Acute and Critical Care

Review Articles

Neurosurgery
Interdisciplinary collaboration in neurocritical care management: Hyunchul Jung, Seung Bin Kim, Seungjoo Lee, Moinay Kim; Received August 7, 2025 Accepted December 9, 2025 Published online January 29, 2026; DOI: https://doi.org/10.4266/acc.003275 [Epub ahead of print]

301 View
33 Download

Abstract PDF: The complexity of neurocritical care requires a shift from traditional, discipline-specific practice toward a collaborative, interdisciplinary model. This review explores the conceptual and practical framework of interdisciplinary collaboration in neuro-intensive care units, examining the roles of key specialists including neurosurgeons, neurologists, intensivists, pharmacists, nutritionists, and rehabilitation experts. We discuss the benefits of coordinated care in improving patient-centered outcomes, reducing morbidity and mortality, and enhancing intensive care unit efficiency. Emerging evidence supports the integration of neurointensivists, structured communication tools, and team-based decision-making as essential components of modern critical care delivery. This article provides a comprehensive review of current strategies and proposes directions for advancing interdisciplinary practice in neurocritical care settings.

Neurosurgery
Personalized treatment approaches in neurocritical care: Jae Hyun Kim, Chang-Hyun Kim, Hanwool Jeon, Hyun-Chul Jung, Seungjoo Lee; Received July 25, 2025 Accepted September 1, 2025 Published online December 8, 2025; DOI: https://doi.org/10.4266/acc.003050 [Epub ahead of print]

1,605 View
235 Download

Abstract PDF: Acute brain injuries—including traumatic brain injury, subarachnoid hemorrhage, and intracerebral hemorrhage—exhibit profound pathophysiological heterogeneity, yet are often managed using standardized treatment protocols. While evidence-based guidelines have improved outcomes at a population level, they frequently overlook patient-specific variations in cerebral compliance, autoregulation, and metabolic reserve. This review explores the evolving paradigm of personalized neurocritical care, which integrates dynamic multimodal monitoring, individualized intracranial pressure management strategies, and real-time physiological indices such as pressure reactivity index, cerebral perfusion pressure optimization, and waveform analytics. We highlight the role of noninvasive modalities including quantitative pupillometry, transcranial Doppler, optic nerve sheath diameter ultrasound, near-infrared spectroscopy, and electroencephalography as adjuncts when invasive monitoring is limited or contraindicated. Furthermore, we examine tissue-level monitoring using brain oxygen tension and cerebral microdialysis and emerging blood-based biomarkers such as glial fibrillary acidic protein and neurofilament light. These tools provide granular insight into evolving secondary injury processes. In parallel, advances in artificial intelligence (AI) and machine learning enable deep phenotyping, predictive modeling, and integration of high-dimensional data including imaging, physiology, and omics-based profiles. The development of digital twin models further supports individualized simulation and therapeutic planning. While challenges remain in implementation, data harmonization, and resource availability, the convergence of physiologic monitoring, molecular profiling, and computational modeling offers a transformative pathway toward precision medicine in neurocritical care.

Nursing
Implementation of a partnership involving parents in the care of critically ill children: an integrative review: Tuti Seniwati, Nani Nurhaeni, Dessie Wanda; Acute Crit Care. 2025;40(4):521-537. Published online November 24, 2025; DOI: https://doi.org/10.4266/acc.001896

910 View
114 Download

Abstract PDF: The admission of a child to an intensive care unit, such as pediatric or neonatal intensive care units, serves as a significant stressor for parents. This condition is exacerbated when the child undergoes treatment in isolation from their parents. One strategy to address this challenge involves positioning parents at the bedside during the child’s care. This study aimed to identify and synthesize qualitative and quantitative research evidence on partnerships involving parents in the care of critically ill children. This research employed an integrative review method, and it was registered with the International Prospective Register of Systematic Reviews as a research-implementation protocol (ID no. CRD42023414924t). Six databases were searched for relevant literature, including ScienceDirect, Scopus, ProQuest, Sage Journals, PubMed, and Google Scholar. The evaluation of article quality used the 2018 version of the Mixed Methods Appraisal Tool, while content analysis was employed for data analysis. The results indicated that 18 articles fulfilled the inclusion requirements, out of the 5,435 articles found during the search phase. The analysis resulted in the discovery of three primary themes: partnership components, partnership outcomes and factors influencing partnerships. These three themes collectively constitute the conceptual model of partnerships in treating children with critical illness. It can be concluded that the active participation of parents in a child's critical care will yield positive outcomes for both the child and the parents. Existing empirical data underscore the significance of comprehending the factors influencing this specific situation.

Nursing
Nursing delirium management to promoting critically ill patients’ safety: an umbrella review: Daniela Carvalho Plácido, Maria do Rosário Pinto, Maria Cândida Durão, Helga Rafael Henriques, Joana Ferreira Teixeira; Acute Crit Care. 2025;40(3):373-392. Published online August 29, 2025; DOI: https://doi.org/10.4266/acc.005221

5,332 View
158 Download

Abstract PDF: Delirium is an acute disorder characterized by changes in the patient’s cognitive function, which another neurocognitive or pre-existing disease cannot explain. It produces adverse outcomes for critically ill patients and their families related to adverse events associated with the accidental removal of medical devices that increase the risk of the patient and the length of stay at the hospital, manifested by agitation and confusion behaviors. Five reviewers conducted An Umbrella Review from May to August 2023 through research in the databases Medline, CINAHL, Scopus, Web of Science, Cochrane Database of Systematic Reviews and articles obtained through research in other sources. After verifying their eligibility, we obtained 22 systematic reviews and meta-analyses for data extraction and analysis. From the results obtained, the importance of the implementation of surveillance interventions and systematic evaluation of the presence of delirium is highlighted, with particular emphasis on the use of the scale, Confusion Assessment Method, followed by the implementation of multicomponent interventions, pharmacological or not, highlighting the use of dexmedetomidine and family as support, as well early mobilization for the management of delirium. Managing delirium in critically ill patients based on Meyer and Lavin's theory, is an area sensitive to nursing care with an impact on the prevention of complications and consequent promotion of the safety of these patients, which also translates into positive results for the family and health organizations, reducing morbidity, mortality, length of stay and health costs.

Original Articles

Pediatrics
Low vitamin C concentrations and prognosis in critically ill children: Min Jung Kim, Yoon Hee Kim, Soo Yeon Kim, Jong Deok Kim, Mireu Park, Hamin Kim, Myung Hyun Sohn, Kyung Won Kim; Acute Crit Care. 2025;40(3):482-490. Published online August 29, 2025; DOI: https://doi.org/10.4266/acc.000975

1,831 View
40 Download
1 Web of Science
1 Crossref

Abstract PDF

Background
The administration of high-dose vitamins has been focused on in critically ill patients as adjunctive therapy for life-threatening conditions. We evaluated the association between serum vitamin C concentrations and patient prognosis. Methods: We retrospectively reviewed and collected clinical and biochemical data, including thiamine and vitamin C levels, of patients admitted to the pediatric intensive care unit (PICU). Results: In total, 177 patients were admitted to the PICU during the study period, and 63 children were enrolled in this study. The most common reason for PICU admission was sepsis (33.3%). The median thiamine and vitamin C levels were 3.6 µg/dl (interquartile range [IQR], 2.9–4.5 µg/dl) and 2.84 µg/ml (IQR, 1.61–4.55 µg/ml), respectively. Thiamine deficiency was observed in 10 patients (15.9%), and 17 (27.0%) had vitamin C deficiency. There were no differences in the vitamin levels according to the reason for PICU admission. Vitamin C levels were affected by nutritional status. The length of stay in the PICU and duration of mechanical ventilation were longer in patients with vitamin C deficiency than in those without (P=0.035 and P=0.010, respectively). The serum delta neutrophil index and C-reactive protein and lactate levels increased in the vitamin C-deficient group (P=0.028 and P=0.039, respectively). There was a significant difference in Pediatric Index of Mortality 3 scores according to vitamin C levels but not in mortality directly. Conclusions: Vitamin C deficiency was associated with elevated inflammatory marker levels, increased mechanical ventilation durations, and PICU admission. Our results support the potential benefits of vitamin C administration in critically ill children.

Citations

Citations to this article as recorded by

Clinical Characteristics and Outcomes of Pediatric Vitamin C Deficiency
Thanaporn Trangkanont, Maneerat Puwanant, Thirachit Chotsampancharoen
Nutrients.2025; 17(23): 3755. CrossRef

General ICU care
Biological age and clinical frailty scale measured at intensive care unit admission as predictors of hospital mortality among the critically ill in Western Australia: a retrospective cohort study: Nicholas Phillip Anthony, Kwok Ming Ho; Acute Crit Care. 2025;40(2):264-272. Published online May 28, 2025; DOI: https://doi.org/10.4266/acc.000200

4,278 View
337 Download
1 Web of Science
2 Crossref

Abstract PDF Supplementary Material

Background
Frailty is a widely accepted predictor of health outcomes in patients including the critically ill. Biological age is also increasingly recognized as a determinant of chronic health outcomes. Whether these factors are independently predictive of mortality among the critically ill is unknown. We assessed whether biological age, measured as PhenoAge at Intensive Care Unit (ICU) admission, predicts mortality in critically ill patients independent of the Clinical Frailty Scale (CFS).
Methods
This single-center retrospective cohort study included adult patients with available CFS and PhenoAge data at admission to ICU, excluding patients with incomplete records for key variables. The Levine PhenoAge model was used to estimate each patient’s biological age (PhenoAge). PhenoAge was then calibrated to generate a regression residual to reflect excessive biological age unexplained by chronological age.
Results
Of the 1,073 critically ill adult patients analyzed, 117 died (10.9%) before hospital discharge. PhenoAge and CFS were significantly correlated (correlation coefficient, 0.235; P=0.001). PhenoAge (receiver operating characteristic curve [AUROC], 0.622) and its residuals (AUROC, 0.627) and CFS (AUROC, 0.601) were predictive of hospital mortality, with no significant differences in their ability to differentiate between survivors and non-survivors (paired comparison to CFS: P=0.586 and P=0.537, respectively). PhenoAge interacted with frailty in its effect on mortality (P=0.004) which was particularly prominent among those who were not clinically frail (CFS ≤3).
Conclusions
PhenoAge and CFS, both measured at ICU admission, independently predicted hospital mortality. PhenoAge showed a notable interaction with frailty, particularly in non-frail patients.

Citations

Citations to this article as recorded by

Deep Biological Clocks in Critical Care Medicine: A Scoping Review Toward Translational Precision Care
Ithamar Cheyne, Magdalena Voinič, Tara Radaideh, Abdullah Daher, Julia Niezgoda, Maja Anna Romanowska, Małgorzata Mikaszewska-Sokolewicz
Journal of Personalized Medicine.2026; 16(2): 92. CrossRef
Biological age in critical care: current evidence, future prospects, and clinical implications
Li-bing Jiang, Wen Han
Frontiers in Medicine.2025;[Epub] CrossRef

Nursing
Engagement and perspectives regarding the family conference process when considering discontinuation of life-sustaining treatments among critical care specialist nurses: a nationwide cross-sectional survey in Japan: Akane Kato, Yuta Tanaka, Yoshiyuki Kizawa, Hiroaki Yamase, Asami Tado, Junko Tatsuno, Mitsunori Miyashita; Acute Crit Care. 2025;40(2):339-348. Published online May 20, 2025; DOI: https://doi.org/10.4266/acc.003096

2,731 View
21 Download

Abstract PDF: Background
Recognizing the importance of multidisciplinary collaboration during treatment family conferences is increasing in critical care settings. We aimed to elucidate how critical care specialist nurses engage in the family conference process in terms of the actual discussions held, the recommended topics, and their perspectives regarding transfer of critical care patients to general wards.
Methods
This self-administered nationwide survey was conducted between October and December 2020, targeting a random sample of 740 critical care specialist nurses. An anonymous questionnaire based on established guidelines and pilot tests was used to assess the level of engagement with the family conference process, content of discussions, considerations regarding withholding or withdrawing treatment, and perspectives concerning patient care location and discontinuation of life-sustaining treatments among the surveyed nurses.
Results
Of the 396 returned questionnaires (response rate, 51.9%), 384 were analyzed. Less than 35% of the nurses consistently participated in family conferences and ensured that decisions regarding withholding or withdrawing life-sustaining treatments were re-evaluated following the conferences. Discussions focused predominantly on the patients’ physical aspects, whereas the nurses believed that patients’ values and preferences should be discussed. More than 70% of the nurses supported transferring patients from critical care settings to general wards for end-of-life scenarios.
Conclusions
Critical care specialist nurses in Japan exhibit limited engagement in family conferences and often fail to address their patients’ values and preferences. Educational programs and enhanced interprofessional collaborations are warranted to improve nurse involvement in family conferences and ensure continuity of care between critical care and general ward settings.

Surgery
Classification of postoperative fever patients in the intensive care unit following intra-abdominal surgery: a machine learning-based cluster analysis using the Medical Information Mart for Intensive Care (MIMIC)-IV database, developed in the United States: Sang Mok Lee, Hongjin Shim; Acute Crit Care. 2025;40(2):293-303. Published online April 30, 2025; DOI: https://doi.org/10.4266/acc.004464

5,276 View
56 Download
1 Web of Science
2 Crossref

Abstract PDF

Background
Postoperative fever is common. However, it can sometimes indicate severe complications such as sepsis or pneumonia. Intensive care unit (ICU) patients who have undergone abdominal surgery have a higher risk of postoperative fever due the physical severity of this type of surgery. Nevertheless, determining when more aggressive or invasive management of fever is necessary remains a challenge.
Methods
We analyzed the Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC-IV-Note databases, which are open critical care big databases from a single institute in the United States. From this, we selected ICU patients who developed fever after intra-abdominal surgery and classified these patients into two groups using cluster analysis based on diverse variables from the MIMIC-IV databases. Following this cluster analysis, we assessed differences among the identified groups.
Results
Of 2,858 ICU stays after intra-abdominal surgery, 331 postoperative fever cases were identified. These patients were clustered into two groups. Group A included older patients with a higher mortality rate, while group B consisted of younger patients with a lower mortality rate.
Conclusions
Postoperative ICU patients with a fever could be classified into two distinct groups, a high-risk group and low-risk group. The high-risk patient group was characterized by older age, higher Sequential Organ Failure Assessment (SOFA) score, and more unstable hemodynamic status, indicating the need for aggressive management. Clustering postoperative fever patients by clinical variables can support medical decision-making and targeted treatment to improve patient outcomes.

Citations

Citations to this article as recorded by

Nomogram predictive model for the incidence and risk factors of persistent fever after cardiovascular surgery
Feng Zang, Guangxu Mao, Ziyao Quan, Yongfeng Shao, Sheng Zhao, Liyun Wang, Zhanjie Li, Zhongqiu You, Lu Liu, Wensen Chen
BMC Surgery.2025;[Epub] CrossRef
BODY TEMPERATURE MANAGEMENT IN PERIOPERATIVE AND INTENSIVE CARE: CLINICAL STRATEGIES FOR IMPROVING PATIENT OUTCOMES
Marta Nowocień, Karolina Witek, Joanna Kaźmierczak, Anna Mandecka, Kornela Kotucha-Cyl, Weronika Komala, Natalia Guzik, Joanna Gerlach, Dorota Plechawska
International Journal of Innovative Technologies in Social Science.2025;[Epub] CrossRef

Epidemiology
Simulating the effects of reducing transfer latency from the intensive care unit on intensive care unit bed utilization in a Korean Tertiary Hospital: Jaeyoung Choi, Song-Hee Kim, Ryoung-Eun Ko, Gee Young Suh, Jeong Hoon Yang, Chi-Min Park, Joongbum Cho, Chi Ryang Chung; Acute Crit Care. 2025;40(1):18-28. Published online February 21, 2025; DOI: https://doi.org/10.4266/acc.002976

4,122 View
180 Download
1 Web of Science
1 Crossref

Abstract PDF Supplementary Material

Background
Latency in transferring patients from intensive care units (ICUs) to general wards impedes the optimal allocation of ICU resources, underscoring the urgency of initiatives to reduce it. This study evaluates the extent of ICU transfer latency and assesses the potential benefits of minimizing it.
Methods
Transfer latency was measured as the time between the first transfer request and the actual ICU discharge at a single-center tertiary hospital in 2021. Computer-based simulations and cost analyses were performed to examine how reducing transfer latency could affect average hourly ICU bed occupancy, the proportion of time ICU occupancy exceeds 80%, and hospital costs. The first analysis evaluated all ICU admissions, and the second analysis targeted a subset of ICU admissions with longer transfer latency, those requiring infectious precautions.
Results
A total of 7,623 ICU admissions were analyzed, and the median transfer latency was 5.7 hours. Eliminating transfer latency for all ICU admissions would have resulted in a 32.8% point decrease in the proportion of time ICU occupancy exceeded 80%, and a potential annual savings of $6.18 million. Eliminating transfer latency for patients under infectious precautions would have decreased the time ICU occupancy exceeded 80% by 13.5% points, and reduced annual costs by a potential $1.26 million.
Conclusions
Transfer latency from ICUs to general wards might contribute to high ICU occupancy. Efforts to minimize latency for all admissions, or even for a subset of admissions with particularly long transfer latency, could enable more efficient use of ICU resources.

Citations

Citations to this article as recorded by

Association between emergency department–to–intensive care unit transfer time and mortality in patients with septic shock: a target trial emulation with septic shock in South Korea
Ji Hyun Cha, Danbee Kang, Ryoung-Eun Ko, Won Young Kim, Dong-gon Hyun, Yeon Joo Lee, Woo Hyun Cho, Sunghoon Park, Juhee Cho, Gee Young Suh
Acute and Critical Care.2025; 40(4): 548. CrossRef

Trauma
Predictive value of initial lactate levels for mortality and morbidity in critically ill pediatric trauma patients: a retrospective study from a Turkish pediatric intensive care unit: Abdulrahman Özel, Esra Nur İlbeği, Servet Yüce; Acute Crit Care. 2025;40(1):87-94. Published online February 18, 2025; DOI: https://doi.org/10.4266/acc.003528

6,011 View
173 Download
2 Web of Science
3 Crossref

Abstract PDF

Background
This study investigated the relationship between initial lactate levels and both mortality and morbidity in critically ill pediatric trauma patients requiring intensive care.
Methods
This retrospective study at tertiary center’s pediatric intensive care unit from January 2020 to June 2024 aimed to characterize trauma patients and assess admission lactate levels' prognostic value.
Results
A total of 190 critically ill pediatric trauma patients were included in the study. The mortality rate was 7.9%, with most deaths occurring within the first 48 hours of admission. Initial lactate levels ≥6.9 mmol/L demonstrated moderate predictive power (area under the curve [AUC], 0.878) for mortality. Pediatric Risk of Mortality III (PRISM III) score showed good predictive ability (AUC, 0.922), while Pediatric Trauma Scores exhibited variable predictive performance (AUC, 0.863). Higher initial lactate levels were significantly associated with severe brain injury, the need for intubation, and an increased incidence of thoracic or abdominal injuries.
Conclusions
Initial lactate levels and PRISM III score are effective predictors of mortality in critically ill pediatric trauma patients. Lactate levels ≥5 mmol/L upon admission should prompt close monitoring and consideration of aggressive management strategies.

