Impact of Shenfu injection on a composite of organ dysfunction development in critically ill patients with coronavirus disease 2019 (COVID-19): A structured summary of a study protocol for a randomized controlled trial.

Objectives: This study aims to determine the protection provided by Shenfu injection (a traditional Chinese medicine) against development of organ dysfunction in critically ill patients with coronavirus disease 2019 (COVID-19).

Trial Design: This study is a multicenter, randomized, controlled, open-label, two-arm ratio 1:1, parallel group clinical trial.

Participants: The patients, who are aged from 18 to 75 years old, with a confirmed or suspected diagnosis of severe or critical COVID-19, will be consecutively recruited in the study, according to the guideline on diagnosis and treatment of COVID-19 (the 7 version) issued by National Health Commission of the People's Republic of China.

International-focused Online Forum: A Good Way to Jointly Manage the COVID-19 Pandemic for Global Critical Care Community.

Xiao-Bo H, Poonyathawon S, Semedi BP, Xiao-Yi Z, Wei F, Da-Wei W, International-focused Online Forum: A Good Way to Jointly Manage the COVID-19 Pandemic for Global Critical Care Community. Indian J Crit Care Med 2020;24(4):283-284.

Normal saline for intravenous fluid therapy in critically ill patients.

The efficacy and safety of normal saline (NS) for fluid therapy in critically ill patients remain controversy. In this review, we summarized the evidence of randomized controlled trials (RCTs) which compared NS with other solutions in critically ill patients. The results showed that when compared with 6% hydroxyethyl starch (HES), NS may reduce the onset of acute kidney injury (AKI).

Early fluid loading for septic patients: Any safety limit needed?

Early adequate fluid loading was the corner stone of hemodynamic optimization for sepsis and septic shock. Meanwhile, recent recommended protocol for fluid resuscitation was increasingly debated on hemodynamic stability vs risk of overloading. In recent publications, it was found that a priority was often given to hemodynamic stability rather than organ function alternation in the early fluid resuscitation of sepsis.

Sources of Heterogeneity in Trials Reporting Hydroxyethyl Starch 130/0.4 or 0.42 Associated Excess Mortality in Septic Patients: A Systematic Review and Meta-regression.

Background: This meta-analysis was to determine the association of the cumulative dose of 130/0.4 or 0.42 (hydroxyethyl starch [HES] 130/0.

Extensive variability in vasoactive agent therapy: a nationwide survey in Chinese intensive care units.

Background: Inconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies. A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings.

Methods: A nationwide survey of physicians was conducted from August 17 to December 30, 2012.

Factors associated with low adherence to head-of-bed elevation during mechanical ventilation in Chinese intensive care units.

Background: Elevating the head of bed (HOB) 30° - 45° has been widely supported as a means of ventilator associated pneumonia (VAP) prevention. However, it was poorly adhered in clinical practice. This observational study aimed to investigate the factors impeding this simple practice at the bedside.

[The relationship of ultrastructure and function of hypothalamus-pituitary-adrenal axis in early stage of sepsis in rats].

Objective: To observe the changes in ultrastructure and function of hypothalamic-pituitary-adrenal axis (HPAA), and to approach the relationship between them in early stage of sepsis in rats.

Methods: Thirty male Sprague-Dawley (SD) rats were randomly divided into normal control group, sham group, sepsis group. The sepsis model was reproduced by cecal ligation and puncture (CLP).

[Effect of endothelial nitric oxide synthase gene polymorphisms upon disease severity and outcome in septic patients].

Objective: To investigate the association of eNOS 894G-->T, -786T-->C gene polymorphisms with disease severity and outcome in septic patients.

Methods: A total of 117 patients with severe sepsis were randomly selected from ICUs at 9 academic hospitals in Beijing during April 2007 to May 2009. PCR-RFLP and PCR-SSCP were used to analyze the alleles and genotypes in eNOS 894G-->T and -786T--> C gene polymorphisms.

[Clinical investigation on the compliance and the validity of ventilator bundle].

Objective: To investigate the compliance of ventilator bundle implementation and its preventive effect on ventilator associated pneumonia (VAP).

Methods: A before and after design was used in this single center study. Patients aged from 18 to 80 years, with mechanical ventilation (MV) duration over 48 hours were recruited during 1 year before (control group) and 2 years after bundle implementation (intervention group).

[Relationship between severity of illness and mental status in ICU conscious patients: a nationwide multi-center clinical study].

Objective: To survey the incidence of psychological adverse events in critical conscious patients during their ICU stay and analyze the relationship between the incidence and the severity of illness.

Methods: 234 conscious patients, 133 males and 101 females, aged (55.4 +/- 19.

[Epidemiology of unpleasant experiences in conscious critically ill patients during intensive care unit stay].

Objective: To survey the incidences of psychological and physiological unpleasant experiences in conscious critically ill patients during their intensive care unit (ICU) stay, and investigate the inducing factors.

Methods: A two-month consecutive nationwide investigation was prospectively performed in 31 academic hospital ICUs. An in-person questionnaire interview to each conscious patient was performed by specific trained staff from RMC-ROMIT Healthcare Consulting Company within 2 days after the patient was transferred from ICU.

[Midazolam attenuates mental stress in conscious patients during cardiopulmonary resuscitation performed next bed in intensive care unit].

Objective: To evaluate the mental stress level and alterations in circulatory physiology in conscious patients during cardiopulmonary resuscitation (CPR) performed next bed in intensive care unit (ICU), and to investigate the possible effective interventions.

Methods: Eighty-seven conscious patients, selected consecutively from June 2003 to September 2006, were randomly allocated into control group (received normal saline), psychological nursing group (received psychological nursing intervention) or sedation group (received midazolam 0.1 mg/kg intravenous injection based on psychological nursing intervention) when CPR was performed in our ICU.

[Prospective, multi-center investigation on safety of critical patients in intensive care units].

Objective: To perform a prospective, multi-center investigation of the incidence and causes of medical errors happened in intensive care unit (ICU).

Methods: This investigation was performed in eight ICUs in level A, grade 3 teaching hospitals from October 23 to December 23, 2006. One attending physician and the head nurse in each center were entrusted with the responsibility for this project.

[Comparison of reliability of bispectral index and sedation-agitation scale in assessing the depth of sedation in patients treated with mechanical ventilation].

Objective: To compare the reliability of bispectral index (BIS) with sedation agitation scale (SAS) in assessing the depth of sedation in ill patients on mechanical ventilation in intensive care unit (ICU).

Methods: Fifteen patients, aged 18-65 years old, who were receiving mechanical ventilation in ICU for longer than 72 hours and without brain dysfunction, were enrolled in this study. Sedatives and analgesics were suspended at 7:00 am.

[Study on safety of apnea test in clinical determination of brain death].

Objective: To determine the occurrence of severe complications such as hypotension, pulmonary artery hypertension as well as hypercapnia during apnea test in the affirmation of brain death and to investigate the possible effective prophylactic interventions.

Methods: Conventional apnea test was performed in 15 clinically suspected brain death patients. Stable circulation was achieved by adjusting preload only (n=4) or combined with titrating norepinephrine (NE, n=11).

[Association of different alleles in interleukin-1 family genes with the coded cytokines production and outcome of sepsis].

Objective: To investigate the association of alleles in interleukin-1(IL-1) family genes with IL-1alpha, IL-1beta, IL-1ra production as well as mRNA expression and the outcome of sepsis.

Methods: Sixty septic patients and equal number of healthy volunteers were enrolled in this study. Monocytes of healthy volunteers segregated by Ficoll were stimulated by lipopolysaccharide (LPS) in vitro.