Baek, Young Suk Kwon, Sang Soo Kang, Daechul Shim, Youngsang Yoon, Jong Ho Kim
Acute Crit Care. 2024;39(1):127-137.   Published online February 20, 2024
DOI: https://doi.org/10.4266/acc.2023.01613
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AbstractAbstract PDFSupplementary Material
Background
The Controlling Nutritional Status (CONUT) score and the prognostic nutritional index (PNI) have emerged as important nutritional indices because they provide an objective assessment based on data. We aimed to investigate how these nutritional indices relate to outcomes in patients with sepsis.
Methods
Data were collected retrospectively at five hospitals for patients aged ≥18 years receiving treatment for sepsis between January 1, 2017, and December 31, 2021. Serum albumin and total cholesterol concentrations, and peripheral lymphocytes were used to calculate the CONUT score and PNI. To identify predictors correlated with 30-day mortality, analyses were conducted using univariate and multivariate Cox proportional hazards models.
Results
The 30-day mortality rate among 9,763 patients was 15.8% (n=1,546). The median CONUT score was 5 (interquartile range [IQR], 3–7) and the median PNI score was 39.6 (IQR, 33.846.4). Higher 30-day mortality rates were associated with individuals with moderate (CONUT score: 5–8; PNI: 35–38) or severe (CONUT: 9–12; PNI: <35) malnutrition compared with those with no malnutrition (CONUT: 0–1; PNI: >38). With CONUT scores, the hazard ratio (HR) associated with moderate malnutrition was 1.52 (95% confidence interval [CI], 1.24–1.87; P<0.001); for severe, HR=2.42 (95% CI, 1.95–3.02; P<0.001). With PNI scores, the HR for moderate malnutrition was 1.29 (95% CI, 1.09–1.53; P=0.003); for severe, HR=1.88 (95% CI, 1.67–2.12; P<0.001).
Conclusions
The nutritional indices CONUT score and PNI showed significant associations with mortality of sepsis patients within 30 days.

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  • Relationship between the geriatric nutritional risk index and sepsis in elderly critically ill patients: a retrospective cohort study
    Yujiao Jin, Tianyun Zhou, Chenshu Hou, Huihui Zhang, Binbin Xu
    European Journal of Medical Research.2025;[Epub]     CrossRef
  • Epidemiology and Microbiology of Healthcare-Associated Infections in Neurosurgery Department: A Cross-Sectional Study
    Renata Jabłońska, Paweł Sokal, Magdalena Zając, Agnieszka Królikowska, Karolina Filipska - Blejder, Irena Wrońska, Robert Ślusarz
    Biological Research For Nursing.2025;[Epub]     CrossRef
  • Development and validation of a predictive model for in-hospital mortality from perioperative bacteremia in gastrointestinal surgery
    Yusuke Taki, Shinsuke Sato, Masaya Watanabe, Ko Ohata, Hideyuki Kanemoto, Noriyuki Oba
    European Journal of Clinical Microbiology & Infectious Diseases.2024; 43(11): 2117.     CrossRef
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    Myriam Jean Cadet
    MEDSURG Nursing.2024; 33(5): 214.     CrossRef
Trauma
Role of platelet-to-lymphocyte ratio at the time of arrival to the emergency room as a predictor of short-term mortality in trauma patients with severe trauma team activation
Jae Kwang Kim, Kyung Hoon Sun
Acute Crit Care. 2024;39(1):146-154.   Published online February 15, 2024
DOI: https://doi.org/10.4266/acc.2023.01319
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AbstractAbstract PDF
Background
Platelet-to-Lymphocyte ratio (PLR) has been studied as a prognostic factor for various diseases and traumas. This study examined the utility of PLR as a tool for predicting 30-day mortality in patients experiencing severe trauma.
Methods
This study included 139 patients who experienced trauma and fulfilled ≥1 criteria for activation of the hospital’s severe trauma team. Patients were divided into non-survivor and survivor groups. Mean PLR values were compared between the groups, the optimal PLR cut-off value was determined, and mortality and survival analyses were performed. Statistical analyses were performed using SPSS ver. 26.0. The threshold of statistical significance was P<0.05.
Results
There was a significant difference in mean (±standard deviation) PLR between the non-survivor (n=36) and survivor (n=103) groups (53.4±30.1 vs. 89.9±53.3, respectively; P<0.001). Receiver operating characteristic (ROC) curve analysis revealed an optimal PLR cut-off of 65.35 (sensitivity, 0.621; specificity, 0.694, respectively; area under the ROC curve, 0.742), and Kaplan-Meier survival analysis revealed a significant difference in mortality rate between the two groups.
Conclusions
PLR can be calculated quickly and easily from a routine complete blood count, which is often performed in the emergency department for individuals who experience trauma. The PLR is useful for predicting 30-day mortality in trauma patients with severe trauma team activation.

