Articles

Lung ultrasound score predicts outcomes in COVID-19 patients admitted to the emergency department

During the COVID-19 pandemic, creating tools to assess disease severity is one of the most important aspects of reducing the burden on emergency departments. Lung ultrasound has a high accuracy for the diagnos...

Authors: Julio Cesar Garcia de Alencar, Julio Flavio Meirelles Marchini, Lucas Oliveira Marino, Sabrina Correa da Costa Ribeiro, Cauê Gasparotto Bueno, Victor Paro da Cunha, Felippe Lazar Neto, Rodrigo Antonio Brandão Neto and Heraldo Possolo Souza

Pilot trial of high-dose vitamin C in critically ill COVID-19 patients

Few specific medications have been proven effective for the treatment of patients with severe coronavirus disease 2019 (COVID-19). Here, we tested whether high-dose vitamin C infusion was effective for severe ...

Authors: Jing Zhang, Xin Rao, Yiming Li, Yuan Zhu, Fang Liu, Guangling Guo, Guoshi Luo, Zhongji Meng, Daniel De Backer, Hui Xiang and Zhiyong Peng

Preoperative endothelial dysfunction in cutaneous microcirculation is associated with postoperative organ injury after cardiac surgery using extracorporeal circulation: a prospective cohort study

Cardiac surgery is known to induce acute endothelial dysfunction, which may be central to the pathophysiology of postoperative complications. Preoperative endothelial dysfunction could also be implicated in th...

Authors: Stanislas Abrard, Olivier Fouquet, Jérémie Riou, Emmanuel Rineau, Pierre Abraham, Cyril Sargentini, Yannick Bigou, Christophe Baufreton, Sigismond Lasocki and Samir Henni

Ultraprotective ventilation allowed by extracorporeal CO₂ removal improves the right ventricular function in acute respiratory distress syndrome patients: a quasi-experimental pilot study

Right ventricular (RV) failure is a common complication in moderate-to-severe acute respiratory distress syndrome (ARDS). RV failure is exacerbated by hypercapnic acidosis and overdistension induced by mechani...

Authors: Suzanne Goursaud, Xavier Valette, Julien Dupeyrat, Cédric Daubin and Damien du Cheyron

Management of late onset urea cycle disorders—a remaining challenge for the intensivist?

Hyperammonemia caused by a disorder of the urea cycle is a rare cause of metabolic encephalopathy that may be underdiagnosed by the adult intensivists because of its rarity. Urea cycle disorders are autosomal ...

Authors: S. Redant, A. Empain, A. Mugisha, P. Kamgang, R. Attou, P. M. Honoré and D. De Bels

Microcirculation-targeted resuscitation in septic shock: can complex problems have simple answers?

Authors: Jérémie Joffre and Matthieu Legrand

Characteristics and risk factors associated with critical illness in pediatric COVID-19

While much has been reported regarding the clinical course of COVID-19 in children, little is known regarding factors associated with organ dysfunction in pediatric COVID-19. We describe critical illness in pe...

Authors: Grace Fisler, Stephanie M. Izard, Sareen Shah, Deirdre Lewis, Mundeep K. Kainth, Stefan H. F. Hagmann, Joshua A. Belfer, Lance M. Feld, Fiore Mastroianni, Charlotte L. Kvasnovsky, Christine A. Capone, James Schneider, Todd Sweberg, Charles Schleien and Matthew D. Taylor

Post-resuscitation shock: recent advances in pathophysiology and treatment

A post-resuscitation shock occurs in 50–70% of patients who had a cardiac arrest. It is an early and transient complication of the post-resuscitation phase, which frequently leads to multiple-organ failure and...

Authors: Mathieu Jozwiak, Wulfran Bougouin, Guillaume Geri, David Grimaldi and Alain Cariou

Brazilian guidelines for the management of brain-dead potential organ donors. The task force of the AMIB, ABTO, BRICNet, and the General Coordination of the National Transplant System

To contribute to updating the recommendations for brain-dead potential organ donor management.

Authors: Glauco Adrieno Westphal, Caroline Cabral Robinson, Alexandre Biasi Cavalcanti, Anderson Ricardo Roman Gonçalves, Cátia Moreira Guterres, Cassiano Teixeira, Cinara Stein, Cristiano Augusto Franke, Daiana Barbosa da Silva, Daniela Ferreira Salomão Pontes, Diego Silva Leite Nunes, Edson Abdala, Felipe Dal-Pizzol, Fernando Augusto Bozza, Flávia Ribeiro Machado, Joel de Andrade…

Measurement site of inferior vena cava diameter affects the accuracy with which fluid responsiveness can be predicted in spontaneously breathing patients: a post hoc analysis of two prospective cohorts

The collapsibility index of the inferior vena cava (cIVC) has potential for predicting fluid responsiveness in spontaneously breathing patients, but a standardized approach for measuring the inferior vena cava...

