Prognostic significance of cytokine dysregulation in critically ill COVID-19 patients.

Background: Understanding the immunopathogenesis of COVID-19 has yielded valuable insights into predicting adverse outcomes-particularly mortality. However, significant gaps persist in our comprehension of the complex interplay among the proposed pathophysiological mechanisms. Here, we aim to investigate the immunological factors associated with mortality in critically ill, unvaccinated COVID-19 patients admitted to the intensive care unit (ICU).

Mixed discipline 'Simulation Integrating Metal and Physical health Learning' (SMIPL): A qualitative study of student experience and learning.

Background/problems: Individuals with comorbid physical and mental health conditions face significant threats to their well-being while placing a substantial burden on healthcare systems through increased service costs. Nursing professionals encounter multiple challenges in delivering effective care to this population. These challenges include a lack of integrated care models, communication barriers among providers, the complexity of addressing dual health needs, insufficient training in comorbidity management, resource and time constraints, and pervasive stigma toward mental illness.

Experience of an advanced practice nurse in an intensive care unit.

The intensive care units structure, the technological improvement and the severity of the patients, require that there be harmony between all the actors involved in assisting the critically ill patient. Added to this context is that the current role of the supervisor involves assuming more and more management skills, without losing sight of the need to frame professional practice within the framework of a philosophy of care. Given this challenge for the supervisor, the appearance in our environment of the Advance Practice Nurse figure (APN) is an opportunity.

Phenomenological Description of the Experiences of Teenagers With Critically Ill Parents.

Background: Critical illness not only threatens the life of the patient but also may profoundly impact the lives of their loved ones. For teenagers with a critically ill parent, these impacts may have significant, developmentally impactful effects. A descriptive understanding of these effects may advance scholarly understanding of the challenges these teenagers face.

Use of AI in Cardiac CT and MRI: A Scientific Statement from the ESCR, EuSoMII, NASCI, SCCT, SCMR, SIIM, and RSNA.

Artificial intelligence (AI) offers promising solutions for many steps of the cardiac imaging workflow, from patient and test selection through image acquisition, reconstruction, and interpretation, extending to prognostication and reporting. Despite the development of many cardiac imaging AI algorithms, AI tools are at various stages of development and face challenges for clinical implementation. This scientific statement, endorsed by several societies in the field, provides an overview of the current landscape and challenges of AI applications in cardiac CT and MRI.

Image reconstruction for compressed ultrafast photography based on manifold learning and the alternating direction method of multipliers.

Compressed ultrafast photography (CUP) is a high-speed imaging technique with a frame rate of up to ten trillion frames per second (fps) and a sequence depth of hundreds of frames. This technique is a powerful tool for investigating ultrafast processes. However, since the reconstruction process is an ill-posed problem, the image reconstruction will be more difficult with the increase of the number of reconstruction frames and the number of pixels of each reconstruction frame.

Blood culture isolates and antimicrobial sensitivities from 1621 critically ill neonatal foals (2005-2022).

Introduction: Sepsis is a leading cause of morbidity and mortality in neonatal foals. Administration of appropriate antimicrobials and early aggressive supportive treatment is central to the efficacious treatment of neonatal sepsis and has proven to positively influence outcomes. The primary aim of our study was to evaluate microorganism results and antimicrobial sensitivities of neonatal foals with a positive blood culture submitted to our intensive care unit (ICU) during 2005-2022.

Choice of resuscitation fluids in critically ill adults: key messages from the European Society of Intensive Care Medicine 2024 clinical practice guideline.

The 2024 European Society of Intensive Care Medicine clinical practice guideline provide clinicians with evidence-based recommendations on intravenous fluid in critically ill adults across a range of common conditions. These guidelines aim to improve the practices of fluid therapy by adopting a global perspective that considers both clinical efficacy and resource utilization in diverse healthcare settings. The guidelines address three key questions: (1) albumin versus crystalloids, (2) balanced crystalloids versus isotonic saline, and (3) small-volume hypertonic solutions versus isotonic crystalloids.

Evaluating the accuracy of impaired skin integrity in critically ill patients: Key characteristics and clinical implications.

Objective: To evaluate the accuracy of the defining characteristics of the nursing diagnosis Impaired skin integrity (00046) in patients admitted to intensive care units (ICUs).

