Intensive care unit-acquired weakness (ICU-AW) is a serious complication in critically ill patients. Therefore, timely and accurate diagnosis and monitoring of ICU-AW are crucial for effectively preventing its associated morbidity and mortality. This article provides a comprehensive review of ICU-AW, focusing on the different methods used for its diagnosis and monitoring. Additionally, it highlights the role of bedside ultrasound in muscle assessment and early detection of ICU-AW. Furthermore, the article explores potential strategies for preventing ICU-AW. Healthcare providers who manage critically ill patients utilize diagnostic approaches such as physical exams, imaging, and assessment tools to identify ICU-AW. However, each method has its own limitations. The diagnosis of ICU-AW needs improvement due to the lack of a consensus on the appropriate approach for its detection. Nevertheless, bedside ultrasound has proven to be the most reliable and cost-effective tool for muscle assessment in the ICU. Combining the Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score assessment, and ultrasound can be a convenient approach for the early detection of ICU-AW. This approach can facilitate timely intervention and prevent catastrophic consequences. However, further studies are needed to strengthen the evidence.
Background Although gastric reserve volume (GRV) is a surrogate marker of gastrointestinal dysfunction and feeding intolerance, there is ambiguity in its estimation due to problems associated with its measurement. Introduction of point-of-care ultrasound as a tool for anesthetists kindled interest in its use for GRV estimation. Methods: In this prospective observational study, we recruited 57 critically ill patients and analyzed 586 samples of GRV obtained by both ultrasonography (USG) and manual aspiration. Results: The analysis showed that USG-guided GRV was significantly correlated (r=0.788, P<0.001) and in positive agreement with manual aspiration based on Bland-Altman plot, with a mean difference of 8.50±14.84 (95% confidence interval, 7.389–9.798). The upper and lower limits of agreement were 37.7 and –20.5, respectively, within the ±1.96 standard deviation (P<0.001). The respective sensitivity and positive predictive value, specificity and negative predictive value, and area under the curve of USG for feeding intolerance were 66.67%, 98.15%, and 0.82%, with 96.49% diagnostic accuracy. Conclusions: Ultrasonographic estimation of GRV was positively, significantly correlated and in agreement with the manual aspiration method and estimated feeding intolerance earlier. Routine use of gastric USG could avoid clinical situations where feeding status is unclear and there is high risk of aspiration and could become a standard practice of critical care.
Citations
Citations to this article as recorded by
Gastrointestinal function in critically ill patients Annika Reintam Blaser, Kaspar F. Bachmann, Adam M. Deane Current Opinion in Clinical Nutrition & Metabolic Care.2023; 26(5): 463. CrossRef
Background Alcohol use disorders (AUD) are common in patients admitted to intensive care units (ICU) and increase the risk for worse outcomes. In this study, we describe factors associated with patient mortality after ICU admission and the effect of chemical dependency (CD) counseling on outcomes in the year following ICU admission. Methods: We retrospectively reviewed patient demographics, hospital data, and documentation of CD counseling by medical providers for all ICU patients with AUD admitted to our institution between January 2017 and March 2019. Primary outcomes were in-hospital and 1-year mortality. Results: Of the 527 patients with AUD requiring ICU care, median age was 56 years (range, 18–86). Both in-hospital (12%) and 1-year mortality rates (27%) were high. Rural patients, comorbidities, older age, need for mechanical ventilation, and complications were associated with increased risk of in-hospital and 1-year mortality. CD counseling was documented for 73% of patients, and 50% of these patients accepted alcohol treatment or resources prior to discharge. CD evaluation and acceptance was associated with a significantly decreased rate of readmission for liver or alcohol-related issues (36% vs. 58%; odds ratio [OR], 0.41; 95% confidence interval [CI], 0.27–0.61) and 1-year mortality (7% vs. 19.5%; OR, 0.32; 95% CI, 0.16–0.64). CD evaluation alone, regardless of patient acceptance, was associated with a significantly decreased 1-year post-discharge mortality rate (12% vs. 23%; OR, 0.44; 95% CI, 0.25–0.77). Conclusions: ICU patients with AUD had high in-hospital and 1-year mortality. CD evaluation, regardless of patient acceptance, was associated with a significant decrease in 1-year mortality
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
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
Matthew H Anstey, Rashmi Rauniyar, Ethan Fitzclarence, Natalie Tran, Emma Osnain, Bianca Mammana, Angela Jacques, Robert N Palmer, Andrew Chapman, Bradley Wibrow
Acute Crit Care. 2022;37(3):295-302. Published online June 27, 2022
Background
To explore the feasibility, safety, and potential benefits of administration of the anabolic steroid nandrolone to patients in the recovery phase from critical illness weakness.
Methods In this phase II, double blind, randomized, controlled trial, adult critically ill patients admitted to one of two tertiary Intensive Care Units in Western Australia for longer than 7 days with significant weakness were enrolled. Patients received nandrolone (200 mg males, 100 mg females) intramuscularly or placebo weekly for up to 3 weeks in addition to standard care. The primary outcome measures were improvement in grip strength, Medical Research Council muscle strength sum score, and functional activity level (Chelsea critical care assessment tool [CPAx]).
Results A total of 22 patients was enrolled between September 2017 and May 2019. No significant adverse events were detected. Median grip strength change was non-significantly greater in the nandrolone group (8.5 vs. 13.0, P=0.185), while hospital length of stay (36 vs. 26 days, P=0.023) and duration of mechanical ventilation (377 vs. 168, P=0.032) were lower. The discharge CPAx and intensive care unit mobility scores were higher in the nandrolone group, although there was no difference in the change in CPAx score (17.0 vs. 17.7, P=0.865). There were no changes in ultrasound-detected muscle thickness between the two groups.
Conclusions In patients with prolonged critical illness, nandrolone appears to be safe. However, a larger study, potentially combined with resistance exercise, is needed to definitively address the potential benefits of nandrolone.
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
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
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, 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
A systemic review was performed to evaluate the epidemiological, pathophysiological, and
clinical features of sarcopenia, the relationship of sarcopenia with critical illness and its impact on mortality, and diagnostic methods and treatment modalities. Generally, in the presence of critical illness, sarcopenia is not included in the treatment approach strategies. An intensivist should be aware that sarcopenia may be present in critically ill patients. Although the main modalities against sarcopenia are early mobilization and nutritional support, they can only prevent its development and may have positive effects on prognosis rather than treating the existing sarcopenia.