Authors: Morgan Caplan, Arthur Durand, Perrine Bortolotti, Delphine Colling, Julien Goutay, Thibault Duburcq, Elodie Drumez, Anahita Rouze, Saad Nseir, Michael Howsam, Thierry Onimus, Raphael Favory and Sebastien Preau

Protracted viral shedding and viral load are associated with ICU mortality in Covid-19 patients with acute respiratory failure

Protracted viral shedding is common in hospitalized patients with COVID-19 pneumonia, and up to 40% display signs of pulmonary fibrosis on computed tomography (CT) after hospital discharge. We hypothesized tha...

Authors: L. Bitker, F. Dhelft, L. Chauvelot, E. Frobert, L. Folliet, M. Mezidi, S. Trouillet-Assant, A. Belot, B. Lina, F. Wallet and J. C. Richard

Reliability and limits of transport-ventilators to safely ventilate severe patients in special surge situations

Intensive Care Units (ICU) have sometimes been overwhelmed by the surge of COVID-19 patients. Extending ICU capacity can be limited by the lack of air and oxygen pressure sources available. Transport ventilato...

Authors: Dominique Savary, Arnaud Lesimple, François Beloncle, François Morin, François Templier, Alexandre Broc, Laurent Brochard, Jean-Christophe Richard and Alain Mercat

Are single-lumen 5Fr and triple-lumen 6Fr PICCs suitable for hemodynamic assessment by trans-pulmonary thermodilution? A pilot study

Single-lumen 4Fr or double-lumen 5Fr power injectable peripherally inserted central catheters (PICCs) are not accurate for trans-pulmonary thermodilution (TPTD), since they overestimate cardiac index and other...

Authors: Sonia D’Arrigo, Claudio Sandroni, Sofia Cacciola, Antonio Maria Dell’Anna, Mauro Pittiruti, Maria Giuseppina Annetta, Cesare Colosimo and Massimo Antonelli

Response to: 500 mg as bolus followed by an extended infusion of 1500 mg of meropenem every 8 h failed to achieve in one-third of the patients an optimal PK/PD against nonresistant strains of these organisms: is CRRT responsible for this situation?

Authors: Amol Kothekar, Jigeeshu Vasishtha Divatia, Sheila Nainan Myatra and Vikram Gota

500 mg as bolus followed by an extended infusion of 1500 mg of meropenem every 8 h failed to achieve in one-third of the patients an optimal PK/PD against non-resistant strains of these organisms: is CRRT responsible for this situation?

Authors: Patrick M. Honore, Leonel Barret Gutierrez, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani and David De Bels

SORT as any easy technique to do; but needs more trials to be as a routine practice

Authors: Sarvin Sanaie and Ata Mahmoodpoor

Feasibility, safety, and resource utilisation of active mobilisation of patients on extracorporeal life support: a prospective observational study

There is scarce evidence on the feasibility, safety and resource utilisation of active mobilisation in critically ill patients on extracorporeal life support (ECLS).

Authors: Stephan Braune, Patrick Bojes, Anne Mecklenburg, Federico Angriman, Gerold Soeffker, Katja Warnke, Dirk Westermann, Stefan Blankenberg, Mathias Kubik, Hermann Reichenspurner and Stefan Kluge

SORT maneuver: ease and safety for the practitioner and the patient

Authors: Mahdi Najafi

The effect of bed-to-nurse ratio on hospital mortality of critically ill children on mechanical ventilation: a nationwide population-based study

Despite the high workload of mechanical ventilation, there has been a lack of studies on the association between nurse workforce and mortality in mechanically ventilated patients. We evaluated the association ...

Authors: Minyoung Jung, Hyejeong Park, Danbee Kang, Esther Park, Kyeongman Jeon, Chi Ryang Chung, Jeong Hoon Yang, Gee Young Suh, Eliseo Guallar, Juhee Cho and Joongbum Cho

Ventilator-associated pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: a retrospective cohort study

The data on incidence, clinical presentation, and outcomes of ventilator-associated pneumonia (VAP) in patients with severe coronavirus disease 2019 (COVID-19) pneumonia requiring mechanical ventilation (MV) a...