Citations

Citations to this article as recorded by

Beyond survival: Early markers of poor outcome in pediatric trauma
Kubra Boydag Guvenc, Ebru Guney Sahin, Idris Abdullah Yılmaz, Refik Ozturk, Ceyhan Sahin, Fatih Varol, Cansu Durak
The American Journal of Emergency Medicine.2026; 101: 103. CrossRef
Incidence, severity and outcomes of hypoxemia in paediatric emergencies seen at a tertiary hospital in Southern Nigeria
Moses T. Abiodun, Gabriel Oziegbe, Imuwahen A. Mbarie, Wilson O. Osarogiagbon, Collins E. Etin-Osa, Rosena O. Oluwafemi, Godwin E. Okungbowa, Ovonomo Ewhe, Rahmon Olusola, Benjamin Nandom, Adesuwa Kpongo-Ogieva, Jane Aghama, Cyril Oputa
International Journal of Contemporary Pediatrics.2025; 12(8): 1289. CrossRef
Prognostic value of the lactate dehydrogenase-to-albumin ratio for predicting mortality in critically ill pediatric patients: a retrospective cohort study
Ming Liu, Yunpeng Gou, Ping Yang
Frontiers in Pediatrics.2025;[Epub] CrossRef

Review Article

Nursing
Promoting patient safety in critically ill patients: nursing interventions in surveillance and prevention of ocular injuries: Anabela Carvalho Raposo, Maria Candida Durao, Maria do Rosário Pinto, Helga Rafael Henriques, Joana Ferreira Teixeira; Acute Crit Care. 2025;40(1):10-17. Published online February 12, 2025; DOI: https://doi.org/10.4266/acc.005014

9,288 View
261 Download
1 Web of Science
2 Crossref

Abstract PDF

Corneal surface injuries occur frequently (59.4%) in critically ill patients, and the average time for their appearance is 8 days. Such injuries are primarily related to dry eye, which increases the risk of exposure injury in patients admitted to intensive care units. This can result in a severe ulcer or perforation that results in partial to total loss of vision, decreasing the quality of the patient's life. This is a sensitive nursing care area requiring further investigation. Thus, this review aims to analyse nursing interventions that aim to prevent ocular surface injuries. An integrative literature review was carried out from May to August 2023 in the Medline, CINAHL, Scopus, Web of Science, and PubMed databases using the Whittemore and Knafl methodology. Inclusion and exclusion criteria were subsequently applied to assess the results. After verifying result eligibility, seven documents were identified for data extraction and analysis. The results suggest the importance of recognizing risk factors for ocular injuries in critically ill patients, surveillance as a nursing competency, adequate ocular hygiene and effective lubrication, and managing environmental conditions to prevent corneal injuries. Implementing surveillance and intervention protocols for critically ill patients at risk of corneal injuries requires specialized training for critical care nurses. Specifically, environmental management, including temperature and humidity control, is highlighted as an area that merits further research.

Citations

Citations to this article as recorded by

Lens on eye care in intensive care units: deficiencies, training, and improvement recommendations – a descriptive observational study
Ayşegül Tuğba Yıldız, Özlem Ceyhan
BMC Nursing.2025;[Epub] CrossRef
Ocular Surface Disorders in ICU Patients: Evidence-Based Nursing Prevention Strategies
Weiwei Ni, Xinwei Jiao
Translational Vision Science & Technology.2025; 14(12): 21. CrossRef

Original Article

Surgery
Performance evaluation of non-invasive cardiac output monitoring device (HemoVista) based on multi-channel thoracic impedance plethysmography technology: Jaehee Park, Byung-Moon Choi; Acute Crit Care. 2024;39(4):565-572. Published online November 18, 2024; DOI: https://doi.org/10.4266/acc.2024.00731

6,652 View
193 Download
1 Web of Science
1 Crossref

Abstract PDF

Background
A non-invasive method of measuring cardiac output (CO) can be beneficial in the care of critically ill patients. HemoVista (BiLab Co., Ltd.) is a medical device that measures CO non-invasively using multi-channel impedance plethysmography technology. The purpose of this study was to exploratively evaluate the performance of HemoVista in critically ill patients undergoing CO monitoring with the FloTrac (Edwards Lifesciences).
Methods
After non-invasively installing the HemoVista sensor in critically ill patients whose CO was monitored with the FloTrac, CO values measured by both devices were collected for 30 minutes. Cardiac output measured by both devices was selected every 10 seconds, creating approximately 360 data pairs per patient. Linear correlation analysis with Pearson correlation coefficients, Bland-Altman analysis, and four-quadrant plot analysis were performed to evaluate the performance of HemoVista.
Results
A total of 7,138 pairs of CO data from the 20 patients were included in the analysis. A significant correlation was observed between the two methods of measuring CO (Pearson's r=0.489, P<0.001). The mean bias was 1.03 L/min, the 95% CI for the limit of agreement was –1.83 L/min to 3.93 L/min and the percentage error was 55.8%. The concordance rate of time-dependent CO between the two devices was 14.6%.
Conclusions
It was observed that the current version of HemoVista has unsuitable performance for use in intensive care units. To be used for critically ill patients, the algorithm must be improved and reevaluated with an enhanced version.

Citations

Citations to this article as recorded by

Wearable ECG-PPG Deep Learning Model for Cardiac Index-Based Noninvasive Cardiac Output Estimation in Cardiac Surgery Patients
Minwoo Kim, Min Dong Sung, Jimyeoung Jung, Sung Pil Cho, Junghwan Park, Sarah Soh, Hyun Chel Joo, Kyung Soo Chung
Sensors.2026; 26(2): 735. CrossRef

Review Articles

Meta-analysis
The impact of ketamine on outcomes in critically ill patients: a systematic review with meta-analysis and trial sequential analysis of randomized controlled trials: Yerkin Abdildin, Karina Tapinova, Assel Nemerenova, Dmitriy Viderman; Acute Crit Care. 2024;39(1):34-46. Published online February 28, 2024; DOI: https://doi.org/10.4266/acc.2023.00829

24,881 View
563 Download
4 Web of Science
6 Crossref

Abstract PDF

Background
This meta-analysis aims to evaluate the effects of ketamine in critically ill intensive care unit (ICU) patients.
Methods
We searched for randomized controlled trials (RCTs) in PubMed, Scopus, and the Cochrane Library; the search was performed initially in January but was repeated in December of 2023. We focused on ICU patients of any age. We included studies that compared ketamine with other traditional agents used in the ICU. We synthesized evidence using RevMan v5.4 and presented the results as forest plots. We also used trial sequential analysis (TSA) software v. 0.9.5.10 Beta and presented results as TSA plots. For synthesizing results, we used a random-effects model and reported differences in outcomes of two groups in terms of mean difference (MD), standardized MD, and risk ratio with 95% confidence interval. We assessed the risk of bias using the Cochrane RoB tool for RCTs. Our outcomes were mortality, pain, opioid and midazolam requirements, delirium rates, and ICU length of stay.
Results
Twelve RCTs involving 805 ICU patients (ketamine group, n=398; control group, n=407) were included in the meta-analysis. The ketamine group was not superior to the control group in terms of mortality (in five studies with 318 patients), pain (two studies with 129 patients), mean and cumulative opioid consumption (six studies with 494 patients), midazolam consumption (six studies with 304 patients), and ICU length of stay (three studies with 270 patients). However, the model favored the ketamine group over the control group in delirium rate (four studies with 358 patients). This result is significant in terms of conventional boundaries (alpha=5%) but is not robust in sequential analysis. The applicability of the findings is limited by the small number of patients pooled for each outcome.
Conclusions
Our meta-analysis did not demonstrate differences between ketamine and control groups regarding any outcome except delirium rate, where the model favored the ketamine group over the control group. However, this result is not robust as sensitivity analysis and trial sequential analysis suggest that more RCTs should be conducted in the future.

Citations

Citations to this article as recorded by

Continuous ketamine infusion for surgical patients in the intensive care unit: a systematic review and meta-analysis of randomized controlled trials with GRADE assessment
Abdulrahman Ibrahim Alzmmam, Reema Fahad Alghanem, Asma Alshahrani, Raneem Aljawaied, Faisal Sulaiman Alolayqi, Salem Khalaf Alanazi, Lafi Alanazi, Ghaida Alkawabah, Nawal Ali Zaeri, Khawlah Alrabghi, Zainab Alshemali, Alawi S. Alsaeedi
Critical Care.2026;[Epub] CrossRef
Ketamine use in adult intensive care unit: a narrative review of emerging applications, efficacy challenges, and safety concerns
Siyao Zeng, Zhipeng Yao, Chunming Guan, Shanpeng Cui, Zhen Quan, Yue Li, Junbo Zheng, Hongliang Wang
Emergency and Critical Care Medicine.2025; 5(3): 153. CrossRef
The effect of low-dose ketamine compared to morphine on the severity of acute pain in emergency situations: a systematic review and meta-analysis
Jun Zhang, Bin Ma
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.2025;[Epub] CrossRef
Sedation and analgesia strategies in the neuro intensive care unit
Zachary I Merhavy, Tereque Raeburn, Gloria M Torres-Ayala, Melissa A McCulloch, Thomas C Varkey
World Journal of Critical Care Medicine.2025;[Epub] CrossRef
Ketamine sedation in critically ill patients: Past, present and future
Sameer Sharif, Jay Prakash, Bram Rochwerg
Indian Journal of Anaesthesia.2024; 68(8): 674. CrossRef
Opioid-Free Using Ketamine versus Opioid-Sparing Anesthesia during the Intraoperative Period in Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial
Hoon Choi, Jaewon Huh, Minju Kim, Seok Whan Moon, Kyung Soo Kim, Wonjung Hwang
Journal of Personalized Medicine.2024; 14(8): 881. CrossRef

Trauma
Abdominal compartment syndrome in critically ill patients: Hyunseok Jang, Naa Lee, Euisung Jeong, Yunchul Park, Younggoun Jo, Jungchul Kim, Dowan Kim; Acute Crit Care. 2023;38(4):399-408. Published online November 29, 2023; DOI: https://doi.org/10.4266/acc.2023.01263

27,131 View
4,229 Download
4 Web of Science
5 Crossref

Abstract PDF

Intra-abdominal hypertension can have severe consequences, including abdominal compartment syndrome, which can contribute to multi-organ failure. An increase in intra-abdominal hypertension is influenced by factors such as diminished abdominal wall compliance, increased intraluminal content, and certain systemic conditions. Regular measurement of intra-abdominal pressure is essential, and particular attention must be paid to patient positioning. Nonsurgical treatments, such as decompression of intraluminal content using a nasogastric tube, percutaneous drainage, and fluid balance optimization, play crucial roles. Additionally, point-of-care ultrasonography aids in the diagnosis and treatment of intra-abdominal hypertension. Emphasizing the importance of regular measurements, timely decompressive laparotomy is a definitive, but complex, treatment option. Balancing the urgency of surgical intervention against potential postoperative complications is challenging.

Citations

Citations to this article as recorded by

Successful Abdominal Wall Reconstruction Using a Reinforced Tissue Matrix After Severe Pancreatitis and Abdominal Compartment Syndrome: A Case Report
David A Baer, James R DeLine
Cureus.2025;[Epub] CrossRef
Hemodynamics assessment in critically ill children with increased intra-abdominal pressure
Marwa Tolba, Ahmed Mesbah, Ahmed Abd El-Bassat, Amr Mohamed Zoair, Nahed Hablas, Khaled Talaat
Egyptian Pediatric Association Gazette.2025;[Epub] CrossRef
Trajectories of cumulative fluid balance and the association with pressure injuries in ICU patients
Xiangping Chen, Peiqi Liu, Bingyan Zhu, Xiumin Qiu, Wei Yu, Yuewen Lao, Xiaoyan Gong, Yiyu Zhuang
International Journal of Nursing Sciences.2025; 12(6): 566. CrossRef
Efficacy and safety of electroacupuncture for paralytic ileus in severe stroke: a protocol of multicenter, randomized controlled trial
Dehui Nie, Meiling Zhang, Bin Han, Dan Jin, Jianlong Huang, Liming Lu
Frontiers in Neurology.2025;[Epub] CrossRef
International cross-sectional survey on current and updated definitions of intra-abdominal hypertension and abdominal compartment syndrome
Prashant Nasa, Robert D. Wise, Marije Smit, Stefan Acosta, Scott D’Amours, William Beaubien–Souligny, Zsolt Bodnar, Federico Coccolini, Neha S. Dangayach, Wojciech Dabrowski, Juan Duchesne, Janeth C. Ejike, Goran Augustin, Bart De Keulenaer, Andrew W. Kir
World Journal of Emergency Surgery.2024;[Epub] CrossRef

Original Articles

Nursing
The effects of environmental interventions for delirium in critically ill surgical patients: Hak-Jae Lee, Yoon-Joong Jung, Nak-Joon Choi, Suk-Kyung Hong; Acute Crit Care. 2023;38(4):479-487. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00990

9,051 View
205 Download
6 Web of Science
6 Crossref

Abstract PDF

Background
Delirium occurs at high rates among patients in intensive care units and increases the risk of morbidity and mortality. The purpose of this study was to investigate the effects of environmental interventions on delirium.
Methods
This prospective cohort study enrolled 192 patients admitted to the surgical intensive care unit (SICU) during the pre-intervention (June 2013 to October 2013) and post-intervention (June 2014 to October 2014) periods. Environmental interventions involved a cognitive assessment, an orientation, and a comfortable environment including proper sleep conditions. The primary outcomes were the prevalence, duration, and onset of delirium.
Results
There were no statistically significant differences in incidence rate, time of delirium onset, general characteristics, and mortality between the pre-intervention and post-intervention groups. The durations of delirium were 14.4±19.1 and 7.7±7.3 days in the pre-intervention and post-intervention groups, respectively, a significant reduction (P=0.027). The lengths of SICU stay were 20.0±22.9 and 12.6±8.7 days for the pre-intervention and post-intervention groups, respectively, also a significant reduction (P=0.030).
Conclusions
The implementation of an environmental intervention program reduced the duration of delirium and length of stay in the SICU for critically ill surgical patients.

Citations

Citations to this article as recorded by

The effectiveness of family participation interventions for the prevention of delirium in intensive care units: A systematic review
Marli Lopo Vitorino, Adriana Henriques, Graça Melo, Helga Rafael Henriques
Intensive and Critical Care Nursing.2025; 89: 103976. CrossRef
Delirium in Critically Ill Geriatric Surgical Patients: A Systematic Review of Screening, Risk Factors, Diagnosis, and Management
Zackary Yates, Philip Lee, Nikita Nunes Espat, Ruth Zagales, Nickolas Hernandez, Quratulain Amin, Andrew Ford, Caitlin Tweedie, Adel Elkbuli
Journal of Trauma Nursing.2025; 32(4): 169. CrossRef
The incidence and risk factors of perioperative delirium in elderly patients with hip fracture under the Unaccompanied- Care model
XiaoLing Chen, Yixin Huang, Fengxiang Chen, Xiaole Jiang, Dongze Lin, Fengfei Lin
Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
The effects of restricted visitation on delirium incidence in the intensive care units of a tertiary hospital in South Korea
Leerang Lim, Christine Kang, Minseob Kim, Jinwoo Lee, Hong Yeul Lee, Seung-Young Oh, Ho Geol Ryu, Hannah Lee
Acute and Critical Care.2025; 40(3): 452. CrossRef
Clinical Nursing Management of Adult Patients with Delirium in a Hospital Setting—A Systematic Review
Anna Szewczak, Dorota Siwicka, Jadwiga Klukow, Joanna Czerwik-Marcinkowska, Szymon Zmorzynski
Journal of Clinical Medicine.2025; 14(22): 8113. CrossRef
Reasons influencing the nurses’ prioritization process while preventing and managing delirium: findings from a qualitative study
Luisa Sist, Nikita Valentina Ugenti, Stefania Chiappinotto, Rossella Messina, Paola Rucci, Alvisa Palese
Aging Clinical and Experimental Research.2024;[Epub] CrossRef

Infection
Healthcare-associated infections in critical COVID-19 patients in Tunis: epidemiology, risk factors, and outcomes: Ahlem Trifi, Selim Sellaouti, Asma Mehdi, Lynda Messaoud, Eya Seghir, Badis Tlili, Sami Abdellatif; Acute Crit Care. 2023;38(4):425-434. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00773

4,975 View
85 Download
3 Web of Science
3 Crossref

Abstract PDF Supplementary Material

Background
Coronavirus disease 2019 (COVID-19) pandemic disrupted adherences to healthcare-associated infection (HAI) prevention protocols. Herein, we studied the characteristics of all HAIs occurring in critically ill COVID-19 patients.
Methods
A retrospective, single-center cohort of critical COVID-19 patients during 2021. Microbiological samples were collected if HAI was suspected. We analyzed all factors that could potentially induce HAI, using septic shock and mortality as endpoints.
Results
Sixty-four among 161 included patients (39.7%) presented a total of 117 HAIs with an incidence density of 69.2 per 1,000 hospitalization days. Compared to the prior COVID-19 period (2013–2019), the identification of HAI increased in 2021. HAIs were classified into ventilator-associated pneumonia (VAP; n=38), bloodstream infection (n=32), urinary tract infection (n=24), catheter-related infection (n=12), and fungal infection (n=11). All HAIs occurred significantly earlier in the post–COVID-19 period (VAP: 6 vs. 10 days, P=0.045, in 2017 and 2021). Acinetobacter baumannii (39.5%) and Klebsiella pneumoniae (27%) were the most commonly isolated pathogens that exhibited a multidrug-resistant (MDR) profile, observed in 89% and 64.5%, respectively. The HAI factors were laboratory abnormalities (odds ratio [OR], 6.4; 95% confidence interval [CI], 2.3–26.0), cumulative steroid dose (OR, 1.9; 95% CI, 1.3–4.0), and invasive procedures (OR, 20.7; 95% CI, 5.3–64.0). HAI was an independent factor of mortality (OR, 8.5; P=0.004).
Conclusions
During the COVID-19 era, the incidence of HAIs increased and MDR isolates remained frequent. A severe biological inflammatory syndrome, invasive devices, and elevated cumulative steroid dosages were related to HAIs. HAI was a significant death factor.

Citations

Citations to this article as recorded by

Burden of Healthcare-Associated Infections on Mortality Among COVID-19 Hospitalized Patients
Corina Voinea, Elena Mocanu, Elena Dantes, Sanda Jurja, Ana-Maria Neculai, Aurora Craciun, Sorin Rugina
Journal of Clinical Medicine.2025; 14(23): 8279. CrossRef
Depression during the COVID pandemic in La Manouba Governorate, Tunisia: A community survey
Mauro G Carta, Viviane Kovess, Amina Aissa, Amine Larnaout, Yosra Zgueb, Lubna A Alnasser, Maria Francesca Moro, Federica Sancassiani, Elisa Cantone, Salsabil Rjaibi, Nada Zoghlami, Mejdi Zid, Hajer Aounallah-Skhiri, Uta Ouali
International Journal of Social Psychiatry.2024; 70(6): 1128. CrossRef
Multidrug-Resistant Klebsiella pneumoniae Strains in a Hospital: Phylogenetic Analysis to Investigate Local Epidemiology
Maria Vittoria Ristori, Fabio Scarpa, Daria Sanna, Marco Casu, Nicola Petrosillo, Umile Giuseppe Longo, De Florio Lucia, Silvia Spoto, Rosa Maria Chiantia, Alessandro Caserta, Raffaella Rosy Vescio, Flavio Davini, Lucrezia Bani, Elisabetta Riva, Massimo C
Microorganisms.2024; 12(12): 2541. CrossRef

CPR/Resuscitation
Percent fluid overload for prediction of fluid de-escalation in critically ill patients in Saudi Arabia: a prospective observational study: Reham A. Alharbi, Namareq F. Aldardeer, Emily L. G. Heaphy, Ahmad H. Alabbasi, Amjad M. Albuqami, Hassan Hawa; Acute Crit Care. 2023;38(2):209-216. Published online May 16, 2023; DOI: https://doi.org/10.4266/acc.2022.01550

7,512 View
182 Download
1 Crossref

Abstract PDF Supplementary Material

Background
Percent fluid overload greater than 5% is associated with increased mortality. The appropriate time for fluid deresuscitation depends on the patient's radiological and clinical findings. This study aimed to assess the applicability of percent fluid overload calculations for evaluating the need for fluid deresuscitation in critically ill patients.
Methods
This was a single-center, prospective, observational study of critically ill adult patients requiring intravenous fluid administration. The study's primary outcome was median percent fluid accumulation on the day of fluid deresuscitation or intensive care unit (ICU) discharge, whichever came first.
Results
A total of 388 patients was screened between August 1, 2021, and April 30, 2022. Of these, 100 with a mean age of 59.8±16.2 years were included for analysis. The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 15.4±8.0. Sixty-one patients (61.0%) required fluid deresuscitation during their ICU stay, while 39 (39.0%) did not. Median percent fluid accumulation on the day of deresuscitation or ICU discharge was 4.5% (interquartile range [IQR], 1.7%–9.1%) and 5.2% (IQR, 2.9%–7.7%) in patients requiring deresuscitation and those who did not, respectively. Hospital mortality occurred in 25 (40.9%) of patients with deresuscitation and six (15.3%) patients who did not require it (P=0.007).
Conclusions
The percent fluid accumulation on the day of fluid deresuscitation or ICU discharge was not statistically different between patients who required fluid deresuscitation and those who did not. A larger sample size is needed to confirm these findings.

