Articles

Ethical considerations about artificial intelligence for prognostication in intensive care

Prognosticating the course of diseases to inform decision-making is a key component of intensive care medicine. For several applications in medicine, new methods from the field of artificial intelligence (AI) ...

Authors: Michael Beil, Ingo Proft, Daniel van Heerden, Sigal Sviri and Peter Vernon van Heerden

Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section

Critical Care Nephrology is an emerging sub-specialty of Critical Care. Despite increasing awareness about the serious impact of acute kidney injury (AKI) and renal replacement therapy (RRT), important knowled...

Authors: M. Ostermann, A. Schneider, T. Rimmele, I. Bobek, M. van Dam, M. Darmon, L. Forni, O. Joannes-Boyau, M. Joannidis, M. Legrand, J. Prowle, A. Zarbock and E. Hoste

Methane and Inflammation - A Review (Fight Fire with Fire)

Mammalian methanogenesis is regarded as an indicator of carbohydrate fermentation by anaerobic gastrointestinal flora. Once generated by microbes or released by a non-bacterial process, methane is generally co...

Authors: Marietta Zita Poles, László Juhász and Mihály Boros

Moderately prolonged permissive hypotension results in reversible metabolic perturbation evaluated by intracerebral microdialysis - an experimental animal study

Damage control resuscitation (DCR) and damage control surgery (DCS) is the main strategy in patients with uncontrollable hemorrhagic shock. One aspect of DCR is permissive hypotension. However, the duration of...

Authors: Rasmus Peter Jakobsen, Troels Halfeld Nielsen, Simon Mølstrøm, Carl-Henrik Nordström, Asger Granfeldt and Palle Toft

Correction to: Impact of intensive care unit supportive care on the physiology of Ebola virus disease in a universally lethal non-human primate model

Please note that four authors (Logan Banadyga, Alixandra Albietz, Brad Pickering, and Gary Wong) have been erroneously omitted from the author list in the published original article [1].

Authors: Guillaume Poliquin, Duane Funk, Shane Jones, Kaylie Tran, Charlene Ranadheera, Mable Hagan, Kevin Tierney, Allen Grolla, Amrinder Dhaliwal, Alexander Bello, Anders Leung, Cory Nakamura, Darwyn Kobasa, Darryl Falzarano, Lauren Garnett, Hugues Fausther Bovendo…

Esmolol for cardioprotection during resuscitation with adrenaline in an ischaemic porcine cardiac arrest model

The effectiveness of adrenaline during resuscitation continues to be debated despite being recommended in international guidelines. There is evidence that the β-adrenergic receptor (AR) effects of adrenaline a...

Authors: Hilde Karlsen, Harald Arne Bergan, Per Steinar Halvorsen, Kjetil Sunde, Eirik Qvigstad, Geir Øystein Andersen, Jan Frederik Bugge and Theresa Mariero Olasveengen

Bench to bedside review: therapeutic modulation of nitric oxide in sepsis—an update

Nitric oxide is a signalling molecule with an extensive range of functions in both health and disease. Discovered in the 1980s through work that earned the Nobel prize, nitric oxide is an essential factor in r...

Authors: Simon Lambden

Needle-free connectors catheter-related bloodstream infections: a prospective randomized controlled trial

In the critically ill, catheter-related bloodstream infection can result from bacterial contamination of infusion hubs of intravascular catheters. Needle-free connectors (NFC) have been suggested to reduce the...

Authors: Michael Koeppen, Franziska Weinert, Sabrina Oehlschlaeger, Andreas Koerner, Peter Rosenberger and Helene Anna Haeberle

Combination of cardiac and thoracic pump theories in rodent cardiopulmonary resuscitation: a new method of three-side chest compression

High-quality cardiopulmonary resuscitation (HQ-CPR) is of paramount importance to improve neurological outcomes of cardiac arrest (CA). The purpose of this study was to evaluate chest compression methods by co...

Authors: Yu Okuma, Koichiro Shinozaki, Tsukasa Yagi, Kota Saeki, Tai Yin, Junhwan Kim and Lance B. Becker

Mechanical power at a glance: a simple surrogate for volume-controlled ventilation

Mechanical power is a summary variable including all the components which can possibly cause VILI (pressures, volume, flow, respiratory rate). Since the complexity of its mathematical computation is one of the...