Citations
Citations to this article as recorded by
High prevalence of pre-existing sarcopenia in critically ill patients with hematologic malignancies admitted to the intensive care unit for sepsis or septic shock Antoine Herault, Emilie Lévêque, Simon Draye-Carbonnier, Pierre Decazes, Alexandra Zduniak, Romain Modzelewski, Julie Libraire, Najate Achamrah, Anne-Lise Ménard, Pascal Lenain, Nathalie Contentin, Maximilien Grall, Stéphane Leprêtre, Emilie Lemasle, Hélè Clinical Nutrition ESPEN.2023; 55: 373. CrossRef
Acute Changes in Body Muscle Mass and Fat Depletion in Hospitalized Young Trauma Patients: A Descriptive Retrospective Study Hassan Al-Thani, Bianca M. Wahlen, Ayman El-Menyar, Mohammad Asim, Lena Ribhi Nassar, Mohamed Nadeem Ahmed, Syed Nabir, Monira Mollazehi, Husham Abdelrahman Diseases.2023; 11(3): 120. CrossRef
Low muscle mass in COVID-19 critically-ill patients: Prognostic significance and surrogate markers for assessment I.A. Osuna-Padilla, N.C. Rodríguez-Moguel, S. Rodríguez-Llamazares, C.E. Orsso, C.M. Prado, M.A. Ríos-Ayala, O. Villanueva-Camacho, A. Aguilar-Vargas, L.E. Pensado-Piedra, F. Juárez-Hernández, C.M. Hernández-Cárdenas Clinical Nutrition.2022; 41(12): 2910. CrossRef
A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults Bethan Jenkins, Philip C. Calder, Luise V. Marino Clinical Nutrition ESPEN.2022; 49: 92. CrossRef
The Diagnostic Value of Ultrasound of the Rectus Femoris for the diagnosis of Sarcopenia in adults: A systematic review I. Nies, L.L.G.C. Ackermans, M. Poeze, T.J. Blokhuis, Jan A. Ten Bosch Injury.2022; 53: S23. CrossRef
Intra-Aortic Balloon Pump Placement in the Axillary Artery: Where are We? Gustavo André Boeing Boros, Claudia Yanet San Martin de Bernoche, Pedro Felipe Gomes Nicz ABC: Heart Failure & Cardiomyopathy.2022; 2(2): 209. CrossRef
Current practice and barriers in the implementation of ultrasound-based assessment of muscle mass in Japan: A nationwide, web-based cross-sectional study Keishi Nawata, Nobuto Nakanishi, Shigeaki Inoue, Keibun Liu, Masafumi Nozoe, Yuko Ono, Isamu Yamada, Hajime Katsukawa, Joji Kotani, Supat Chupradit PLOS ONE.2022; 17(11): e0276855. CrossRef
A scoping review considering potential biomarkers or functional measures of gastrointestinal dysfunction and enteral feeding intolerance in critically ill adults Bethan Jenkins, Philip C. Calder, Luise V. Marino Clinical Nutrition ESPEN.2022; 52: 331. CrossRef
ICU Acquired Weakness in patients with respiratory failure Sergei A. Andreichenko, Mikhail V. Bychinin, Dmitriy I. Korshunov, Tatiana V. Klypa Journal of Clinical Practice.2021; 12(2): 5. CrossRef
Predicting outcome in abdominal sepsis: putting the puzzle together Catherine S. Reid, Vanessa M. Banz, Joerg C. Schefold, Markus M. Luedi Journal of Cachexia, Sarcopenia and Muscle.2021; 12(5): 1119. CrossRef
Ultrasound assessment of muscle mass has potential to identify patients with low muscularity at intensive care unit admission: A retrospective study Yuta Arai, Nobuto Nakanishi, Yuko Ono, Shigeaki Inoue, Joji Kotani, Masafumi Harada, Jun Oto Clinical Nutrition ESPEN.2021; 45: 177. CrossRef
Background This study investigated the clinical features and outcome of hospitalized coronavirus disease 2019 (COVID-19) patients admitted to our quaternary care hospital.
Methods In this retrospective cohort study, we included all adult patients with COVID-19 infection admitted to a quaternary care hospital in Pakistan from March 1 to April 15, 2020. The extracted variables included demographics, comorbidities, presenting symptoms, laboratory tests and radiological findings during admission. Outcome measures included in-hospital mortality and length of stay.
Results Sixty-six COVID-19 patients were hospitalized during the study period. Sixty-one percent were male and 39% female; mean age was 50.6±19.1 years. Fever and cough were the most common presenting symptoms. Serial chest X-rays showed bilateral pulmonary opacities in 33 (50%) patients. The overall mortality was 14% and mean length of stay was 8.4±8.9 days. Ten patients (15%) required intensive care unit (ICU) care during admission, of which six (9%) were intubated. Age ≥60 years, diabetes, ischemic heart disease, ICU admission, neutrophil to lymphocyte ratio ≥3.3, and international normalized ratio ≥1.2 were associated with increased risk of mortality.
Conclusions We found a mortality rate of 14% in hospitalized COVID-19 patients. COVID-19 cases are still increasing exponentially around the world and may overwhelm healthcare systems in many countries soon. Our findings can be used for early identification of patients who may require intensive care and aggressive management in order to improve outcomes.