Methods: A cross-sectional diagnostic accuracy study was conducted with 105 adult patients admitted to an ICU. A latent class model with random effects was used to test the sensitivity and specificity of the defining characteristics investigated.

identification through bronchoscope in intensive care unit - a retrospective, databased cohort study.

Introduction: Invasive pulmonary aspergillosis (IPA) increases the risk of mortality of critically ill patients. Diagnostic criteria specifically targeting patients in intensive care units(ICUs) have been developed to improve diagnostic sensitivity. This study investigated health outcomes among patients in ICUs with Aspergillus isolates identified using bronchoscopy.

Outcomes and risk factors of transported patients with extracorporeal membrane oxygenation: An ECMO center experience.

Background: Extracorporeal membrane oxygenation (ECMO) has been proven to be a support method and technology for patients with cardiopulmonary failure. However, the transport of patients under ECMO support is challenging given the high-risk technical maneuvers and patient-care concerns involved. Herein, we examined the safety of ECMO during the transport of critically ill patients and its impact on mortality rates, to provide more secure and effective transport strategies in clinical practice.

New drugs for acute kidney injury.

Acute kidney injury (AKI) presents a significant challenge in the management of critically ill patients, as it is associated with increased mortality, prolonged hospital stays, and increased healthcare costs. In certain conditions, such as during sepsis or after cardiac surgery, AKI is one of the most frequent complications, affecting 30%-50% of patients. Over time, even after the resolution of AKI, it can evolve into chronic kidney disease, a leading global cause of mortality, and cardiovascular complications.

Impact of Biochemical Parameters on Mortality in Critically Ill ICU Patients: The Role of Mechanical Ventilation, Elevated Lactate, Red Blood Cell Distribution Width (RDW-CV) Levels, and Nutrition Risk Screening 2002 (NRS-2002) Score.

Objective: The mortality risk for critically ill patients in the intensive care unit (ICU) can be predicted through clinical assessments and laboratory test results. The accurate utilization of these parameters is essential for timely intervention and the initiation of appropriate therapeutic strategies. This study aims to retrospectively examine the relationship between patients' clinical status at ICU admission, prognostic risk scoring systems, biochemical and hematological parameters, and mortality outcomes.

The Public Mental Health Framework: thinking about law as preventive medicine.

Health, mental health, and well-being are not 'natural' but are shaped by social and environmental factors. This article aims to reorient the development of all laws and policies to do more to prevent mental ill-health and promote well-being as a core function of the contemporary state. It introduces a new conceptual and empirical model, the Public Mental Health Framework, based on three areas of research: (i) the social determinants of health and mental health, which include social structures and daily living conditions (such as poverty, inequality, education, employment, discrimination, adverse childhood experiences, and crime); (ii) health and human rights; and (iii) the intermediate social model of disability.

Race and Ethnicity, Neighborhood Social Deprivation and Medicare Home Health Agency Quality for Persons Living With Serious Illness.

Objective: Examine the relationship between race and ethnicity and area-level social deprivation and Medicare home health care (HHC) agency quality for seriously ill older adults receiving HHC.

Methods: A linear probability fixed effects model analyzed the association between patient-level predictors and HHC agency quality (star-rating), controlling for neighborhood level fixed effects. Linear mixed regression modeled the relationship between area-level social deprivation and receiving care from a high-quality HHC agency.

Unraveling the Mystery: COVID-19 and Diabetic Complications - A Journey from Pathophysiology to Treatment.

The connection between COVID-19 and DM unveils a multifaceted interplay that significantly impacts disease severity and management strategies. Initial studies reveal that people with DM had higher severity rates of COVID-19 due to the infection by SARS-CoV-2. The virus solely induces hyperglycemia and, at the same time, profoundly influences the immune and inflammatory reactions, increasing the rate of severe complications and death among diabetes patients.

Intensive care nurses' experiences of teamwork during the covid-19 pandemic. a qualitative study.

Background: Teamwork is a core competence for all health care professionals and quality of care is a vital outcome. The pandemic backdrop of 2020-2022 led to initial chaos and adaptation of the nurses' roles and responsibilities in the intensive care unit. Therefore, the purpose was to describe the intensive care nurses' experiences of working in teams during the Covid-19 pandemic and discussing the results through the lens of transitiontheory.