Authors: Lorenzo Giosa, Mattia Busana, Iacopo Pasticci, Matteo Bonifazi, Matteo Maria Macrì, Federica Romitti, Francesco Vassalli, Davide Chiumello, Michael Quintel, J. J. Marini and Luciano Gattinoni

Increased effort during partial ventilatory support is not associated with lung damage in experimental acute lung injury

An on-going debate exists as to whether partial ventilatory support is lung protective in an acute phase of ARDS. So far, the effects of different respiratory efforts on the development of ventilator-associate...

Authors: Dietrich Henzler, Alf Schmidt, Zhaolin Xu, Nada Ismaiel, Haibo Zhang, Arthur S. Slutsky and Paolo Pelosi

Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury

Dynamic single-slice CT (dCT) is increasingly used to examine the intra-tidal, physiological variation in aeration and lung density in experimental lung injury. The ability of dCT to predict whole-lung values ...

Authors: John N. Cronin, João Batista Borges, Douglas C. Crockett, Andrew D. Farmery, Göran Hedenstierna, Anders Larsson, Minh C. Tran, Luigi Camporota and Federico Formenti

Increased mortality in elderly patients with acute respiratory distress syndrome is not explained by host response

Advanced age is associated with increased mortality in acute respiratory distress syndrome (ARDS) patients. Preclinical studies suggest that the host response to an injurious challenge is age-dependent. In ARD...

Authors: Laura R. A. Schouten, Lieuwe D. J. Bos, A. Serpa Neto, Lonneke A. van Vught, Maryse A. Wiewel, Arie J. Hoogendijk, Marc J. M. Bonten, Olaf L. Cremer, Janneke Horn, Tom van der Poll, Marcus J. Schultz and Roelie M. Wösten-van Asperen

The peripheral blood transcriptome in septic cardiomyopathy: an observational, pilot study

Septic cardiomyopathy (SCM) is common in sepsis and associated with increased morbidity and mortality. Left ventricular global longitudinal strain (LV GLS), measured by speckle tracking echocardiography, allow...

Authors: Meghan M. Cirulis, Sarah J. Beesley, Emily L. Wilson, Chris Stubben, Troy D. Olsen, Eliotte L. Hirshberg, Lane M. Smith, Michael J. Lanspa, Theodore P. Abraham, Colin K. Grissom, Matthew T. Rondina and Samuel M. Brown

ESICM LIVES 2019

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Respiratory and metabolic acidosis correction with the ADVanced Organ Support system

The lung, the kidney, and the liver are major regulators of acid-base balance. Acidosis due to the dysfunction of one or more organs can increase mortality, especially in critically ill patients. Supporting co...

Authors: Aritz Perez Ruiz de Garibay, John A. Kellum, Johannes Honigschnabel and Bernhard Kreymann

Impact of intensive care unit supportive care on the physiology of Ebola virus disease in a universally lethal non-human primate model

There are currently limited data for the use of specific antiviral therapies for the treatment of Ebola virus disease (EVD). While there is anecdotal evidence that supportive care may be effective, there is a ...

Authors: Guillaume Poliquin, Duane Funk, Shane Jones, Kaylie Tran, Charlene Ranadheera, Mable Hagan, Kevin Tierney, Allen Grolla, Amrinder Dhaliwal, Alexander Bello, Anders Leung, Cory Nakamura, Darwyn Kobasa, Darryl Falzarano, Lauren Garnett, Hugues Fausther Bovendo…

Peroxynitrite decomposition catalyst reduces vasopressin requirement in ovine MRSA sepsis

Sepsis is one of the most frequent causes of death in the intensive care unit. Host vascular hypo-responsiveness to vasopressors during septic shock is one of the challenging problems. This study tested the hy...

Authors: Osamu Fujiwara, Satoshi Fukuda, Ernesto Lopez, Yaping Zeng, Yosuke Niimi, Douglas S. DeWitt, David N. Herndon, Donald S. Prough and Perenlei Enkhbaatar

Determining rhythmicity and determinism of temperature curves in septic and non-septic critically ill patients through chronobiological and recurrence quantification analysis: a pilot study

A few studies have demonstrated that critically ill patients exhibit circadian deregulation and reduced complexity of different time series, such as temperature.

Authors: Vasilios E. Papaioannou, Eleni N. Sertaridou, Ioanna G. Chouvarda, George C. Kolios and Ioannis N. Pneumatikos

The impact of the systemic inflammatory response on hepatic bacterial elimination in experimental abdominal sepsis

Bacterial translocation from the gut has been suggested to induce a systemic inflammatory response syndrome (SIRS) and organ dysfunction. The liver has a pivotal role in eliminating circulating bacteria enteri...

