Critical Care




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COVID-19 ARDS is characterized by higher extravascular lung water than non-COVID-19 ARDS: the PiCCOVID study

Rui Shi, Christopher Lai, Jean-Louis Teboul, Martin Dres, Francesca Moretto, Nello De Vita, Tài Pham, Vincent Bonny, Julien Mayaux, Rosanna Vaschetto, Alexandra Beurton and Xavier Monnet

doi : 10.1186/s13054-021-03594-6

Critical Care 2021 25:186

In acute respiratory distress syndrome (ARDS), extravascular lung water index (EVLWi) and pulmonary vascular permeability index (PVPI) measured by transpulmonary thermodilution reflect the degree of lung injury. Whether EVLWi and PVPI are different between non-COVID-19 ARDS and the ARDS due to COVID-19 has never been reported. We aimed at comparing EVLWi, PVPI, respiratory mechanics and hemodynamics in patients with COVID-19 ARDS vs. ARDS of other origin.

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Potential protective effects of continuous anterior chest compression in the acute respiratory distress syndrome: physiology of an illustrative case

Guillaume Carteaux, Samuel Tuffet and Armand Mekontso Dessap

doi : 10.1186/s13054-021-03619-0

Critical Care 2021 25:187

no abstract

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Targeted treatment of iron deficiency in prolonged critical illness: an opportunity to improve survival or not?

Jan Gunst, Greet Van den Berghe and Michael P. Casaer

doi : 10.1186/s13054-021-03590-w

Critical Care 2021 25:188

no abstract

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Effects of early extubation followed by noninvasive ventilation versus standard extubation on the duration of invasive mechanical ventilation in hypoxemic non-hypercapnic patients: a systematic review and individual patient data meta-analysis of randomized controlled trials

Rosanna Vaschetto, Alessandro Pecere, Gavin D. Perkins, Dipesh Mistry, Gianmaria Cammarota, Federico Longhini, Miguel Ferrer, Renata Pletsch-Assunç?o, Michele Carron, Francesca Moretto, Haibo Qiu, Francesco Della Corte, Francesco Barone-Adesi and Paolo Navalesi

doi : 10.1186/s13054-021-03595-5

Critical Care 2021 25:189

Usefulness of noninvasive ventilation (NIV) in weaning patients with non-hypercapnic hypoxemic acute respiratory failure (hARF) is unclear. The study aims to assess in patients with non-hypercapnic hARF, the efficacy of NIV after early extubation, compared to standard weaning.

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Hemofiltration with the Seraph® 100 Microbind® Affinity filter decreases SARS-CoV-2 nucleocapsid protein in critically ill COVID-19 patients

Jan T. Kielstein, Dan-Nicolae Borchina, Thomas Fühner, Soyoon Hwang, Dawn Mattoon and Andrew J. Ball

doi : 10.1186/s13054-021-03597-3

Critical Care 2021 25:190

no abstract

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Why and how to open intensive care units to family visits during the pandemic

Giovanni Mistraletti, Alberto Giannini, Giuseppe Gristina, Paolo Malacarne, Davide Mazzon, Elisabetta Cerutti, Alessandro Galazzi, Ilaria Giubbilo, Marco Vergano, Vladimiro Zagrebelsky, Luigi Riccioni, Giacomo Grasselli, Silvia Scelsi, Maurizio Cecconi and Flavia Petrini

doi : 10.1186/s13054-021-03608-3

Critical Care 2021 25:191

Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe precise strategic goals are essential and operational guidance is needed on how to achieve them. Even during the pandemic, we consider it a priority to share strategies adapted to every local setting to allow family members to enter intensive care units and all the other hospital wards.

