The Potential Predictive Role of Oxidative Stress and Antioxidant Parameters Regarding Mortality and the Type of Causative Agent in Sepsis.

Oxidative stress represents an imbalance between oxidants and antioxidants, with a predominance of oxidants leading to cellular and tissue damage. Given the limited number of studies showing the predictive value of oxidative stress factors regarding sepsis type, the objectives of this study emerged as follows: to determine whether pro-oxidant and antioxidant values could predictively differentiate between Gram-positive (GP) and Gram-negative (GN) sepsis. Additionally, the study sought to assess whether bacterial type impacts treatment outcomes in sepsis patients.

Do dynamic changes in haematological and biochemical parameters predict mortality in critically ill COVID-19 patients?

Background: Critically ill COVID-19 patients are usually subjected to clinical, laboratory, and radiological diagnostic procedures resulting in numerous findings. Utilizing these findings as indicators for disease progression or outcome prediction is particularly intriguing.

Objectives: Exploring the significance of dynamic changes in haematological and biochemical parameters in predicting the mortality of critically ill COVID-19 patients.

Thrombocytopenia risks in ARDS COVID-19 patients treated with high-dose linezolid during vvECMO therapy: an observational study.

Patients treated with ECMO are at great risk of nosocomial infections, and around 10% of isolates are gram-positive pathogens. Linezolid (LZD) is effective in the treatment of these infections but appropriate dosing is challenging. The aim was to evaluate the occurrence of thrombocytopenia during ECMO when treated with LZD.

Does adjunctive hemoadsorption provide benefit in the management of ischemia-reperfusion syndrome following near-drowning? A case report.

Drowning remains a significant global health concern, claiming over 300,000 lives annually, with a disproportionate impact on young individuals in low-and middle-income countries. Conventional mechanical ventilation, while common, falls short in addressing the hypoxemia and hypercapnia often observed in severe near-drowning cases. Veno-venous extracorporeal membrane oxygenation (vvECMO) emerges as a critical intervention for cardiopulmonary failure post-drowning.

Population Pharmacokinetic Model of Linezolid and Probability of Target Attainment in Patients with COVID-19-Associated Acute Respiratory Distress Syndrome on Veno-Venous Extracorporeal Membrane Oxygenation-A Step toward Correct Dosing.

During veno-venous extracorporeal membrane oxygenation (vv ECMO) therapy, antimicrobial drugs are frequently used, and appropriate dosing is challenging due to there being limited data to support the dosage. Linezolid is effective against multidrug-resistant Gram-positive pathogens frequently isolated in ECMO patients. In total, 53 steady-state linezolid levels were obtained following 600 mg intravenous (IV) injections every 8 h, and these were used to develop a population pharmacokinetic (PopPK) model in patients with COVID-19-associated acute respiratory distress syndrome (CARDS) on vv ECMO.

Post VV-ECMO Weaning Hyperinflammation-Can Prophylactic Hemoadsorption Treatment Prevent Complications?

Acute respiratory distress syndrome (ARDS) is a severe clinical condition characterized by acute respiratory failure and a high mortality risk despite conventional mechanical ventilatory support. Veno-venous extracorporeal membrane oxygenation (vvECMO) has emerged as an effective life-support technology for patients with ARDS. However, complications may arise following the decannulation of vvECMO, with a relatively frequent development of systemic hyperinflammation (SHI).

Boosting ICU capacity during the COVID-19 pandemic in the western Balkan region, The Republic of Srpska experience.

Background: Response to the outbreak of poliomyelitis in mid-1950 led to recognition and consequent development of critical care. Seventy years later the humankind was struck by COVID-19, another major challenge for critical care medicine which was especially big in Low-Resources-Settings where more than two thirds of the world population live, including the population of the Republic of Srpska (RS).

Design And Methods: The main aim was to show an overview of all interventions in order to boost hospitals' capacities to the level which is sufficient to manage high amount of critically ill COVID-19 patients in the RS.

Does the Prolonged Duration of Continuous Ambulatory Peritoneal Dialysis Affect the Serum Levels of Endothelin-1 and Nitric Oxide?