Citations
Citations to this article as recorded by
Incidence and clinical outcomes of bacterial superinfections in critically ill patients with COVID-19 Si Mong Yoon, Jinwoo Lee, Sang-Min Lee, Hong Yeul Lee Frontiers in Medicine.2023;[Epub] CrossRef
Difference in determinants of ICU admission and death among COVID-19 hospitalized patients in two epidemic waves in Portugal: possible impact of healthcare burden and hospital bed occupancy on clinical management and outcomes, March–December 2020 Vasco Ricoca Peixoto, André Vieira, Pedro Aguiar, Carlos Carvalho, Daniel Thomas, Paulo Sousa, Carla Nunes, Alexandre Abrantes Frontiers in Public Health.2023;[Epub] CrossRef
Early Death Among COVID-19 Patients: A Cross-sectional Analysis of the First 10,000 COVID-19 Deaths from the Indian State of Tamil Nadu Zarin Pilakkadavath, Janice M. Weinberg, Serin Kuriakose, Shahul H. Ebrahim, Lekha D. Bhat, Bindhya Vijayan, Salman Khan, Soji D. Jose, Premini Rajeev, Jinbert L. Azariah, Shaffi Fazaludeen Koya Dr. Sulaiman Al Habib Medical Journal.2023;[Epub] CrossRef
The clinical association between Periodontitis and COVID-19 Shipra Gupta, Ritin Mohindra, Mohita Singla, Sagar Khera, Vaibhav Sahni, Poonam Kanta, Roop Kishor Soni, Amit Kumar, Krishan Gauba, Kapil Goyal, Mini P. Singh, Arnab Ghosh, Kamal Kajal, Varun Mahajan, Ashish Bhalla, Timo Sorsa, Ismo Räisänen Clinical Oral Investigations.2022; 26(2): 1361. CrossRef
Prothrombin time, international normalized rate and in-hospital mortality in COVID-19 Panagiotis PALIOGIANNIS, Angelo ZINELLU, Arduino A. MANGONI, Antonio PAZZOLA, Francesco L. BANDIERA, Antonio SPANO, Chiara SANNA, Valentina SCANO, Sara S. FOIS, Verdiana MUSCAS, Elena MASOTTO, Stefano DORE, Vito FIORE, Pietro PIRINA, Ciriaco CARRU, Alessa Minerva Respiratory Medicine.2022;[Epub] CrossRef
Patterns of presentation, prevalence and associated factors of mortality in ICU among adult patients during the pandemic of COVID 19: A retrospective cross-sectional study Shimelis Seid, Habtu Adane, Getachew Mekete Annals of Medicine and Surgery.2022; 77: 103618. CrossRef
Hospital length of stay for COVID-19 patients: A systematic review and meta-analysis Yousef Alimohamadi, Elahe Mansouri Yekta, Mojtaba Sepandi, Maedeh Sharafoddin, Maedeh Arshadi, Elahe Hesari Multidisciplinary Respiratory Medicine.2022;[Epub] CrossRef
Evaluation of the models generated from clinical features and deep learning-based segmentations: Can thoracic CT on admission help us to predict hospitalized COVID-19 patients who will require intensive care? Mutlu Gülbay, Aliye Baştuğ, Erdem Özkan, Büşra Yüce Öztürk, Bökebatur Ahmet Raşit Mendi, Hürrem Bodur BMC Medical Imaging.2022;[Epub] CrossRef
Characterization and determinant factors of critical illness and in-hospital mortality of COVID-19 patients: A retrospective cohort of 1,792 patients in Kenya Isinta M Elijah, Endawoke Amsalu, Xuening Jian, Mingyang Cao, Eric K Mibei, Danvas O Kerosi, Francis G Mwatsahu, Wei Wang, Faith Onyangore, Youxin Wang Biosafety and Health.2022; 4(5): 330. CrossRef
SARS-CoV-2-Infection (COVID-19): Clinical Course, Viral Acute Respiratory Distress Syndrome (ARDS) and Cause(s) of Death Giuliano Pasquale Ramadori Medical Sciences.2022; 10(4): 58. CrossRef
Risk factors for SARS-CoV-2 related mortality and hospitalization before vaccination: A meta-analysis Hannah N. Marmor, Mindy Pike, Zhiguo (Alex) Zhao, Fei Ye, Stephen A. Deppen, Julio Croda PLOS Global Public Health.2022; 2(11): e0001187. CrossRef
Comorbid Asthma Increased the Risk for COVID-19 Mortality in Asia: A Meta-Analysis Liqin Shi, Jiahao Ren, Yujia Wang, Huifen Feng, Fang Liu, Haiyan Yang Vaccines.2022; 11(1): 89. CrossRef
Outcomes of nutritionally at-risk Coronavirus Disease 2019 (COVID 19) patients admitted in a tertiary government hospital: A follow-up study of the MalnutriCoV study Ramon B. Larrazabal, Harold Henrison C. Chiu, Lia Aileen M. Palileo-Villanueva Clinical Nutrition ESPEN.2021; 43: 239. CrossRef
Prognostic value of neutrophil‐to‐lymphocyte ratio in COVID‐19 patients: A systematic review and meta‐analysis Juan R. Ulloque‐Badaracco, W. Ivan Salas‐Tello, Ali Al‐kassab‐Córdova, Esteban A. Alarcón‐Braga, Vicente A. Benites‐Zapata, Jorge L. Maguiña, Adrian V. Hernandez International Journal of Clinical Practice.2021;[Epub] CrossRef
A meta-analysis on the risk factors adjusted association between cardiovascular disease and COVID-19 severity Jie Xu, Wenwei Xiao, Xuan Liang, Li Shi, Peihua Zhang, Ying Wang, Yadong Wang, Haiyan Yang BMC Public Health.2021;[Epub] 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
Background Published coronavirus disease 2019 (COVID-19) reports suggest higher mortality with increasing age and comorbidities. Our study describes the clinical characteristics and outcomes for all intensive care unit (ICU) patients admitted across the Cleveland Clinic enterprise, a 10-hospital health care system in Northeast Ohio, serving more than 2.7 million people.
Methods We analyzed the quality data registry for clinical characteristics and outcomes of all COVID-19-confirmed ICU admissions. Differences in outcomes from other health care systems and published cohorts from other parts of the world were delineated.
Results Across our health care system, 495 COVID-19 patients were admitted from March 15 to June 1, 2020. Mean patient age was 67.3 years, 206 (41.6%) were females, and 289 (58.4%) were males. Mean Acute Physiology Score was 45.3, and mean Acute Physiology and Chronic Health Evaluation III score was 60.5. In total, 215 patients (43.3%) were intubated for a mean duration of 9.2 days. Mean ICU and hospital length of stay were 7.4 and 13.9 days, respectively, while mean ICU and hospital mortality rates were 18.4% and 23.8%.
Conclusions Our health care system cohort is the fourth largest to be reported. Lower ICU and hospital mortality and length of stay were seen compared to most other published reports. Better preparedness and state-level control of the surge in COVID-19 infections are likely the reasons for these better outcomes. Future research is needed to further delineate differences in mortality and length of stay across health care systems and over time.
