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Original Article
Meta-analysis
Comparison of safety and efficacy between therapeutic or intermediate versus prophylactic anticoagulation for thrombosis in COVID-19 patients: a systematic review and meta-analysis
Hyeon-Jeong Lee, Hye Jin Jang, Won-Il Choi, Joonsung Joh, Junghyun Kim, Jungeun Park, Miyoung Choi
Acute Crit Care. 2023;38(2):160-171.   Published online May 25, 2023
DOI: https://doi.org/10.4266/acc.2022.01424
Correction in: Acute Crit Care 2023;38(4):516
  • 2,517 View
  • 173 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary Material
Background
Patients with coronavirus disease 2019 (COVID-19) infections often have macrovascular or microvascular thrombosis and inflammation, which are known to be associated with a poor prognosis. Heparin has been hypothesized that administration of heparin with treatment dose rather than prophylactic dose for prevention of deep vein thrombosis in COVID-19 patients. Methods: Studies comparing therapeutic or intermediate anticoagulation with prophylactic anticoagulation in COVID-19 patients were eligible. Mortality, thromboembolic events, and bleeding were the primary outcomes. PubMed, Embase, the Cochrane Library, and KMbase were searched up to July 2021. A meta-analysis was performed using random-effect model. Subgroup analysis was conducted according to disease severity. Results: Six randomized controlled trials (RCTs) with 4,678 patients and four cohort studies with 1,080 patients were included in this review. In the RCTs, the therapeutic or intermediate anticoagulation was associated with significant reductions in the occurrence of thromboembolic events (5 studies, n=4,664; relative risk [RR], 0.72; P=0.01), and a significant increase in bleeding events (5 studies, n=4,667; RR, 1.88; P=0.004). In the moderate patients, therapeutic or intermediate anticoagulation was more beneficial than prophylactic anticoagulation in terms of thromboembolic events, but showed significantly higher bleeding events. In the severe patients, the incidence of thromboembolic and bleeding events in the therapeutic or intermediate. Conclusions: The study findings suggest that prophylactic anticoagulant treatment should be used in patients with moderate and severe COVID-19 infection groups. Further studies are needed to determine more individualized anticoagulation guidance for all COVID-19 patients.

Citations

Citations to this article as recorded by  
  • The Community Pharmacy as a Study Center for the Epidemiological Analysis of the Population Vaccination against SARS-CoV-2: Evaluation of Vaccine Safety and Pharmaceutical Service
    Jacopo Raffaele Dibenedetto, Michela Cetrone, Marina Antonacci, Domenico Pio Cannone, Stefania Antonacci, Pasquale Bratta, Francesco Leonetti, Domenico Tricarico
    Pharmacy.2024; 12(1): 16.     CrossRef
  • Specific and Non-specific Aspects and Future Challenges of ICU Care Among COVID-19 Patients with Obesity: A Narrative Review
    Alexandra Beurton, Emma J. Kooistra, Audrey De Jong, Helmut Schiffl, Mercedes Jourdain, Bruno Garcia, Damien Vimpère, Samir Jaber, Peter Pickkers, Laurent Papazian
    Current Obesity Reports.2024;[Epub]     CrossRef
Review Article
Infection
Oxygen therapy for sepsis and prevention of complications
Hayk Minasyan
Acute Crit Care. 2022;37(2):137-150.   Published online March 17, 2022
DOI: https://doi.org/10.4266/acc.2021.01200
  • 9,331 View
  • 454 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Patients with sepsis have a wide range of respiratory disorders that can be treated with oxygen therapy. Experimental data in animal sepsis models show that oxygen therapy significantly increases survival, while clinical data on the use of different oxygen therapy protocols are ambiguous. Oxygen therapy, especially hyperbaric oxygenation, in patients with sepsis can aggravate existing oxidative stress and contribute to the development of disseminated intravascular coagulation. The purpose of this article is to compare experimental and clinical data on oxygen therapy in animals and humans, to discuss factors that can influence the results of oxygen therapy for sepsis treatment in humans, and to provide some recommendations for reducing oxidative stress and preventing disseminated intravascular coagulation during oxygen therapy.