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Unmatched ventilation and perfusion measured by electrical impedance tomography predicts the outcome of ARDS

Elena Spinelli, Michael Kircher, Birgit Stender, Irene Ottaviani, Maria C. Basile, Ines Marongiu, Giulia Colussi, Giacomo Grasselli, Antonio Pesenti and Tommaso Mauri

doi : 10.1186/s13054-021-03615-4

Critical Care 2021 25:192

In acute respiratory distress syndrome (ARDS), non-ventilated perfused regions coexist with non-perfused ventilated regions within lungs. The number of unmatched regions might reflect ARDS severity and affect the risk of ventilation-induced lung injury. Despite pathophysiological relevance, unmatched ventilation and perfusion are not routinely assessed at the bedside. The aims of this study were to quantify unmatched ventilation and perfusion at the bedside by electrical impedance tomography (EIT) investigating their association with mortality in patients with ARDS and to explore the effects of positive end-expiratory pressure (PEEP) on unmatched ventilation and perfusion in subgroups of patients with different ARDS severity based on PaO2/FiO2 and compliance.

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Timing of intubation in COVID-19: Not just location, location, location?

David A. Thomson and Gregory L. Calligaro

doi : 10.1186/s13054-021-03617-2

Critical Care 2021 25:193

no abstract

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Clinical impact of implementing humidified high-flow nasal cannula on interhospital transport among children admitted to a PICU with respiratory distress: a cohort study

Shinya Miura, Kazue Yamaoka, Satoshi Miyata, Warwick Butt and Sile Smith

doi : 10.1186/s13054-021-03620-7

Critical Care 2021 25:194

There is a limited evidence for humidified high-flow nasal cannula (HHFNC) use on inter-hospital transport. Despite this, its use during transport is increasing in children with respiratory distress worldwide. In 2015 HHFNC was implemented on a specialized pediatric retrieval team serving for Victoria. The aim of this study is to investigate the effect of the HHFNC implementation on the retrieval team on the paediatric intensive care unit (PICU) length of stay and respiratory support use.

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Letter to the editor regarding Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes

Karlijn J. P. van Wessem and Luke P. H. Leenen

doi : 10.1186/s13054-021-03604-7

Critical Care 2021 25:195

no abstract

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Flow Index: a novel, non-invasive, continuous, quantitative method to evaluate patient inspiratory effort during pressure support ventilation

Filippo Albani, Luigi Pisani, Gianni Ciabatti, Federica Fusina, Barbara Buizza, Anna Granato, Valeria Lippolis, Eros Aniballi, Francesco Murgolo, Antonio Rosano, Nicola Latronico, Massimo Antonelli, Salvatore Grasso and Giuseppe Natalini

doi : 10.1186/s13054-021-03624-3

Critical Care 2021 25:196

The evaluation of patient effort is pivotal during pressure support ventilation, but a non-invasive, continuous, quantitative method to assess patient inspiratory effort is still lacking. We hypothesized that the concavity of the inspiratory flow-time waveform could be useful to estimate patient’s inspiratory effort. The purpose of this study was to assess whether the shape of the inspiratory flow, as quantified by a numeric indicator, could be associated with inspiratory effort during pressure support ventilation.

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Staphylococcus aureus ventilator-associated pneumonia in patients with COVID-19: clinical features and potential inference with lung dysbiosis

Gennaro De Pascale, Flavio De Maio, Simone Carelli, Giulia De Angelis, Margherita Cacaci, Luca Montini, Giuseppe Bello, Salvatore Lucio Cutuli, Gabriele Pintaudi, Eloisa Sofia Tanzarella, Rikardo Xhemalaj, Domenico Luca Grieco, Mario Tumbarello, Maurizio Sanguinetti, Brunella Posteraro and Massimo Antonelli

doi : 10.1186/s13054-021-03623-4

Critical Care 2021 25:197

Hospitalized patients with COVID-19 admitted to the intensive care unit (ICU) and requiring mechanical ventilation are at risk of ventilator-associated bacterial infections secondary to SARS-CoV-2 infection. Our study aimed to investigate clinical features of Staphylococcus aureus ventilator-associated pneumonia (SA-VAP) and, if bronchoalveolar lavage samples were available, lung bacterial community features in ICU patients with or without COVID-19.