Citations
Citations to this article as recorded by
Racial inequality in COVID-treatment and in-hospital length of stay in the US over time Benjamin M. Althouse, Charlotte Baker, Peter D. Smits, Samuel Gratzl, Ryan H. Lee, Brianna M. Goodwin Cartwright, Michael Simonov, Michael D. Wang, Nicholas L. Stucky Frontiers in Public Health.2023;[Epub] CrossRef
Effects of race on the outcome of COVID-19 in hospitalized patients Getahun Abate, Aniruddh Kapoor, Edward Charbek, Bryan Beck, Qian Wang, Grace C. Wang, Mackenzie Steck, Jason Zoglman, Robin R. Chambeg, Sharon Frey, Daniel F. Hoft, Timothy L. Wiemken Journal of the National Medical Association.2022; 114(1): 56. CrossRef
Hospital length of stay for COVID-19 patients: A systematic review and meta-analysis Yousef Alimohamadi, Elahe Mansouri Yekta, Mojtaba Sepandi, Maedeh Sharafoddin, Maedeh Arshadi, Elahe Hesari Multidisciplinary Respiratory Medicine.2022;[Epub] CrossRef
Learning from the First Wave of the Pandemic in England, Wales, and Northern Ireland David Pilcher, Matthew Durie American Journal of Respiratory and Critical Care Medicine.2021; 203(5): 532. CrossRef
Epidemiology, outcomes, and utilization of intensive care unit resources for critically ill COVID-19 patients in Libya: A prospective multi-center cohort study Muhammed Elhadi, Ahmed Alsoufi, Abdurraouf Abusalama, Akram Alkaseek, Saedah Abdeewi, Mohammed Yahya, Alsnosy Mohammed, Mohammed Abdelkabir, Mohammed Huwaysh, Emad Amkhatirah, Kamel Alshorbaji, Samer Khel, Marwa Gamra, Abdulmueti Alhadi, Taha Abubaker, Mo PLOS ONE.2021; 16(4): e0251085. CrossRef
A Multicenter Evaluation of Survival After In-Hospital Cardiac Arrest in Coronavirus Disease 2019 Patients Abhishek Bhardwaj, Mahmoud Alwakeel, Talha Saleem, Saira Afzal, Sura Alqaisi, Aisha R. Saand, Hanan Al. Najjar, Lori Griffiths, Xiaozhen Han, Xiaofeng Wang, Silvia Perez-Protto, Benjamin S. Abella, David F. Gaieski, Abhijit Duggal, Francois Abi Fadel Critical Care Explorations.2021; 3(5): e0425. CrossRef
Overcoming gaps: regional collaborative to optimize capacity management and predict length of stay of patients admitted with COVID-19 Michael G Usher, Roshan Tourani, Gyorgy Simon, Christopher Tignanelli, Bryan Jarabek, Craig E Strauss, Stephen C Waring, Niall A M Klyn, Burke T Kealey, Rabindra Tambyraja, Deepti Pandita, Karyn D Baum JAMIA Open.2021;[Epub] CrossRef
Examining the Clinical Prognosis of Critically Ill Patients with COVID-19 Admitted to Intensive Care Units: A Nationwide Saudi Study Abbas Al Mutair, Alyaa Elhazmi, Saad Alhumaid, Gasmelseed Ahmad, Ali Rabaan, Mohammed Alghadeer, Hiba Chagla, Raghavendra Tirupathi, Amit Sharma, Kuldeep Dhama, Khulud Alsalman, Zainab Alalawi, Ziyad Aljofan, Alya Al Mutairi, Mohammed Alomari, Mansour Awa Medicina.2021; 57(9): 878. 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
Some patients admitted to the intensive care unit (ICU) because of an acute illness, complicated surgery, or multiple traumas develop muscle weakness affecting the limbs and respiratory muscles during acute care in the ICU. This condition is referred to as ICU-acquired weakness (ICUAW), and can be evoked by critical illness polyneuropathy (CIP), critical illness myopathy (CIM), or critical illness polyneuromyopathy (CIPNM). ICUAW is diagnosed using the Medical Research Council (MRC) sum score based on bedside manual muscle testing in cooperative patients. The MRC sum score is the sum of the strengths of the 12 regions on both sides of the upper and lower limbs. ICUAW is diagnosed when the MRC score is less than 48 points. However, some patients require electrodiagnostic studies, such as a nerve conduction study, electromyography, and direct muscle stimulation, to differentiate between CIP and CIM. Pulmonary rehabilitation in the ICU can be divided into modalities intended to remove retained airway secretions and exercise therapies intended to improve respiratory function. Physical rehabilitation, including early mobilization, positioning, and limb exercises, attenuates the weakness that occurs during critical care. To perform mobilization in mechanically ventilated patients, pretreatment by removing secretions is necessary. It is also important to increase the strength of respiratory muscles and to perform lung recruitment to improve mobilization in patients who are weaned from the ventilator. For these reasons, pulmonary rehabilitation is important in addition to physical therapy. Early recognition of CIP, CIM, and CIPNM and early rehabilitation in the ICU might improve patients’ functional recovery and outcomes.