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  • Utility of platelet- to lymphocyte ratio as an inflammatory biomarker in major burns. our experience
    Dayamí Zaldívar Castillo MD, Néstor Nemer Pérez MD, Carlos Lora Buelvas MD, Adelmo de J González Méndez MD, Freddy J Cruz Reyes MD, Yaqueline Castellanos MD
    Journal of Anesthesia & Critical Care: Open Access.2025; 17(1): 1.     CrossRef
  • The predictors of prognostic nutritional index and its association with in-hospital mortality among critically ill geriatric patients
    Khalid Elsayed Elsorady, Ahmed Ahmed Mohamed Abotaha, Mohammed Abdelmoaty Ebrahim Shaheen, Hisham Ahmed Hani Mostafa Abdelaziz, Essam Yehia Ali Aggour, Mohamed Elwan Mohamed Mahmoud
    Electronic Journal of General Medicine.2025; 22(4): em656.     CrossRef
  • Key laboratory changes in severe trauma, a different pattern for each clinical phenotype
    Adrián Marcos-Morales, Jesús Abelardo Barea Mendoza, Marcos Valiente Fernández, Carlos García Fuentes, Fernando Calvo Boyero, Cecilia Cueto-Felgueroso, Judith Gutiérrez Gutiérrez, Francisco de Paula Delgado Moya, Carolina Mudarra Reche, Susana Bermejo Azn
    Medicina Intensiva (English Edition).2025; : 502227.     CrossRef
  • Utility of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio as a predictive biomarker in pediatric traumatic brain injury
    Muhammad Arifin Parenrengi, Wihasto Suryaningtyas, Ahmad Data Dariansyah, Budi Utomo, Glenn Otto Taryana, Catur Kusumo, Surya Pratama Brilliantika
    Surgical Neurology International.2024; 15: 456.     CrossRef
Pulmonary
Risk factors for mortality in intensive care unit patients with Stenotrophomonas maltophilia pneumonia in South Korea
Yong Hoon Lee, Jaehee Lee, Byunghyuk Yu, Won Kee Lee, Sun Ha Choi, Ji Eun Park, Hyewon Seo, Seung Soo Yoo, Shin Yup Lee, Seung-Ick Cha, Chang Ho Kim, Jae Yong Park
Acute Crit Care. 2023;38(4):442-451.   Published online November 21, 2023
DOI: https://doi.org/10.4266/acc.2023.00682
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AbstractAbstract PDFSupplementary Material
Background
Stenotrophomonas maltophilia has been increasingly recognized as an opportunistic pathogen associated with high morbidity and mortality. Data on the prognostic factors associated with S. maltophilia pneumonia in patients admitted to intensive care unit (ICU) are lacking.
Methods
We conducted a retrospective analysis of data from 117 patients with S. maltophilia pneumonia admitted to the ICUs of two tertiary referral hospitals in South Korea between January 2011 and December 2022. To assess risk factors associated with in-hospital mortality, multivariable logistic regression analyses were performed.
Results
The median age of the study population was 71 years. Ventilator-associated pneumonia was 76.1% of cases, and the median length of ICU stay before the first isolation of S. maltophilia was 15 days. The overall in-hospital mortality rate was 82.1%, and factors independently associated with mortality were age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.00–1.09; P=0.046), Sequential Organ Failure Assessment (SOFA) score (OR, 1.21; 95%; CI, 1.02–1.43; P=0.025), corticosteroid use (OR, 4.19; 95% CI, 1.26–13.91; P=0.019), and polymicrobial infection (OR, 95% CI 0.07–0.69). However, the impact of appropriate antibiotic therapy on mortality was insignificant. In a subgroup of patients who received appropriate antibiotic therapy (n=58), antibiotic treatment modality-related variables, including combination or empirical therapy, also showed no significant association with survival.
Conclusions
Patients with S. maltophilia pneumonia in ICU have high mortality rates. Older age, higher SOFA score, and corticosteroid use were independently associated with increased in-hospital mortality, whereas polymicrobial infection was associated with lower mortality. The effect of appropriate antibiotic therapy on prognosis was insignificant.