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Effect of intra-arrest trans-nasal evaporative cooling in out-of-hospital cardiac arrest: a pooled individual participant data analysis

Fabio Silvio Taccone, Jacob Hollenberg, Sune Forsberg, Anatolij Truhlar, Martin Jonsson, Filippo Annoni, Dan Gryth, Mattias Ringh, Jerome Cuny, Hans-J?rg Busch, Jean-Louis Vincent, Leif Svensson and Per Nordberg

doi : 10.1186/s13054-021-03583-9

Critical Care 2021 25:198

Randomized trials have shown that trans-nasal evaporative cooling initiated during CPR (i.e. intra-arrest) effectively lower core body temperature in out-of-hospital cardiac arrest patients. However, these trials may have been underpowered to detect significant differences in neurologic outcome, especially in patients with initial shockable rhythm.

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An appraisal of respiratory system compliance in mechanically ventilated covid-19 patients

Gianluigi Li Bassi, Jacky Y. Suen, Heidi J. Dalton, Nicole White, Sally Shrapnel, Jonathon P. Fanning, Benoit Liquet, Samuel Hinton, Aapeli Vuorinen, Gareth Booth, Jonathan E. Millar, Simon Forsyth, Mauro Panigada, John Laffey, Daniel Brodie, Eddy Fan…

doi : 10.1186/s13054-021-03518-4

Critical Care 2021 25:199

Heterogeneous respiratory system static compliance (CRS) values and levels of hypoxemia in patients with novel coronavirus disease (COVID-19) requiring mechanical ventilation have been reported in previous small-case series or studies conducted at a national level.

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Proportional assist ventilation versus pressure support ventilation for weaning from mechanical ventilation in adults: weaning success and mortality

Ioannis Pantazopoulos, Georgios Mavrovounis, Maria Mermiri and Christos Kampolis

doi : 10.1186/s13054-021-03575-9

Critical Care 2021 25:200

no abstract

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Extracorporeal treatment for poisoning to beta-adrenergic antagonists: systematic review and recommendations from the EXTRIP workgroup

Josée Bouchard, Greene Shepherd, Robert S. Hoffman, Sophie Gosselin, Darren M. Roberts, Yi Li, Thomas D. Nolin, Valéry Lavergne and Marc Ghannoum

doi : 10.1186/s13054-021-03585-7

Critical Care 2021 25:201

?-adrenergic antagonists (BAAs) are used to treat cardiovascular disease such as ischemic heart disease, congestive heart failure, dysrhythmias, and hypertension. Poisoning from BAAs can lead to severe morbidity and mortality. We aimed to determine the utility of extracorporeal treatments (ECTRs) in BAAs poisoning.

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Comparison of renal histopathology and gene expression profiles between severe COVID-19 and bacterial sepsis in critically ill patients

Meint Volbeda, Daniela Jou-Valencia, Marius C. van den Heuvel, Marjolein Knoester, Peter J. Zwiers, Janesh Pillay, Stefan P. Berger, Peter H. J. van der Voort, Jan G. Zijlstra, Matijs van Meurs and Jill Moser

doi : 10.1186/s13054-021-03631-4

Critical Care 2021 25:202

The mechanisms driving acute kidney injury (AKI) in critically ill COVID-19 patients are unclear. We collected kidney biopsies from COVID-19 AKI patients within 30 min after death in order to examine the histopathology and perform mRNA expression analysis of genes associated with renal injury.

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Palliative, palliative or palliative?