Citations

Citations to this article as recorded by

THE RELATIONSHIP BETWEEN FLUID BALANCE AND FLUID MANAGEMENT STRATEGIES WITH MORTALITY AND CLINICAL OUTCOMES IN ICU: A SYSTEMATIC REVIEW
Arda Tri Wahyuningsih
Indonesian Journal of Anesthesiology and Critical Care Medicine.2026; 1(2): 53. CrossRef

Infection
Evaluating the use of the respiratory-rate oxygenation index as a predictor of high-flow nasal cannula oxygen failure in COVID-19: Scott Weerasuriya, Savvas Vlachos, Ahmed Bobo, Namitha Birur Jayaprabhu, Lauren Matthews, Adam R Blackstock, Victoria Metaxa; Acute Crit Care. 2023;38(1):31-40. Published online February 27, 2023; DOI: https://doi.org/10.4266/acc.2022.01081

5,931 View
145 Download

Abstract PDF Supplementary Material: Background
It can be challenging for clinicians to predict which patients with respiratory failure secondary to coronavirus disease 2019 (COVID-19) will fail on high-flow nasal cannula (HFNC) oxygen and require escalation of therapy. This study set out to evaluate the association between the respiratory rate-oxygenation index (ROX) and HFNC failure in such patients and to assess whether ROX trajectory correlates with treatment failure.
Methods
This was a single-centre, retrospective, observational study of patients with COVID-19 requiring HFNC, conducted over a 3-month period. ROX was calculated as “pulse-oximetry oxygen saturation (SpO2) over the fractional inspired oxygen concentration (FiO2)/respiratory rate” for each patient at 2, 4, and 12 hours from starting HFNC. HFNC failure was defined as escalation to continuous positive airway pressure ventilation or invasive mechanical ventilation (IMV). Time-to-event analyses were performed to account for the longitudinal data set and time-dependent variables.
Results
We included 146 patients. Ninety-three (63.7%) experienced HFNC failure, with 53 (36.3%) requiring IMV. Higher ROX values were associated with a lower subhazard of HFNC failure on time-to-HFNC failure analysis (subhazard ratio, 0.29; 95% confidence interval [CI], 0.18–0.46; P<0.001). This remained true after controlling for informative censoring. Median ROX values changed differentially over time, increasing in the HFNC success group (0.06 per hour; 95% CI, 0.05–0.08; P<0.001) but not in the HFNC failure group (0.004 per hour; 95% CI, –0.05 to 0.08; P=0.890).
Conclusions
A higher ROX is associated with a lower risk of HFNC failure. Monitoring ROX trajectory over time may help identify patients at risk of treatment failure. This has potential clinical applications; however, future prospective studies are required.

Review Article

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

12,144 View
283 Download
2 Web of Science
6 Crossref

Abstract PDF Supplementary 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; 30(3): 194. CrossRef
Interaction Experiences of Family Members With Their Unconscious Relatives on Mechanical Ventilation in the Intensive Care Unit: A Phenomenological Qualitative Study
Hülya Koçyiğit Kavak, Suna Demirci
Nursing in Critical Care.2025;[Epub] CrossRef
Lived experiences of critical care nurses in communicating with non-verbal or unconscious patients in Western Amhara, Northwest Ethiopia: A descriptive phenomenological study
Abebe Dilie Afenigus, Mastewal Ayehu Sinshaw
International Journal of Africa Nursing Sciences.2025; 23: 100924. CrossRef
Communication Methods Used with Conscious Intubated Patients: Scoping Review
Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said
The Open Nursing Journal.2024;[Epub] CrossRef
A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
The Application of Augmentative and Alternative Communication in Intubated Patients in the Intensive Care Unit: A Scoping Review
Mee-Kyung Shin, Hyejin Jeon
The Korean Journal of Rehabilitation Nursing.2023; 26(2): 97. CrossRef

Original Article

Epidemiology
Multicenter validation of a deep-learning-based pediatric early-warning system for prediction of deterioration events: Yunseob Shin, Kyung-Jae Cho, Yeha Lee, Yu Hyeon Choi, Jae Hwa Jung, Soo Yeon Kim, Yeo Hyang Kim, Young A Kim, Joongbum Cho, Seong Jong Park, Won Kyoung Jhang; Acute Crit Care. 2022;37(4):654-666. Published online October 26, 2022; DOI: https://doi.org/10.4266/acc.2022.00976

9,177 View
259 Download
7 Web of Science
8 Crossref

Abstract PDF Supplementary Material

Background
Early recognition of deterioration events is crucial to improve clinical outcomes. For this purpose, we developed a deep-learning-based pediatric early-warning system (pDEWS) and aimed to validate its clinical performance.
Methods
This is a retrospective multicenter cohort study including five tertiary-care academic children’s hospitals. All pediatric patients younger than 19 years admitted to the general ward from January 2019 to December 2019 were included. Using patient electronic medical records, we evaluated the clinical performance of the pDEWS for identifying deterioration events defined as in-hospital cardiac arrest (IHCA) and unexpected general ward-to-pediatric intensive care unit transfer (UIT) within 24 hours before event occurrence. We also compared pDEWS performance to those of the modified pediatric early-warning score (PEWS) and prediction models using logistic regression (LR) and random forest (RF).
Results
The study population consisted of 28,758 patients with 34 cases of IHCA and 291 cases of UIT. pDEWS showed better performance for predicting deterioration events with a larger area under the receiver operating characteristic curve, fewer false alarms, a lower mean alarm count per day, and a smaller number of cases needed to examine than the modified PEWS, LR, or RF models regardless of site, event occurrence time, age group, or sex.
Conclusions
The pDEWS outperformed modified PEWS, LR, and RF models for early and accurate prediction of deterioration events regardless of clinical situation. This study demonstrated the potential of pDEWS as an efficient screening tool for efferent operation of rapid response teams.

Citations

Citations to this article as recorded by

A Realist Evaluation of a Rapid Response System for Mental State Deterioration in Acute Hospital Settings
Tendayi Bruce Dziruni, Alison M. Hutchinson, Sandra Keppich‐Arnold, Tracey Bucknall
Journal of Advanced Nursing.2026;[Epub] CrossRef
Implementation of the bedside paediatric early warning system, its sustainability in clinical practice and patient outcomes: a quality improvement initiative
Ruqiah Ali AlZaher, Syed Jamil, Iris Murabi, Eidah Ahmari
BMJ Open Quality.2025; 14(2): e002454. CrossRef
AI-driven transcriptomic biomarker discovery for early identification of pediatric deterioration in Acute Care
Qing Wang, Lina Sun, Wei Meng, Chen Chen
SLAS Technology.2025; 35: 100357. CrossRef
Predicting cardiac arrest after neonatal cardiac surgery
Alexis L. Benscoter, Mark A. Law, Santiago Borasino, A. K. M. Fazlur Rahman, Jeffrey A. Alten, Mihir R. Atreya
Intensive Care Medicine – Paediatric and Neonatal.2024;[Epub] CrossRef
Volumetric regional MRI and neuropsychological predictors of motor task variability in cognitively unimpaired, Mild Cognitive Impairment, and probable Alzheimer's disease older adults
Michael Malek-Ahmadi, Kevin Duff, Kewei Chen, Yi Su, Jace B. King, Vincent Koppelmans, Sydney Y. Schaefer
Experimental Gerontology.2023; 173: 112087. CrossRef
Predicting sepsis using deep learning across international sites: a retrospective development and validation study
Michael Moor, Nicolas Bennett, Drago Plečko, Max Horn, Bastian Rieck, Nicolai Meinshausen, Peter Bühlmann, Karsten Borgwardt
eClinicalMedicine.2023; 62: 102124. CrossRef
A model study for the classification of high-risk groups for cardiac arrest in general ward patients using simulation techniques
Seok Young Song, Won-Kee Choi, Sanggyu Kwak
Medicine.2023; 102(37): e35057. CrossRef
An advanced pediatric early warning system: a reliable sentinel, not annoying extra work
Young Joo Han
Acute and Critical Care.2022; 37(4): 667. CrossRef

Review Article

Basic science and research
Barriers and facilitators in the provision of palliative care in adult intensive care units: a scoping review: Christantie Effendy, Yodang Yodang, Sarah Amalia, Erna Rochmawati; Acute Crit Care. 2022;37(4):516-526. Published online October 18, 2022; DOI: https://doi.org/10.4266/acc.2022.00745

13,410 View
545 Download
17 Web of Science
22 Crossref

Abstract PDF

The provision of palliative care in the intensive care unit (ICU) is increasing. While some scholars have suggested the goals of palliative care to not be aligned with the ICU, some evidence show benefits of the integration. This review aimed to explore and synthesize research that identified barriers and facilitators in the provision of palliative care in the ICU. This review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines based on population, concept, and context. We searched for eligible studies in five electronic databases (Scopus, PubMed, ProQuest, Science Direct, and Sage) and included studies on the provision of palliative care (concept) in the ICU (context) that were published in English between 2005–2021. We describe the provision of palliative care in terms of barriers and facilitators. We also describe the study design and context. A total of 14 papers was included. Several barriers and facilitators in providing palliative care in the ICU were identified and include lack of capabilities, family boundaries, practical issues, cultural differences. Facilitators of the provision of palliative care in an ICU include greater experience and supportive behaviors, i.e., collaborations between health care professionals. This scoping review demonstrates the breadth of barriers and facilitators of palliative care in the ICU. Hospital management can consider findings of the current review to better integrate palliative care in the ICU.

Citations

Citations to this article as recorded by

Factors Influencing Terminal Care Performance in Korean Hospitals: A Cross-Sectional Study
Jiwon Oh, Jooyoung Cheon
OMEGA - Journal of Death and Dying.2026;[Epub] CrossRef
What does it mean to die a bad death? Provider perspectives in the surgical intensive care unit
Samantha L. Savitch, Sarah E. Bradley, C. Ann Vitous, Cara Humphrey, Pasithorn A. Suwanabol
Surgery.2026; : 110076. CrossRef
How the nursing work environment moderates the relationship between clinical judgment and person-centered care among intensive care unit nurses
Mi Hwa Seo, Eun A. Kim, Hae Ran Kim, Mohammad Jamil Rababa
PLOS ONE.2025; 20(1): e0316654. CrossRef
Triggers for Palliative Care consultation and its modalities in non-malignant mechanically ventilated patients in the Intensive Care Unit: A prospective observational study
Mansi Suresh, Souvik Chaudhuri, Krithika Rao, Pratibha Todur
Clinical Epidemiology and Global Health.2025; 32: 101914. 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
Palliative care outcomes in adult intensive care units: candidate quality outcome indicator items a scoping review protocol
Heru Suwardianto, Christantie Effendy, Sri Setiyarini
Salud, Ciencia y Tecnología.2025; 5: 1698. CrossRef
Perception of futile care and the reasons behind providing it for the patients at end-of-life stages from the care providers’ perspective
Rasoul Ramazani, Samira Beiranvand, Sogand Daei, Zeinab Kord, Hadis Ashrafizadeh
Philosophy, Ethics, and Humanities in Medicine.2025;[Epub] CrossRef
Impact of a decision-making support framework on nurse burnout and quality of end-of-life care: A before-and-after study in intensive care units
Yoshihiko Takahashi, Shu Utsumi, Kenji Fujizuka, Hiroyuki Suzuki, Yumiko Takadera, Mitsunobu Nakamura
International Journal of Nursing Studies Advances.2025; 9: 100438. CrossRef
Translation, Cultural Adaptation, and Validation of the Swedish Thanatophobia Scale
Susanna Pusa, Rebecca Baxter, Anna Sandgren, Sofia Andersson
Journal of Palliative Care.2025;[Epub] CrossRef
Characteristics and outcomes of patients receiving palliative care in the intensive care unit: retrospective single-center cohort study
Mayara Laíse Assis, Thais Dias Midega, Fábio Tanzillo Moreira, Vinícius Barbosa Galindo, Farah Christina de La Cruz Scarin, Pedro Guadix Zulian Teixeira, Ricardo Luiz Cordioli, Thiago Domingos Corrêa
einstein (São Paulo).2025;[Epub] CrossRef
Facteurs contraignant ou facilitant la prestation des soins palliatifs au sein d’une équipe interdisciplinaire au Liban
Mona Saouma Nehmé
Revue internationale de soins palliatifs.2025; Vol. 39(4): 184. CrossRef
A necessidade dos cuidados paliativos na Unidade de Terapia Intensiva (UTI)
Larissa Kênia de Oliveira Barros Dos Santos, Isabella Rodrigues Ribeiro, João Pedro Manduca Ferreira, Victor Hugo Oliveira Moraes, Érika Aguiar Lara Pereira
Cuadernos de Educación y Desarrollo.2024;[Epub] CrossRef
End-of-life Care in the Intensive Care Unit and Ethics of Withholding/Withdrawal of Life-sustaining Treatments
Andrea Cortegiani, Mariachiara Ippolito, Sebastiano Mercadante
Anesthesiology Clinics.2024; 42(3): 407. CrossRef
What helps or hinders effective end-of-life care in adult intensive care units in Middle Eastern countries? A systematic review
Nabat Almalki, Breidge Boyle, Peter O’Halloran
BMC Palliative Care.2024;[Epub] CrossRef
Patterns of care at the end of life: a retrospective study of Italian patients with advanced breast cancer
Irene Giannubilo, Linda Battistuzzi, Eva Blondeaux, Tommaso Ruelle, Francesca Benedetta Poggio, Giulia Buzzatti, Alessia D’Alonzo, Federica Della Rovere, Maria Maddalena Latocca, Chiara Molinelli, Maria Grazia Razeti, Simone Nardin, Luca Arecco, Marta Per
BMC Palliative Care.2024;[Epub] CrossRef
Palliative Care in the Intensive Care Unit: The Standard of Care
Clareen Wiencek
AACN Advanced Critical Care.2024; 35(2): 112. CrossRef
Assessing palliative care practices in intensive care units and interpreting them using the lens of appropriate care concepts. An umbrella review
Naveen Salins, Vijay Shree Dhyani, Mebin Mathew, Ashmitha Prasad, Arathi Prahallada Rao, Anuja Damani, Krithika Rao, Shreya Nair, Vishal Shanbhag, Shwethapriya Rao, Shivakumar Iyer, Roop Gursahani, Raj Kumar Mani, Sushma Bhatnagar, Srinagesh Simha
Intensive Care Medicine.2024; 50(9): 1438. CrossRef
Barriers and Facilitators of Early Palliative Care in the Trajectory of People Living with Chronic Condition: A Mini Review Using Socio-ecological Framework to Inform Public Health Strategy
Hartiah Haroen, Sidik Maulana, Alia Harlasgunawan, Sri Rahmawati, Alvi Riansyah, Faizal Musthofa, Jerico Pardosi
Journal of Multidisciplinary Healthcare.2024; Volume 17: 4189. CrossRef
Shared Decision-making in Palliative and End‑of‑life Care in the Cardiac Intensive Care Unit
Sarah Godfrey, Alexis Barnes, Jing Gao, Jason N Katz, Sarah Chuzi
US Cardiology Review.2024;[Epub] CrossRef
Assessing IoT integration in ICUs’ settings and management: a cross-country analysis among local healthcare organizations
Anna Roberta Gagliardi, Luca Carrubbo, Shai Rozenes, Adi Fux, Daniela Siano
Digital Policy, Regulation and Governance.2024;[Epub] CrossRef
Implementing palliative care in the intensive care unit: a systematic review and mapping of knowledge to the implementation research logic model
Stephanie A. Meddick‐Dyson, Jason W. Boland, Mark Pearson, Sarah Greenley, Rutendo Gambe, John R. Budding, Fliss E. M. Murtagh
Intensive Care Medicine.2024; 50(11): 1778. CrossRef
Healthcare Professionals’ Attitudes towards and Knowledge and Understanding of Paediatric Palliative Medicine (PPM) and Its Meaning within the Paediatric Intensive Care Unit (PICU): A Summative Content Analysis in a Tertiary Children’s Hospital in Scotlan
Satyajit Ray, Emma Victoria McLorie, Jonathan Downie
Healthcare.2023; 11(17): 2438. CrossRef

Original Articles

Epidemiology
Characteristics and prognostic factors of very elderly patients admitted to the intensive care unit: Song-I Lee, Younsuck Koh, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim; Acute Crit Care. 2022;37(3):372-381. Published online August 4, 2022; DOI: https://doi.org/10.4266/acc.2022.00066

8,483 View
289 Download
4 Web of Science
4 Crossref

Abstract PDF Supplementary Material

Background
Korea is rapidly becoming a super aging society and is facing the increased burden of critical care for the elderly people. Traditionally, far-advanced age has been regarded as a triage criterion for intensive care unit (ICU) admission. We evaluated how the characteristics and prognostic factors of very elderly patients (≥85 years) admitted to the ICU changed over the last decade.
Methods
We retrospectively evaluated the data of patients admitted to the ICU over 11 years (2007–2017). The clinical characteristics and outcomes of the very elderly-patients group were evaluated. Factors associated with mortality were assessed by a cox regression analysis.
Results
Comparing the first half (2007–2012) and the second half (2013–2017) of the study period, the proportion of very elderly group increased from 603/47,657 (1.3%), to 697/37,756 (1.8%) (P<0.001). Among 1,294 very elderly patients, 1,274 patients were analyzed excluding hopeless discharge (n=20). The non-surgical reasons for ICU admission (67.0% vs. 76.1%, P<0.001) and the percentage of patients with co-morbidities (78.3% vs. 82.7%, P=0.048) were increased. Nevertheless, the hospital mortality decreased (21.3% vs. 14.9%, P=0.001). High creatinine levels, use of vasopressors and ventilator weaning failure were associated with in-hospital mortality.
Conclusions
The proportion of very elderly people in the ICU increased over the last decade. The non-surgical causes of ICU admission increased compared with the surgical causes. Despite an increasement in ICU admissions of very elderly patients, in-hospital mortality of very elderly ICU patients decreased.

Citations

Citations to this article as recorded by

Clinical characteristics and outcome of very old (≥90 years) critically ill patients with need for intensive care after surgical intervention
Jöran Lücke, Franziska Stallbaum, Rikus Daniels, Pauline Theile, Jakob Izbicki, Anastasios D. Giannou, Stefan Wolter, Anna Duprée, Oliver Mann, Jakob Müller, Stefan Kluge, Matthias Reeh, Kevin Roedl
Frontiers in Medicine.2025;[Epub] CrossRef
Factors Associated with Re-attendance at Emergency Departments Among Older Adults: A Cross-Sectional Analytical Study
Saengdao Janda, Juree Sansuk
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2025;[Epub] CrossRef
Chronicles of change for the future: The imperative of continued data collection in French ICUs
Takashi Tagami
Anaesthesia Critical Care & Pain Medicine.2023; 42(5): 101294. CrossRef
We need a comprehensive intensive care unit management strategy for older patients
Dong-Ick Shin
Acute and Critical Care.2022; 37(3): 468. CrossRef

Meta-analysis
Effect of a nutritional support protocol on enteral nutrition and clinical outcomes of critically ill patients: a retrospective cohort study: Heemoon Park, Sung Yoon Lim, Sebin Kim, Hyung-Sook Kim, Soyeon Kim, Ho Il Yoon, Young-Jae Cho; Acute Crit Care. 2022;37(3):382-390. Published online July 19, 2022; DOI: https://doi.org/10.4266/acc.2022.00220

8,451 View
313 Download
1 Web of Science
3 Crossref

Abstract PDF Supplementary Material

Background
Enteral nutrition (EN) supply within 48 hours after intensive care unit (ICU) admission improves clinical outcomes. The “new ICU evaluation & development of nutritional support protocol (NICE-NST)” was introduced in an ICU of tertiary academic hospital. This study showed that early EN through protocolized nutritional support would supply more nutrition to improve clinical outcomes.
Methods
This study screened 170 patients and 62 patients were finally enrolled; patients who were supplied nutrition without the protocol were classified as the control group (n=40), while those who were supplied according to the protocol were classified as the test group (n=22).
Results
In the test group, EN started significantly earlier (3.7±0.4 days vs. 2.4±0.5 days, P=0.010). EN calorie (4.0±1.0 kcal/kg vs. 6.7±0.9 kcal/kg, P=0.006) and protein (0.17±0.04 g/kg vs. 0.32±0.04 g/kg, P=0.002) supplied were significantly higher in the test group. Although EN was supplied through continuous feeding in the test group, there was no difference in complications such as feeding hold due to excessive gastric residual volume or vomit, and hyper- or hypo-glycemia between the two groups. Hospital mortality was significantly lower in the group that started EN within 1.5 days (42.9% vs. 11.8%, P=0.018). The proportion of patients who started EN within 1.5 days was higher in the test group (40.9% vs. 17.5%, P=0.044).
Conclusions
The NICE-NST may improve EN supply and mortality of critically ill patients without increasing complications.