Citations

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  • How do I manage a patient with Stenotrophomonas maltophilia infection?
    Roberta Monardo, Maria F. Mojica, Marco Ripa, Samuel L. Aitken, Robert A. Bonomo, David van Duin
    Clinical Microbiology and Infection.2025;[Epub]     CrossRef
  • Stenotrophomonas maltophilia Outbreak in an ICU: Investigation of Possible Routes of Transmission and Implementation of Infection Control Measures
    Maria Luisa Cristina, Marina Sartini, Gianluca Ottria, Elisa Schinca, Giulia Adriano, Leonello Innocenti, Marco Lattuada, Stefania Tigano, David Usiglio, Filippo Del Puente
    Pathogens.2024; 13(5): 369.     CrossRef
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    Jie Wang, Pei Zhao, Mengchuan Zhao, Duoxiao Zhang, Shan Chen, Ying Liu, Yuan Gao, Yanqing Tie, Zhishan Feng, Siu-Kei Chow
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    Akihiko Goto, Kentaro Ishikawa, Kosaku Komiya
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Cardiology
Evaluation of neopterin levels and kynurenine pathway in patients with acute coronary syndrome
Ibrahim Kember, Sonia Sanajou, Bilge Kilicarslan, Gözde Girgin, Terken Baydar
Acute Crit Care. 2023;38(3):325-332.   Published online August 30, 2023
DOI: https://doi.org/10.4266/acc.2023.00024
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AbstractAbstract PDF
Background
Coronary atherosclerosis is the leading cause of coronary artery disease. Several investigations have indicated that tear-sensitive plaques contain macrophages and T cells. Neopterin is an essential cellular immune response biomarker. The main goal of this study was to see if there were any changes in biomarkers like unconjugated pteridines, neopterin, and biopterin, as well as kynurenine pathway enzymes like indoleamine 2,3-dioxygenase (IDO), which catalyzes the rate-limiting step in tryptophan degradation, in patients with the acute coronary syndrome (ACS) caused by angiographic atherosclerosis.
Methods
High-performance liquid chromatography was used to determine the amounts of neopterin, biopterin, and creatinine in urine samples, as well as tryptophan and kynurenine in serum samples. The enzyme-linked immunosorbent assay was used to assess the amounts of neopterin in serum samples. The measured parameters were evaluated between ACS patients and controls.
Results
The measured levels of neopterin, biopterin and the kynurenine to tryptophan ratio reflecting IDO activity, and the specifically known biomarkers such as cardiac troponin, creatine kinase, myoglobin, and natriuretic peptides are statistically higher in ACS patients compared to control subjects. On the other hand, the measured parameters are inadequate to classify the conventional kinds of ACS, ST-elevation- and non-ST-elevation- myocardial infarction.
Conclusions
The study found that determining and using neopterin and IDO parameters as biomarkers in individuals with the ACS can support traditional biomarkers. However, it can be concluded that evaluating pteridine biomarkers solely have no privilege to clinical findings in ACS diagnosis and classification.