René Robert and Michel Goldberg

doi : 10.1186/s13054-021-03633-2

Critical Care 2021 25:203

no abstract

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Feasibility of achieving different protein targets using a hypocaloric high-protein enteral formula in critically ill patients

Pierre Singer, Itai Bendavid, Ilana BenArie, Liran Stadlander and Ilya Kagan

doi : 10.1186/s13054-021-03625-2

Critical Care 2021 25:204

Combining energy and protein targets during the acute phase of critical illness is challenging. Energy should be provided progressively to reach targets while avoiding overfeeding and ensuring sufficient protein provision. This prospective observational study evaluated the feasibility of achieving protein targets guided by 24-h urinary nitrogen excretion while avoiding overfeeding when administering a high protein-to-energy ratio enteral nutrition (EN) formula.

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Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery

Antonio Messina, Chiara Robba, Lorenzo Calabr?, Daniel Zambelli, Francesca Iannuzzi, Edoardo Molinari, Silvia Scarano, Denise Battaglini, Marta Baggiani, Giacomo De Mattei, Laura Saderi, Giovanni Sotgiu, Paolo Pelosi and Maurizio Cecconi

doi : 10.1186/s13054-021-03629-y

Critical Care 2021 25:205

Postoperative complications impact on early and long-term patients’ outcome. Appropriate perioperative fluid management is pivotal in this context; however, the most effective perioperative fluid management is still unclear. The enhanced recovery after surgery pathways recommend a perioperative zero-balance, whereas recent findings suggest a more liberal approach could be beneficial. We conducted this trial to address the impact of restrictive vs. liberal fluid approaches on overall postoperative complications and mortality.

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Predictors of weaning from helmet CPAP in patients with COVID-19 pneumonia

Dejan Radovanovic, Stefano Pini, Marina Saad, Luca Perotto, Fabio Giuliani and Pierachille Santus

doi : 10.1186/s13054-021-03627-0

Critical Care 2021 25:206

no abstract

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Effects of levosimendan on renal blood flow and glomerular filtration in patients with acute kidney injury after cardiac surgery: a double blind, randomized placebo-controlled study

Maria Tholén, Sven-Erik Ricksten and Lukas Lannemyr

doi : 10.1186/s13054-021-03628-z

Critical Care 2021 25:207

Acute kidney injury (AKI) is a common and serious complication after cardiac surgery, and current strategies aimed at treating AKI have proven ineffective. Levosimendan, an inodilatating agent, has been shown to increase renal blood flow and glomerular filtration rate in uncomplicated postoperative patients and in patients with the cardiorenal syndrome. We hypothesized that levosimendan through its specific effects on renal vasculature, a preferential vasodilating effect on preglomerular resistance vessels, could improve renal function in AKI-patients with who did not have clinical indication for inotropic support.

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Breath-holding as a novel approach to risk stratification in COVID-19

Ludovico Messineo, Elisa Perger, Luciano Corda, Simon A. Joosten, Francesco Fanfulla, Leonardo Pedroni, Philip I. Terrill, Carolina Lombardi, Andrew Wellman, Garun S. Hamilton, Atul Malhotra, Guido Vailati, Gianfranco Parati and Scott A. Sands

doi : 10.1186/s13054-021-03630-5

Critical Care 2021 25:208

Despite considerable progress, it remains unclear why some patients admitted for COVID-19 develop adverse outcomes while others recover spontaneously. Clues may lie with the predisposition to hypoxemia or unexpected absence of dyspnea (‘silent hypoxemia’) in some patients who later develop respiratory failure. Using a recently-validated breath-holding technique, we sought to test the hypothesis that gas exchange and ventilatory control deficits observed at admission are associated with subsequent adverse COVID-19 outcomes (composite primary outcome: non-invasive ventilatory support, intensive care admission, or death).

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Awake prone positioning in patients with hypoxemic respiratory failure due to COVID-19: the PROFLO multicenter randomized clinical trial

Jacob Rosén, Erik von Oelreich, Diddi Fors, Malin Jonsson Fagerlund, Knut Taxbro, Paul Skorup, Ludvig Eby, Francesca Campoccia Jalde, Niclas Johansson, Gustav Bergstr?m and Peter Frykholm

doi : 10.1186/s13054-021-03602-9

Critical Care 2021 25:209

The effect of awake prone positioning on intubation rates is not established. The aim of this trial was to investigate if a protocol for awake prone positioning reduces the rate of endotracheal intubation compared with standard care among patients with moderate to severe hypoxemic respiratory failure due to COVID-19.