Citations

Citations to this article as recorded by

Effect of nutrition support team on 28-day mortality in Korean patients with acute respiratory failure
Inhan Lee, Junghyun Kim, Mihyun Ku, Yurim Choi, Sohyun Park, Jihyeon Bang, Joohae Kim
Acute and Critical Care.2025; 40(2): 313. CrossRef
Nutritional support for patients with abdominal surgical pathology: the view of a surgeon and an anesthesiologist — opponents or allies?
Natalya P. Shen, Svetlana Yu. Mukhacheva
Clinical nutrition and metabolism.2023; 3(4): 181. CrossRef
Provision of Enteral Nutrition in the Surgical Intensive Care Unit: A Multicenter Prospective Observational Study
Chan-Hee Park, Hak-Jae Lee, Suk-Kyung Hong, Yang-Hee Jun, Jeong-Woo Lee, Nak-Jun Choi, Kyu-Hyouck Kyoung
Annals of Clinical Nutrition and Metabolism.2022; 14(2): 66. CrossRef

Infection
In-hospital mortality prediction using frailty scale and severity score in elderly patients with severe COVID-19: Yong Sub Na, Jin Hyoung Kim, Moon Seong Baek, Won-Young Kim, Ae-Rin Baek, Bo young Lee, Gil Myeong Seong, Song-I Lee; Acute Crit Care. 2022;37(3):303-311. Published online July 5, 2022; DOI: https://doi.org/10.4266/acc.2022.00017

8,360 View
247 Download
11 Web of Science
13 Crossref

Abstract PDF

Background
Elderly patients with coronavirus disease 2019 (COVID-19) have a high disease severity and mortality. However, the use of the frailty scale and severity score to predict in-hospital mortality in the elderly is not well established. Therefore, in this study, we investigated the use of these scores in COVID-19 cases in the elderly.
Methods
This multicenter retrospective study included severe COVID-19 patients admitted to seven hospitals in Republic of Korea from February 2020 to February 2021. We evaluated patients’ Acute Physiology and Chronic Health Evaluation (APACHE) II score; confusion, urea nitrogen, respiratory rate, blood pressure, 65 years of age and older (CURB-65) score; modified early warning score (MEWS); Sequential Organ Failure Assessment (SOFA) score; clinical frailty scale (CFS) score; and Charlson comorbidity index (CCI). We evaluated the predictive value using receiver operating characteristic (ROC) curve analysis.
Results
The study included 318 elderly patients with severe COVID-19 of whom 237 (74.5%) were survivors and 81 (25.5%) were non-survivors. The non-survivor group was older and had more comorbidities than the survivor group. The CFS, CCI, APACHE II, SOFA, CURB-65, and MEWS scores were higher in the non-survivor group than in the survivor group. When analyzed using the ROC curve, SOFA score showed the best performance in predicting the prognosis of elderly patients (area under the curve=0.766, P<0.001). CFS and SOFA scores were associated with in-hospital mortality in the multivariate analysis.
Conclusions
The SOFA score is an efficient tool for assessing in-hospital mortality in elderly patients with severe COVID-19.

Citations

Citations to this article as recorded by

Navigating the nexus between senior tourism and healthy aging: a post-neoliberal perspective
Yangyang Jiang, Guohong Yu
Asia Pacific Journal of Marketing and Logistics.2026; 38(1): 148. CrossRef
Respiratory and Pleural Pathogens in Octogenarians Hospitalized with COVID-19: Impact of Secondary Bacterial Pneumonia on Day-5 SOFA and Mortality
Petrinela Daliu, Felix Bratosin, Ovidiu Rosca, Monica Licker, Elena Hogea, Livia Stanga, Camelia Vidita Gurban, Delia Muntean
Microorganisms.2026; 14(1): 164. CrossRef
Quadriceps Muscle Layer Thickness and its association with frailty in critically ill patients: A prospective observational study
Vijay Sundarsingh, R. Manoj Kumar, Manjunath Kulkarni, Debasis Pradhan, Pramela Renisha Rodrigues, Nishanth Baliga, Mamata Prasad, Pooja Yadav, Monish Thomas, Tania Eltrida Pinto
Journal of Critical Care.2025; 85: 154930. CrossRef
Prevalence of New Frailty at Hospital Discharge in Severe COVID-19 Survivors and Its Associated Factors
Jong Hwan Jeong, Manbong Heo, Sunghoon Park, Su Hwan Lee, Onyu Park, Taehwa Kim, Hye Ju Yeo, Jin Ho Jang, Woo Hyun Cho, Jung-Wan Yoo
Tuberculosis and Respiratory Diseases.2025; 88(2): 361. CrossRef
Biological age and clinical frailty scale measured at intensive care unit admission as predictors of hospital mortality among the critically ill in Western Australia: a retrospective cohort study
Nicholas Phillip Anthony, Kwok Ming Ho
Acute and Critical Care.2025; 40(2): 264. CrossRef
Accuracy of Different COVID-19 Severity Scores in ICU Transfer Prediction and Mortality Prediction Among Inpatients at Lebanese American University Medical Center-Rizk Hospital (LAUMC-RH)
Evelyne Towair, Zeina Al Achkar, Romanos Haykal, Ahmad Kassar, Eric Bou Karam, Pascale Salameh, Toufic Chaaban
Cureus.2025;[Epub] CrossRef
Risk factors for progressing to critical illness in patients with hospital-acquired COVID-19
Kyung-Eui Lee, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee
The Korean Journal of Internal Medicine.2024; 39(3): 477. CrossRef
Omicron, Long-COVID, and the Safety of Elective Surgery for Adults and Children: Joint Guidance from the Therapeutics and Guidelines Committee of the Surgical Infection Society and the Surgery Strategic Clinical Network, Alberta Health Services
Philip S. Barie, Mary E. Brindle, Rachel G. Khadaroo, Tara L. Klassen, Jared M. Huston
Surgical Infections.2023; 24(1): 6. CrossRef
Evaluation of risk scores as predictors of mortality and hospital length of stay for older COVID‐19 patients
Banu Buyukaydin, Tahsin Karaaslan, Omer Uysal
AGING MEDICINE.2023; 6(1): 56. CrossRef
Atypical presentation of COVID-19 in older patients is associated with frailty but not with adverse outcomes
Joy E. van Son, Elisabeth C. P. Kahn, Jessica M. van der Bol, Dennis G. Barten, Laura C. Blomaard, Carmen van Dam, Jacobien Ellerbroek, Steffy W. M. Jansen, Anita Lekx, Carolien M. J. van der Linden, Roy Looman, Huub A. A. M. Maas, Francesco U. S. Mattace
European Geriatric Medicine.2023;[Epub] CrossRef
Neurological Manifestations and Complications of the Central Nervous System as Risk Factors and Predictors of Mortality in Patients Hospitalized with COVID-19: A Cohort Study
Ana Luisa Corona-Nakamura, Martha Judith Arias-Merino, Rayo Morfín-Otero, Guillermo Rodriguez-Zavala, Alfredo León-Gil, Juan Ramsés Camarillo-Escalera, Idarmis Brisseida Reyes-Cortés, María Gisela Valdovinos-Ortega, Erick René Nava-Escobar, Ana María de l
Journal of Clinical Medicine.2023; 12(12): 4065. CrossRef
Modified Early Warning Score: Clinical Deterioration of Mexican Patients Hospitalized with COVID-19 and Chronic Disease
Nicolás Santiago González, María de Lourdes García-Hernández, Patricia Cruz-Bello, Lorena Chaparro-Díaz, María de Lourdes Rico-González, Yolanda Hernández-Ortega
Healthcare.2023; 11(19): 2654. CrossRef
Risk Factors and Predictive Model for Mortality of Hospitalized COVID-19 Elderly Patients from a Tertiary Care Hospital in Thailand
Mallika Chuansangeam, Bunyarat Srithan, Pattharawin Pattharanitima, Pawit Phadungsaksawasdi
Medicines.2023; 10(11): 59. CrossRef

Epidemiology
Hearing screening outcomes in pediatric critical care survivors: a 1-year report: Pattita Suwannatrai, Chanapai Chaiyakulsil; Acute Crit Care. 2022;37(2):209-216. Published online March 8, 2022; DOI: https://doi.org/10.4266/acc.2021.00899

5,848 View
170 Download
2 Web of Science
3 Crossref

Abstract PDF

Background
Hearing loss is a potentially serious complication that can occur after surviving a critical illness. Study on screening for hearing problems in pediatric critical care survivors beyond the neonatal period is lacking. This study aimed to identify the prevalence of abnormal hearing screening outcomes using transitory evoked otoacoustic emission (TEOAE) screening in children who survived critical illness and to find possible associating factors for abnormal hearing screening results.
Methods
This study was a single-center, prospective, observational study. All children underwent otoscopy to exclude external and middle ear abnormalities before undergoing TEOAE screening. The screening was conducted before hospital discharge. Descriptive statistics, chi-square, and logistic regression tests were used for data analysis.
Results
A total of 92 children were enrolled. Abnormal TEOAE responses were identified in 26 participants (28.3%). Children with abnormal responses were significantly younger than those with normal responses with a median age of 10.0 months and 43.5 months, respectively (P<0.001). Positive association with abnormal responses was found in children younger than 12 months of age (adjusted odds ratio [OR], 3.07; 95% confidence interval [CI], 1.06–8.90) and children with underlying genetic conditions (adjusted OR, 6.95; 95% CI, 1.49–32.54).
Conclusions
Our study demonstrates a high prevalence of abnormal TEOAE screening responses in children surviving critical illness, especially in patients younger than 12 months of age. More extensive studies should be performed to identify the prevalence and associated risk factors of hearing problems in critically ill children.

Citations

Citations to this article as recorded by

Hearing loss assessment by pure tone audiometry amongst the survivors of intensive care unit: A prospective observational cohort study
Sai Saran, Abhishek Bahadur Singh, Avinash Agrawal, Saumitra Misra, Suhail Sarwar Siddiqui, Ayush Lohiya, Prabhaker Misra
Journal of Critical Care.2025; 87: 155042. CrossRef
Hearing Deficits Assessment by Pure Tone Audiometry Amongst the Survivors of Intensive Care Unit: A Prospective Observational Cohort Study
Avinash Agrawal, Suhail Sarwar Siddiqui, Sai Saran, Saumitra Misra, Abhishek Bahadur Singh
Indian Journal of Critical Care Medicine.2025; 29(S1): S126. CrossRef
Physiological and electrophysiological evaluation of the hearing system in low birth weight neonates treated with cholestin: a cohort study
Nastaran Khosravi, Malihah Mazaheryazdi, Majid Kalani, Nasrin Khalesi, Zinat Shakeri, Saeedeh Archang, Maryam Archang
The Egyptian Journal of Otolaryngology.2023;[Epub] CrossRef

Review Articles

Pulmonary
Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation: Su Hwan Lee; Acute Crit Care. 2022;37(1):26-34. Published online February 22, 2022; DOI: https://doi.org/10.4266/acc.2022.00031

11,246 View
337 Download
13 Web of Science
11 Crossref

Abstract PDF

Although the rate of lung transplantation (LTx), the last treatment option for end-stage lung disease, is increasing, some patients waiting for LTx need a bridging strategy for LTx due to the limited number of available donor lungs. For a long time, mechanical ventilation has been employed as a bridge to LTx because the outcome of using extracorporeal membrane oxygenation (ECMO) as a bridging strategy has been poor. However, the outcome after mechanical ventilation as a bridge to LTx was poor compared with that in patients without bridges. With advances in technology and the accumulation of experience, the outcome of ECMO as a bridge to LTx has improved, and the rate of ECMO use as a bridging strategy has increased over time. However, whether the use of ECMO as a bridge to LTx can achieve survival rates similar to those of non-bridged LTx patients remains controversial. In 2010, one center introduced awake ECMO strategy for LTx bridging, and its use as a bridge to LTx has been showing favorable outcomes to date. Awake ECMO has several advantages, such as maintenance of physical activity, spontaneous breathing, avoidance of endotracheal intubation, and reduced use of sedatives and analgesics, but it may cause serious problems. Nonetheless, several studies have shown that awake ECMO performed by a multidisciplinary team is safe. In cases where ECMO or mechanical ventilation is required due to unavoidable exacerbation in patients awaiting LTx, the application of awake ECMO performed by an appropriately trained ECMO multi-disciplinary team can be useful.

Citations

Citations to this article as recorded by

ISHLT Consensus Statement on the Perioperative use of ECLS in Lung Transplantation: Part I: Preoperative Considerations
Anna K. Reed, Olaf Mercier, Juergen Behr, Kavita Dave, Göran Dellgren, Sakhee Kotecha, Jasleen Kukreja, Caroline Landry, Bronwyn Levvey, Haifa Lyster, Orla Morrissey, Siavosh Saatee, Melissa Sanchez, Marc Schecter, James Walsh, Ashley Virginia Fritz, Ther
The Journal of Heart and Lung Transplantation.2026; 45(1): e1. CrossRef
Innovative Approaches in Tracheal Resection and Anastomosis Surgery: Integrating Extracorporeal Membrane Oxygenation for Enhanced Safety
Joohyung Son, Bong Soo Son, Jong Myung Park, Jeong Su Cho, Yeongdae Kim, Hoseok I, Do Hyung Kim
Yonsei Medical Journal.2025; 66(5): 289. CrossRef
Sedation management and processed EEG-based solutions during venovenous extracorporeal membrane oxygenation: a narrative review of key challenges and potential benefits
Lajos Szentgyorgyi, Samuel Henry Howitt, Heather Iles-Smith, Bhuvaneswari Krishnamoorthy
Journal of Artificial Organs.2025; 28(3): 293. CrossRef
The Path Forward: A Review on Enhanced Recovery After Cardiothoracic Transplantation
Irene Bello, Laurens J. Ceulemans, Cristiano Amarelli
Transplant International.2025;[Epub] CrossRef
Development and application of a novel framework for mobility & rehabilitation under support of extracorporeal life support: The MUSECLS framework
Aaron H. Thrush, Samantha Tylor, Praveen Kumar Ghisulal, Vivek Kakar
Perfusion.2025;[Epub] CrossRef
Evolution of extracorporeal membrane oxygenation: historical milestones and advanced developments
Lajos Szentgyorgyi, Salman Pervaiz Butt, Bhuvaneswari Krishnamoorthy
The Journal of ExtraCorporeal Technology.2025; 57(4): 243. CrossRef
Extracorporeal membrane oxygenation as a bridge to lung transplantation: Practice patterns and patient outcomes
Hannah J. Rando, Jonathon P. Fanning, Sung-Min Cho, Bo S. Kim, Glenn Whitman, Errol L. Bush, Steven P. Keller
The Journal of Heart and Lung Transplantation.2024; 43(1): 77. CrossRef
Anesthetic considerations for perioperative ECMO in lung transplantation
Julien Fessler, Jaromir Vajter, Archer Kilbourne Martin
Best Practice & Research Clinical Anaesthesiology.2024; 38(1): 58. CrossRef
Nurses’ Interventions in Minimizing Adult Patient Vulnerability During Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplantation: An Integrative Review
Nuno Costa, Helga Rafael Henriques, Candida Durao
SAGE Open Nursing.2024;[Epub] CrossRef
Long-Term Follow-Up of Patients Needing Extracorporeal Membrane Oxygenation Following a Critical Course of COVID-19
Samuel Genzor, Pavol Pobeha, Martin Šimek, Petr Jakubec, Jan Mizera, Martin Vykopal, Milan Sova, Jakub Vaněk, Jan Praško
Life.2023; 13(4): 1054. CrossRef
Dangers in using beta-blockers in patients with venovenous extracorporeal membrane oxygenation
Diego Rodríguez Álvarez, Elena Pérez-Costa, Juan José Menéndez Suso
Acute and Critical Care.2022; 37(4): 683. CrossRef