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    Abdullah Burak Karaduman, Sinem Ilgın, Özlem Aykaç, Mehmetcan Yeşilkaya, Serkan Levent, Atilla Özcan Özdemir, Gozde Girgin
    Journal of Clinical Medicine.2025; 14(3): 755.     CrossRef
  • Kynurenines as a Novel Target for the Treatment of Inflammatory Disorders
    Adrian Mor, Anna Tankiewicz-Kwedlo, Marianna Ciwun, Janina Lewkowicz, Dariusz Pawlak
    Cells.2024; 13(15): 1259.     CrossRef
  • Biomarkers to monitor the prognosis, disease severity, and treatment efficacy in coronary artery disease
    Armand N. Yazdani, Michaela Pletsch, Abraham Chorbajian, David Zitser, Vikrant Rai, Devendra K. Agrawal
    Expert Review of Cardiovascular Therapy.2023; 21(10): 675.     CrossRef
  • Evaluation of Neopterin as a Neuroinflammatory Marker for Peripheral Neuropathy in Type 2 Diabetic Patients
    Israa Abdelmalik Salem, Sura Ahmed Abdulsattar, Haider Fadhil Alrubaye
    Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2023; 5(1S): S183.     CrossRef
Review Articles
Ethics
Impact of institutional case volume on intensive care unit mortality
Christine Kang, Ho Geol Ryu
Acute Crit Care. 2023;38(2):151-159.   Published online May 31, 2023
DOI: https://doi.org/10.4266/acc.2023.00689
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AbstractAbstract PDF
The primary aim of this review is to explore current knowledge on the relationship between institutional intensive care unit (ICU) patient volume and patient outcomes. Studies indicate that a higher institutional ICU patient volume is positively correlated with patient survival. Although the exact mechanism underlying this association remains unclear, several studies have proposed that the cumulative experience of physicians and selective referral between institutions may play a role. The overall ICU mortality rate in Korea is relatively high compared to other developed countries. A distinctive aspect of critical care in Korea is the existence of significant disparities in the quality of care and services provided across regions and hospitals. Addressing these disparities and optimizing the management of critically ill patients necessitates thoroughly trained intensivists who are well-versed in the latest clinical practice guidelines. A fully functioning unit with adequate patient throughput is also essential for maintaining consistent and reliable quality of patient care. However, the positive impact of ICU volume on mortality outcomes is also linked to complex organizational factors, such as multidisciplinary rounds, nurse staffing and education, the presence of a clinical pharmacist, care protocols for weaning and sedation, and a culture of teamwork and communication. Despite some inconsistencies in the association between ICU patient volume and patient outcomes, which are thought to arise from differences in healthcare systems, ICU case volume significantly affects patient outcomes and should be taken into account when formulating related healthcare policies.

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  • Volume-outcome relationship in pediatric blunt liver and spleen injuries: A multicenter retrospective cohort study
    Susumu Matsushime, Akira Kuriyama, Morihiro Katsura
    Journal of Pediatric Surgery Open.2025; 10: 100194.     CrossRef
  • Association Between Nurse Staffing Coverage and Patient Outcomes in a Context of Prepandemic Structural Understaffing: A Patient‐Unit‐Level Analysis
    Maria-Eulàlia Juvé-Udina, Jordi Adamuz, Maribel González-Samartino, Marta Tapia-Pérez, Emilio Jiménez-Martínez, Carme Berbis-Morello, Oliver Polushkina-Merchanskaya, Adelaida Zabalegui, María-Magdalena López-Jiménez, Claire Su-Yeon Park
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    Jun Fujinaga, Takanao Otake, Takehide Umeda, Toshio Fukuoka
    Journal of Intensive Care.2024;[Epub]     CrossRef
  • Association of Intensive Care Unit Case Volume With Mortality and Cost in Sepsis Based on a Japanese Nationwide Medical Claims Database Study
    Takehiko Oami, Taro Imaeda, Taka‑aki Nakada, Tuerxun Aizimu, Nozomi Takahashi, Toshikazu Abe, Yasuo Yamao, Satoshi Nakagawa, Hiroshi Ogura, Nobuaki Shime, Yutaka Umemura, Asako Matsushima, Kiyohide Fushimi
    Cureus.2024;[Epub]     CrossRef
Nursing
Theoretical definition of nurse–conscious mechanically ventilated patient communication: a scoping review with qualitative content analysis
Arezoo Mohamadkhani Ghiasvand, Meimanat Hosseini, Foroozan Atashzadeh-Shoorideh
Acute Crit Care. 2023;38(1):8-20.   Published online February 27, 2023
DOI: https://doi.org/10.4266/acc.2022.01039
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AbstractAbstract PDFSupplementary Material
Providing critical nursing care for conscious mechanically ventilated patients is mediated via effective communication. This study aimed to identify and map the antecedents, attributes, consequences, and definition of nurse–conscious mechanically ventilated patient communication (N-CMVPC). This scoping review was conducted by searching the Cochrane Library and the CINAHL, EMBASE, PubMed, Web of Science, and Scopus databases, between 2001 and 2021. The keywords queried included "nurses," "mechanically ventilated patients," "mechanical ventilation," "intubated patients," "communication," "interaction," "relationships," "nurse–patient communication," "nurse–patient relations," "intensive care units," and "critical care." Studies related to communication with healthcare personnel or family members were excluded. The results indicated that N-CMVPC manifests as a set of attributes in communication experiences, emotions, methods, and behaviors of the nurse and the patient and is classified into three main themes, nurse communication, patient communication, and quantitative-qualitative aspects. N-CMVPC is a complex, multidimensional, and multi-factor concept. It is often nurse-controlled and can express itself as questions, sentences, or commands in the context of experiences, feelings, and positive or negative behaviors involving the nurse and the patient.