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Anti-Xa activity and hemorrhagic event: isn’t it time to consider time ?

Sébastien Redant, Xavier Beretta-Piccoli, Patrick M. Honore, David De Bels and Dominique Biarent

doi : 10.1186/s13054-021-03612-7

Critical Care 2021 25:210

no abstract

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Extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis

Kollengode Ramanathan, Kiran Shekar, Ryan Ruiyang Ling, Ryan P. Barbaro, Suei Nee Wong, Chuen Seng Tan, Bram Rochwerg, Shannon M. Fernando, Shinhiro Takeda, Graeme MacLaren, Eddy Fan and Daniel Brodie

doi : 10.1186/s13054-021-03634-1

Critical Care 2021 25:211

There are several reports of extracorporeal membrane oxygenation (ECMO) use in patients with coronavirus disease 2019 (COVID-19) who develop severe acute respiratory distress syndrome (ARDS). We conducted a systematic review and meta-analysis to guide clinical decision-making and future research.

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Serum uric acid, disease severity and outcomes in COVID-19

Inès Dufour, Alexis Werion, Leila Belkhir, Anastazja Wisniewska, Marie Perrot, Julien De Greef, Gregory Schmit, Jean Cyr Yombi, Xavier Wittebole, Pierre-François Laterre, Michel Jadoul, Ludovic Gérard and Johann Morelle

doi : 10.1186/s13054-021-03616-3

Critical Care 2021 25:212

The severity of coronavirus disease 2019 (COVID-19) is highly variable between individuals, ranging from asymptomatic infection to critical disease with acute respiratory distress syndrome requiring mechanical ventilation. Such variability stresses the need for novel biomarkers associated with disease outcome. As SARS-CoV-2 infection causes a kidney proximal tubule dysfunction with urinary loss of uric acid, we hypothesized that low serum levels of uric acid (hypouricemia) may be associated with severity and outcome of COVID-19.

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A systemic ultrasound positioning protocol for nasointestinal tube in critically ill patients

Ruizhong Ye, Xuping Cheng, Huihui Chai, Chengzhong Peng, Jingquan Liu and Jiyong Jing

doi : 10.1186/s13054-021-03641-2

Critical Care 2021 25:213

no abstract

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Lung distribution of gas and blood volume in critically ill COVID-19 patients: a quantitative dual-energy computed tomography study

Lorenzo Ball, Chiara Robba, Jacob Herrmann, Sarah E. Gerard, Yi Xin, Maura Mandelli, Denise Battaglini, Iole Brunetti, Giuseppe Minetti, Sara Seitun, Giulio Bovio, Antonio Vena, Daniele Roberto Giacobbe, Matteo Bassetti, Patricia R. M. Rocco, Maurizio Cereda…

doi : 10.1186/s13054-021-03610-9

Critical Care 2021 25:214

Critically ill COVID-19 patients have pathophysiological lung features characterized by perfusion abnormalities. However, to date no study has evaluated whether the changes in the distribution of pulmonary gas and blood volume are associated with the severity of gas-exchange impairment and the type of respiratory support (non-invasive versus invasive) in patients with severe COVID-19 pneumonia.