Authors: Charles-Edouard Luyt, Tarek Sahnoun, Melchior Gautier, Pauline Vidal, Sonia Burrel, Marc Pineton de Chambrun, Juliette Chommeloux, Cyrielle Desnos, Jeremy Arzoine, Ania Nieszkowska, Nicolas Bréchot, Matthieu Schmidt, Guillaume Hekimian, David Boutolleau, Jérôme Robert, Alain Combes…

Management of pharmaceutical and recreational drug poisoning

Poisoning is one of the leading causes of admission to the emergency department and intensive care unit. A large number of epidemiological changes have occurred over the last years such as the exponential grow...

Authors: Bruno Mégarbane, Mathieu Oberlin, Jean-Claude Alvarez, Frederic Balen, Sébastien Beaune, Régis Bédry, Anthony Chauvin, Isabelle Claudet, Vincent Danel, Guillaume Debaty, Arnaud Delahaye, Nicolas Deye, Jean-Michel Gaulier, Francis Grossenbacher, Philippe Hantson, Frédéric Jacobs…

P-SILI as justification for intubation in COVID-19: readers as arbiters

Authors: Martin J. Tobin, Amal Jubran and Franco Laghi

Effectiveness of corticosteroids for post-extubation stridor and extubation failure in pediatric patients: a systematic review and meta-analysis

While the results of previous meta-analyses have shown beneficial effects of corticosteroid therapy on post-extubation stridor and extubation failure in adults, these results might not be generalizable to chil...

Authors: Satoshi Kimura, JiYoon B. Ahn, Mai Takahashi, Sohee Kwon and Stefania Papatheodorou

Adsorption therapy in critically ill with septic shock and acute kidney injury: a retrospective and prospective cohort study

Haemoadsorption has been described as an effective way to control increased pro- and anti-inflammatory mediators (“cytokine storm”) in septic shock patients. No prospective or randomised clinical study has yet...

Authors: Gregor A. Schittek, Philipp Zoidl, Michael Eichinger, Simon Orlob, Holger Simonis, Martin Rief, Philipp Metnitz, Tobias Fellinger and Jens Soukup

Physiologic responses to a staircase lung volume optimization maneuver in pediatric high-frequency oscillatory ventilation

Titration of the continuous distending pressure during a staircase incremental–decremental pressure lung volume optimization maneuver in children on high-frequency oscillatory ventilation is traditionally driv...

Authors: Pauline de Jager, Johannes G. M. Burgerhof, Alette A. Koopman, Dick G. Markhorst and Martin C. J. Kneyber

Retinal blood flow in critical illness and systemic disease: a review

Assessment and maintenance of end-organ perfusion are key to resuscitation in critical illness, although there are limited direct methods or proxy measures to assess cerebral perfusion. Novel non-invasive meth...

Authors: E. Courtie, T. Veenith, A. Logan, A. K. Denniston and R. J. Blanch

Rescue therapy with inhaled nitric oxide and almitrine in COVID-19 patients with severe acute respiratory distress syndrome

In COVID-19 patients with severe acute respiratory distress syndrome (ARDS), the relatively preserved respiratory system compliance despite severe hypoxemia, with specific pulmonary vascular dysfunction, sugge...

Authors: François Bagate, Samuel Tuffet, Paul Masi, François Perier, Keyvan Razazi, Nicolas de Prost, Guillaume Carteaux, Didier Payen and Armand Mekontso Dessap

Effects of capillary refill time-vs. lactate-targeted fluid resuscitation on regional, microcirculatory and hypoxia-related perfusion parameters in septic shock: a randomized controlled trial

Persistent hyperlactatemia has been considered as a signal of tissue hypoperfusion in septic shock patients, but multiple non-hypoperfusion-related pathogenic mechanisms could be involved. Therefore, pursuing ...

Authors: Ricardo Castro, Eduardo Kattan, Giorgio Ferri, Ronald Pairumani, Emilio Daniel Valenzuela, Leyla Alegría, Vanessa Oviedo, Nicolás Pavez, Dagoberto Soto, Magdalena Vera, César Santis, Brusela Astudillo, María Alicia Cid, Sebastian Bravo, Gustavo Ospina-Tascón, Jan Bakker…

Impact of systematic screening for AmpC-hyperproducing Enterobacterales intestinal carriage in intensive care unit patients

Empirical antimicrobial therapy (EAT) is a challenge for community-acquired, hospital-acquired and ventilator-associated pneumonia, particularly in the context of the increasing occurrence of third-generation ...

Authors: Manquat Elsa, Le Dorze Matthieu, Pean De Ponfilly Gauthier, Benmansour Hanaa, Amarsy Rishma, Cambau Emmanuelle, Soyer Benjamin, Chousterman Benjamin Glenn and Jacquier Hervé

Irrespective of the degree of hyperlactatemia, similar lactate levels were associated with a lower mortality rate in metformin users compared with non-users: beware of confounders!