Citations
Citations to this article as recorded by
Clinical impact of rehabilitation and ICU diary on critically ill patients: A systematic review and meta‐analysis Tomohiro Ishinuki, Ling Zhang, Keisuke Harada, Hiroomi Tatsumi, Nobuaki Kokubu, Yoshika Kuno, Kanon Kumasaka, Rina Koike, Toshio Ohyanagi, Hirofumi Ohnishi, Eichi Narimatsu, Yoshiki Masuda, Toru Mizuguchi Nursing in Critical Care.2023; 28(4): 554. CrossRef
Enteral nutrition management in critically ill adult patients and its relationship with intensive care unit-acquired muscle weakness: A national cohort study Ignacio Zaragoza-García, Susana Arias-Rivera, María Jesús Frade-Mera, Joan Daniel Martí, Elisabet Gallart, Alicia San José-Arribas, Tamara Raquel Velasco-Sanz, Eva Blazquez-Martínez, Marta Raurell-Torredà, Sebastien Kenmoe PLOS ONE.2023; 18(6): e0286598. CrossRef
THE EFFECTIVENESS OF PASSIVE EXERCISES ON ARTERIAL BLOOD GASES IN MECHANICALLY VENTILATED SUBJECTS FROM INTENSIVE CARE UNITS Delia-Claudia STAN, Iosif SANDOR Studia Universitatis Babeş-Bolyai Educatio Artis Gymnasticae.2023; 67(4): 183. CrossRef
Pulmonary rehabilitation in the intensive care unit using surface electromyography in a patient with diaphragmatic injury: A case report Ho Jeong Shin, Myung Hun Jang, Myung Jun Shin, Jun Woo Lee Turkish Journal of Physical Medicine and Rehabilitation.2023; 69(2): 248. CrossRef
Enhancing pulmonary function and arterial blood gas readings through immediate chest physiotherapy among extubated patients in ICU Fadia Ahmed Abdelkader Reshia, Basma Salameh, Nourah Alsadaan, Mohammed Alqahtani, Ahmad Ayed, Maysa Fareed Kassabry, Asmaa Ibrahem Abo Seada Journal of International Medical Research.2023;[Epub] CrossRef
The effects of respiratory exercises on partial pressures of gases and anxiety in the acute phase of COVID-19 infection Vesna Grbovic, Natasa Markovic, Predrag Bogojevic, Jovana Nikolic, Jelena Milosevic, Stefan Simovic, Ivan Cekerevac, Aleksandra Jurišić-Škevin, Nebojša Zdravkovic, Sara Mijailovic, Natasa Zdravkovic Physiotherapy Theory and Practice.2022; 38(13): 2736. CrossRef
Reliability and validity of the Korean version of the Functional Status Score for the ICU after translation and cross-cultural adaptation Jong Geol Do, Gee Young Suh, Yu Hui Won, Won Hyuk Chang, Stephanie Hiser, Dale M. Needham, Chi Ryang Chung Disability and Rehabilitation.2022; 44(24): 7528. CrossRef
The Investigation of Pulmonary Function Changes of COVID-19 Patients in Three Months Lingyan Ye, Guifei Yao, Shuangxiang Lin, Yicheng Fang, Xi Chen, Liangxing Wang, Susu He, Gu Xiaoqing Journal of Healthcare Engineering.2022; 2022: 1. CrossRef
Intensive care‐related cognitive impairment: A biopsychosocial overview Jamie L. Tingey, Nickolas A. Dasher, Aaron E. Bunnell, Amy J. Starosta PM&R.2022; 14(2): 259. CrossRef
Awakening in extracorporeal membrane oxygenation as a bridge to lung transplantation Su Hwan Lee Acute and Critical Care.2022; 37(1): 26. CrossRef
The impact of physical medicine and rehabilitation consultation on clinical outcomes in the surgical intensive care unit Onuma Chaiwat, Benjaporn Sathitkarnmanee, Piyapat Dajpratham, Chayanan Thanakiattiwibun, Sunit Jarungjitaree, Suchera Rattanamung Medicine.2022; 101(9): e28990. CrossRef
Role of Physiotherapyin Respiratory Rehabilitation and Managing COVID-19 Patients in All Stages of the Disease Petty Miyanda Journal of Preventive and Rehabilitative Medicine.2022; 4(1): 21. CrossRef
The validity, reliability and feasibility of four instruments for assessing the consciousness of stroke patients in a neurological intensive care unit compared Xiaoxiang Yan, Lingjun Xiao, Meixin Liao, Jiajian Huang, Zhijie He, Tiebin Yan BMC Medical Research Methodology.2022;[Epub] CrossRef
Functional assessment and rehabilitation protocol in acute patients affected by SARS-CoV-2 infection hospitalized in the Intensive Care Unit and in the Medical Care Unit Susanna RICOTTI, Lucia PETRUCCI, Gabriella CARENZIO, Ettore CARLISI, Giuseppe DI NATALI, Annalisa DE SILVESTRI, Claudio LISI European Journal of Physical and Rehabilitation Medicine.2022;[Epub] CrossRef
Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill Patients—A Systematic Review Maryam Balke, Marc Teschler, Hendrik Schäfer, Pantea Pape, Frank C. Mooren, Boris Schmitz Frontiers in Physiology.2022;[Epub] CrossRef
Efficacy of Physiotherapy Interventions on Weaning in Mechanically Ventilated Critically Ill Patients: A Systematic Review and Meta-Analysis Lorenzo Lippi, Alessandro de Sire, Francesco D’Abrosca, Biagio Polla, Nicola Marotta, Luigi Mario Castello, Antonio Ammendolia, Claudio Molinari, Marco Invernizzi Frontiers in Medicine.2022;[Epub] CrossRef
Expert consensus on liver transplantation perioperative evaluation and rehabilitation for acute-on-chronic liver failure Haijin Lv, Haiqing Zheng, Jianrong Liu, Qing Cai, Yuji Ren, Huimin Yi, Yang Yang, Xiquan Hu, Guihua Chen Liver Research.2022; 6(3): 121. CrossRef
Case report: Personalized adapted motor activity in a COVID-19 patient complicated by critical illness polyneuropathy and myopathy Oscar Crisafulli, Marta Baroscelli, Luca Grattarola, Giuseppe Tansini, Cristian Zampella, Giuseppe D’Antona Frontiers in Physiology.2022;[Epub] CrossRef
Letter to the Editor: Comparison Between Inspiratory Muscle Training and Early Mobilization on Weaning of Mechanical Ventilation Rodrigo Torres-Castro, Gonzalo Rivera-Lillo, Jordi Vilaró, Homero Puppo Archives of Physical Medicine and Rehabilitation.2021; 102(3): 556. CrossRef
The Feasibility of High-Intensity Interval Training in Patients with Intensive Care Unit-Acquired Weakness Syndrome Following Long-Term Invasive Ventilation Simon Wernhart, Jürgen Hedderich, Svenja Wunderlich, Kunigunde Schauerte, Eberhard Weihe, Dominic Dellweg, Karsten Siemon Sports Medicine - Open.2021;[Epub] CrossRef
Could Physical Therapy Interventions Be Adopted in the Management of Critically Ill Patients with COVID-19? A Scoping Review Carlos Bernal-Utrera, Ernesto Anarte-Lazo, Juan Jose Gonzalez-Gerez, Elena De-La-Barrera-Aranda, Manuel Saavedra-Hernandez, Cleofas Rodriguez-Blanco International Journal of Environmental Research and Public Health.2021; 18(4): 1627. CrossRef