Authors: Katja Hanslin, Jan Sjölin, Paul Skorup, Frida Wilske, Robert Frithiof, Anders Larsson, Markus Castegren, Eva Tano and Miklos Lipcsey

Low flow rate alters haemostatic parameters in an ex-vivo extracorporeal membrane oxygenation circuit

Extracorporeal membrane oxygenation (ECMO) is a life-saving modality used to manage cardiopulmonary failure refractory to conventional medical and surgical therapies. Despite advances in ECMO equipment, bleedi...

Authors: Katrina K. Ki, Margaret R. Passmore, Chris H. H. Chan, Maximilian V. Malfertheiner, Jonathon P. Fanning, Mahé Bouquet, Jonathan E. Millar, John F. Fraser and Jacky Y. Suen

Predictive validity of a novel non-invasive estimation of effective shunt fraction in critically ill patients

Accurate measurement of pulmonary oxygenation is important for classification of disease severity and quantification of outcomes in clinical studies. Currently, tension-based methods such as P/F ratio are in w...

Authors: Emma M. Chang, Andrew Bretherick, Gordon B. Drummond and J Kenneth Baillie

Effect of landiolol on sex-related transcriptomic changes in the myocardium during sepsis

The aims of this study are to better understand phenotypic differences between male and female rats during sepsis, to characterise the contribution of the beta1-adrenergic blocker landiolol to septic cardiomyo...

Authors: Thi Thom Tran, Calypso Mathieu, Magali Torres, Béatrice Loriod, Linh Thuy Lê, Catherine Nguyen, Monique Bernard, Marc Leone and Nathalie Lalevée

Ventilator-induced diaphragm dysfunction: translational mechanisms lead to therapeutical alternatives in the critically ill

Mechanical ventilation [MV] is a life-saving technique delivered to critically ill patients incapable of adequately ventilating and/or oxygenating due to respiratory or other disease processes. This necessaril...

Authors: Oscar Peñuelas, Elena Keough, Lucía López-Rodríguez, Demetrio Carriedo, Gesly Gonçalves, Esther Barreiro and José Ángel Lorente

Development of a model for anemia of inflammation that is relevant to critical care

Anemia of inflammation (AI) is common in critically ill patients. Although this syndrome negatively impacts the outcome of critical illness, understanding of its pathophysiology is limited. Also, new therapies...

Authors: Margit Boshuizen, Robin van Bruggen, Sebastian A. Zaat, Marcus J. Schultz, Eli Aguilera, Ana Motos, Tarek Senussi, Francesco Antonio Idone, Paolo Pelosi, Antonio Torres, Gianluigi Li Bassi and Nicole P. Juffermans

Extracorporeal life support and systemic inflammation

Extracorporeal life support (ECLS) encompasses a wide range of extracorporeal modalities that offer short- and intermediate-term mechanical support to the failing heart or lung. Apart from the daily use of car...

Authors: Abdulrahman Al-Fares, Tommaso Pettenuzzo and Lorenzo Del Sorbo

Histopathological changes of organ dysfunction in sepsis

Sepsis is a highly lethal disorder. Organ dysfunction in sepsis is not defined as a clinicopathological entity but rather by changes in clinical, physiological, or biochemical parameters. Pathogenesis and spec...

Authors: Antonio M. Garofalo, Marta Lorente-Ros, Gesly Goncalvez, Demetrio Carriedo, Aída Ballén-Barragán, Ana Villar-Fernández, Óscar Peñuelas, Raquel Herrero, Rosario Granados-Carreño and José A. Lorente

The diagnostic accuracy for ARDS of global versus regional lung ultrasound scores - a post hoc analysis of an observational study in invasively ventilated ICU patients

Semi-quantification of lung aeration by ultrasound helps to assess presence and extent of pulmonary pathologies, including the acute respiratory distress syndrome (ARDS). It is uncertain which lung regions add...

Authors: Luigi Pisani, Veronica Vercesi, Patricia S. I. van Tongeren, Wim K. Lagrand, Stije J. Leopold, Mischa A. M. Huson, Patricia C. Henwood, Andrew Walden, Marry R. Smit, Elisabeth D. Riviello, Paolo Pelosi, Arjen M. Dondorp and Marcus J. Schultz

Patient-ventilator asynchronies during mechanical ventilation: current knowledge and research priorities

Mechanical ventilation is common in critically ill patients. This life-saving treatment can cause complications and is also associated with long-term sequelae. Patient-ventilator asynchronies are frequent but ...