End-stage renal disease and its treatment with continuous ambulatory peritoneal dialysis (CAPD) can affect almost all organs and organ systems including vascular endothelium. Consequently, disturbance in the production of vasoactive substances endothelin-1 (ET-1) and nitric oxide (NO) occurs in these patients. There are only a small number of studies that investigated the impact of long-term CAPD on imbalance in production of vasoactive substances ET-1 and NO among these patients.

Characteristics and Outcomes of Critically Ill Pregnant/Postpartum Women with COVID-19 Pneumonia in Western Balkans, The Republic of Srpska Report.

: Coronavirus disease 2019 (COVID-19) is a novel infectious disease that has spread worldwide. As of 5 March 2020, the COVID-19 pandemic has resulted in approximately 111,767 cases and 6338 deaths in the Republic of Srpska and 375,554 cases and 15,718 deaths in Bosnia and Herzegovina. Our objective in the present study was to determine the characteristics and outcomes of critically ill pregnant/postpartum women with COVID-19 in the Republic of Srpska.

Dynamic changes in coagulation, hematological and biochemical parameters as predictors of mortality in critically ill COVID-19 patients: A prospective observational study.

Introduction: This study was created to analyze dynamic alterations in coagulation, hematological and biochemical parameters and their association with mortality of COVID-19 patients. To identify the most sensitive biomarkers as predictors of mortality more research is required.

Methods: The present study was a prospective, one-year-long observational study conducted on all critically ill, COVID-19 patients with respiratory failure.

Impact of prolonged duration of different types of renal replacement therapies on serum levels of endothelin-1 and pulmonary function tests.

Introduction: This study was carried out to investigate the impact of duration of different renal replacement therapies such as hemodialysis and continuous ambulatory peritoneal dialysis on potential overproduction of endothelin-1 (ET-1) and pulmonary function tests in these patients.

Materials And Methods: The study included 26 patients (14 males, mean age 54.9±16.

Successful Outcomes of Critically Ill Patients with Extreme Metabolic Acidosis Treated with Structured Approach: Case Series.

Introduction: Hydrogen ion concentration which is expressed as pH value is in human blood maintained in narrow physiological range (7.36-7.44 in arterial blood).

Use of CytoSorb® as a therapeutic option in a critically ill patient with acute respiratory distress syndrome caused by influenza A (H1N1) pneumonia: A case report.

Acute respiratory distress syndrome is an acute inflammatory lung process, which leads to protein-rich nonhydrostatic pulmonary edema, refractory hypoxemia, and lung "stiffness". There are a number of therapies that are currently being investigated in the treatment of sepsis; one of the most promising treatment options at this moment is cytokine removal by hemoperfusion (CytoSorb). We present the case of a 29-year-old male patient who was admitted to the Medical Intensive Care Unit in a state of multiple organ dysfunction and massive bilateral pneumonia caused by influenza type A.

Impact of Checklist for Early Recognition and Treatment of Acute Illness on Treatment of Critically Ill Septic Patients in a Low-Resource Medical Intensive Care Unit.

Treatment of sepsis and septic shock can be a challenge even for intensive care units (ICUs) in high income countries, but it is especially difficult for ICUs with limited resources. To evaluate the impact of CERTAIN on treatment of critically ill septic patients in low-resource medical ICU. In a before-and-after study design, we compared clinical outcomes, processes, and complications (hospital acquired infections) 1 year before and 2 years after (2016 and 2017) introduction of CERTAIN.

Characteristics and outcomes of critically ill patients with influenza A (H1N1) in the Western Balkans during the 2019 post-pandemic season.

Background: This study looked at the characteristics and outcomes of critically ill patients with confirmed influenza A (H1N1) pdm09 infection in the Western Balkans in the post-pandemic period.

Materials And Methods: This retrospective observational study of medical records and associated data collected during the post-pandemic period included all mechanically ventilated adult patients of two university-affiliated hospitals of the Western Balkans between 1 January and 31 March 2019 who had influenza A (H1N1) pdm09 infection confirmed by real-time reverse transcriptase-polymerase chain reaction from nasopharyngeal swab specimens and respiratory secretions.