Feasibility of subacute rehabilitation for mechanically ventilated patients with COVID-19 disease: a retrospective case series Simone Pancera, Luca N. C. Bianchi, Roberto Porta, Silvia Galeri, Maria Chiara Carrozza, Jorge H. Villafañe International Journal of Rehabilitation Research.2021; 44(1): 77. CrossRef
Clinical Characteristics and Early Interventional Responses in Patients with Severe COVID-19 Pneumonia Susu He, Lina Fang, Lingzhen Xia, Shuangxiang Lin, Junhui Ye, Dinghai Luo, Kaijian Xia Computational and Mathematical Methods in Medicine.2021; 2021: 1. CrossRef
Step-by-step inpatient rehabilitation for critical illness after coronavirus disease 2019 Dae-Won Gwak, Jong-Moon Hwang Medicine.2021; 100(23): e26317. CrossRef
The Effect of Physical Therapy on Regional Lung Function in Critically Ill Patients Christine Eimer, Katharina Freier, Norbert Weiler, Inéz Frerichs, Tobias Becher Frontiers in Physiology.2021;[Epub] CrossRef
Post–Intensive Care Syndrome in Covid-19 Patients Discharged From the Intensive Care Unit Sevda Gardashkhani, Mehdi Ajri-Khameslou, Mehdi Heidarzadeh, SeyedMohammad Rajaei Sedigh Journal of Hospice & Palliative Nursing.2021; 23(6): 530. CrossRef
The Role of Physical Therapy in the Intensive Care Unit Zofia Kosson, Marek Paśnicki, Marcin Kołacz Emergency Medical Service.2021; 8(3): 171. CrossRef
Rehabilitación pulmonar en fase hospitalaria y ambulatoria N. Carvajal Tello, A. Segura Ordoñez, A.J. Arias Balanta Rehabilitación.2020; 54(3): 191. CrossRef
Guidance for the management of adult patients with coronavirus disease 2019 Jie-Ming Qu, Chen Wang, Bin Cao Chinese Medical Journal.2020; 133(13): 1575. CrossRef
Recommendations for respiratory rehabilitation in adults with coronavirus disease 2019 Hong-Mei Zhao, Yu-Xiao Xie, Chen Wang Chinese Medical Journal.2020; 133(13): 1595. CrossRef
Physiotherapy Care of Patients with Coronavirus Disease 2019 (COVID-19) - A Brazilian Experience Renato Fraga Righetti, Mirian Akemi Onoue, Flavia Vanessa Aurea Politi, Débora Trigo Teixeira, Patricia Nery de Souza, Claudia Seiko Kondo, Eliana Vieira Moderno, Igor Gutierrez Moraes, Ana Lígia Vasconcellos Maida, Laerte Pastore, Felipe Duarte Silva, Ch Clinics.2020; 75: e2017. CrossRef
Approach to critical illness myopathy and polyneuropathy in the older SARS-CoV-2 patients Brendan McClafferty, Ibrahim Umer, Gary Fye, Douglas Kepko, Ricci Kalayanamitra, Zainab Shahid, Devyani Ramgobin, Alice Cai, Andrew Groff, Abani Bhandari, Chander Shekher Aggarwal, Ravi Patel, Dhirisha Bhatt, Hyma Polimera, Nitasa Sahu, Ramarao Vunnam, Re Journal of Clinical Neuroscience.2020; 79: 241. CrossRef
COVID-19 Pandemic: A Physiotherapy Update Paolo Pedersini, Jorge Hugo Villafañe, Camilo Corbellini, Marcos Roberto Tovani-Palone Electronic Journal of General Medicine.2020; 18(1): em264. CrossRef
Muscle weakness assessment in older intensive care unit patients Amanda Colombo Peteck Lopes, Paulo Henrique Coltro, Vagner José Lopes, Sandra Mari Pistore Fiori, Jaqueline Santana Knapik, Tatiane Caroline Boumer Geriatrics, Gerontology and Aging.2020; 14(3): 166. CrossRef
Background Critical illness-related corticosteroid insufficiency (CIRCI) and adrenocorticotropic hormone (ACTH)-cortisol dissociation are hormonal conditions frequently observed in patients in the intensive care unit (ICU). The aim of this study was to evaluate the association between ACTH-cortisol dissociation and clinical outcomes of critically ill patients. Methods: We retrospectively reviewed the medical records of 94 ICU patients who underwent two rapid cosyntropin tests during hospital admission and compared the clinical aspects of patients with and without ACTH-cortisol dissociation. ACTH-cortisol dissociation was defined as plasma ACTH and serum cortisol concentrations of <22 pmol/L and >600 nmol/L, respectively. Results: Dissociation was present in 30 of the 94 patients (31.9%). Patients with ACTH-cortisol dissociation in the initial test had significantly higher hospital mortality rate than those in the control group (55% vs. 25.7%, P=0.013) There was no difference in hospital mortality between patients classified as having CIRCI and those who were not. In multivariate adjusted Cox regression analysis, the mortality risk was higher in the group with ACTH-cortisol dissociation (hazard ratio, 2.98; 95% confidence interval, 1.34 to 6.63; P=0.007). Patients with dissociation in two consecutive stimulation tests showed the highest hospital mortality rate among groups classified according to stimulation test results (100% vs. 31.3%). Conclusions: The hospital mortality was higher in ICU patients diagnosed with ACTH-cortisol dissociation. It is clinically feasible to evaluate the presence of ACTH-cortisol dissociation by analyzing rapid ACTH stimulation test results in critically ill patients.
Citations
Citations to this article as recorded by
PROGNOSTIC VALUE OF LOW-DOSE ADRENOCORTICOTROPIC HORMONE TEST IN CRITICALLY ILL PATIENTS Ahmad B. Abdelrehim, Fatma M. Mohsen, Mostafa A. Haredi, Zeinab Abdel Hameed, Walaa H. Ibrahim Shock.2023; 59(6): 871. CrossRef
Copeptin and stress-induced hyperglycemia in critically ill patients: A prospective study Lilian Rodrigues Henrique, Daisy Crispim, Tarsila Vieceli, Ariell Freires Schaeffer, Priscila Bellaver, Cristiane Bauermann Leitão, Tatiana Helena Rech, Antonio Palazón-Bru PLOS ONE.2021; 16(4): e0250035. CrossRef
Comparison of salivary and serum cortisol levels in mechanically ventilated patients and non-critically ill patients Jung Hee Kim, Yoon Ji Kim, Sang-Min Lee, Jinwoo Lee Acute and Critical Care.2020; 35(3): 149. CrossRef
Background Delirium is common among intensive care unit (ICU) patients, so recent clinical guidelines recommended routine delirium monitoring in the ICU. But, its effect on the patient’s clinical outcome is still controversial. In particular, the effect of systems that inform the primary physician of the results of monitoring is largely unknown.