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

39,803 View
1,353 Download
44 Web of Science
47 Crossref

Abstract PDF

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

Citations

Citations to this article as recorded by

Recent advances in hydrogel therapy for traumatic brain injury
Zheng Zou, Mengjia Chen, Jun Liu, Huan Ma, Guobiao Liang, Jingyuan Li
Colloids and Surfaces B: Biointerfaces.2026; 260: 115424. CrossRef
A nomogram for predicting the risk of acute respiratory distress syndrome in patients with severe acute brain injury
Qiaoqiao You, Chang Su, Jianping Ye, Miaomiao Chen, JunLong Xu, Xian Zhang, Wen Hu
BMC Neurology.2026;[Epub] CrossRef
The brain-lung axis: bridging neurological and respiratory disorders via neural-immune-microbial dialogue
Wenpei Yang, Xiaoyu Shi, Lizheng Xie, Hao Zhang, Lina Shen, Li Pan, Shi Feng, Xiang Mao, Xiao Wu
Chinese Journal of Traumatology.2026;[Epub] CrossRef
Development and validation of nomogram for predicting neurogenic pulmonary edema in hypertensive intracerebral hemorrhage
Yajuan Xu, Yinxian Shi
Frontiers in Cardiovascular Medicine.2026;[Epub] CrossRef
Analysis of pathogen distribution and sTREM-1 and miR-126 levels in patients with pulmonary infection after craniocerebral injury
Lei Gu, Yun Zhen, Zhenlin Huang, Tianbao Chen, Fuxiong Li, Kaipeng Chen
Technology and Health Care.2025; 33(1): 157. CrossRef
Dynamic pathophysiological features of early primary blast lung injury: a novel functional incapacity pig model
Shifeng Shao, Shasha Wu, Jun Liu, Zhikang Liao, Pengfei Wu, Yuan Yao, Zhen Wang, Liang Zhang, Yaoli Wang, Hui Zhao
European Journal of Trauma and Emergency Surgery.2025;[Epub] CrossRef
Extracranial Effects of Traumatic Brain Injury: A Narrative Review
Nathan K. Evanson, Pratyusha Veldhi, Caitlyn Scherpenberg, John M. Riccobono, Haitham Eid, Jennifer L. McGuire
Clinics and Practice.2025; 15(3): 47. CrossRef
Review of Ventilation in Traumatic Brain Injury
Ellen R. Becker, Gregory C. Wetmore, Michael D. Goodman, Dario Rodriquez, Richard D. Branson
Respiratory Care.2025; 70(4): 450. CrossRef
Does helmet CPAP reduce carotid flow compared to oronasal mask CPAP? A randomized cross-over trial in healthy subjects
Andrea Duca, Laura Frosio, Luca Molinero, Andrea Finazzi, Ivan Oppedisano, Carlo Bellazzi, Giovanni Nattino, Fabiola Signorini, Guido Bertolini, Eugenia Belotti, Roberto Cosentini
Internal and Emergency Medicine.2025; 20(8): 2559. CrossRef
Directional interactions from non-small cell lung cancer to brain glucose metabolism revealed by total-body PET imaging
Tianzheng Zhong, Yanhua Duan, Kun Li, Jianfeng Qiu, Zhaoping Cheng, Weizhao Lu
European Journal of Nuclear Medicine and Molecular Imaging.2025; 52(12): 4467. CrossRef
Challenges in Pulmonary Management after Traumatic Brain and Spinal Cord Injury
Xiaofei Zhou, Adam Hwan Bates, Alan Hoffer
Neurosurgery Clinics of North America.2025; 36(3): 355. CrossRef
Multilevel risk analysis of postoperative pulmonary complications following mandibular fractures: a retrospective cohort study based on patient characteristics and healthcare system factors
Shuwei Liao, Guanxiong Zhu, Liting Zeng, Yang Yu, Zeyu Zhang, Hongru Zhang, Jingyuan Wang, Lina Yu
BMC Oral Health.2025;[Epub] CrossRef
Admission braden scale is an effective marker for predicting pneumonia in critically ill patients with traumatic brain injury
Xuelian Meng, Xia Li, Zhihong Tang
Neurosurgical Review.2025;[Epub] CrossRef
Does pneumonia increase the risk of dementia and cognitive decline? A systematic review and meta-analysis
Zhen Yan, Min Zhang, Lifang Yu, Fulian Zhang
Annals of Medicine.2025;[Epub] CrossRef
Utility of Serum Occludin as a Prognostic Biomarker of Severe Traumatic Brain Injury and Mediation Role of Acute Lung Injury: A Two-Center Prospective Cohort Study
Shaojun Zhang, Xiufeng Ye, Mi Guo, Yidong Jin, Xuebo Zhang, Jiehao Tu, Jing Huang, Zhiqiang Lian, Fangfang You, Han Zhang
International Journal of General Medicine.2025; Volume 18: 3525. CrossRef
Association between traumatic brain injury and risk of developing infections in the central nervous system and periphery
Cristiano Julio Faller, Amanda C. S. Kursancew, Beatriz Brandão Lima, Nicole Golombieski Duarte, Júlia Torcelli Noetzold, Natalli Studnicka, Khiany Mathias, Fabricia Petronilho, Emilio Luiz Streck, Jaqueline S. Generoso
Metabolic Brain Disease.2025;[Epub] CrossRef
Quercetin attenuates acute lung injury after intracerebral hemorrhage in rats via PI3K/AKT/NF-κB-mediated anti-inflammatory mechanisms
Heng Xin, Yong-Hui Lv, Zheng-Ting Qian, Qi-Xian Li, Xiang Li, Yong Tang, Yan Shi, He-Ming Wu
Journal of Radiation Research and Applied Sciences.2025; 18(3): 101732. CrossRef
Predictors of Survival in Patients With Severe Traumatic Brain Injury Undergoing Extracorporeal Membrane Oxygenation
Wardah Rafaqat, Yasmin Arda, Zoha Z. Fazal, May Abiad, Emanuele Lagazzi, Vahe S. Panossian, Ikemsinachi C. Nzenwa, Haytham M.A. Kaafarani, George C. Velmahos, Michael P. DeWane, Benjamin C. Renne
Journal of Surgical Research.2025; 313: 526. CrossRef
Lung-brain axis-generated inflammatory biomarkers in traumatic brain injury and acute respiratory distress syndrome: Role of mechanical ventilation/stress
Nathan H. Johnson, Nancy G. Casanova, Susannah Patarroyo-White, Jason Canizales, Sara M. Camp, Jon Perez Barcena, Juan Pablo de Rivero Vaccari, Bellal Joseph, Joe G.N. Garcia
Advances in Biomarker Sciences and Technology.2025; 7: 238. CrossRef
From Brain to Lung: Emerging Insights into Mesenchymal Stem Cell-Derived Extracellular Vesicle-Associated Cargos in Ischemia-Reperfusion Injury
Yiqing Zhang, Xiaodong Shi, Shuang Li, Shi Yan, Lyu Mei, Yuchen Zou, Chunhua Yan
Journal of Inflammation Research.2025; Volume 18: 11645. CrossRef
Pathophysiology and clinical applications of PEEP in acute brain injury
Ida Giorgia Iavarone, Patricia Rieken Macedo Rocco, Domenico Luca Grieco, Tommaso Rosà, Mariangela Pellegrini, Rafael Badenes, Robert D. Stevens, Karim Asehnoune, Chiara Robba, Luigi Camporota, Antoine Roquilly
Intensive Care Medicine.2025; 51(11): 2104. CrossRef
Development and Validation of an Interpretable Machine Learning Model for Predicting venous Thromboembolism in ICU patients With Traumatic Brain Injury: A Multicenter Study
Hao Qi, Lingli Li, Juan Fang, Tianwei Pei, Ao Li, Zhisong Ding, Tao Chen
World Neurosurgery.2025; 202: 124399. CrossRef
Brain Protective Ventilation Strategies in Severe Acute Brain Injury
Sarah Al Sharie, Rahma Almari, Saif Azzam, Lou’i Al-Husinat, Mohammad Araydah, Denise Battaglini, Marcus J. Schultz, Nicolo’ Antonino Patroniti, Patricia RM Rocco, Chiara Robba
Current Neurology and Neuroscience Reports.2025;[Epub] CrossRef
Dynamic nomogram for predicting early tracheotomy in patients diagnosed with supratentorial deep seated intracranial hemorrhage
Chubin Liu, Suqiong Yang, Gang Wang, Jiayin Wang, Liangqin Luo, Yasong Li
Frontiers in Neurology.2025;[Epub] CrossRef
Glymphatic Dysfunction in Neuro-Pulmonary Complications Following Subarachnoid Hemorrhage: A New Perspective on Brain–Lung Axis Disruption
Eun Chae Lee, Jae Sang Oh
Cells.2025; 14(21): 1739. CrossRef
Epidemiology and Outcomes of Battlefield-Related Penetrating and Closed Traumatic Brain Injuries Compared to Non-Head Injuries: A Retrospective Cohort Study
Melissa R Meister, Jason H Boulter, Callum D Dewar, Caren Stuebe, Erica Sercy, M Leigh Carson, Faraz Shaikh, Joseph M Yabes, Laveta Stewart, David R Tribble, Viktor Bartanusz, Bradley Dengler
Military Medicine.2025;[Epub] CrossRef
Early Prediction of Acute Respiratory Distress Syndrome in Critically Ill Polytrauma Patients Using Balanced Random Forest ML: A Retrospective Cohort Study
Nesrine Ben El Hadj Hassine, Sabri Barbaria, Omayma Najah, Halil İbrahim Ceylan, Muhammad Bilal, Lotfi Rebai, Raul Ioan Muntean, Ismail Dergaa, Hanene Boussi Rahmouni
Journal of Clinical Medicine.2025; 14(24): 8934. CrossRef
Uncertainty in Neurocritical Care: Recognizing Its Relevance for Clinical Decision-Making
Luis Rafael Moscote-Salazar, William A. Florez-Perdomo, Tariq Janjua
Indian Journal of Neurotrauma.2024; 21(01): 092. CrossRef
Manejo postoperatorio de resección de tumores cerebrales en la unidad de cuidado intensivo
Andrés Felipe Naranjo Ramírez, Álvaro de Jesús Medrano Areiza, Bryan Arango Sánchez, Juan Carlos Arango Martínez, Luis Fermín Naranjo Atehortúa
Acta Colombiana de Cuidado Intensivo.2024; 24(2): 140. CrossRef
Effects of positive end-expiratory pressure on intracranial pressure, cerebral perfusion pressure, and brain oxygenation in acute brain injury: Friend or foe? A scoping review
Greta Zunino, Denise Battaglini, Daniel Agustin Godoy
Journal of Intensive Medicine.2024; 4(2): 247. CrossRef
Acute brain injury increases pulmonary capillary permeability via sympathetic activation-mediated high fluid shear stress and destruction of the endothelial glycocalyx layer
Na Zhao, Chao Liu, Xinxin Tian, Juan Yang, Tianen Wang
Experimental Cell Research.2024; 434(2): 113873. CrossRef
Oral administration of lysozyme protects against injury of ileum via modulating gut microbiota dysbiosis after severe traumatic brain injury
Weijian Yang, Caihua Xi, Haijun Yao, Qiang Yuan, Jun Zhang, Qifang Chen, Gang Wu, Jin Hu
Frontiers in Cellular and Infection Microbiology.2024;[Epub] CrossRef
Pulmonary Effects of Traumatic Brain Injury in Mice: A Gene Set Enrichment Analysis
Wei-Hung Chan, Shih-Ming Huang, Yi-Lin Chiu
International Journal of Molecular Sciences.2024; 25(5): 3018. CrossRef
Beyond the brain: General intensive care considerations in pediatric neurocritical care
Thao L. Nguyen, Dennis W. Simon, Yi-Chen Lai
Seminars in Pediatric Neurology.2024; 49: 101120. CrossRef
Research Progress of Hemorrhagic Stroke Combined with Stroke-Associated Pneumonia
松刘
Advances in Clinical Medicine.2024; 14(05): 2336. CrossRef
The Impact of Pulmonary Disorders on Neurological Health (Lung-Brain Axis)
Hongryeol Park, Chan Hee Lee
Immune Network.2024;[Epub] CrossRef
Modeling of the brain-lung axis using organoids in traumatic brain injury: an updated review
Jong-Tae Kim, Kang Song, Sung Woo Han, Dong Hyuk Youn, Harry Jung, Keun-Suh Kim, Hyo-Jung Lee, Ji Young Hong, Yong-Jun Cho, Sung-Min Kang, Jin Pyeong Jeon
Cell & Bioscience.2024;[Epub] CrossRef
Standard versus individualised positive end-expiratory pressure (PEEP) compared by electrical impedance tomography in neurocritical care: a pilot prospective single centre study
Vera Spatenkova, Mikulas Mlcek, Alan Mejstrik, Lukas Cisar, Eduard Kuriscak
Intensive Care Medicine Experimental.2024;[Epub] CrossRef
Perioperative Ventilation in Neurosurgical Patients: Considerations and Challenges
Ida Giorgia Iavarone, Patricia R.M. Rocco, Pedro Leme Silva, Shaurya Taran, Sarah Wahlster, Marcus J. Schultz, Nicolo’ Antonino Patroniti, Chiara Robba
Current Anesthesiology Reports.2024; 14(4): 512. CrossRef
Ventilatory targets following brain injury
Shaurya Taran, Sarah Wahlster, Chiara Robba
Current Opinion in Critical Care.2023; 29(2): 41. CrossRef
Targeted Nanocarriers Co-Opting Pulmonary Intravascular Leukocytes for Drug Delivery to the Injured Brain
Jia Nong, Patrick M. Glassman, Jacob W. Myerson, Viviana Zuluaga-Ramirez, Alba Rodriguez-Garcia, Alvin Mukalel, Serena Omo-Lamai, Landis R. Walsh, Marco E. Zamora, Xijing Gong, Zhicheng Wang, Kartik Bhamidipati, Raisa Y. Kiseleva, Carlos H. Villa, Colin F
ACS Nano.2023; 17(14): 13121. CrossRef
Modulation of MAPK/NF-κB Pathway and NLRP3 Inflammasome by Secondary Metabolites from Red Algae: A Mechanistic Study
Asmaa Nabil-Adam, Mohamed L. Ashour, Mohamed Attia Shreadah
ACS Omega.2023; 8(41): 37971. CrossRef
American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma clinical protocol for management of acute respiratory distress syndrome and severe hypoxemia
Jason A. Fawley, Christopher J. Tignanelli, Nicole L. Werner, George Kasotakis, Samuel P. Mandell, Nina E. Glass, David J. Dries, Todd W. Costantini, Lena M. Napolitano
Journal of Trauma and Acute Care Surgery.2023; 95(4): 592. CrossRef
The role of cardiac dysfunction and post-traumatic pulmonary embolism in brain-lung interactions following traumatic brain injury
Mabrouk Bahloul, Karama Bouchaala, Najeh Baccouche, Kamilia Chtara, Hedi Chelly, Mounir Bouaziz
Acute and Critical Care.2022; 37(2): 266. CrossRef
Allocation of Donor Lungs in Korea
Hye Ju Yeo
Journal of Chest Surgery.2022; 55(4): 274. CrossRef
Mapping brain endophenotypes associated with idiopathic pulmonary fibrosis genetic risk
Ali-Reza Mohammadi-Nejad, Richard J. Allen, Luke M. Kraven, Olivia C. Leavy, R. Gisli Jenkins, Louise V. Wain, Dorothee P. Auer, Stamatios N. Sotiropoulos
eBioMedicine.2022; 86: 104356. CrossRef
Use of bedside ultrasound in the evaluation of acute dyspnea: a comprehensive review of evidence on diagnostic usefulness
Ivan David Lozada-Martinez, Isabela Zenilma Daza-Patiño, Gerardo Jesus Farley Reina-González, Sebastián Rojas-Pava, Ailyn Zenith Angulo-Lara, María Paola Carmona-Rodiño, Olga Gissela Sarmiento-Najar, Jhon Mike Romero-Madera, Yesid Alonso Ángel-Hernandez
Revista Investigación en Salud Universidad de Boyacá.2022;[Epub] CrossRef

Original Articles

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

12,469 View
347 Download
15 Web of Science
19 Crossref

Abstract PDF Supplementary Material

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

Citations

Citations to this article as recorded by

Revealing the diagnostic value of cerebrospinal fluid presepsin (sCD14) as a new biomarker for postneurosurgical and nosocomial central nervous system infections: A systematic review and meta-analysis of diagnostic test accuracy studies
Hazem E. Mohammed, Mohamed Nasser, Moaz Elsayed Abouelmagd, Mohamed E. Haseeb, Mohamed Khalafalla Darwish, Mohamed Salem Abdelqader, Ahmed Tawfik, Rania Elsayed Mahmoud Abdel-Mawla, Mahmoud Diaa Hindawi
Clinical Neurology and Neurosurgery.2025; 249: 108767. CrossRef
Microbial isolates and resistance profiles in cerebrospinal fluid cultures: a five-year experience at a tertiary center
Merve Gürler, Füsun Kırca, Figen Türen, İrem Tümkaya Kılınç, Ferhat Gürkan Aslan, Emrah Salman, Nilay Çöplü, Bedia Dinç
Future Microbiology.2025; 20(10): 669. CrossRef
The impact of hemorrhage extension on external ventricular drain associated infections in patients with non-aneurysmal primary intracerebral and/or intraventricular hemorrhage
Emilia Westarp, Florian Ebel, Simon Stohler, Matthias von Rotz, Matteo Poretti, Raymond Chen, Tim Jonas Hallenberger, Nadine Cueni, Raphael Guzman, Maja Weisser-Rohacek, Sarah Tschudin-Sutter, Luigi Mariani, Michel Roethlisberger
Neurological Research.2025; : 1. CrossRef
Ventriculitis: A Retrospective Cohort Study of Clinical Features, Outcomes and Device Management Practices
Alejandro Díez-Vidal, Fernando Fernández-Hinojal, Cristina Marcelo-Calvo, Borja Hernández-García, Emilio Cendejas-Bueno, David Grandioso-Vas, Nuria Pérez-Chulia, Belén Civantos-Martín, Patricia Martínez-Martín, Carmen Novo-González, Nicolás García-Arenzan
Open Forum Infectious Diseases.2025;[Epub] CrossRef
Influence of surgical access on bacterial contamination of autologous blood in neurosurgical patients
O.K. Kvan, N.B. Teryaeva, M.V. Sukhorukova, O.Yu. Titov, A.Yu. Lubnin, A.V. Kozlov, D.Yu. Usachev
Burdenko's Journal of Neurosurgery.2025; 89(5): 79. CrossRef
PREDOMINANCE OF COAGULASE-NEGATIVE STAPHYLOCOCCI AND ESCALATION OF GRAM-NEGATIVE RESISTANCE IN CEREBROSPINAL FLUID INFECTIONS (2018-2024)
Erkan Sanmak, Elif Aydın, Yalçın Dicle, Zeynep Ayaydın, Hayri Canbaz
Karya Journal of Health Science.2025; 6(3): 87. CrossRef
Procalcitonin As Diagnostic Tool for CNS Infections—Overall, Not Good Enough (Yet?)*
Michael A. Pizzi, Katharina M. Busl
Critical Care Medicine.2024; 52(1): 163. CrossRef
A retrospective analysis of 20,178 adult neurological infection admissions to United Kingdom critical care units from 2001 to 2020
Joseph Donovan, Abena Glover, John Gregson, Andrew W. Hitchings, Emma C. Wall, Robert S. Heyderman
BMC Infectious Diseases.2024;[Epub] CrossRef
Clinical Characteristics, Treatment, and Outcomes of Veterans with Cerebrospinal Fluid Culture Positive for Gram-Negative Rod Bacteria: A Retrospective Analysis over 18 Years in 125 Veterans Health Administration Hospitals
Shinya Hasegawa, Eiyu Matsumoto, Jennifer R. Carlson, Hiroyuki Suzuki
Current Microbiology.2024;[Epub] CrossRef
Confronting multidrug-resistant Klebsiella meningitis after mid-clival Cerebrospinal Fluid leak repair: a therapeutic odyssey
Anbarasi Madoure, Dharanya Gopalakrishnan Srinivasan, Tejaswi Mishra, Lokesh Kumar Penubarthi
BMJ Case Reports.2024; 17(6): e257872. CrossRef
Glioma grade and post-neurosurgical meningitis risk
Sakke Niemelä, Jarmo Oksi, Jussi Jero, Eliisa Löyttyniemi, Melissa Rahi, Jaakko Rinne, Jussi P. Posti, Dan Laukka
Acta Neurochirurgica.2024;[Epub] CrossRef
Etiologies and comorbidities of meningitis deaths in children under 5 years in high-mortality settings: Insights from the CHAMPS Network in the post-pneumococcal vaccine era
Sana Mahtab, Zachary J. Madewell, Vicky Baillie, Ziyaad Dangor, Sanjay G. Lala, Nega Assefa, Mulu Berihun, Lola Madrid, Lemma Demissie Regassa, J. Anthony G. Scott, Soter Ameh, Joseph S. Bangura, Okokon Ita, Erick Kaluma, Ikechukwu Udo Ogbuanu, Brigitte G
Journal of Infection.2024; 89(6): 106341. CrossRef
Decolonization of autologous blood with cefuroxime during hardware reinfusion in neurosurgical patients
O.K. Kvan, N.B. Teryaeva, M.V. Sukhorukova, A.V. Kozlov, A.Yu. Lubnin
Burdenko's Journal of Neurosurgery.2024; 88(6): 47. CrossRef
Bacterial meningitis in adults: a retrospective study among 148 patients in an 8-year period in a university hospital, Finland
Sakke Niemelä, Laura Lempinen, Eliisa Löyttyniemi, Jarmo Oksi, Jussi Jero
BMC Infectious Diseases.2023;[Epub] CrossRef
Bacterial meningitis in children with an abnormal craniocerebral structure
Jiali Pan, Wei Xu, Wenliang Song, Tao Zhang
Frontiers in Pediatrics.2023;[Epub] CrossRef
Fieber in der Intensivmedizin
Jan-Hendrik Naendrup, Boris Böll, Jorge Garcia Borrega
Intensivmedizin up2date.2023; 19(01): 17. CrossRef
Neurosurgical management of penetrating brain injury during World War I: A historical cohort
Rayan Fawaz, Mathilde Schmitt, Philémon Robert, Nathan Beucler, Jean-Marc Delmas, Nicolas Desse, Aurore Sellier, Arnaud Dagain
Neurochirurgie.2023; 69(3): 101439. CrossRef
Etiology and Outcomes of Healthcare-Associated Meningitis and Ventriculitis—A Single Center Cohort Study
Hana Panic, Branimir Gjurasin, Marija Santini, Marko Kutlesa, Neven Papic
Infectious Disease Reports.2022; 14(3): 420. CrossRef
Healthcare-associated central nervous system infections
Mariachiara Ippolito, Antonino Giarratano, Andrea Cortegiani
Current Opinion in Anaesthesiology.2022; 35(5): 549. CrossRef

Ethics
Outcomes of critically ill patients according to the perception of intensivists on the appropriateness of intensive care unit admission: Youjin Chang, Kyoung Ran Kim, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim; Acute Crit Care. 2021;36(4):351-360. Published online November 26, 2021; DOI: https://doi.org/10.4266/acc.2021.00283

8,168 View
163 Download
5 Web of Science
5 Crossref

Abstract PDF Supplementary Material

Background
It is important for intensivists to determine which patient may benefit from intensive care unit (ICU) admission. We aimed to assess the outcomes of patients perceived as non-beneficially or beneficially admitted to the ICU and evaluate whether their prognosis was consistent with the intensivists’ perception.
Methods
A prospective observational study was conducted on patients admitted to the medical ICU of a tertiary referral center between February and April 2014. The perceptions of four intensivists at admission (day 1) and on day 3 were investigated as non-beneficial admission, beneficial admission, or indeterminate state.
Results
A total of 210 patients were enrolled. On days 1 and 3, 22 (10%) and 23 (11%) patients were judged as having non-beneficial admission; 166 (79%) and 159 (79%), beneficial admission; and 22 (10%) and 21 (10%), indeterminate state, respectively. The ICU mortality rates of each group were 64%, 22%, and 57%, respectively; their 6-month mortality rates were 100%, 46%, and 81%, respectively. The perceptions of non-beneficial admission or indeterminate state were the significant predictors of ICU mortality (day 3, odds ratio [OR], 4.049; 95% confidence interval [CI], 1.892–8.664; P<0.001) and 6-month mortality (day 1: OR, 4.983; 95% CI, 1.260–19.703; P=0.022; day 3: OR, 4.459; 95% CI, 1.162–17.121; P=0.029).
Conclusions
The outcomes of patients perceived as having non-beneficial admission were extremely poor. The intensivists’ perception was important in predicting patients’ outcomes and was more consistent with long-term prognosis than with immediate outcomes. The intensivists’ role can be reflected in limited ICU resource utilization.