Authors: Patrick M. Honore, Leonel Barreto Gutierrez, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani and David De Bels

Comment on “Respiratory mechanics and gas exchanges in the early course of COVID-19 ARDS: a hypothesis-generating study”

Authors: Elisa Damiani, Andrea Carsetti, Erika Casarotta, Roberta Domizi, Claudia Scorcella, Erica Adrario and Abele Donati

Acute respiratory failure in immunocompromised patients: outcome and clinical features according to neutropenia status

The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of n...

Authors: Djamel Mokart, Michael Darmon, Peter Schellongowski, Peter Pickkers, Marcio Soares, Jordi Rello, Philippe R. Bauer, Andry van de Louw, Virginie Lemiale, Fabio Silvio Taccone, Ignacio Martin-Loeches, Jorge Salluh, Katerina Rusinova, Sangeeta Mehta, Massimo Antonelli, Achille Kouatchet…

Sepsis and septic shock in France: incidences, outcomes and costs of care

Sepsis is one of the leading causes of death worldwide. The associated incidence, mortality and trends do not differ greatly between documented reports. The purpose of this study was to provide an in-depth des...

Authors: Claire Dupuis, Lila Bouadma, Stéphane Ruckly, Anne Perozziello, Damien Van-Gysel, Arthur Mageau, Bruno Mourvillier, Etienne de Montmollin, Sébastien Bailly, Gregory Papin, Fabrice Sinnah, Camille Vinclair, Sonia Abid, Romain Sonneville and Jean-François Timsit

Patient–ventilator asynchrony in acute brain-injured patients: a prospective observational study

Patient–ventilator asynchrony is common in mechanically ventilated patients and may be related to adverse outcomes. Few studies have reported the occurrence of asynchrony in brain-injured patients. We aimed to...

Authors: 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 and Jian-Xin Zhou

Immune-related adverse events: a retrospective look into the future of oncology in the intensive care unit

Immune checkpoint inhibitors have reshaped the standard of care in oncology. However, they have been associated with potentially life-threatening immune-related adverse events. With the growing indications of ...

Authors: Adrien Joseph, Audrey Simonaggio, Annabelle Stoclin, Antoine Vieillard-Baron, Guillaume Geri, Stéphane Oudard, Jean-Marie Michot, Olivier Lambotte, Elie Azoulay and Virginie Lemiale

Epidemiology, clinical characteristics, and outcome of candidemia in critically ill patients in Germany: a single-center retrospective 10-year analysis

Despite advances in the management of bloodstream infections (BSI) caused by Candida spp., the mortality still remains high in critically ill patients. The worldwide epidemiology of yeast-related BSI is subject t...

Authors: Maria Schroeder, Theresa Weber, Timme Denker, Sarah Winterland, Dominic Wichmann, Holger Rohde, Ann-Kathrin Ozga, Marlene Fischer and Stefan Kluge

Biased and unbiased estimation of the average length of stay in intensive care units in the Covid-19 pandemic

The average length of stay (LOS) in the intensive care unit (ICU_ALOS) is a helpful parameter summarizing critical bed occupancy. During the outbreak of a novel virus, estimating early a reliable ICU_ALOS esti...

Authors: Nathanael Lapidus, Xianlong Zhou, Fabrice Carrat, Bruno Riou, Yan Zhao and Gilles Hejblum

Tigecycline pharmacokinetics in critically ill patients on renal replacement therapy: possible warnings and potential perspectives for the research agenda

Authors: Salvatore Lucio Cutuli, Gennaro De Pascale, Lucia Lisi, Simone Carelli, Pierluigi Navarra and Massimo Antonelli

Response to Damiani and colleagues

Authors: J-L Diehl, N. Peron, A. Philippe and D. M. Smadja

High doses of tigecycline are associated with satisfactory plasmatic and pulmonary concentrations for the treatment of severe infections due to fully susceptible bacteria: do we need even higher doses in patients under CRRT?

Authors: Patrick M. Honore, Leonel Barreto Gutierrez, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani and David De Bels

Persistent swallowing disorders after extubation in mechanically ventilated patients in ICU: a two-center prospective study

Persistent swallowing disorders (SD) are non-pulmonary complications of mechanical ventilation (MV). However, there are few clinical studies on persistent SD in critically ill patients undergoing tracheal intu...