Authors: Candelaria de Haro, Ana Ochagavia, Josefina López-Aguilar, Sol Fernandez-Gonzalo, Guillem Navarra-Ventura, Rudys Magrans, Jaume Montanyà and Lluís Blanch

Use of a high platelet-to-RBC ratio of 2:1 is more effective in correcting trauma-induced coagulopathy than a ratio of 1:1 in a rat multiple trauma transfusion model

Platelet dysfunction importantly contributes to trauma-induced coagulopathy (TIC). Our aim was to examine the impact of transfusing platelets (PLTs) in a 2:1 PLT-to-red blood cell (RBC) ratio versus the standa...

Authors: Derek J. B. Kleinveld, Mathijs R. Wirtz, Daan P. van den Brink, M. Adrie W. Maas, Joris J. T. H. Roelofs, J. Carel Goslings, Markus W. Hollmann and Nicole P. Juffermans

Modulating the distribution and fate of exogenously delivered MSCs to enhance therapeutic potential: knowns and unknowns

Mesenchymal stem/stromal cells (MSCs) are undergoing intensive translational research for several debilitating conditions, including critical illnesses such as ARDS and sepsis. MSCs exert diverse biologic effe...

Authors: Claire H. Masterson, Gerard F. Curley and John G. Laffey

Why translational research matters: proceedings of the third international symposium on acute lung injury translational research (INSPIRES III)

Current treatment of acute respiratory distress syndrome (ARDS) in critically ill patients is limited to supportive measures including mechanical ventilation. It is our view that effective therapies for ARDS c...

Authors: Nicole P. Juffermans, Marcus Schultz, Lieuwe D. Bos, Oscar Penuelas, John Laffey and Jose A. Lorente

The role of hypercapnia in acute respiratory failure

The biological effects and physiological consequences of hypercapnia are increasingly understood. The literature on hypercapnia is confusing, and at times contradictory. On the one hand, it may have protective...

Authors: Luis Morales-Quinteros, Marta Camprubí-Rimblas, Josep Bringué, Lieuwe D. Bos, Marcus J. Schultz and Antonio Artigas

Power to mechanical power to minimize ventilator-induced lung injury?

Mechanical ventilation is a life-supportive therapy, but can also promote damage to pulmonary structures, such as epithelial and endothelial cells and the extracellular matrix, in a process referred to as vent...

Authors: Pedro Leme Silva, Lorenzo Ball, Patricia R. M. Rocco and Paolo Pelosi

Manipulation of the microbiome in critical illness—probiotics as a preventive measure against ventilator-associated pneumonia

To describe the possible modes of action of probiotics and provide a systematic review of the current evidence on the efficacy of probiotics to prevent ventilator-associated pneumonia (VAP) in critically ill p...

Authors: Marel C. E. van Ruissen, Lieuwe D. Bos, Robert P. Dickson, Arjen M. Dondorp, Constance Schultsz and Marcus J. Schultz

Antithrombin plus alpha-1 protease inhibitor does not affect coagulation and inflammation in two murine models of acute lung injury

In acute respiratory distress syndrome (ARDS), uncontrolled production of activators of coagulation and proinflammatory mediators results in a shift from an adequate local innate immune response to hypercoagul...

Authors: Jenny Juschten, Sarah Anne Ingelse, Martinus Adrianus Wilhelmus Maas, Armand Roelof Johan Girbes, Nicole Petra Juffermans, Marcus Josephus Schultz and Pieter Roel Tuinman

Pulmonary complement depositions in autopsy of critically ill patients have no relation with ARDS

The complement system has frequently been suggested to play a role in the pathophysiology of acute respiratory distress syndrome (ARDS). The current study explored the association between pulmonary depositions...

Authors: Friso M. de Beer, Mark P. V. Begieneman, Joris J. T. H. Roelofs, Janneke Horn, Hans W. M. Niessen, Marcus J. Schultz and Wim K. Lagrand

Alveolar dynamics during mechanical ventilation in the healthy and injured lung

Mechanical ventilation is a life-saving therapy in patients with acute respiratory distress syndrome (ARDS). However, mechanical ventilation itself causes severe co-morbidities in that it can trigger ventilato...

