Role of Initial Albumin Levels Among Other Liver Tests and Prognostic Scores in Predicting In-Hospital Mortality and Illness Severity in Critically Ill Septic Patients

Objectives: The role of automatic tube compensation (ATC) compared to other spontaneous breathing trials (SBTs) in critically ill receiving mechanical ventilation remains uncertain. The aim of this meta-analysis was to determine the role of ATC in critically ill patients compared to alternative SBT techniques. Methods: We searched PubMed, Cochrane Library, and Embase to capture all potential randomized controlled trials (RCTs) investigating the comparative efficacy of ATC related to other SBT techniques including pressure support (PS), T-piece, continuous positive airway pressure (CPAP) from their inception to February 2020. Primary outcomes were successful extubation rate. Duration of weaning, intensive care unit (ICU) stay, hospital stay, and hospital mortality was regarded as secondary outcomes. We used a risk ratio with accompanying 95% confidence interval (CI) to express estimates. Reviewer Manager (RevMan) 5.1.0 was used to complete all statistical analyses. Results: We included 13 studies enrolling 1117 patients in the final analysis. Pooled results indicated no significant difference when ATC plus CPAP (ATC/CAPA) compared to PS (6 RCTs; 572 patients; risk ratio [RR], 1.15; 95% confidence interval [CI], 1.00 to 1.31), ATC versus T-piece (2 RCTs; 157 patients; RR, 1.14; 95% CI, 0.93 to 1.40), ATC plus PS (ATC/PS) versus PS alone (1 RCTs; 100 patients; RR, 1.15; 95% CI, 0.98 to 1.35), ATC/CPAP versus CPAP alone (3 RCTs; 247 patients; RR, 1.12; 95% CI, 0.97 to 1.29) in terms of successful extubation. Additionally, ATC was also not superior to PS, T-piece, or CPAP in improving the rate of reintubation, the duration of weaning, ICU stay, hospital stay, and hospital mortality. Conclusions: Compared to alternative SBT techniques including PSV and T-piece, ATC may have comparable predictive power of successful extubation in critically ill patients. However, a definite conclusion on this topic can not be drawn due to limited data. Therefore, further studies were required to establish our findings due to limited number of eligible studies and small accumulated sample size.

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Cadmium excretion predicting hospital mortality and illness severity of critically ill medical patients*

Critical Care Medicine ◽

10.1097/ccm.0b013e318198675c ◽

2009 ◽

Vol 37 (3) ◽

pp. 957-962 ◽

Cited By ~ 10

Author(s):

Ja-Liang Lin ◽

Dan-Tzu Lin-Tan ◽

Pao-Hsien Chu ◽

Yung-Chang Chen ◽

Yen-Lin Huang ◽

...

Keyword(s):

Hospital Mortality ◽

Critically Ill ◽

Illness Severity ◽

Medical Patients

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Evaluation of the role of sex as a prognostic factor in critically ill adults with sepsis: systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-035927 ◽

2020 ◽

Vol 10 (5) ◽

pp. e035927

Author(s):

Jesus Lopez-Alcalde ◽

Alba Antequera Martín ◽

Elena Stallings ◽

Alfonso Muriel ◽

Borja Fernández-Félix ◽

...

Keyword(s):

Systematic Review ◽

Prognostic Factor ◽

Hospital Mortality ◽

Critically Ill ◽

Evaluation System ◽

Scientific Journal ◽

Effect Estimate ◽

Systematic Review Protocol ◽

Review Protocol

IntroductionSepsis is a leading cause of mortality in critically ill patients. Recently, it has been recognised that sex may contribute to a differential risk for developing sepsis and it remains uncertain if the prognosis of sepsis varies between the sexes. The aim of this systematic review is to summarise the available evidence to assess the role of sex as a prognostic factor in patients with sepsis managed in the intensive care unit (ICU).Methods and analysisThis is a systematic review protocol of prognostic studies of sex in patients with sepsis managed in the ICU. The primary outcomes include all-cause hospital mortality and all-cause hospital mortality during the first 28 days. The secondary outcomes include all-cause hospital mortality during the first 7 days and all-cause mortality at 1 year. We will conduct a search strategy based on the population (sepsis), the prognostic factor (sex), the outcome of interest (mortality) and prognostic study methods. We will search in the following databases up to December 2019: MEDLINE Ovid (from 1976), Embase Elsevier (from 1974), Web of Science and two trial registries. We will impose no language restrictions. Two authors will independently screen titles, abstracts and full-text articles for eligibility of studies, and subsequently extract data. Two authors will independently assess the risk of bias of each study using the Quality in Prognostic Studies (QUIPS) tool. If possible, we will carry out a meta-analysis to provide a pooled prognostic effect estimate for each outcome. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the quality of evidence.Ethics and disseminationEthical approval will not be required. Findings from this review will be reported in a peer-reviewed scientific journal. Additionally, the results will be disseminated at conferences and in the mass media.PROSPERO registration numberCRD42019145054.

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Evaluating the Role of the Interleukin-23/17 Axis in Critically Ill COVID-19 Patients

Journal of Personalized Medicine ◽

10.3390/jpm11090891 ◽

2021 ◽

Vol 11 (9) ◽

pp. 891

Author(s):

Edison Jahaj ◽

Alice G. Vassiliou ◽

Chrysi Keskinidou ◽

Parisis Gallos ◽

Charikleia S. Vrettou ◽

...