Authors: G. Beduneau, V. Souday, J. C. Richard, J. F. Hamel, D. Carpentier, J. M. Chretien, P. Bouchetemble, L. Laccoureye, A. Astier, V. Tanguy, A. Mercat, F. Beloncle and F. Tamion

pCLIF-SOFA is a reliable outcome prognostication score of critically ill children with cirrhosis: an ESPNIC multicentre study

Data on outcome of critically ill children with cirrhosis are scarce. We aimed to evaluate the prognostic accuracy of sequential organs scoring systems in children with cirrhosis admitted to Paediatric Intensi...

Authors: Caroline Claude, Akash Deep, Martin Kneyber, Salman Siddiqui, Sylvain Renolleau, Luc Morin, Emmanuel Jacquemin, Jean-Paul Teglas, Vincent Gajdos, Pierre Tissières and Philippe Durand

Treatment variables associated with outcome in emergency department patients with suspected sepsis

Early treatment is advocated in the management of patients with suspected sepsis in the emergency department (ED). We sought to understand the association between the ED treatments and outcome in patients admi...

Authors: Narani Sivayoham, Lesley A. Blake, Shafi E. Tharimoopantavida, Saad Chughtai, Adil N. Hussain and Andrew Rhodes

COVID-19: scientific reasoning, pragmatism and emotional bias

Authors: Luciano Gattinoni, John J. Marini, Davide Chiumello, Mattia Busana and Luigi Camporota

Use of critical care resources during the first 2 weeks (February 24–March 8, 2020) of the Covid-19 outbreak in Italy

A Covid-19 outbreak developed in Lombardy, Veneto and Emilia-Romagna (Italy) at the end of February 2020. Fear of an imminent saturation of available ICU beds generated the notion that rationing of intensive c...

Authors: Tommaso Tonetti, Giacomo Grasselli, Alberto Zanella, Giacinto Pizzilli, Roberto Fumagalli, Simone Piva, Luca Lorini, Giorgio Iotti, Giuseppe Foti, Sergio Colombo, Luigi Vivona, Sandra Rossi, Massimo Girardis, Vanni Agnoletti, Anselmo Campagna, Giovanni Gordini…

Best-practice IgM- and IgA-enriched immunoglobulin use in patients with sepsis

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Despite treatment being in line with current guidelines, mortality remains high in those with septic shock. I...

Authors: Axel Nierhaus, Giorgio Berlot, Detlef Kindgen-Milles, Eckhard Müller and Massimo Girardis

Characteristics and outcomes of acute respiratory distress syndrome related to COVID-19 in Belgian and French intensive care units according to antiviral strategies: the COVADIS multicentre observational study

Limited data are available regarding antiviral therapy efficacy in most severe patients under mechanical ventilation for Covid-19-related acute respiratory distress syndrome (ARDS).

Authors: David Grimaldi, Nadia Aissaoui, Gauthier Blonz, Giuseppe Carbutti, Romain Courcelle, Stephane Gaudry, Aurelie Gaultier, Alain D’hondt, Julien Higny, Geoffrey Horlait, Sami Hraiech, Laurent Lefebvre, Francois Lejeune, Andre Ly, Michael Piagnerelli, Bertrand Sauneuf…

Intra-abdominal hypertension and abdominal compartment syndrome in patients admitted to the ICU

Intra-abdominal hypertension is frequently present in critically ill patients and is an independent predictor for mortality. Risk factors for intra-abdominal hypertension and abdominal compartment syndrome hav...

Authors: Marije Smit, Bart Koopman, Willem Dieperink, Jan B. F. Hulscher, H. Sijbrand Hofker, Matijs van Meurs and Jan G. Zijlstra

Transpulmonary pressures in obese and non-obese COVID-19 ARDS

Data on respiratory mechanics of COVID-19 ARDS patients are scarce. Respiratory mechanics and response to positive expiratory pressure (PEEP) may be different in obese and non-obese patients.

Authors: Mehdi Mezidi, Florence Daviet, Paul Chabert, Sami Hraiech, Laurent Bitker, Jean-Marie Forel, Hodane Yonis, Ines Gragueb, Francois Dhelft, Laurent Papazian, Jean-Christophe Richard and Christophe Guervilly

Early mechanical ventilation in patients with Guillain-Barré syndrome at high risk of respiratory failure: a randomized trial

About 30% of patients with Guillain-Barré syndrome become ventilator dependent, of whom roughly 75% develop pneumonia. This trial aimed at assessing the impact of early mechanical ventilation (EMV) on pneumoni...

Authors: Marie-Anne Melone, Nicholas Heming, Paris Meng, Dominique Mompoint, Jerôme Aboab, Bernard Clair, Jerôme Salomon, Tarek Sharshar, David Orlikowski, Sylvie Chevret and Djillali Annane