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Letter to the editor in response to "Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis"

Fellery de Lange, Inge T. Bootsma and E. Christiaan Boerma

doi : 10.1186/s13054-021-03613-6

Critical Care 2021 25:215

no abstract

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A reply to “Addressing gender imbalance in intensive care”

Federica Fusina

doi : 10.1186/s13054-021-03601-w

Critical Care 2021 25:216

no abstract

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SARS-COV-2 colonizes coronary thrombus and impairs heart microcirculation bed in asymptomatic SARS-CoV-2 positive subjects with acute myocardial infarction

Raffaele Marfella, Pasquale Paolisso, Celestino Sardu, Luciana Palomba, Nunzia D’Onofrio, Arturo Cesaro, Michelangela Barbieri, Maria Rosaria Rizzo, Ferdinando Carlo Sasso, Lucia Scisciola, Fabrizio Turriziani, Massimiliano Galdiero, Danilo Pignataro, Fabio Minicucci, Maria Consiglia Trotta, Michele D’Amico…

doi : 10.1186/s13054-021-03643-0

Critical Care 2021 25:217

The viral load of asymptomatic SAR-COV-2 positive (ASAP) persons has been equal to that of symptomatic patients. On the other hand, there are no reports of ST-elevation myocardial infarction (STEMI) outcomes in ASAP patients. Therefore, we evaluated thrombus burden and thrombus viral load and their impact on microvascular bed perfusion in the infarct area (myocardial blush grade, MBG) in ASAP compared to SARS-COV-2 negative (SANE) STEMI patients.

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Psychological evaluation and support in COVID-19 critically ill patients: a feasibility study

Renaud Prével, Julien Coelho, Arthur Orieux, Pierre Philip, Didier Gruson and Stéphanie Bioulac

doi : 10.1186/s13054-021-03642-1

Critical Care 2021 25:218

no abstract

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Psychological evaluation and support in COVID-19 critically ill patients: a feasibility study

Renaud Prével, Julien Coelho, Arthur Orieux, Pierre Philip, Didier Gruson and Stéphanie Bioulac

doi : 10.1186/s13054-021-03642-1

Critical Care 2021 25:218

no abstract

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Non-invasive ventilation versus high-flow nasal oxygen for postextubation respiratory failure in ICU: a post-hoc analysis of a randomized clinical trial

Arnaud W. Thille,corresponding author1,2 Grégoire Monseau,1 Rémi Coudroy,1,2 Mai-Anh Nay,3 Arnaud Gacouin,4 Maxens Decavèle,5 Romain Sonneville,6 François Beloncle,7 Christophe Girault,8 Laurence Dangers,9 Alexandre Lautrette,10 Quentin Levrat,11 Anahita Rouzé,12 Emmanuel Vivier,13 Jean-Baptiste Lascarrou,14 Jean-Damien Ricard,15 Keyvan Razazi,16 Guillaume Barberet,17 Christine Lebert,18 Stephan Ehrmann,19 Alexandre Massri,20 Jeremy Bourenne,21 Gael Pradel,22 Pierre Bailly,23 Nicolas Terzi,24 Jean Dellamonica,25 Guillaume Lacave,26 René Robert,1,2 Stéphanie Ragot,2 Jean-Pierre Frat,1,2 and for the HIGH-WEAN Study Group and the REVA research network

doi : 10.1186/s13054-021-03621-6

Crit Care. 2021; 25: 221.

In intensive care units (ICUs), patients experiencing post-extubation respiratory failure have poor outcomes. The use of noninvasive ventilation (NIV) to treat post-extubation respiratory failure may increase the risk of death. This study aims at comparing mortality between patients treated with NIV alternating with high-flow nasal oxygen or high-flow nasal oxygen alone.

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Monocyte distribution width (MDW) performance as an early sepsis indicator in the emergency department: comparison with CRP and procalcitonin in a multicenter international European prospective study

Pierre Hausfater,corresponding author1,2,3 Neus Robert Boter,4,5 Cristian Morales Indiano,5,7 Marta Cancella de Abreu,1,2 Adria Mendoza Marin,4,5 Julie Pernet,1 Dolores Quesada,5,8 Iris Castro,9 Diana Careaga,9 Michel Arock,6 Liliana Tejidor,9 and Laetitia Velly1,2

doi : 10.1186/s13054-021-03622-5

Crit Care. 2021; 25: 227.