Results: The study included 89 patients, 49 males (55.

Serum levels of nitric oxide and endothelin-1 in vasculopathy managed with hyperbaric oxygen therapy.

Roles of nitric oxide (NO) and endothelin-1 (ET-1) in the local regulation of blood flow under physiological conditions are important and well known, while data on their effects and interactions in conditions of hyperbaric hyperoxia is still insufficient. This was a prospective observational study which included patients who underwent hyperbaric oxygen therapy (HBOT) in accordance with existing therapeutic protocol for peripherial arterial disease (PAD) during time period of six months, between january and july of 2016. Clinical stage of PAD according to Fontain was taken into account, as well as risk factors, demographic, anthropometric and clinical characteristics of studied patients.

Population pharmacokinetic model of Vancomycin based on therapeutic drug monitoring data in critically ill septic patients.

Purpose: The present study aimed to establish a population pharmacokinetic model of vancomycin, including adult critically ill septic patients, with normal and impaired renal function.

Materials And Methods: A prospective analysis of 146 concentrations from 73 adult critically ill septic patients treated with 1-h intravenous infusion of vancomycin were included in the study. A nonlinear mixed effects modeling (NONMEM) approach was applied for data analysis and evaluation of the final model.

An Alternative Approach to Treatment of Hypophosphatemia in Nonsurgical Critically Ill Patients in Countries With Limited Resources.

Background: Hypophosphatemia can complicate and prolong the treatment of critically ill patients, and it is even thought to be related to mortality rate.

Objectives: The aim of this study is to determine whether using extemporary prepared phosphate buffer in pharmacy would help correct serum phosphate in critically ill patients.

Methods: A prospective study was conducted at the medical intensive care unit over a period of 1 year and included 50 patients who were diagnosed with hypophosphatemia.

The Effect of Hypoalbuminemia on the Therapeutic Concentration and Dosage of Vancomycin in Critically Ill Septic Patients in Low-Resource Countries.

Purpose: To determine whether severe hypoalbuminemia (<25 mg/L) has a significant effect on serum levels of vancomycin and whether it can effect vancomycin dosage regimen and the loading dose administration.

Material And Methods: Prospective, cohort, and a single-center study included 61 patients whose vancomycin serum levels were measured in steady state. Vancomycin trough levels ( ) that were in the range 15 to 20 µg/mL were considered therapeutic and trough levels higher than 15 µg/mL were considered potentially nephrotoxic.

Impact of weekly case-based tele-education on quality of care in a limited resource medical intensive care unit.

Background: Limited critical care subspecialty training and experience is available in many low- and middle-income countries, creating barriers to the delivery of evidence-based critical care. We hypothesized that a structured tele-education critical care program using case-based learning and ICU management principles is an efficient method for knowledge translation and quality improvement in this setting.

Methods And Interventions: Weekly 45-min case-based tele-education rounds were conducted in the recently established medical intensive care unit (MICU) in Banja Luka, Bosnia and Herzegovina.

Microorganisms Profile and Antibiotics Sensitivity Patterns in the Only Medical Intensive Care Unit in Bosnia and Herzegovina.

Treatment of critically ill patients entails a great risk for intrahospital infections. Systematic monitoring of intrahospital infection data is a widely used practice in developed countries, while in developing and underdeveloped countries these data are scarce. In Bosnia and Herzegovina, a developing country, precise data cannot be found; hence, this study was created with the aim to monitor the profile and resistance patterns of microorganisms isolated from patients being treated in the only medical intensive care unit (MICU) in the country.

Ventriculitis Caused by Multidrug-Resistant Bacteria in a Medical Intensive Care Unit with Limited Resources.

The widespread use of various devices in the diagnosis or treatment of critically ill neurological patients has led to the more frequent appearance of a new group of meningitis and ventriculitis caused by resistant Gram-negative bacteria or staphylococci. In literature, it has been labeled as health care-associated meningitis and ventriculitis. In our clinical practice (in resource-limited countries), we still have any viable experience neither in the application of these diagnostic and therapeutic tools nor in the handling of complications resulting from their use.