Citations

Citations to this article as recorded by

Characteristics of potentially inappropriate, and inappropriately prolonged, ICU admissions in dying ICU patients: A retrospective cohort study
Sandra Lussier, Carys Jones, Stephen Thornhill, Ary Serpa Neto, Daryl Jones
Anaesthesia and Intensive Care.2025;[Epub] CrossRef
Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study
Carla Marchini Dias da Silva, Bruno Adler Maccagnan Pinheiro Besen, Antônio Paulo Nassar Jr
Journal of Critical Care.2024; 79: 154468. CrossRef
Characteristics, ICU Interventions, and Clinical Outcomes of Patients With Palliative Care Triggers in a Mixed Community-Based Intensive Care Unit
Michele M. Iguina, Aunie M. Danyalian, Ilko Luque, Umair Shaikh, Sanaz B. Kashan, Dionne Morgan, Daniel Heller, Mauricio Danckers
Journal of Palliative Care.2023; 38(2): 126. CrossRef
Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients
Carla Marchini Dias Silva, Janaina Naiara Germano, Anna Karolyne de Araujo Costa, Giovanna Alves Gennari, Pedro Caruso, Antonio Paulo Nassar Jr
Internal and Emergency Medicine.2023; 18(4): 1191. CrossRef
Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
SeungYong Park
Acute and Critical Care.2021; 36(4): 388. CrossRef

Nursing
Effect of modified care bundle for prevention of ventilator-associated pneumonia in critically-ill neurosurgical patients: Suphannee Triamvisit, Wassana Wongprasert, Chalermwoot Puttima, Matchima Na Chiangmai, Nawaphan Thienjindakul, Laksika Rodkul, Chumpon Jetjumnong; Acute Crit Care. 2021;36(4):294-299. Published online November 23, 2021; DOI: https://doi.org/10.4266/acc.2021.00983

18,054 View
628 Download
2 Web of Science
3 Crossref

Abstract PDF

Background
Care bundles for ventilator-associated pneumonia (VAP) have been shown to minimize the rate of VAP in critically ill patients. Standard care bundles may need to be modified in resource-constrained situations. The goal of this study was to see if our modified VAP-care bundles lowered the risk of VAP in neurosurgical patients.
Methods
A prospective cohort study was conducted in mechanically ventilated neurosurgical patients. The VAP bundle was adjusted in the cohort group by increasing the frequency of intermittent endotracheal tube cuff pressure monitoring to six times a day while reducing oral care with 0.12% chlorhexidine to three times a day. The rate of VAP was compared to the historical control group.
Results
A total of 146 and 145 patients were enrolled in control and cohort groups, respectively. The mean age of patients was 52±16 years in both groups (P=0.803). The admission Glasgow coma scores were 7.79±2.67 and 7.80±2.77 in control and cohort group, respectively (P=0.969). VAP was found in nine patients in control group but only one patient in cohort group. The occurrence rate of VAP was significantly reduced in cohort group compared to control group (0.88/1,000 vs. 6.84/1,000 ventilator days, P=0.036).
Conclusions
The modified VAP bundle is effective in lowering the VAP rate in critically ill neurosurgical patients. It requires low budget and manpower and can be employed in resource-constrained settings.

Citations

Citations to this article as recorded by

Impact of Modified Ventilator‐Associated Pneumonia Prevention Bundle on Clinical Parameters and Outcomes Among Mechanically Ventilated Patients: An Interventional Study
Yuvaraj Arumugam, Judie Arulappan, Sivakumar M. Nandakumar
Nursing in Critical Care.2026;[Epub] CrossRef
Pharmacotherapy interventions in ventilator care bundles for preventing VAP in adults: A literature review
Neilsen Gazo, Cherie Chu
Journal of Mechanical Ventilation.2025; 6(2): 88. CrossRef
Ventilator-Associated Pneumonia (VAP) in Neurocritical Patients: The Hidden Dialog of Brain and Infection
Alejandro Rodríguez, Laura Claverias, Ignacio Martín-Loeches, Frederic Gómez Bertomeu, Ester Picó Plana, Sara Rosich, Vanessa Blázquez, Dennis H. Céspedes Torrez, Ruth Lau, María Bodí
Biomedicines.2025; 13(12): 3112. CrossRef

Nursing
How do physicians and nurses differ in their perceived barriers to effective enteral nutrition in the intensive care unit?: Masoumeh Mirhosiny, Mansour Arab, Parvin Mangolian Shahrbabaki; Acute Crit Care. 2021;36(4):342-350. Published online November 16, 2021; DOI: https://doi.org/10.4266/acc.2021.00185

11,710 View
247 Download
10 Web of Science
10 Crossref

Abstract PDF

Background
Patients hospitalized in intensive care units are susceptible to chronic malnutrition from changes in protein and energy metabolism in response to trauma. Therefore, nutritional support, especially enteral nutrition, is one of the most important treatment measures for these patients. However, there are several barriers in the hospitals in treating patients with enteral nutrition. This study was performed to compare the perceptions of care providers (physicians and nurses) on the barriers to enteral nutrition in intensive care units.
Methods
This was a cross-sectional descriptive and analytic study. This study included 263 nurses and 104 physicians in the intensive care units of XXXX southeast hospitals. A questionnaire of enteral nutrition barriers in intensive care units was used. IBM SPSS ver. 19 was used to analyze data.
Results
There was a significant difference between the two groups in the three subscales of intensive care units (P=0.034), dietician support (p=0.001>) and critical care provider attitudes and behavior (P=0.031). There was also a significant difference between having completed educational courses and the score of enteral nutrition barriers in the two groups (P<0.05); the people who received an educational course had a better perception of enteral nutrition barriers.
Conclusions
Physicians and nurses agreed with the perception of enteral nutrition barriers, but there was a difference in their perception on some barriers. Strategies such as in-service training and increasing the knowledge and skills of physicians and nurses can reduce these differences.

Citations

Citations to this article as recorded by

What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed‐methods systematic review
Jia Qi Li, Ting Sun, Jun Tao Zuo, Yao Xu, Li Na Cai, Heng Yu Zheng, Xiang Hong Ye
Journal of Advanced Nursing.2025; 81(3): 1172. CrossRef
Enteral Nutrition Practices and Complications in ICU Settings: A Cross-Sectional Study of Healthcare Professionals’ Perspectives in Saudi Arabia
Sara Zaher, Reham Alhindi, Layan Alturki, Elaf Alsobhi, Lora Alahmadi, Hadeel Aldhowayan
Journal of Multidisciplinary Healthcare.2025; Volume 18: 289. CrossRef
Knowledge, attitude, and practice of nurses regarding enteral feeding for patients admitted to intensive care units of National Referral Hospitals in Dar es Salaam, Tanzania: a cross-sectional study
Shamim Muhudi Abeid, Masunga Kidula Iseselo, Menti Lastone Ndile, Dickson A. Mkoka, Rashidi Heri Kiangi
International Journal of Africa Nursing Sciences.2025; 23: 100920. CrossRef
Nutrition practices in critically ill adults receiving noninvasive ventilation: A quantitative survey of Australian and New Zealand intensive care clinicians
Kaitlyn Page, Elizabeth Viner Smith, Mark P. Plummer, Emma J. Ridley, Kristy Burfield, Lee-anne S. Chapple
Australian Critical Care.2024; 37(1): 43. CrossRef
El hambre invisible en la Unidad de Cuidados Intensivos. Estrategias de Cuidado y Consideraciones Esenciales
Ignacio Zaragoza-García
Enfermería Intensiva.2024; 35(1): 1. CrossRef
Invisible hunger in the Intensive Care Unit: Care strategies and essential considerations
I. Zaragoza-García
Enfermería Intensiva (English ed.).2024; 35(1): 1. CrossRef
Evidence-Based Investigation of Nurses' Nutrition Interventions in Intensive Care Patients Regarding Enteral Nutrition
Mensure Turan, Zeliha Cengiz, Dilek Olmaz
Dimensions of Critical Care Nursing.2024; 43(3): 123. CrossRef
Contribution to the Validation of the Portuguese Version of the “Barriers to Enterally Feeding Critically Ill Patients” Questionnaire and Its Application in a Hospital Context
Mário Rui Abade, Noémia Lopes, José de Santo Amaro
Topics in Clinical Nutrition.2024; 39(3): 184. CrossRef
Adequacy of protein and calorie delivery according to the expected calculated targets: a day‐by‐day assessment in critically ill patients undergoing enteral feeding
Adam Fabiani, Lorella Dreas, Enzo Mazzaro, Elena Trampus, Michela Zanetti, Antonella Calabretti, Giuseppe Gatti, Gianfranco Sanson
Journal of Human Nutrition and Dietetics.2023; 36(3): 697. CrossRef
Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs
Sara Zaher
Risk Management and Healthcare Policy.2022; Volume 15: 2357. CrossRef

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

9,922 View
155 Download
8 Web of Science
9 Crossref

Abstract PDF Supplementary Material

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

Citations

Citations to this article as recorded by

ICU Capacity Management and Surge Preparedness
Joseph L. Nates, Nirmala Manjappachar, Joshua Botdorf
Critical Care Clinics.2026;[Epub] CrossRef
Post-COVID-19 pandemic lived experiences of nurses about evidence-based care: A phenomenological study
Mohammad Malekzadeh, Mohammadsaeed Mirzaee, Leyla Homayuni, Elham Mirshah, Leila Bozorgin, Tahereh Gilvari, Soheyla Zabolipoor, Leila Gholami
Journal of Education and Health Promotion.2025;[Epub] CrossRef
The COVID-19 Tracheostomy Experience at a Large Academic Medical Center in New York during the First Year
Dhruv Patel, Anthony Devivo, Evan Leibner, Atinuke Shittu, Usha Govindarajulu, Pranai Tandon, David Lee, Randall Owen, Gustavo Fernandez-Ranvier, Robert Hiensch, Michael Marin, Roopa Kohli-Seth, Adel Bassily-Marcus
Journal of Clinical Medicine.2024; 13(7): 2130. CrossRef
Why are there so many hospital beds in Germany?
Matthias Brunn, Torsten Kratz, Michael Padget, Marie-Caroline Clément, Marc Smyrl
Health Services Management Research.2023; 36(1): 75. CrossRef
Flow-Sizing Critical Care Resources*
Joseph L. Nates, John M. Oropello, Neeraj Badjatia, Gregory Beilman, Craig M. Coopersmith, Neil A. Halpern, Daniel L. Herr, Judith Jacobi, Roozehra Kahn, Sharon Leung, Nitin Puri, Ayan Sen, Stephen M. Pastores
Critical Care Medicine.2023; 51(11): 1552. CrossRef
Sustaining the Australian respiratory workforce through the COVID‐19 pandemic: a scoping literature review
Emily Stone, Louis B. Irving, Katrina O. Tonga, Bruce Thompson
Internal Medicine Journal.2022; 52(7): 1115. CrossRef
Outcomes of hip fracture surgery during the COVID-19 pandemic
Sherrie Wang, MaKenzie Chambers, Kelsey Martin, Grace Gilbert, Pietro M. Gentile, Rock Hwang, Rakesh Mashru, Kenneth W. Graf, Henry J. Dolch
European Journal of Orthopaedic Surgery & Traumatology.2022; 33(6): 2453. CrossRef
Rapid communication for effective medical resource allocation in the COVID-19 pandemic
Kwangha Lee
Acute and Critical Care.2021; 36(3): 262. CrossRef
Triage: Medical Details and Words Matter
Jolion McGreevy, Rosamond Rhodes
The American Journal of Bioethics.2021; 21(11): 64. CrossRef

Neurology
Continuous heart rate variability and electroencephalography monitoring in severe acute brain injury: a preliminary study: Hyunjo Lee, Sang-Beom Jeon, Kwang-Soo Lee; Acute Crit Care. 2021;36(2):151-161. Published online March 18, 2021; DOI: https://doi.org/10.4266/acc.2020.00703

10,734 View
170 Download
4 Web of Science
5 Crossref

Abstract PDF

Background
Decreases in heart rate variability have been shown to be associated with poor outcomes in severe acute brain injury. However, it is unknown whether the changes in heart rate variability precede neurological deterioration in such patients. We explored the changes in heart rate variability measured by electrocardiography in patients who had neurological deterioration following severe acute brain injury, and examined the relationship between heart rate variability and electroencephalography parameters.
Methods
Retrospective analysis of 25 patients who manifested neurological deterioration after severe acute brain injury and underwent simultaneous electroencephalography plus electrocardiography monitoring.
Results
Eighteen electroencephalography channels and one simultaneously recorded electrocardiography channel were segmented into epochs of 120-second duration and processed to compute 10 heart rate variability parameters and three quantitative electroencephalography parameters. Raw electroencephalography of the epochs was also assessed by standardized visual interpretation and categorized based on their background abnormalities and ictalinterictal continuum patterns. The heart rate variability and electroencephalography parameters showed consistent changes in the 2-day period before neurological deterioration commenced. Remarkably, the suppression ratio and background abnormality of the electroencephalography parameters had significant reverse correlations with all heart rate variability parameters.
Conclusions
We observed a significantly progressive decline in heart rate variability from the day before the neurological deterioration events in patients with severe acute brain injury were first observed.

Citations

Citations to this article as recorded by

Cross-modal synchronization of EEG and ECG reveals hidden signatures of recovery in traumatic brain injury
Xulong Li, Haibo Teng, Peng Chen, Yuzhe Yuan, Pingchun Li, Mali Song, Jiaxin Yu, Jianguo Xu, Xiangyun Li, Kang Li, Zhiyong Liu
Journal of NeuroEngineering and Rehabilitation.2026;[Epub] CrossRef
Heart Rate Variability Applications in Medical Specialties: A Narrative Review
Jennifer S. Addleman, Nicholas S. Lackey, Molly A. Tobin, Grace A. Lara, Sankalp Sinha, Rebecca M. Morse, Alexander G. Hajduczok, Raouf S. Gharbo, Richard N. Gevirtz
Applied Psychophysiology and Biofeedback.2025; 50(3): 359. CrossRef
Heart Rate Variability and Autonomic Dysfunction After Stroke: Prognostic Markers for Recovery
Sara Lago, Toon T. de Beukelaar, Ilaria Casetta, Giorgio Arcara, Dante Mantini
Biomedicines.2025; 13(7): 1659. CrossRef
Association of Depressive and Somatic Symptoms with Heart Rate Variability in Patients with Traumatic Brain Injury
Seung Don Yoo, Eo Jin Park
Journal of Clinical Medicine.2022; 12(1): 104. CrossRef
Influencing Cardiovascular Outcomes through Heart Rate Variability Modulation: A Systematic Review
Alexandru Burlacu, Crischentian Brinza, Iolanda Valentina Popa, Adrian Covic, Mariana Floria
Diagnostics.2021; 11(12): 2198. CrossRef

Review Article

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

10,044 View
417 Download
6 Web of Science
6 Crossref

Abstract PDF

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

Citations

Citations to this article as recorded by

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

Original Article

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

7,370 View
102 Download
2 Web of Science
1 Crossref

Abstract PDF

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

Citations

Citations to this article as recorded by

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

Review Articles

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

13,774 View
340 Download
16 Web of Science
14 Crossref

Abstract PDF

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

Citations

Citations to this article as recorded by

Material and human resources invested in a program aimed at potentially critical trauma patients in the emergency department
Alejandro Arturo Caballo Manuel, Carlos García Fuentes, Jesús Barea Mendoza, Susana Bermejo-Aznáres, Mario Chico-Fernández
Medicina Intensiva (English Edition).2025; 49(4): 245. CrossRef
Recursos humanos y materiales dirigidos en un programa de atención al paciente traumático potencialmente grave en urgencias
Alejandro Arturo Caballo Manuel, Carlos García Fuentes, Jesús Barea Mendoza, Susana Bermejo-Aznáres, Mario Chico-Fernández
Medicina Intensiva.2025; 49(4): 245. CrossRef
Critical emergency medicine unit: a new model to mitigate critically ill patient boarding in emergency department
Felice Urso, Daniele Catalano, Ileana Suprina Petrovic, Enrico Boero, Paola Berchialla, Luigi Vetrugno, Daniela Silengo
Journal of Anesthesia, Analgesia and Critical Care.2025;[Epub] CrossRef
Intermediate Care Units in Europe and Italy: A Review of Structure, Outcomes, and Policy Implications for Internal Medicine
Gianni Turcato, Arian Zaboli, Alessandro Cipriano, Andrea Montagnani, Vieri Vannucchi, Filippo Pieralli, Anna Belfiore, Filippo Valbusa, Massimo Marchetti, Paolo Ferretto, Lucia Filippi, Antonio Voza, Lorenzo Ghiadoni, Walter Ageno, Christian J. Wiederman
Journal of Clinical Medicine.2025; 14(18): 6543. CrossRef
Construction of an integrated treatment and management model for psychiatric emergency and intensive care units in a specialized psychiatric hospital: practice of subspecialty development
Yi-chao Wang, Hui Yu, Fu-gang Luo, Hong-mei Wang
Frontiers in Health Services.2025;[Epub] CrossRef
Curriculum „Internistische Intensivmedizin und Notfallmedizin“
Guido Michels, Stefan John, Hans-Jörg Busch, Matthias Baumgärtel, Klaus-Friedrich Bodmann, Stephan Braune, Michael Buerke, Kai-Uwe Eckardt, Philipp Enghard, Frank Erbguth, Georg Ertl, Wolf Andreas Fach, Valentin Fuhrmann, Frank Hanses, Hans Jürgen Heppner
Medizinische Klinik - Intensivmedizin und Notfallmedizin.2025; 120(S4): 269. CrossRef
Inhaled anaesthetic gas for severe bronchospasm at the emergency department
Osman Adi, Farah Nuradhwa Apoo, Chan Pei Fong, Azma Haryaty Ahmad, Nurul Liana Roslan, Faheem Ahmed Khan, Shahridan Fathil
The American Journal of Emergency Medicine.2024; 75: 179. CrossRef
Patients’ Expectations in Emergency Department at King Abdulaziz University Hospital: A Cross-Sectional Survey-Based Study
Ahmad H Bakhribah, Ghaida A. Eissa, Dania W Alsulami, Marah A Alotaibi, Htoun M Abdulmannan, Imad M Khojah
Cureus.2024;[Epub] CrossRef
CRP/Albumin Ratio and NLR in Recognizing Critically Ill Patients
Abuzer Özkan
Eurasian Journal of Critical Care.2024; 6(1): 38. CrossRef
Rearranging the furniture: A blueprint for reappropriating fixed resources to create an emergency department resuscitative care unit
Angela Barskaya, Liliya Abrukin, Christopher McStay
JACEP Open.2024; 5(3): e13211. CrossRef
The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study
Ahmed Faidh Ramzee, Ayman El-Menyar, Mohammad Asim, Ahad Kanbar, Khalid Ahmed, Bahaa Daoud, Saji Mathradikkal, Ahmad Kloub, Hassan Al-Thani, Sandro Rizoli
World Journal of Emergency Medicine.2023; 14(2): 96. CrossRef
Value of Intensive Nursing Detail Management in Intensive Care Unit Nursing
Yansong Li, Lehong Zhou, Qin Wei, Zhaoqi Dong
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef
[Retracted] Effect of Early Low‐Calorie Enteral Nutrition Support in Critically Ill Patients: A Systematic Review and Meta‐analysis
Qidong Jiang, Tao Xu, Dinesh Rokaya
BioMed Research International.2022;[Epub] CrossRef
Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model
Elizabeth Powell, Iana Sahadzic, Daniel Najafali, Emilie Berman, Katie Andersen, Leenah Z. Afridi, Zoe Gasparotti, Erin Niles, Jeffrey Rea, Thomas Scalea, Daniel J. Haase, Quincy K. Tran, Edward A. Bittner
Critical Care Research and Practice.2022; 2022: 1. CrossRef

Trauma
Damage control strategy in bleeding trauma patients: Maru Kim, Hangjoo Cho; Acute Crit Care. 2020;35(4):237-241. Published online November 30, 2020; DOI: https://doi.org/10.4266/acc.2020.00941

13,921 View
436 Download
4 Web of Science
6 Crossref

Abstract PDF

Hemorrhagic shock is a main cause of death in severe trauma patients. Bleeding trauma patients have coagulopathy on admission, which may even be aggravated by incorrectly directed resuscitation. The damage control strategy is a very urgent and essential aspect of management considering the acute coagulopathy of trauma and the physiological status of bleeding trauma patients. This strategy has gained popularity over the past several years. Patients in extremis cannot withstand prolonged definitive surgical repair. Therefore, an abbreviated operation, referred to as damage control surgery (DCS), is needed. In addition to DCS, the likelihood of survival should be maximized for patients in extremis by providing appropriate critical care, including permissive hypotension, hemostatic resuscitation, minimization of crystalloid use, early use of tranexamic acid, and avoidance of hypothermia and hypocalcemia. This review presents an overview of the evolving strategy of damage control in bleeding trauma patients.