Early sepsis diagnosis has emerged as one of the main challenges in the emergency room. Measurement of sepsis biomarkers is largely used in current practice to improve the diagnosis accuracy. Monocyte distribution width (MDW) is a recent new sepsis biomarker, available as part of the complete blood count with differential. The objective was to evaluate the performance of MDW for the detection of sepsis in the emergency department (ED) and to compare to procalcitonin (PCT) and C-reactive protein (CRP).

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Diaphragm thickening fraction predicts noninvasive ventilation outcome: a preliminary physiological study

Giovanna Mercurio,corresponding author1 Sonia D’Arrigo,1 Rossana Moroni,2 Domenico Luca Grieco,1 Luca Salvatore Menga,1 Anna Romano,3 Maria Giuseppina Annetta,1 Maria Grazia Bocci,1 Davide Eleuteri,1 Giuseppe Bello,1 Luca Montini,1,3 Mariano Alberto Pennisi,1,3 Giorgio Conti,1,3 and Massimo Antonelli1,3

doi : 10.1186/s13054-021-03638-x

Crit Care. 2021; 25: 219.

A correlation between unsuccessful noninvasive ventilation (NIV) and poor outcome has been suggested in de-novo Acute Respiratory Failure (ARF) patients. Consequently, it is of paramount importance to identify accurate predictors of NIV outcome. The aim of our preliminary study is to evaluate the Diaphragmatic Thickening Fraction (DTF) and the respiratory rate/DTF ratio as predictors of NIV outcome in de-novo ARF patients.

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Timing and causes of death in severe COVID-19 patients

Charles de Roquetaillade,1,2 Swann Bredin,3 Jean-Baptiste Lascarrou,4 Thibaud Soumagne,5 Mariana Cojocaru,6 Benjamin Glenn Chousterman,1,2 Maxime Leclerc,7 Albin Gouhier,8 Gaël Piton,5 Frédéric Pène,3 Annabelle Stoclin,9 and Jean-François Llitjoscorresponding author9

doi : 10.1186/s13054-021-03639-w

Crit Care. 2021; 25: 224.

Previous studies reporting the causes of death in patients with severe COVID-19 have provided conflicting results. The objective of this study was to describe the causes and timing of death in patients with severe COVID-19 admitted to the intensive care unit (ICU).

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Neurally adjusted ventilatory assist as a weaning mode for adults with invasive mechanical ventilation: a systematic review and meta-analysis

Xueyan Yuan,1 Xinxing Lu,1 Yali Chao,1 Jennifer Beck,2,4,5 Christer Sinderby,3,4,5 Jianfeng Xie,1 Yi Yang,1 Haibo Qiu,corresponding author1 and Ling Liucorresponding author1

doi : 10.1186/s13054-021-03644-z

Crit Care. 2021; 25: 222.

Prolonged ventilatory support is associated with poor clinical outcomes. Partial support modes, especially pressure support ventilation, are frequently used in clinical practice but are associated with patient–ventilation asynchrony and deliver fixed levels of assist. Neurally adjusted ventilatory assist (NAVA), a mode of partial ventilatory assist that reduces patient–ventilator asynchrony, may be an alternative for weaning. However, the effects of NAVA on weaning outcomes in clinical practice are unclear.

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Early individualized positive end-expiratory pressure guided by electrical impedance tomography in acute respiratory distress syndrome: a randomized controlled clinical trial

Huaiwu He,1 Yi Chi,1 Yingying Yang,1 Siyi Yuan,1 Yun Long,corresponding author1 Pengyu Zhao,2 Inéz Frerichs,3 Feng Fu,4 Knut M?ller,5 and Zhanqi Zhaocorresponding author4,5

doi : 10.1186/s13054-021-03645-y

Crit Care. 2021; 25: 230.

Individualized positive end-expiratory pressure (PEEP) by electrical impedance tomography (EIT) has potential interest in the optimization of ventilation distribution in acute respiratory distress syndrome (ARDS). The aim of the study was to determine whether early individualized titration of PEEP with EIT improved outcomes in patients with ARDS.

