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Noninvasive respiratory support following extubation in critically ill adults with obesity: a systematic review and network meta-analysis.

EClinicalMedicine

January 2025

Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, CEDEX 5, France.

Background: Patients with obesity are at high-risk of extubation failure. Discrepancies were found in the results of recent randomized controlled trials (RCTs) regarding the roles of noninvasive ventilation (NIV), high flow nasal cannula (HFNC) and conventional oxygen therapy (COT) to prevent extubation failure in critically ill patients with obesity.

Methods: In this systematic review and network meta-analysis, we searched MEDLINE, Cochrane Center Register of Controlled Trials and Web of Science from 1 January 1998 to 1 July 2024 for RCTs evaluating noninvasive respiratory support therapies (NIV, HFNC, COT, NIV + HFNC) after extubation in critically ill adults with obesity.

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Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.

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Background: Clinically amyopathic dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis often linked with the presence of autoantibodies targeting melanoma differentiation-associated protein 5 (MDA5). Patients with CADM are at increased risk of developing rapidly progressing interstitial lung disease, which significantly increases both morbidity and mortality compared to other forms of inflammatory myopathies. While there is no standardized treatment regimen, current therapeutic strategies are generally focused on combination immunosuppressive therapies.

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Background For The Study: This study looks into the relationship between febrile seizures in children between the ages of 6 months to 5 years who suffer from iron insufficiency. Febrile seizures, which are common in early life, are associated with abrupt temperature increases, and iron deficiency impacts neurological development in young infants. Understanding this relationship would lead to interventions that mitigate febrile seizure impact.

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The tightly-regulated spatial and temporal distribution of zinc ion concentrations within cellular compartments is controlled by two groups of Zn transporters: the 14-member ZIP/SLC39 family, facilitating Zn influx into the cytoplasm from the extracellular space or intracellular organelles; and the 10-member ZnT/SLC30 family, mobilizing Zn in the opposite direction. Genetic aberrations in most zinc transporters cause human syndromes. Notably, previous studies demonstrated osteopenia and male-specific cardiac death in mice lacking the ZnT5/ zinc transporter, and suggested association of two homozygous frameshift variants with perinatal mortality in humans, due to hydrops fetalis and hypertrophic cardiomyopathy.

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