Citations

Citations to this article as recorded by

A comprehensive review of massive transfusion and major hemorrhage protocols: origins, core principles and practical implementation
David Silveira Marinho, Denise Menezes Brunetta, Luciana Maria de Barros Carlos, Luany Elvira Mesquita Carvalho, Jessica Silva Miranda
Brazilian Journal of Anesthesiology (English Edition).2025; 75(2): 844583. CrossRef
Targeting Inflammation After Hemorrhagic Shock as a Molecular and Experimental Journey to Improve Outcomes: A Review
Kenneth Meza Monge, Astrid Ardon-Lopez, Akshay Pratap, Juan-Pablo Idrovo
Cureus.2025;[Epub] CrossRef
Comprehensive meta-analysis of emergency trauma outcomes: trends, interventions, and survival rates
Aiming Li, Qiaoyan Feng, Ye Zhao, Xianhuan Zhang, Weijie Jiang
Frontiers in Public Health.2025;[Epub] CrossRef
Hypovolemic shock in adults. Guidelines of the All-Russian Public Organization “Federation of Anesthesiologists and Reanimatologists”
Igor B. Zabolotskikh, E. V. Grigoryev, V. S. Afonchikov, A. Yu. Bulanov, S. V. Grigoryev, A. N. Kuzovlev, V. V. Kuzkov, R. E. Lakhin, K. M. Lebedinskii, O. V. Orlova, E. V. Roitman, S. V. Sinkov, N. P. Shen, A. V. Schegolev
Annals of Critical Care.2024; (4): 7. CrossRef
Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care
Kenneth Meza Monge, Caleb Rosa, Christopher Sublette, Akshay Pratap, Elizabeth J. Kovacs, Juan-Pablo Idrovo
Biomedicines.2024; 12(12): 2864. CrossRef
Current Approaches to the Treatment of Traumatic Shock (Review)
D. A. Ostapchenko, A. I. Gutnikov, L. A. Davydova
General Reanimatology.2021; 17(4): 65. CrossRef

Original Articles

Pulmonary
Predictive value of the negative inspiratory force index as a predictor of weaning success: a crosssectional study: Phuong Hoang Vu, Viet Duc Tran, Minh Cuong Duong, Quyet Thang Cong, Thu Nguyen; Acute Crit Care. 2020;35(4):279-285. Published online November 30, 2020; DOI: https://doi.org/10.4266/acc.2020.00598

15,644 View
768 Download
5 Web of Science
9 Crossref

Abstract PDF

Background
Identifying when intubated patients are ready to be extubated remains challenging. The negative inspiratory force (NIF) is a recommended predictor of weaning success. However, little is known about the role of NIF in the weaning process for the Asian surgical intensive population, especially for the Vietnamese population. Here, we aimed to investigate the cutoff threshold and predictive value of the NIF index for predicting the success of ventilator weaning in Vietnamese surgical intensive care patients.
Methods
A cross-sectional study was conducted at the Surgical Intensive Care Unit of Viet Duc Hospital from October 2016 to August 2017. A total of 64 patients aged 16–70 years undergoing ventilatory support through an orotracheal tube satisfied the criteria for readiness to begin weaning. The correlation between the NIF index with outcomes of the weaning process was analyzed. Specificity (Sp), sensitivity (Se), positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve, and area under the curve (AUC) were calculated.
Results
The success rate of the entire weaning process was 67.2% (43/64). The median NIF values were –26.0 cm H₂O (interquartile range [IQR], –28.0 to –25.0) in the successful weaning group and –24.0 cm H₂O (IQR, –25.0 to –23.0) in the weaning failure group (P<0.001). According to ROC analysis, an NIF value ≤–25 cm H₂O predicted weaning success (AUC, 0.836) with 91% Se, 62% Sp, 83% PPV, and 77% NPV.
Conclusions
An NIF cutoff threshold ≤–25 cm H₂O can be used as predictor of weaning success in Vietnamese surgical intensive care patients.

Citations

Citations to this article as recorded by

Exploring Extubation Readiness in Guillain-Barré Syndrome: A Case Report and Literature Review
Victoria Watson, Saif Ghishan, Tata Avalishvili, Sinen Zeleke, Saron Tigabe, Anderson White, Fuad Zeid, Zakaria Alagha
Journal of Investigative Medicine High Impact Case Reports.2025;[Epub] CrossRef
Monitoring of external respiratory recovery during postmedication (literature review)
O. E. Kutina, A. Yu. Zaitsev, S. G. Zhukova, E. G. Usikyan, D. I. Novikov
Messenger of ANESTHESIOLOGY AND RESUSCITATION.2025; 22(4): 125. CrossRef
Intensive Management of a Patient with HIV, Active Tuberculosis, and COVID-19: A Multidisciplinary Approach in the Intensive Care Unit
Brayan Ricardo Mosquera-Arias, Valeria Sanclemente-Cardoza, Jose Luis Estela-Zape
Life.2025; 15(9): 1435. CrossRef
Structural, morphological and functional changes of diaphragm in patients with chronic heart failure
V.S. Shabaev, I.A. Makarov, L.B. Mitrofanova, L.G. Vasilyeva, L.Z. Biktasheva, V.A. Mazurok, I.A. Danilova, N.A. Osipova
Russian Journal of Anesthesiology and Reanimatology.2024; (5): 88. CrossRef
Diaphragm dysfunction as a prognostic criterion of external respiratory impairment and necessary extracorporeal membrane oxygenation in patients with chronic heart failure
V.S. Shabaev, V.A. Mazurok, L.Z. Biktasheva, L.G. Vasilyeva, K.Yu. Kozhieva, I.A. Danilova, N.A. Osipova
Russian Journal of Anesthesiology and Reanimatology.2024; (6): 38. CrossRef
Pendelluft as a predictor of weaning in critically ill patients: An observational cohort study
Danqiong Wang, Yaxin Ning, Linya He, Keqi Pan, Xiaohua Xiong, Shanshan Jing, Jianhua Hu, Jian Luo, Dehua Ye, Zubing Mei, Weiwen Zhang
Frontiers in Physiology.2023;[Epub] CrossRef
Morphological and Functional Alterations of Respiratory Muscle Performance and Spirometry Parameters in Patients with Congestive Heart Failure
V. S. Shabaev, I. V. Orazmagomedova, V. A. Mazurok, A. V. Berezina, A. E. Bautin, L. G. Vasilyeva, D. A. Aleksandrova
General Reanimatology.2023; 19(5): 39. CrossRef
Diaphragmatic dysfunction in patients with chronic heart failure
V.S. Shabaev, I.V. Orazmagomedova, V.A. Mazurok, A.V. Berezina, A.E. Bautin, L.G. Vasilyeva, D.A. Aleksandrova
Russian Journal of Anesthesiology and Reanimatology.2023; (5): 44. CrossRef
Biosignal-Based Digital Biomarkers for Prediction of Ventilator Weaning Success
Ji Eun Park, Tae Young Kim, Yun Jung Jung, Changho Han, Chan Min Park, Joo Hun Park, Kwang Joo Park, Dukyong Yoon, Wou Young Chung
International Journal of Environmental Research and Public Health.2021; 18(17): 9229. CrossRef

Pediatric
Effects of the presence of a pediatric intensivist on treatment in the pediatric intensive care unit: Jung Eun Kwon, Da Eun Roh, Yeo Hyang Kim; Acute Crit Care. 2020;35(2):87-92. Published online May 12, 2020; DOI: https://doi.org/10.4266/acc.2019.00752

6,987 View
113 Download
4 Web of Science
4 Crossref

Abstract PDF

Background
There are few studies on the effect of intensivist staffing in pediatric intensive care units (PICUs) in Korea. We aimed to evaluate the effect of pediatric intensivist staffing on treatment outcomes in a Korean hospital PICU.
Methods
We analyzed two time periods according to pediatric intensivist staffing: period 1, between November 2015 to January 2017 (no intensivist staffing, n=97) and period 2, between February 2017 to February 2018 (intensivists staffing, n=135).
Results
Median age at admission was 5.4 years (range, 0.7–10.3 years) in period 1 and 3.6 years (0.2–5.1 years) in period 2 (P=0.013). The bed occupancy rate decreased in period 2 (75%; 73%–88%) compared to period 1 (89%; 81%–94%; P=0.015). However, the monthly bed turnover rate increased in period 2 (2.2%; 1.9%–2.7%) compared to period 1 (1.5%, 1.1%– 1.7%; P=0.005). In both periods, patients with chronic neurologic illness were the most common. Patients with cardiovascular problems were more prevalent in period 2 than period 1 (P=0.008). Daytime admission occurred more frequently in period 2 than period 1 (63% vs. 39%, P<0.001). The length of PICU stay, parameters related with mechanical ventilation and tracheostomy, and pediatric Sequential Organ Failure Assessment score were not different between periods. Sudden cardiopulmonary resuscitations occurred in two cases during period 1, but no case occurred during period 2.
Conclusions
Pediatric intensivist staffing in the PICU may affect efficient ICU operations.

Citations

Citations to this article as recorded by

Impact of medical crisis on the critical care system in South Korea
Ye Rim Chang, Jae Hwa Cho, Joongbum Cho, Tae Sun Ha, Bo Gun Kho, Eunhye Kim, Im-kyung Kim, Dong Hyun Lee, Suk-Kyung Hong
Acute and Critical Care.2025; 40(3): 393. CrossRef
The impact of pediatric intensivists on the management of pediatric diabetic ketoacidosis in pediatric intensive care units
Ah Young Choi, Esther Park
BMC Pediatrics.2023;[Epub] CrossRef
Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
PLOS ONE.2021; 16(10): e0259092. CrossRef
Intensivists in the pediatric intensive care unit: conductors for better operational efficiency
June Dong Park
Acute and Critical Care.2020; 35(2): 115. CrossRef

Ethics
Characteristics and Outcomes of Potentially Inappropriate Admissions to the Intensive Care Unit: Sooim Sin, Sang-Min Lee, Jinwoo Lee; Acute Crit Care. 2019;34(1):46-52. Published online February 28, 2019; DOI: https://doi.org/10.4266/acc.2018.00388

9,699 View
165 Download
4 Web of Science
4 Crossref

Abstract PDF Supplementary Material

Background
Admission of patients perceived as potentially inappropriate for intensive care is a very sensitive and controversial issue. We aimed to evaluate the use of medical resources in the intensive care unit (ICU) and outcomes of patients according to a physician’s judgment of appropriateness. Methods: ICU physicians classified patients who were admitted to the medical ICU of a tertiary hospital as appropriate or inappropriate for intensive care within 24 hours of admission. Patient outcomes including mortality were analyzed according to appropriateness. Additionally, the usage and duration of mechanical ventilation (MV), renal replacement therapy (RRT), and extracorporeal membrane oxygenation (ECMO) were analyzed according to appropriateness. Results: In total, 105 patients (male, 55.4%; mean age, 62 years) were included. Twelve (11.4%) patients were considered inappropriate for intensive care based on guidance published by the Society of Critical Care Medicine through a questionnaire survey of physicians. There was no significant difference between patients considered inappropriate or appropriate for ICU admission regarding the use and duration of MV, RRT, and ECMO. In contrast, the ICU, in-hospital, 28-day, 90-day, and total mortality rates were significantly higher among patients with inappropriate admission than among patients with appropriate admission (ICU mortality: 50.0% vs. 25.8%, P=0.008; in-hospital mortality: 58.3% vs. 43.0%, P=0.028; 28-day mortality: 58.3% vs. 33.3%, P=0.019; 90-day mortality: 66.7% vs. 44.1%, P=0.023). Conclusions: Despite higher mortality, the amount of medical resources used for patients considered potentially inappropriate for intensive care did not differ from the resources used for patients considered suitable for ICU care.

Citations

Citations to this article as recorded by

Characteristics of potentially inappropriate, and inappropriately prolonged, ICU admissions in dying ICU patients: A retrospective cohort study
Sandra Lussier, Carys Jones, Stephen Thornhill, Ary Serpa Neto, Daryl Jones
Anaesthesia and Intensive Care.2025;[Epub] CrossRef
Characteristics of critically ill patients with cancer associated with intensivist's perception of inappropriateness of ICU admission: A retrospective cohort study
Carla Marchini Dias da Silva, Bruno Adler Maccagnan Pinheiro Besen, Antônio Paulo Nassar Jr
Journal of Critical Care.2024; 79: 154468. CrossRef
Association of appropriateness for ICU admission with resource use, organ support and long-term survival in critically ill cancer patients
Carla Marchini Dias Silva, Janaina Naiara Germano, Anna Karolyne de Araujo Costa, Giovanna Alves Gennari, Pedro Caruso, Antonio Paulo Nassar Jr
Internal and Emergency Medicine.2023; 18(4): 1191. CrossRef
Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study
Yanchen Liu, Yingchun Chen, Xueyan Cheng, Yan Zhang
International Journal of Environmental Research and Public Health.2020; 17(16): 5963. CrossRef

Surgery
Association of Immediate Postoperative Temperature in the Surgical Intensive Care Unit with 1-Year Mortality: Retrospective Analysis Using Digital Axillary Thermometers: Jiwook Kim, Tak Kyu Oh, Jaebong Lee, Saeyeon Kim, In-Ae Song; Acute Crit Care. 2019;34(1):53-59. Published online January 9, 2019; DOI: https://doi.org/10.4266/acc.2019.00255

9,069 View
129 Download
4 Web of Science
5 Crossref

Abstract PDF Supplementary Material

Background
Postoperative body temperature is closely associated with prognosis although there is limited research regarding this association at postoperative intensive care unit (ICU) admission. Furthermore, no studies have used digital axillary thermometers to measure postoperative body temperature. This study investigated the association between mortality and postoperative temperature measured using a digital axillary thermometer within 10 minutes after ICU admission. Methods: This retrospective observational study evaluated data from adult patients admitted to an ICU after elective or emergency surgery. The primary outcome was 1-year mortality after ICU admission. Multivariable logistic regression analysis with restricted cubic splines was used to evaluate the association between temperature and outcomes. Results: We evaluated data from 5,868 patients admitted between January 1, 2013 and May 31, 2016, including 5,311 patients (90.5%) who underwent noncardiovascular surgery and 557 patients (9.5%) who underwent cardiovascular surgery. Deviation from the median temperature (36.6°C) was associated with increases in 1-year mortality (≤ 36.6°C: linear coefficient, –0.531; P<0.001 and ≥36.6°C: spline coefficient, 0.756; P<0.001). Similar statistically significant results were observed in the noncardiovascular surgery group, but not in the cardiovascular surgery group. Conclusions: An increase or decrease in body temperature (vs. 36.6°C) measured using digital axillary thermometers within 10 minutes of postoperative ICU admission was associated with increased 1-year mortality. However, no significant association was observed after cardiovascular surgery. These results suggest that postoperative temperature is associated with longterm mortality in patients admitted to the surgical ICU in the postoperative period.

Citations

Citations to this article as recorded by

Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study
Lang Peng, Xianxian Zang, Ruili Liu, Ping Bai, Lu Wang, Guoyong Yang
Journal of Advanced Nursing.2024; 80(9): 3653. CrossRef
A prognostic model for 1-month mortality in the postoperative intensive care unit
Mohammad Fathi, Nader Markazi Moghaddam, Saba Naderian Jahromi
Surgery Today.2022; 52(5): 795. CrossRef
Relationship Between First 24-h Mean Body Temperature and Clinical Outcomes of Post-cardiac Surgery Patients
Fei Xu, Cheng Zhang, Chao Liu, Siwei Bi, Jun Gu
Frontiers in Cardiovascular Medicine.2021;[Epub] CrossRef
Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature
Sohan Lal Solanki, Mrida A. K. Jhingan, Avanish P. Saklani
Pleura and Peritoneum.2020;[Epub] CrossRef
Postoperative Hypothermia
Deokkyu Kim
Acute and Critical Care.2019; 34(1): 79. CrossRef

Review Articles

Pulmonary
Critical Care before Lung Transplantation: Jin Gu Lee, Moo Suk Park, Su Jin Jeong, Song Yee Kim, Sungwon Na, Jeongmin Kim, Hyo Chae Paik; Acute Crit Care. 2018;33(4):197-205. Published online November 30, 2018; DOI: https://doi.org/10.4266/acc.2018.00367

11,132 View
265 Download
5 Web of Science
5 Crossref

Abstract PDF

Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

Citations

Citations to this article as recorded by

Optimizing the prelung transplant candidate
John Pagteilan, Scott Atay
Current Opinion in Organ Transplantation.2024; 29(1): 37. CrossRef
Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation
Su Hwan Lee
Acute and Critical Care.2022; 37(1): 26. CrossRef
Recipient Management before Lung Transplantation
Hyoung Soo Kim, Sunghoon Park
Journal of Chest Surgery.2022; 55(4): 265. CrossRef
Outcomes of Patients on the Lung Transplantation Waitlist in Korea: A Korean Network for Organ Sharing Data Analysis
Hye Ju Yeo, Dong Kyu Oh, Woo Sik Yu, Sun Mi Choi, Kyeongman Jeon, Mihyang Ha, Jin Gu Lee, Woo Hyun Cho, Young Tae Kim
Journal of Korean Medical Science.2022;[Epub] CrossRef
Long- and short-term clinical impact of awake extracorporeal membrane oxygenation as bridging therapy for lung transplantation
Nam Eun Kim, Ala Woo, Song Yee Kim, Ah Young Leem, Youngmok Park, Se Hyun Kwak, Seung Hyun Yong, Kyungsoo Chung, Moo Suk Park, Young Sam Kim, Ha Eun Kim, Jin Gu Lee, Hyo Chae Paik, Su Hwan Lee
Respiratory Research.2021;[Epub] CrossRef

Pulmonary
Critical Care after Lung Transplantation: Song Yee Kim, Su Jin Jeong, Jin Gu Lee, Moo Suk Park, Hyo Chae Paik, Sungwon Na, Jeongmin Kim; Acute Crit Care. 2018;33(4):206-215. Published online November 30, 2018; DOI: https://doi.org/10.4266/acc.2018.00360

23,274 View
772 Download
10 Web of Science
11 Crossref

Abstract PDF

Since the first successful lung transplantation in 1983, there have been many advances in the field. Nevertheless, the latest data from the International Society for Heart and Lung Transplantation revealed that the risk of death from transplantation is 9%. Various aspects of postoperative management, including mechanical ventilation, could affect intensive care unit stay, hospital stay, and immediate postoperative morbidity and mortality. Complications such as reperfusion injury, graft rejection, infection, and dehiscence of anastomosis increase fatal adverse side effects immediately after surgery. In this article, we review the possible immediate complications after lung transplantation and summarize current knowledge on prevention and treatment.