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Evaluation of right ventricular function and driving pressure with blood gas analysis could better select patients eligible for VV ECMO in severe ARDS

Matthieu Petit,corresponding author1,2 Armand Mekontso-Dessap,3,4,5 Paul Masi,3,4 Annick Legras,7 Philippe Vignon,6 and Antoine Vieillard-Baron1,2

doi : 10.1186/s13054-021-03646-x

Crit Care. 2021; 25: 220.

no abstract

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Evolution of inspiratory muscle function in children during mechanical ventilation

Benjamin Crulli,1 Atsushi Kawaguchi,1,2,3 Jean-Paul Praud,4 Basil J. Petrof,5 Karen Harrington,1 and Guillaume Emeriaudcorresponding author1

doi : 10.1186/s13054-021-03647-w

Crit Care. 2021; 25: 229.

There is no universally accepted method to assess the pressure-generating capacity of inspiratory muscles in children on mechanical ventilation (MV), and no study describing its evolution over time in this population.

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Evaluation of thiamine as adjunctive therapy in COVID-19 critically ill patients: a two-center propensity score matched study

Khalid Al Sulaiman,corresponding author1,7 Ohoud Aljuhani,2 Maram Al Dossari,1 Asma Alshahrani,3 Aisha Alharbi,4 Rahmah Algarni,4 Majed Al Jeraisy,1,7 Shmeylan Al Harbi,1,7 Abdulmalik Al Katheri,1,7 Fahad Al Eidan,1,5 Abdulkareem M. Al Bekairy,1,7 Nouf Al Qahtani,1 Mashael Al Muqrin,1 Ramesh Vishwakarma,8 and Ghassan Al Ghamdi5,6

doi : 10.1186/s13054-021-03648-9

Crit Care. 2021; 25: 223.

Thiamine is a precursor of the essential coenzyme thiamine pyrophosphate required for glucose metabolism; it improves the immune system function and has shown to reduce the risk of several diseases. The role of thiamine in critically ill septic patient has been addressed in multiple studies; however, it’s role in COVID-19 patients is still unclear. The aim of this study was to evaluate the use of thiamine as an adjunctive therapy on mortality in COVID-19 critically ill patients.

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Increased time from physiological derangement to critical care admission associates with mortality

Stephen F. Whebell,1 Emma J. Prower,2 Joe Zhang,2 Megan Pontin,3 David Grant,4 Andrew T. Jones,1 and Guy W. Glovercorresponding author1

doi : 10.1186/s13054-021-03650-1

Crit Care. 2021; 25: 226.

Rapid response systems aim to achieve a timely response to the deteriorating patient; however, the existing literature varies on whether timing of escalation directly affects patient outcomes. Prior studies have been limited to using ‘decision to admit’ to critical care, or arrival in the emergency department as ‘time zero’, rather than the onset of physiological deterioration. The aim of this study is to establish if duration of abnormal physiology prior to critical care admission [‘Score to Door’ (STD) time] impacts on patient outcomes.

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Success rate of naso-jejunal tube placement influenced by CRRT: possible removal of metoclopramide

Patrick M. Honore,corresponding author1 Sebastien Redant,1 Thierry Preseau,2 Sofie Moorthamers,2 Keitiane Kaefer,1 Leonel Barreto Gutierrez,1 Rachid Attou,1 Andrea Gallerani,1 and David De Bels1

doi : 10.1186/s13054-021-03652-z

Crit Care. 2021; 25: 228.

no abstract

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The impact of frailty on survival in elderly intensive care patients with COVID?19: do not dismiss intensive care unit overcrowding

Romain Jouffroy1,2,3,4 and Benoît Viviencorresponding author5

doi : 10.1186/s13054-021-03653-y

Crit Care. 2021; 25: 225.

no abstract

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