Methods The delirium notification program using bedside signs and electronic chart notifications was applied to the pre-existing delirium monitoring protocol. Every patient was routinely evaluated for delirium, pain, and anxiety using validated tools. Clinical outcomes, including duration of delirium, ICU stay, and mortality were reviewed and compared for 3 months before and after the program implementation.
Results There was no significant difference between the two periods of delirium, ICU stay, and mortality. However, anxiety, an important prognostic factor in the ICU survivor’s mental health, was significantly reduced and pain tended to decrease.
Conclusions Increasing the physician’s awareness of the patient’s mental state by using a notification program could reduce the anxiety of ICU patients even though it may not reduce delirium. The results suggested that the method of delivering the results of monitoring was also an important factor in the success of the delirium monitoring program.
Citations
Citations to this article as recorded by
Adaptation and Validation of a Chart‐Based Delirium Detection Tool for the ICU (CHART‐DEL‐ICU) Karla D. Krewulak, Carmen Hiploylee, E. W. Ely, Henry T. Stelfox, Sharon K. Inouye, Kirsten M. Fiest Journal of the American Geriatrics Society.2021; 69(4): 1027. CrossRef
In mechanically ventilated patients, assisted mechanical ventilation (MV) is employed early, following the acute phase of critical illness, in order to eliminate the detrimental effects of controlled MV, most notably the development of ventilator-induced diaphragmatic dysfunction. Nevertheless, the benefits of assisted MV are often counteracted by the development of patient-ventilator dyssynchrony. Patient-ventilator dyssynchrony occurs when either the initiation and/or termination of mechanical breath is not in time agreement with the initiation and termination of neural inspiration, respectively, or if the magnitude of mechanical assist does not respond to the patient’s respiratory demand. As patient-ventilator dyssynchrony has been associated with several adverse effects and can adversely influence patient outcome, every effort should be made to recognize and correct this occurrence at bedside. To detect patient-ventilator dyssynchronies, the physician should assess patient comfort and carefully inspect the pressure- and flow-time waveforms, available on the ventilator screen of all modern ventilators. Modern ventilators offer several modifiable settings to improve patient-ventilator interaction. New proportional modes of ventilation are also very helpful in improving patient-ventilator interaction.
Citations
Citations to this article as recorded by
A novel application of spectrograms with machine learning can detect patient ventilator dyssynchrony Ishmael Obeso, Benjamin Yoon, David Ledbetter, Melissa Aczon, Eugene Laksana, Alice Zhou, R. Andrew Eckberg, Keith Mertan, Robinder G. Khemani, Randall Wetzel Biomedical Signal Processing and Control.2023; 86: 105251. CrossRef
Effects of Neurally Adjusted Ventilation Assist (NAVA) and conventional modes of mechanical ventilation on diaphragm functions: A randomized controlled trial Vijay Hadda, Sourabh Pahuja, Saurabh Mittal, Karan Madan, Maroof A Khan, Anant Mohan, Randeep Guleria Heart & Lung.2022; 53: 36. CrossRef
Reverse Triggering: An Introduction to Diagnosis, Management, and Pharmacologic Implications Brian Murray, Andrea Sikora, Jason R. Mock, Thomas Devlin, Kelli Keats, Rebecca Powell, Thomas Bice Frontiers in Pharmacology.2022;[Epub] CrossRef
Attention-based convolutional long short-term memory neural network for detection of patient-ventilator asynchrony from mechanical ventilation Dingfu Chen, Kangwei Lin, Ziheng Deng, Dayu Li, Qingxu Deng Biomedical Signal Processing and Control.2022; 78: 103923. CrossRef
Tracheotomy in ventilator-dependent patients with COVID-19: a cross-sectional study of analgesia and sedative requirements Brianne Wiemann, Jessica Mitchell, Preeyaporn Sarangarm, Richard Miskimins Journal of International Medical Research.2022; 50(11): 030006052211384. CrossRef
An interpretable 1D convolutional neural network for detecting patient-ventilator asynchrony in mechanical ventilation Qing Pan, Lingwei Zhang, Mengzhe Jia, Jie Pan, Qiang Gong, Yunfei Lu, Zhongheng Zhang, Huiqing Ge, Luping Fang Computer Methods and Programs in Biomedicine.2021; 204: 106057. CrossRef
Accuracy of Algorithms and Visual Inspection for Detection of Trigger Asynchrony in Critical Patients : A Systematic Review Monique Bandeira, Alícia Almeida, Lívia Melo, Pedro Henrique de Moura, Emanuelle Olympia Ribeiro Silva, Jakson Silva, Armèle Dornelas de Andrade, Daniella Brandão, Shirley Campos, Robert Boots Critical Care Research and Practice.2021; 2021: 1. CrossRef
Patient–Ventilator Dyssynchrony in Critically Ill Patients Bruno De Oliveira, Nahla Aljaberi, Ahmed Taha, Baraa Abduljawad, Fadi Hamed, Nadeem Rahman, Jihad Mallat Journal of Clinical Medicine.2021; 10(19): 4550. CrossRef
Patient–ventilator asynchrony in acute brain-injured patients: a prospective observational study Xu-Ying Luo, Xuan He, Yi-Min Zhou, Yu-Mei Wang, Jing-Ran Chen, Guang-Qiang Chen, Hong-Liang Li, Yan-Lin Yang, Linlin Zhang, Jian-Xin Zhou Annals of Intensive Care.2020;[Epub] CrossRef
Background Fluid overload prior to continuous renal replacement therapy (CRRT) is an important prognostic factor. Thus, precise evaluation of fluid status is necessary to treat such patients. In this study, we investigated whether fluid assessment using bioelectrical impedance analysis (BIA) can predict outcomes in critically ill patients requiring CRRT. Methods: A prospective observational study was performed in patients who were admitted to the intensive care unit and who required CRRT. BIA was conducted before CRRT; then, the ratio of extracellular water to total body water (ECW/TBW) was derived to estimate volume status. Results: A total of 31 patients treated with CRRT were included. There were 18 men (58.1%), and the median age was 67 years (interquartile range, 51 to 78 years). Fourteen patients (45.2%) died within 28 days after CRRT initiation. Patients were divided into 16 with ECW/TBW ≥0.41 and 15 with ECW/TBW <0.41. Survival rate within 28 days was different between the two groups (P = 0.044). Cox regression analysis revealed a relationship between ECW/TBW ≥0.41 and 28-day mortality, but it was not statistically significant (hazard ratio, 3.0; 95% confidence interval, 0.9 to 9.8; P = 0.061). Lastly, the area under the curve of ECW/TBW for 28-day mortality was analyzed. The area under the curve of ECW/TBW was 0.73 (95% confidence interval, 0.54 to 0.92), and this was significant (P = 0.037). Conclusions: Fluid status can be assessed using BIA in critically ill patients requiring CRRT, and BIA can predict mortality. Further large trials are needed to confirm the usefulness of BIA in critically ill patients.