Citations

Citations to this article as recorded by

The Spectrum of Mitral Regurgitation in Lung Transplant Recipients: A Systematic Review
George Bcharah, Juan M. Farina, J. Asher Jenkins, Rawan M. Zeineddine, Andrew G. Saleeb, Estefana Bcharah, Kenan A. Shawwaf, Brian W. Hardaway, Pedro Reck dos Santos, Jonathan D’Cunha, Ashraf Omar
Transplantation.2025; 109(9): e455. CrossRef
Post-operative management of children after lung transplantation
Nicolaus Schwerk, Julia Carlens, Harald Köditz, Fabio Ius, Nicholas Avdimiretz, Don Hayes, Melinda Solomon
JHLT Open.2025; 9: 100301. CrossRef
Caring for Heart and Lung Transplant Patients
Brigitte Hollander, Antonio Rubino, Jasvir Pamar, Florian Falter
Journal of Intensive Care Medicine.2025;[Epub] CrossRef
Aspergillus Galactomannan Titer as a Diagnostic Marker of Invasive Pulmonary Aspergillosis in Lung Transplant Recipients: A Single-Center Retrospective Cohort Study
Eun-Young Kim, Seung-Hyun Yong, Min-Dong Sung, A-La Woo, Young-Mok Park, Ha-Eun Kim, Su-Jin Jung, Song-Yee Kim, Jin-Gu Lee, Young-Sam Kim, Hyo-Chae Paik, Moo-Suk Park
Journal of Fungi.2023; 9(5): 527. CrossRef
Nontuberculous mycobacterial infection after lung transplantation: A single-center experience in South Korea
Youngmok Park, Nam Eun Kim, Se Hyun Kwak, Moo Suk Park, Su Jin Jeong, Jin Gu Lee, Hyo Chae Paik, Song Yee Kim, Young Ae Kang
Journal of Microbiology, Immunology and Infection.2022; 55(1): 123. CrossRef
Medical Complications of Lung Transplantation
Moo Suk Park
Journal of Chest Surgery.2022; 55(4): 338. CrossRef
Roles of electrical impedance tomography in lung transplantation
Hui Jiang, Yijiao Han, Xia Zheng, Qiang Fang
Frontiers in Physiology.2022;[Epub] CrossRef
Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
Emily Sartain, Kelly Schoeppler, Barrett Crowther, Joshua B. Smith, Maheen Z. Abidi, Todd J. Grazia, Mark Steele, Terri Gleason, Krista Porter, Alice Gray
Transplant Infectious Disease.2021;[Epub] CrossRef
The Prediction and Prognosis of Fungal Infection in Lung Transplant Recipients—A Retrospective Cohort Study in South Korea
Yae-Jee Baek, Yun-Suk Cho, Moo-Hyun Kim, Jong-Hoon Hyun, Yu-Jin Sohn, Song-Yee Kim, Su-Jin Jeong, Moo-Suk Park, Jin-Gu Lee, Hyo-Chae Paik
Journal of Fungi.2021; 7(8): 639. CrossRef
Panel-Reactive and Donor-Specific Antibodies before Lung Transplantation can Affect Outcomes in Korean Patients Receiving Lung Transplantation
Sung Woo Moon, Moo Suk Park, Jin Gu Lee, Hyo Chae Paik, Young Tae Kim, Hyun Joo Lee, Samina Park, Sun Mi Choi, Do Hyung Kim, Woo Hyun Cho, Hye Ju Yeo, Seung-il Park, Se Hoon Choi, Sang-Bum Hong, Tae Sun Shim, Kyung-Wook Jo, Kyeongman Jeon, Byeong-Ho Jeong
Yonsei Medical Journal.2020; 61(7): 606. CrossRef
A proof-of principal study using phase-contrast imaging for the detection of large airway pathologies after lung transplantation
Stephan Umkehrer, Carmela Morrone, Julien Dinkel, Laura Aigner, Maximilian F. Reiser, Julia Herzen, Ali Ö. Yildirim, Franz Pfeiffer, Katharina Hellbach
Scientific Reports.2020;[Epub] CrossRef

Original Articles

Epidemiology
Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study: Tak Kyu Oh, Jihoon Jo, Young-Tae Jeon, In-Ae Song; Acute Crit Care. 2018;33(4):230-237. Published online November 13, 2018; DOI: https://doi.org/10.4266/acc.2018.00514

10,942 View
104 Download
6 Web of Science
6 Crossref

Abstract PDF Supplementary Material

Background
Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality.
Methods
This was a retrospective observational study of adult patients aged ≥20 years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses.
Results
A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission.
Conclusions
Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

Citations

Citations to this article as recorded by

Association Between Socioeconomic Status and Outcomes in Critical Care: A Systematic Review and Meta-Analysis
Ryan D. McHenry, Christopher E. J. Moultrie, Tara Quasim, Daniel F. Mackay, Jill P. Pell
Critical Care Medicine.2023; 51(3): 347. CrossRef
The effect of socioeconomic status, insurance status, and insurance coverage benefits on mortality in critically ill patients admitted to the intensive care unit
Moo Suk Park
Acute and Critical Care.2022; 37(1): 118. CrossRef
Association between off-hour admission of critically ill children to intensive care units and mortality in a Japanese registry
Takahiro Kido, Masao Iwagami, Toshikazu Abe, Yuki Enomoto, Hidetoshi Takada, Nanako Tamiya
Scientific Reports.2021;[Epub] CrossRef
Associations Between Socioeconomic Status, Patient Risk, and Short-Term Intensive Care Outcomes
Daniel V. Mullany, David V. Pilcher, Annette J. Dobson
Critical Care Medicine.2021; 49(9): e849. CrossRef
Association of Economic Status and Mortality in Patients with Acute Respiratory Distress Syndrome
Tak Kyu Oh, In-Ae Song, Jae Ho Lee
International Journal of Environmental Research and Public Health.2020; 17(6): 1815. CrossRef
Critical Care Research Using “Big Data”: A Reality in the Near Future
Kwangha Lee
Acute and Critical Care.2018; 33(4): 269. CrossRef

Hematology
Characteristics and Clinical Outcomes of Critically Ill Cancer Patients Admitted to Korean Intensive Care Units: Soo Jin Na, Tae Sun Ha, Younsuck Koh, Gee Young Suh, Shin Ok Koh, Chae-Man Lim, Won-Il Choi, Young-Joo Lee, Seok Chan Kim, Gyu Rak Chon, Je Hyeong Kim, Jae Yeol Kim, Jaemin Lim, Sunghoon Park, Ho Cheol Kim, Jin Hwa Lee, Ji Hyun Lee, Jisook Park, Juhee Cho, Kyeongman Jeon; Acute Crit Care. 2018;33(3):121-129. Published online August 31, 2018; DOI: https://doi.org/10.4266/acc.2018.00143

11,207 View
285 Download
12 Web of Science
13 Crossref

Abstract PDF

Background
The objective of this study was to investigate the characteristics and clinical outcomes of critically ill cancer patients admitted to intensive care units (ICUs) in Korea.
Methods
This was a retrospective cohort study that analyzed prospective collected data from the Validation of Simplified Acute Physiology Score 3 (SAPS3) in Korean ICU (VSKI) study, which is a nationwide, multicenter, and prospective study that considered 5,063 patients from 22 ICUs in Korea over a period of 7 months. Among them, patients older than 18 years of age who were diagnosed with solid or hematologic malignancies prior to admission to the ICU were included in the present study.
Results
During the study period, a total of 1,762 cancer patients were admitted to the ICUs and 833 of them were deemed eligible for analysis. Six hundred fifty-eight (79%) had solid tumors and 175 (21%) had hematologic malignancies, respectively. Respiratory problems (30.1%) was the most common reason leading to ICU admission. Patients with hematologic malignancies had higher Sequential Organ Failure Assessment (12 vs. 8, P<0.001) and SAPS3 (71 vs. 69, P<0.001) values and were more likely to be associated with chemotherapy, steroid therapy, and immunocompromised status versus patients with solid tumors. The use of inotropes/ vasopressors, mechanical ventilation, and/or continuous renal replacement therapy was more frequently required in hematologic malignancy patients. Mortality rates in the ICU (41.7% vs. 24.6%, P<0.001) and hospital (53.1% vs. 38.6%, P=0.002) were higher in hematologic malignancy patients than in solid tumor patients.
Conclusions
Cancer patients accounted for one-third of all patients admitted to the studied ICUs in Korea. Clinical characteristics were different according to the type of malignancy. Patients with hematologic malignancies had a worse prognosis than did patients with solid tumor.

Citations

Citations to this article as recorded by

Mortality-Related Risk Factors in Patients with Hematologic Neoplasm Admitted to the Intensive Care Unit: A Systematic Review
Jhon H. Quintana, Cesar David López-Vanegas, Giovanna Patricia Rivas-Tafurt, Leidy Tatiana Ordoñez-Mora, Heiler Lozada-Ramos, Jorge Enrique Daza-Arana
Current Oncology.2025; 32(3): 132. CrossRef
The critical role of timely medical emergency team activation in oncological and non-oncological patients
Kaspar F. Bachmann, Samuel J. Michimura, Luca Cioccari, Joerg C. Schefold, Anna S. Messmer, Vinaya Satyawan Tari
PLOS One.2025; 20(5): e0324831. CrossRef
Outcomes of Acute Respiratory Failure in Patients With Cancer in the United States
Kiyan Heybati, Jiawen Deng, Archis Bhandarkar, Fangwen Zhou, Cameron Zamanian, Namrata Arya, Mohamad Bydon, Philippe R. Bauer, Ognjen Gajic, Allan J. Walkey, Hemang Yadav
Mayo Clinic Proceedings.2024; 99(4): 578. CrossRef
Characteristics and outcomes of cancer patients admitted to intensive care units in cancer specialized hospitals in China
Wensheng Liu, Dongmin Zhou, Li Zhang, Mingguang Huang, Rongxi Quan, Rui Xia, Yong Ye, Guoxing Zhang, Zhuping Shen
Journal of Cancer Research and Clinical Oncology.2024;[Epub] CrossRef
Short-term and long-term outcomes of critically ill patients with solid malignancy: a retrospective cohort study
Su Yeon Lee, Jin Won Huh, Sang-Bum Hong, Chae-Man Lim, Jee Hwan Ahn
The Korean Journal of Internal Medicine.2024; 39(6): 957. CrossRef
Intensive Care Unit Outcomes and Mortality in Elderly Oncology Patients
Arif TIMUROGLU, Selda MUSLU, Aysegul DANACI, Erce CAN URESIN, Suheyla UNVER
Turkish journal of Geriatrics.2024; 27(1): 118. CrossRef
Predictors of ICU mortality in patients with hemoblastosis and infectious complications
A.V. Lyanguzov, A.S. Luchinin, S.V. Ignatyev, I.V. Paramonov
Russian Journal of Anesthesiology and Reanimatology.2023; (1): 33. CrossRef
Etiologies and Outcome of Patients with Solid Tumors Admitted to ICU with Acute Respiratory Failure: A Secondary Analysis of the EFRAIM Study
Soraya Benguerfi, Guillaume Dumas, Marcio Soares, Anne-Pascale Meert, Ignacio Martin-Loeches, Frederic Pene, Philippe Bauer, Sangeeta Mehta, Victoria Metaxa, Gaston Burghi, Achille Kouatchet, Luca Montini, Djamel Mokart, Andry Van de Louw, Elie Azoulay, V
Respiratory Care.2023; 68(6): 740. CrossRef
Effect of the underlying malignancy on critically ill septic patient's outcome
Man‐Yee Man, Hoi‐Ping Shum, Sin‐Man Lam, Jacky Li, Wing‐Wa Yan, Mei‐Wan Yeung
Asia-Pacific Journal of Clinical Oncology.2022; 18(4): 473. CrossRef
Impacts of Corticosteroid Therapy at Acute Stage of Hospital-Onset Clostridioides difficile Infections
Ching-Chi Lee, Jen-Chieh Lee, Chun-Wei Chiu, Pei-Jane Tsai, Wen-Chien Ko, Yuan-Pin Hung
Infection and Drug Resistance.2022; Volume 15: 5387. CrossRef
Hospital mortality and prognostic factors in critically ill patients with acute kidney injury and cancer undergoing continuous renal replacement therapy
Da Woon Kim, Geum Suk Jang, Kyoung Suk Jung, Hyuk Jae Jung, Hyo Jin Kim, Harin Rhee, Eun Young Seong, Sang Heon Song
Kidney Research and Clinical Practice.2022; 41(6): 717. CrossRef
A Systematic Review and Meta-Analysis Evaluating Geographical Variation in Outcomes of Cancer Patients Treated in ICUs
Lama H. Nazer, Maria A. Lopez-Olivo, Anne Rain Brown, John A. Cuenca, Michael Sirimaturos, Khader Habash, Nada AlQadheeb, Heather May, Victoria Milano, Amy Taylor, Joseph L. Nates
Critical Care Explorations.2022; 4(9): e0757. CrossRef
Clinico-demographic and Outcome Predictors in Solid Tumor Patients with Unplanned Intensive Care Unit Admissions: An Observational Study
Jigeeshu Divatia, Amit M Narkhede, Harish K Chaudhari, Ujwal Dhundi, Natesh Prabu Ravisankar, Satish Sarode
Indian Journal of Critical Care Medicine.2021; 25(12): 1421. CrossRef

Rapid response system
A Pilot Study of the Effectiveness of Medical Emergency System Implementation at a Single Center in Korea: Su Hwan Lee, Ah Young Leem, Youngok Nho, Young Ah Kim, Kyung Duck Kim, Young Sam Kim, Se Kyu Kim, Kyung Soo Chung; Korean J Crit Care Med. 2017;32(2):133-141. Published online May 16, 2017; DOI: https://doi.org/10.4266/kjccm.2016.01011

8,227 View
116 Download
2 Web of Science
2 Crossref

Abstract PDF

Background
An automatic alarm system was developed was developed for unexpected vital sign instability in admitted patients to reduce staffing needs and costs related to rapid response teams. This was a pilot study of the automatic alarm system, the medical emergency system (MES), and the aim of this study was to determine the effectiveness of the MES before expanding this system to all departments.
Methods
This retrospective, observational study compared the performance of patients admitted to the pulmonary department at a single center using patient data from three 3-month periods (before implementation of the MES: December 2013-February 2014; after implementation of the MES: December 2014-February 2015 and December 2015-February 2016).
Results
A total of 571 patients were admitted to the pulmonary department during the three observation periods. During this pilot study, the MES automatically issued 568 alarms for 415 admitted patients. There was no significant difference in the rate of cardiopulmonary resuscitation (CPR) before and after application of the MES. The mortality rate also did not change. However, it appeared that CPR was prevented in four patients admitted from the general ward to the intensive care unit (ICU) during MES implementation. The median length of hospital stay and median length of ICU stay were not significantly different before and after MES implementation.
Conclusions
Although we did not find a significant improvement in outcomes upon MES implementation, the CPR rate and mortality rate did not increase despite increased comorbidities. This was a small pilot study, and, based on these results, we believe that the MES may have significant effects in longer-term and larger-scale studies.

Citations

Citations to this article as recorded by

Society of Critical Care Medicine Guidelines on Recognizing and Responding to Clinical Deterioration Outside the ICU: 2023
Kimia Honarmand, Randy S. Wax, Daleen Penoyer, Geoffery Lighthall, Valerie Danesh, Bram Rochwerg, Michael L. Cheatham, Daniel P. Davis, Michael DeVita, James Downar, Dana Edelson, Alison Fox-Robichaud, Shigeki Fujitani, Raeann M. Fuller, Helen Haskell, Ma
Critical Care Medicine.2024; 52(2): 314. CrossRef
Rapid response systems in Korea
Bo Young Lee, Sang-Bum Hong
Acute and Critical Care.2019; 34(2): 108. CrossRef

Endocrinology
Prevalence and Related Factors of Vitamin D Deficiency in Critically Ill Patients: Hyun Jung Kim, Min Su Sohn, Eun Young Choi; Korean J Crit Care Med. 2016;31(4):300-307. Published online November 30, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00276

10,115 View
194 Download
3 Crossref

Abstract PDF

Background
To identify the prevalence and related factors for vitamin D deficiency in the patients who admitted to the medical intensive care unit (ICU) of a Korean tertiary care hospital.
Methods
We retrospectively analyzed the data from ICU patients requiring mechanical ventilation (MV) for a period of > 48 h to identify the prevalence and associated factors for vitamin D deficiency. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D [25(OH)D] level < 20 ng/mL.
Results
Among 570 patients admitted to the ICU, 221 were enrolled in the study, 194 in the vitamin D deficient group and 27 in the non-deficient group. Prevalence of vitamin D deficiency in critically ill patients was 87.8%. The patient age was lower in the vitamin D deficient group compared with the non-deficient group (64.4 ± 15.4 vs. 71.0 ± 9.6 years, p = 0.049). A higher acute physiology and chronic health evaluation II (APACHE II) score (odds ratio [OR] 1.23, 95% confidence interval [CI] 1.10-1.37) and chronic illness (OR 3.12, 95% CI 1.08-9.01) were associated with vitamin D deficiency after adjusting for age and body mass index. Clinical outcomes of duration of MV, ICU stay, and 28- and 90-day mortality rates were not significantly different between the vitamin D deficient and nondeficient groups.
Conclusions
Vitamin D deficiency was common in critically ill patients, particularly among younger patients. Higher APACHE II score and chronic illness were associated with vitamin D deficiency.

Citations

Citations to this article as recorded by

Vitamin D deficiency and mortality among critically ill surgical patients in an urban Korean hospital
Ji-hyun Lee, Seo-rin Doo, Dongha Kim, Yoo-kyoung Park, Eun-jeong Park, Jae-myeong Lee
International Journal for Vitamin and Nutrition Research.2022; 92(2): 101. CrossRef
Vitamin D Deficiency in Critically Ill Patients
Ji Hyun Lee, Jae-Myeong Lee
Surgical Metabolism and Nutrition.2017; 8(2): 17. CrossRef
Should We Measure Vitamin D Level?
Jae Hwa Cho
The Korean Journal of Critical Care Medicine.2016; 31(4): 369. CrossRef

Review Article

Psychology/Neurology
Intensive Care Unit Delirium: Yongsuk Kim, Sung Jin Hong; Korean J Crit Care Med. 2015;30(2):63-72. Published online May 31, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.2.63

22,967 View
393 Download

Abstract PDF: Delirium is described as a manifestation of acute brain injury and recognized as one of the most common complications in intensive care unit (ICU) patients. Although the causes of delirium vary widely among patients, delirium increases the risk of longer ICU and hospital length of stay, death, cost of care, and post-ICU cognitive impairment. Prevention and early detection are therefore crucial. However, the clinical approach toward delirium is not sufficiently aggressive, despite the condition’s high incidence and prevalence in the ICU setting. While the underlying pathophysiology of delirium is not fully understood, many risk factors have been suggested. As a way to improve delirium-related clinical outcome, high-risk patients can be identified. A valid and reliable bedside screening tool is also needed to detect the symptoms of delirium early. Delirium is commonly treated with medications, and haloperidol and atypical antipsychotics are commonly used as standard treatment options for ICU patients although their efficacy and safety have not been established. The approaches for the treatment of delirium should focus on identifying the underlying causes and reducing modifiable risk factors to promote early mobilization.

Original Article

Nursing
The Inter-Rater Reliability of Simplified Acute Physiology Score 3 (SAPS3) among Intensive Care Unit Nurses: Jun Hyun Kim, Ji Yeon Kim, Wonil Kim, Kyung Woo Kim, Sang-il Lee, Kyung-Tae Kim, Jang Su Park, Won Joo Choe, Jung Won Kim; Korean J Crit Care Med. 2015;30(1):8-12. Published online February 28, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.1.8

11,430 View
94 Download

Abstract PDF: Background
Simplified acute physiology score 3 (SAPS3) was developed in 2005 to evaluate intensive care unit (ICU) performance and to predict patient mortality or disease severity. The score is usually calculated by doctors, but it requires substantial human resources. And many nurse-lead studies use this scoring system. In the present study, we examined the inter-rater reliability of SAPS3 among nurses in an ICU. Methods: Five ICU nurses who worked in an ICU for a mean length of 7.8 years were educated for 2 hours about SAPS3 score and its components. Each nurse scored 26 patients, and the intraclass correlation coefficient (ICC) of the total scores and each subset were evaluated. Results: The ICC (95% confidence interval) of SAPS3 score was 0.89 (0.82-0.95), that of subset I was 0.90 (0.82-0.95), subset II was 0.54 (0.35-0.73), and subset III was 0.95 (0.91-0.97). The ICC of predicted mortality was 0.91 (0.85-0.96). Conclusions: The ICC of SAPS3 score and predicted mortality among ICU nurses were reliable. According to these ICC values, SAPS3 score is a reliable scale to be used by nurses. The ICC of subset II was lower than those of the other subsets, suggesting that education of SAPS3 should focus on the definition of each subset II component.

Case Report

Gastroenterology/Pulmonary
Respiratory Complications Associated with Insertion of Small-Bore Feeding Tube in Critically Ill Patients: Jeong Am Ryu, Joongbum Cho, Sung Bum Park, Daesang Lee, Chi Ryang Chung, Jeong Hoon Yang, Kyeongman Jeon, Gee Young Suh, Chi Min Park; Korean J Crit Care Med. 2014;29(2):131-136. Published online May 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.2.131

12,498 View
104 Download
4 Crossref

Abstract PDF

Small-bore flexible feeding tubes decrease the risk of ulceration of the nose, pharynx, and stomach compared with large-bore and more rigid tubes. However, small-bore feeding tubes have more respiratory system complications, such as pneumothorax, hydropneumothorax, bronchopleural fistula, and pneumonia, which are associated with significant morbidity and mortality. Thus, it is important to confirm the correct position of feeding tubes. Chest X-ray is the gold standard to detect tracheal malpositioning of the feeding tube. We present three cases in which intubated patients exhibited an altered mental state. An assistant guide wire was used at the insertion of small-bore feeding tubes. These conditions are thought to be potential risk factors for tracheobronchial malpositioning of feeding tubes.

Citations

Citations to this article as recorded by

POSICIONAMENTO GÁSTRICO DA SONDA ENTERAL E DESFECHOS CLÍNICOS: ANÁLISE INTEGRATIVA DA LITERATURA CIENTÍFICA
Káryta Jordany Ferreira Rezio, Elias José Oliveira
Revista Contemporânea.2025; 5(11): e9784. CrossRef
Clinical usefulness of capnographic monitoring when inserting a feeding tube in critically ill patients: retrospective cohort study
Jeong-Am Ryu, Kyoungjin Choi, Jeong Hoon Yang, Dae-Sang Lee, Gee Young Suh, Kyeongman Jeon, Joongbum Cho, Chi Ryang Chung, Insuk Sohn, Kiyoun Kim, Chi-Min Park
BMC Anesthesiology.2016;[Epub] CrossRef
Nutritional Assessment of ICU Inpatients with Tube Feeding
Yu-Jin Kim, Jung-Sook Seo
Journal of the Korean Dietetic Association.2015; 21(1): 11. CrossRef
Respiratory Complications of Small-Bore Feeding Tube Insertion in Critically Ill Patients
Kyoung-Jin Choi, Jeong-Am Ryu, Chi-Min Park
JOURNAL OF ACUTE CARE SURGERY.2015; 5(1): 28. CrossRef

First
Prev
Page of 2
Next
Last

Search