Citations

Citations to this article as recorded by  
  • Optimizing infection control: Evaluating nurses' knowledge and practices for preventing infections in mechanically ventilated patients
    Safar awadh alotaibi, Maha AlOtaibi, Hadiya Nassar Alrashedi, Huda Ali S Alasmari, Abdelaziz Hendy, Rasha Kadri Ibrahim
    Infection, Disease & Health.2025;[Epub]     CrossRef
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    Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said
    The Open Nursing Journal.2024;[Epub]     CrossRef
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    Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
    The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28.     CrossRef
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    The Korean Journal of Rehabilitation Nursing.2023; 26(2): 97.     CrossRef
Original Article
Infection
Methylprednisolone pulse therapy for critically ill patients with COVID-19: a cohort study
Keum-Ju Choi, Soo Kyun Jung, Kyung Chan Kim, Eun Jin Kim
Acute Crit Care. 2023;38(1):57-67.   Published online February 7, 2023
DOI: https://doi.org/10.4266/acc.2022.00941
Correction in: Acute Crit Care 2023;38(2):249
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  • 216 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Background
The guidelines recommend the use of dexamethasone 6 mg or an equivalent dose in patients with coronavirus disease 2019 (COVID-19) who require supplemental oxygen. Given that the severity of COVID-19 varies, we investigated the effect of a pulse dose of corticosteroids on the clinical course of critically ill patients with COVID-19.
Methods
This single-center, retrospective cohort study was conducted between September and December 2021, which was when the Delta variant of the COVID-19 virus was predominant. We evaluated the mortality and oxygenation of severe to critical COVID-19 cases between groups that received dexamethasone 6 mg for 10 days (control group) and methylprednisolone 250 mg/day for 3 days (pulse group).
Results
Among 44 patients, 14 and 30 patients were treated with control steroids and pulse steroids, respectively. There was no difference in disease severity, time from COVID-19 diagnosis to steroid administration, or use of remdesivir or antibacterial agents between the two groups. The pulse steroid group showed a significant improvement in oxygenation before and after steroid treatment (P<0.001) compared with the control steroid group (P=0.196). There was no difference in in-hospital mortality (P=0.186); however, the pulse steroid group had a lower mortality rate (23.3%) than the control steroid group (42.9%). There was a significant difference in the length of hospital stay between both two groups (P=0.039).
Conclusions
Pulse steroids showed no mortality benefit but were associated with oxygenation improvement and shorter hospital stay than control steroids. Hyperglycemia should be carefully monitored with pulse steroids.

Citations

Citations to this article as recorded by  
  • The relationship between steroid treatment and mortality in patients with COVID-19 followed up in an intensive care unit
    Huseyin Ali Ozturk, Fatih Necip Arici
    PeerJ.2025; 13: e18606.     CrossRef
  • Baricitinib and Pulse Steroids Combination Treatment in Hyperinflammatory COVID-19: A Rheumatological Approach in the Intensive Care Unit
    Francesco Ferro, Gaetano La Rocca, Elena Elefante, Nazzareno Italiano, Michele Moretti, Rosaria Talarico, Erika Pelati, Katia Valentini, Chiara Baldini, Roberto Mozzo, Luigi De Simone, Marta Mosca
    International Journal of Molecular Sciences.2024; 25(13): 7273.     CrossRef
  • Comparative Efficacy of Inhaled and Intravenous Corticosteroids in Managing COVID-19-Related Acute Respiratory Distress Syndrome
    Ahmed A. Abdelkader, Bshra A. Alsfouk, Asmaa Saleh, Mohamed E. A. Abdelrahim, Haitham Saeed
    Pharmaceutics.2024; 16(7): 952.     CrossRef
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    Imran Sethi, Asim Shaikh, Musa Sethi, Hira Khalid Chohan, Sheraz Younus, Syed A Khan, Salim Surani
    World Journal of Virology.2024;[Epub]     CrossRef

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