Efficacy and safety of an algorithm using C-reactive protein to guide antibiotic therapy applied through a digital clinical decision support system: a study protocol for a randomised controlled clinical trial.

Introduction: The escalating resistance of microorganisms to antimicrobials poses a significant public health threat. Strategies that use biomarkers to guide antimicrobial therapy-most notably Procalcitonin (PCT) and C-reactive protein (CRP)-show promise in safely reducing patient antibiotic exposure. While CRP is less studied, it offers advantages such as lower cost and broader availability compared with PCT.

Intensive care unit acquired weakness and physical rehabilitation in the ICU.

Approximately half of critically ill adults experience intensive care unit acquired weakness (ICUAW). Patients who develop ICUAW may have negative outcomes, including longer duration of mechanical ventilation, greater length of stay, and worse mobility, physical functioning, quality of life, and mortality. Early physical rehabilitation interventions have potential for improving ICUAW; however, randomized trials show inconsistent findings on the efficacy of these interventions.

Association of glycemic variability with short and long-term mortality among critically ill patients with heart failure: Analysis of the MIMIC-IV database.

Objective: High glycemic variability (GV) often indicates a poor prognosis. Our aim is to investigate the relationship between GV and short and long-term mortality in critically ill heart failure (HF) patients.

Methods: We extracted data from the Medical Information Mart for Intensive Care IV database.

Translating PK-PD principles into improved methodology for clinical trials which compare intermittent with prolonged infusion of beta-lactam antibiotics.

Based on the fact that beta-lactam antibiotics demonstrate time-dependent killing, different dosing strategies have been implemented to increase the time that free (f) (unbound) antibiotic concentrations remain above the Minimal Inhibitory Concentration (MIC), including prolonged and continuous infusion. Multiple studies have been performed that compared continuous with traditional intermittent infusion to improve outcomes in patients with severe sepsis and/or septic shock. These studies have yielded inconsistent results for patients as measured by clinical response to treatment and mortality due to heterogeneity of included patients, pathogens, dosing strategies and the absence of Therapeutic Drug Monitoring (TDM).

Therapeutic drug monitoring versus Bayesian AUC-based dosing for vancomycin in routine practice: a cost-benefit analysis.

Background: AUC-based dosing with validated Bayesian software is recommended as a good approach to guide bedside vancomycin dosing.

Objectives: To compare treatment and vancomycin-associated acute kidney injury (AKI) costs between Bayesian AUC-based dosing and conventional therapeutic drug monitoring (TDM) using steady-state plasma concentrations of vancomycin administered as continuous infusion in hospitalized non-critically ill patients with severe Gram-positive infection.

Methods: A cost-benefit analysis presented as a return on investment (ROI) analysis from a hospital perspective was conducted using a decision tree model (TDM versus AUC-based dosing) to simulate treatment cost (personnel, serum sampling and drug cost), vancomycin-associated AKI risk and cost up to 14 days.

Analyzing and mitigating the risks of patient harm during operating room to intensive care unit patient handoffs.

Patients continue to suffer from preventable harm and uneven quality outcomes. Reliable clinical outcomes depend on the quality of robust administrative systems and reliable support processes. Critically ill patient handoffs from the operating room (OR) to the intensive care unit (ICU) are known to be high-risk events.

Effects of early palliative care intervention on medical resource use among end-of-life patients.

Background: In Taiwan, as the population ages, palliative care services (PCS) have expanded significantly to include comprehensive benefit plans for critically ill individuals, supported by reimbursements from the National Health Insurance program. However, incorporating palliative care into the medical management of these patients presents several challenges. We aim to evaluate the effects of palliative care interventions on medical resources in end-of-life scenarios, to promote earlier palliative care access and provide high-quality healthcare services for patients.

Gut microbiota and its impact on critical illness.

Purpose Of Review: This narrative review discusses the mechanisms connecting gut dysbiosis to adverse clinical outcomes in critically ill patients and explores potential therapeutic strategies.

Recent Findings: In recent years, the study of microbiota in ICUs has gained attention because of its potential effects on patient outcomes. Critically ill patients often face severe conditions, which can compromise their immune systems and lead to opportunistic infections from bacteria typically harmless to healthy individuals.