Free and total cortisol levels are useful prognostic markers in critically ill patients: a prospective observational study

ObjectiveThe role of cortisol in the prediction of mortality risk in critical illness is controversial in the literature. The aim of this study was to evaluate the prognostic value of cortisol concentrations in a mixed population of critically ill patients in medical emergencies.DesignIn this prospective, observational study, measurement of total (TC) and free cortisol (FC) levels was made in the serum samples of 69 critically ill patients (39 males and 30 females, median age of 74 years) at admission (0 h) and 6, 24, 48, and 96 h after admission.MethodsCortisol levels were determined using HPLC coupled high-resolution ESI-TOF mass spectrometry. The severity of disease was calculated by prognostic scores. Statistical analyses were performed using the SPSS 22.0 software.ResultsThe range of TC varied between 49.9 and 8797.8 nmol/l, FC between 0.4 and 759.9 nmol/l. The levels of FC at 0, 6, 24, and 48 h and TC at 0, 6 h were significantly elevated in non-survivors and correlated with the predicted mortality. The prognostic value of these cortisol levels was comparable with the routinely used mortality scores. In predictive models, FC at 6, 24, and 48 h proved to be an independent determinant of mortality.ConclusionsThe predictive values of FC in the first 2 days after admission and TC within 6 h are comparable with the complex, routinely used mortality scores in evaluating the prognosis of critically ill patients. The cortisol response probably reflects the severity of disease.

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Prognostic Value of Prolonged Feeding Intolerance in Predicting All‐Cause Mortality in Critically Ill Patients: A Multicenter, Prospective, Observational Study

Journal of Parenteral and Enteral Nutrition ◽

10.1002/jpen.1693 ◽

2019 ◽

Vol 44 (5) ◽

pp. 855-865 ◽

Cited By ~ 2

Author(s):

Bangchuan Hu ◽

Renhua Sun ◽

Aiping Wu ◽

Yin Ni ◽

Jingquan Liu ◽

...

Keyword(s):

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Prognostic Value ◽

Prospective Observational Study ◽

Feeding Intolerance ◽

All Cause Mortality ◽

Multicenter Prospective Observational Study ◽

Prolonged Feeding

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Levels of Protein C and Soluble Thrombomodulin in Critically Ill Patients with Acute Kidney Injury: A Multicenter Prospective Observational Study

PLoS ONE ◽

10.1371/journal.pone.0120770 ◽

2015 ◽

Vol 10 (3) ◽

pp. e0120770 ◽

Cited By ~ 9

Author(s):

Josée Bouchard ◽

Rakesh Malhotra ◽

Shamik Shah ◽

Yu-Ting Kao ◽

Florin Vaida ◽

...

Keyword(s):

Acute Kidney Injury ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Protein C ◽

Prospective Observational Study ◽

Kidney Injury ◽

Soluble Thrombomodulin ◽

Multicenter Prospective Observational Study

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Relationship of energy and protein adequacy with 60-day mortality in mechanically ventilated critically ill patients: A prospective observational study

Clinical Nutrition ◽

10.1016/j.clnu.2017.05.013 ◽

2018 ◽

Vol 37 (4) ◽

pp. 1264-1270 ◽

Cited By ~ 16

Author(s):

Zheng-Yii Lee ◽

Ibrahim Noor Airini ◽

Mohd-Yusof Barakatun-Nisak

Keyword(s):

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Mechanically Ventilated ◽

Relationship Of

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Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study

Critical Care ◽

10.1186/cc8963 ◽

2010 ◽

Vol 14 (2) ◽

pp. R64 ◽

Cited By ~ 77

Author(s):

Michael Fischer ◽

Stephan Rüegg ◽

Adam Czaplinski ◽

Monika Strohmeier ◽

Angelika Lehmann ◽

...

Keyword(s):

Observational Study ◽

Glasgow Coma Scale ◽

Critically Ill ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Rater Reliability ◽

Coma Scale

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Prevalence and risk factors for venous thromboembolic events in critically ill patients with SARS-CoV-2 infection: a prospective observational study

Minerva Anestesiologica ◽

10.23736/s0375-9393.21.15510-5 ◽

2021 ◽

Author(s):

Alessandro F. CHIESA ◽

Marco PREVISDOMINI ◽

Elisa VALENTI ◽

Elisa STOIRA ◽

Hans STRICKER ◽

...

Keyword(s):

Risk Factors ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Thromboembolic Events ◽

Venous Thromboembolic Events ◽

Venous Thromboembolic

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Relation between fluid balance and incidence of morbidity and mortality rates in critically ill patients prospective observational study

QJM ◽

10.1093/qjmed/hcaa039.002 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M G A Gerges ◽

H M M Elazzazi ◽

M H S A Elsersi ◽

S A R Mustafa ◽

M A Saeed

Keyword(s):

Mechanical Ventilation ◽

Observational Study ◽

Critically Ill ◽

Fluid Balance ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Mortality Rates ◽

Morbidity And Mortality ◽

University Hospitals ◽

Cumulative Fluid Balance

Abstract Background While administration of fluid can be lifesaving, it has been suggested that the fluid accumulation after initial resuscitation and hemodynamic stabilization can contribute to potentially avoidable adverse effects and less favorable outcomes. Objective The aim of this study is to assess whether positive fluid balance in comparison with negative or even fluid balance is associated with increased morbidity and mortality rates in critically ill patients. Patients and Methods This prospective observational study was performed on 145 Patients older than 18 years admitted to intensive care units at Helwan university hospitals and Ain shams university hospitals during the period from November 2017 till May 2018. Results A total of 145 patients with an ICU mortality rate of 14.5% were enrolled. The median cumulative fluid balance of the 124 patients who survive was -110 ml (IQR -2.1-2.2 L) after the fourth day following randomization while the median cumulative fluid balance of the 21 patients who not survive was 3800 ml (IQR 1.7-5.2 L) after the fourth day in ICU. In our study critically ill patients with fluid balance more than 1.2 litres per day had higher ICU complications: increased risk of AKI, longer ICU and hospital stays, and mechanical ventilation, and fluid balance was independently associated with mortality. Conclusion In the view of this study, we concluded that:Zero fluid balance and negative fluid balance independently associated with decrease mortality and morbidity rates in critically ill patients after 4 days from admission in ICU.There was higher cumulative fluid balance in non survivors compared to survivors. Cumulative fluid balance after 4 days from admission was independently predictive of mortality in a heterogeneous group of critically ill patients.96 hour negative fluid balance in critically ill patients was associated with less length of stay at ICU and less mechanical ventilation duration.Positive fluid balance, mechanical ventilation, vasopressors, and high admission SAPS II, SOFA, APACHE II and KIDGO were significantly associated with high mortality.

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Predictors of post-extubation stridor in patients on mechanical ventilation: a prospective observational study

Scientific Reports ◽

10.1038/s41598-021-99501-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Aiko Tanaka ◽

Akinori Uchiyama ◽

Yu Horiguchi ◽

Ryota Higeno ◽

Ryota Sakaguchi ◽

...

Keyword(s):

Mechanical Ventilation ◽

Observational Study ◽

Critically Ill ◽

Critically Ill Patients ◽

Prospective Observational Study ◽

Spontaneous Breathing Trial ◽

Leak Test ◽

Endotracheal Suctioning ◽

Cuff Leak ◽

The Impact

AbstractThe cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.

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