Authors: Jana Grune, Arata Tabuchi and Wolfgang M. Kuebler

Sepsis 2019

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Alleviation of exhaustion-induced immunosuppression and sepsis by immune checkpoint blockers sequentially administered with antibiotics—analysis of a new mathematical model

Sepsis-associated immune dysregulation, involving hyper-inflammation and immunosuppression, is common in intensive care patients, often leading to multiple organ dysfunction and death. The aim of this study wa...

Authors: Avi Gillis, Michael Beil, Karin Halevi-Tobias, Peter Vernon van Heerden, Sigal Sviri and Zvia Agur

Response to letter by Drs. Bottinger and van der Hoorn

Authors: David A. Berlin, Seth Manoach and Paul M. Heerdt

Resistin directly inhibits bacterial killing in neutrophils

Sepsis-induced immunosuppression is a key factor contributing to the morbidity and mortality of critically ill patients, and polymorphonuclear neutrophil dysfunction is believed to be a hallmark of this immuno...

Authors: Lauren Miller, Kai Singbartl, Zissis C. Chroneos, Victor Ruiz-Velasco, Charles H. Lang and Anthony Bonavia

Comparison of the source and prognostic utility of cfDNA in trauma and sepsis

Circulating cell-free DNA (cfDNA) may contribute to the pathophysiology of post-injury inflammation and coagulation in trauma. However, the source and mechanism of release of cfDNA in trauma is not well unders...

Authors: Nicholas L. Jackson Chornenki, Robert Coke, Andrew C. Kwong, Dhruva J. Dwivedi, Michael K. Xu, Ellen McDonald, John C. Marshall, Alison E. Fox-Robichaud, Emmanuel Charbonney and Patricia C. Liaw

Early herpes and TTV DNAemia in septic shock patients: a pilot study

Septic shock patients exhibit an increased incidence of viral reactivation. Precise timing of such reactivation—as an early marker of immune suppression, or as a consequence of the later—is not known precisely...

Authors: François Mallet, Magali Perret, Trang Tran, Boris Meunier, Audrey Guichard, Olivier Tabone, Marine Mommert, Karen Brengel-Pesce, Fabienne Venet, Alexandre Pachot, Guillaume Monneret, Frederic Reynier, Christophe Védrine, Philippe Leissner, Virginie Moucadel, Alain Lepape…

Time-controlled adaptive ventilation (TCAV) accelerates simulated mucus clearance via increased expiratory flow rate

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units. Distal airway mucus clearance has been shown to reduce VAP incidence. Studies suggest that mucus clearance...

Authors: Melissa Mahajan, David DiStefano, Joshua Satalin, Penny Andrews, Hassan al-Khalisy, Sarah Baker, Louis A. Gatto, Gary F. Nieman and Nader M. Habashi

Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study

Conduit arteries, especially the aorta, play a major role in ensuring efficient cardiac function and optimal microvascular flow due to their viscoelastic properties. Studies in animals and on isolated arteries...

Authors: Sigita Kazune, Andris Grabovskis, Corrado Cescon, Eva Strike and Indulis Vanags

Adrecizumab, a non-neutralizing anti-adrenomedullin antibody, improves haemodynamics and attenuates myocardial oxidative stress in septic rats

Sepsis still represents a major health issue, with persistent high morbidity and mortality rates. Cardiovascular dysfunction occurs frequently during sepsis. Adrenomedullin has been identified as a key mediato...

Authors: Alice Blet, Benjamin Deniau, Christopher Geven, Malha Sadoune, Anaïs Caillard, Paul-Robert Kounde, Evelyne Polidano, Peter Pickkers, Jane-Lise Samuel and Alexandre Mebazaa

Correction to: Inhalation of specific anti-Pseudomonas aeruginosa IgY antibodies transiently decreases P. aeruginosa colonization of the airway in mechanically ventilated piglets

Following publication of the original article [1], the authors flagged that an incorrect piece of data is given in the Materials and Methods section of the article.

Authors: A. Otterbeck, K. Hanslin, E. Lidberg Lantz, A. Larsson, J. Stålberg and M. Lipcsey

The physiological determinants of near-infrared spectroscopy-derived regional cerebral oxygenation in critically ill adults

To maintain adequate oxygen delivery to tissue, resuscitation of critically ill patients is guided by assessing surrogate markers of perfusion. As there is no direct indicator of cerebral perfusion used in rou...

Authors: Michael D. Wood, Jill A. Jacobson, David M. Maslove, John G. Muscedere and J. Gordon Boyd

Negative pressure ventilation: a special application of expiratory ventilation assistance

Authors: Lena Böttinger and José W. A. van der Hoorn