Citations

Citations to this article as recorded by  
  • Sequential respiratory support in septic patients undergoing continuous renal replacement therapy: A study based on MIMIC-III database
    Chunxia Wang, Jianli Zheng, Yilin Zhao, Tiantian Liu, Yucai Zhang
    Heliyon.2024; 10(6): e27563.     CrossRef
  • Hyperbaric Oxygenation: Can It Be a Novel Supportive Method in Acute Kidney Injury? Data Obtained from Experimental Studies
    Sanjin Kovacevic, Nikola Mitovic, Predrag Brkic, Milan Ivanov, Maja Zivotic, Zoran Miloradovic, Jelena Nesovic Ostojic
    Cells.2024; 13(13): 1119.     CrossRef
  • Personalized medicine targeting different ARDS phenotypes: The future of pharmacotherapy for ARDS?
    Florian Blanchard, Arthur James, Mona Assefi, Natacha Kapandji, Jean-Michel Constantin
    Expert Review of Respiratory Medicine.2023; 17(1): 41.     CrossRef
  • Current data regarding homeostasis of tissues oxygenation in pathophysiological and therapeutic circumstances
    Constantin Munteanu, Mihaela Antonina Călin, Dragoș Manea, Cristina Popescu, Mădălina Iliescu, Elena Valentina Ionescu, Liliana Stanciu, Mihaela Minea, Carmen Oprea, Doinița Oprea, Mariana Rotariu, Gelu Onose
    Balneo and PRM Research Journal.2023; 14(Vol.14, no): 565.     CrossRef
  • Current data regarding homeostasis of tissues oxygenation in pathophysiological and therapeutic circumstances
    Constantin Munteanu, Mihaela Antonina Călin, Dragoș Manea, Cristina Popescu, Mădălina Iliescu, Elena Valentina Ionescu, Liliana Stanciu, Mihaela Minea, Carmen Oprea, Doinița Oprea, Mariana Rotariu, Gelu Onose
    Balneo and PRM Research Journal.2023; 14(Vol.14, no): 565.     CrossRef
Original Article
Pulmonary
Safety and feasibility of hybrid tracheostomy
Daeun Kang, In Beom Jeong, Sun Jung Kwon, Ji Woong Son, Gwan Woo Ku
Acute Crit Care. 2021;36(4):369-373.   Published online November 26, 2021
DOI: https://doi.org/10.4266/acc.2021.00801
  • 4,196 View
  • 119 Download
  • 2 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Background
Percutaneous dilatational tracheostomy (PDT) is widely used in intensive care units, but this conventional method has some disadvantages, such as requirement of a lot of equipment and experts at the site. Especially, in situations where the patient is isolated due to an infectious disease, difficulties in using the equipment may occur, and the number of exposed persons may increase. In this paper, we introduce hybrid tracheostomy that combines the advantages of surgical tracheostomy and PDT and describe our experiences.
Methods
Data from 55 patients who received hybrid tracheostomy without bronchoscopy from January 2020 to February 2021 were collected and reviewed retrospectively. Hybrid tracheostomy was performed at the bedside by a single thoracic surgeon. The hybrid tracheostomy method was as follows: after the skin was incised and the trachea was exposed, only the extent of the endotracheal tube that could not be removed was withdrawn, and then tracheostomy was performed by the Seldinger method using a PDT kit.
Results
The average age was 66.5 years, and the proportion of men was 69.1%. Among the patients, 21.8% were taking antiplatelet drugs and 14.5% were taking anticoagulants. The average duration of the procedure was 13.3 minutes. There was no major bleeding, and there was one case of paratracheal placement of the tracheostomy tube.
Conclusions
In most patients, the procedure can be safely performed without any major complications. However, patients with a short neck, a neck burn or patients who have received radiation therapy to the neck should be treated with conventional methods.

Citations

Citations to this article as recorded by  
  • A Modified Technique for Percutaneous Dilatational Tracheostomy
    Zahra Ghotbi, Mehrdad Estakhr, Mehdi Nikandish, Reza Nikandish
    Journal of Intensive Care Medicine.2023; 38(9): 878.     CrossRef

ACC : Acute and Critical Care