Keyword(s):

Intensive Care Unit ◽

Septic Shock ◽

Intensive Care ◽

Critical Illness ◽

Critically Ill ◽

Potential Role ◽

Illness Severity ◽

Icu Admission ◽

Interleukin 23

Studies have hypothesized a potential role of the interleukin (IL)-23/17 axis in coronavirus disease 2019 (COVID-19). However, to date, levels of IL-23 and 17 have not been compared between critically ill COVID-19 patients and critically ill non-COVID-19 patients. IL-23 and 17 were measured on admission to the intensive care unit (ICU) in critically ill COVID-19 (N = 38) and critically ill non-COVID-19 (N = 34) patients with an equal critical illness severity. Critically ill non-COVID-19 patients did not have sepsis or septic shock on ICU admission. None of the enrolled patients had previously received corticosteroids. In our study, circulating IL-17 levels were higher in the COVID-19 patients. More specifically, critically ill COVID-19 patients had levels of 0.78 (0.05–1.8) pg/mL compared to 0.11 (0.05–0.9) pg/mL in the critically ill non-COVID-19 patients (p = 0.04). In contrast, IL-23 levels were comparable between groups. A group of patients hospitalized in the specialized COVID-19 clinic (N = 16) was also used to evaluate IL-17 and IL-23 levels with respect to COVID-19 severity. Non-critically ill COVID-19 patients had undetectable levels of both cytokines. Our results support the notion of inhibiting IL-17 in critical COVID-19 infection.

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Faculty Opinions recommendation of Association of hyperchloremia with hospital mortality in critically ill septic patients.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725624314.793508295 ◽

2015 ◽

Author(s):

Taka-aki Nakada

Keyword(s):

Hospital Mortality ◽

Critically Ill

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A systematic review on the role of extremity skin temperature as a non-invasive marker for hypoperfusion in critically ill adults in the intensive care setting

JBI Library of Systematic Reviews ◽

10.11124/jbisrir-2010-685 ◽

2010 ◽

Vol 8 (Supplement) ◽

pp. 1-26

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Skin Temperature ◽

Critically Ill ◽

Care Setting ◽

Intensive Care Setting ◽

Non Invasive ◽

Critically Ill Adults ◽

Ill Adults

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Proton pump inhibitors versus histamine-2 receptor blockers for stress ulcer prophylaxis in patients with sepsis: a retrospective cohort study

Journal of International Medical Research ◽

10.1177/03000605211025130 ◽

2021 ◽

Vol 49 (6) ◽

pp. 030006052110251

Author(s):

Minqiang Huang ◽

Ming Han ◽

Wei Han ◽

Lei Kuang

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Hospital Mortality ◽

Critically Ill ◽

Proton Pump ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Stress Ulcer ◽

Increased Risk ◽

Ulcer Prophylaxis

Objective We aimed to compare the efficacy and risks of proton pump inhibitor (PPI) versus histamine-2 receptor blocker (H2B) use for stress ulcer prophylaxis (SUP) in critically ill patients with sepsis and risk factors for gastrointestinal bleeding (GIB). Methods In this retrospective cohort study, we used the Medical Information Mart for Intensive Care III Clinical Database to identify critically ill adult patients with sepsis who had at least one risk factor for GIB and received either an H2B or PPI for ≥48 hours. Propensity score matching (PSM) was conducted to balance baseline characteristics. The primary outcome was in-hospital mortality. Results After 1:1 PSM, 1056 patients were included in the H2B and PPI groups. The PPI group had higher in-hospital mortality (23.8% vs. 17.5%), GIB (8.9% vs. 1.6%), and pneumonia (49.6% vs. 41.6%) rates than the H2B group. After adjusting for risk factors of GIB and pneumonia, PPI use was associated with a 1.28-times increased risk of in-hospital mortality, 5.89-times increased risk of GIB, and 1.32-times increased risk of pneumonia. Conclusions Among critically ill adult patients with sepsis at risk for GIB, SUP with PPIs was associated with higher in-hospital mortality and higher risk of GIB and pneumonia than H2Bs.

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COVID-19: Up to 82% critically ill patients had low Vitamin C values

Nutrition Journal ◽

10.1186/s12937-021-00727-z ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Teresa Maria Tomasa-Irriguible ◽

Lara Bielsa-Berrocal

Keyword(s):

Vitamin C ◽

Critically Ill ◽

Potential Role ◽

Plasma Vitamin ◽

Single Center ◽

Berlin Definition ◽

Single Center Study ◽

Prevention And Treatment ◽

Center Study

AbstractThere are limited proven therapeutic options for the prevention and treatment of COVID-19. We underwent an observational study with the aim of measure plasma vitamin C levels in a population of critically ill COVID-19 adult patients who met ARDS criteria according to the Berlin definition. This epidemiological study brings to light that up to 82% had low Vitamin C values. Notwithstanding the limitation that this is a single-center study, it nevertheless shows an important issue. Given the potential role of vitamin C in sepsis and ARDS, there is gathering interest of whether supplementation could be beneficial in COVID-19.

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