Citations
Citations to this article as recorded by
Nutritional management of children with acute kidney injury—clinical practice recommendations from the Pediatric Renal Nutrition Taskforce Molly R. Wong Vega, Dana Cerminara, An Desloovere, Fabio Paglialonga, José Renken-Terhaerdt, Johan Vande Walle, Vanessa Shaw, Stella Stabouli, Caroline Elizabeth Anderson, Dieter Haffner, Christina L. Nelms, Nonnie Polderman, Leila Qizalbash, Jetta Tuokko Pediatric Nephrology.2023; 38(11): 3559. CrossRef
Ratio of Overhydration and Extracellular Water Versus Ratio of Extracellular Water and Body Cell Mass in the Assessment of Fluid Status in Patients With Acute Kidney Injury Requiring Kidney Replacement Therapy: A Cohort Study Buyun Wu, Sufeng Zhang, Junfeng Wang, Wenyan Yan, Min Gao, Yifei Ge, Kang Liu, Xueqiang Xu, Xiangbao Yu, Yamei Zhu, Xianrong Xu, Changying Xing, Huijuan Mao Journal of Renal Nutrition.2022; 32(2): 152. CrossRef
Towards Artefact-Free Bio-Impedance Measurements: Evaluation, Identification and Suppression of Artefacts at Multiple Frequencies Kanika Dheman, Philipp Mayer, Manuel Eggimann, Michele Magno, Simone Schuerle IEEE Sensors Journal.2022; 22(1): 589. CrossRef
The Use of Bioelectrical Impedance Analysis Measures for Predicting Clinical Outcomes in Critically Ill Children Zi-Hong Xiong, Xue-Mei Zheng, Guo-Ying Zhang, Meng-Jun Wu, Yi Qu Frontiers in Nutrition.2022;[Epub] CrossRef
Applying bio-impedance vector analysis (BIVA) to adjust ultrafiltration rate in critically ill patients on continuous renal replacement therapy: A randomized controlled trial Farin Rashid Farokhi, Effat Kalateh, Shadi Shafaghi, Antoine Guillaume Schneider, Seyed Mehdi Mortazavi, Hamidreza Jamaati, Seyed Mohammad Reza Hashemian Journal of Critical Care.2022; 72: 154146. CrossRef
Ultrafiltration in critically ill patients treated with kidney replacement therapy Raghavan Murugan, Rinaldo Bellomo, Paul M. Palevsky, John A. Kellum Nature Reviews Nephrology.2021; 17(4): 262. CrossRef
Kidney Replacement Therapy for Fluid Management Vikram Balakumar, Raghavan Murugan Critical Care Clinics.2021; 37(2): 433. CrossRef
Assessment of Fluid Status by Bioimpedance Analysis and Central Venous Pressure Measurement and Their Association with the Outcomes of Severe Acute Kidney Injury Justina Karpavičiūtė, Inga Skarupskienė, Vilma Balčiuvienė, Rūta Vaičiūnienė, Edita Žiginskienė, Inga Arūnė Bumblytė Medicina.2021; 57(6): 518. CrossRef
Usefulness of bioelectrical impedance analysis and ECW ratio as a guidance for fluid management in critically ill patients after operation Yoon Ji Chung, Eun Young Kim Scientific Reports.2021;[Epub] CrossRef
Bioimpedance as a measure of fluid status in critically ill patients: A systematic review Janne M. Madsen, Sine Wichmann, Morten H. Bestle, Theis S. Itenov Acta Anaesthesiologica Scandinavica.2021; 65(9): 1155. CrossRef
Bioelectric impedance analysis for body composition measurement and other potential clinical applications in critical illness Hanneke Pierre Franciscus Xaverius Moonen, Arthur Raymond Hubert Van Zanten Current Opinion in Critical Care.2021; 27(4): 344. CrossRef
Hepatocyte growth factor and soluble cMet levels in plasma are prognostic biomarkers of mortality in patients with severe acute kidney injury Lilin Li, Jung Nam An, Jeonghwan Lee, Dong Jin Shin, Shi Mao Zhu, Jin Hyuk Kim, Dong Ki Kim, Dong-Ryeol Ryu, Sejoong Kim, Jung Pyo Lee Kidney Research and Clinical Practice.2021; 40(4): 596. CrossRef
Wireless, Artefact Aware Impedance Sensor Node for Continuous Bio-Impedance Monitoring Kanika Dheman, Philipp Mayer, Michele Magno, Simone Schuerle IEEE Transactions on Biomedical Circuits and Systems.2020; 14(5): 1122. CrossRef
Usefulness of Bioelectrical Impedance Analysis as a Guidance of Fluid Management in Critically Ill Patients after Major Abdomen Surgery; a Single Center, Prospective Cohort Study Yoon Ji Chung, Eun Young Kim Surgical Metabolism and Nutrition.2020; 11(2): 53. CrossRef
Update on body composition tools in clinical settings: computed tomography, ultrasound, and bioimpedance applications for assessment and monitoring Kathleen L. Price, Carrie P. Earthman European Journal of Clinical Nutrition.2019; 73(2): 187. CrossRef
Relative Association of Overhydration and Muscle Wasting with Mortality in Hemodialysis Patients: Assessment by Bioelectrical Impedance Analysis Eunju Kim, Sang Oh Seo, Yu Bum Choi, Mi Jung Lee, Jeong Eun Lee, Hyung Jong Kim The Korean Journal of Medicine.2018; 93(6): 548. CrossRef