Articles

Serum cytokines profile of critically ill COVID-19 patients with cardiac dysfunction

Authors: François Bagate, Nicolas Maziers, Sophie Hue, Paul Masi, Armand Mekontso Dessap and Nicolas de Prost

The effects of tidal volume size and driving pressure levels on pulmonary complement activation: an observational study in critically ill patients

Mechanical ventilation can induce or even worsen lung injury, at least in part via overdistension caused by too large volumes or too high pressures. The complement system has been suggested to play a causative...

Authors: Friso M. de Beer, Luuk Wieske, Gerard van Mierlo, Diana Wouters, Sacha Zeerleder, Lieuwe D. Bos, Nicole P. Juffermans, Marcus J. Schultz, Tom van der Poll, Wim K. Lagrand and Janneke Horn

Effect of routine vs on-demand nebulization of acetylcysteine with salbutamol on accumulation of airway secretions in endotracheal tubes: substudy of a randomized clinical trial

Accumulated airway secretions in the endotracheal tube increase work of breathing and may favor airway colonization eventually leading to pneumonia. The aim of this preplanned substudy of the ‘Preventive Nebul...

Authors: Sophia van der Hoeven, Lorenzo Ball, Federico Constantino, David M. van Meenen, Paolo Pelosi, Ludo F. Beenen, Marcus J. Schultz and Frederique Paulus

Comparison of direct and indirect models of early induced acute lung injury

The animal experimental counterpart of human acute respiratory distress syndrome (ARDS) is acute lung injury (ALI). Most models of ALI involve reproducing the clinical risk factors associated with human ARDS, ...

Authors: Laura Chimenti, Luis Morales-Quinteros, Ferranda Puig, Marta Camprubi-Rimblas, Raquel Guillamat-Prats, Maria Nieves Gómez, Jessica Tijero, Lluis Blanch, Gustavo Matute-Bello and Antonio Artigas

The predictive validity for mortality of the driving pressure and the mechanical power of ventilation

Outcome prediction in critically ill patients under invasive ventilation remains extremely challenging. The driving pressure (ΔP) and the mechanical power of ventilation (MP) are associated with patient-center...

Authors: David M. P. van Meenen, Ary Serpa Neto, Frederique Paulus, Coen Merkies, Laura R. Schouten, Lieuwe D. Bos, Janneke Horn, Nicole P. Juffermans, Olaf L. Cremer, Tom van der Poll and Marcus J. Schultz

Continuous external negative pressure improves oxygenation and respiratory mechanics in Experimental Lung Injury in Pigs – A pilot proof-of-concept trial

Continuous external negative pressure (CENP) during positive pressure ventilation can recruit dependent lung regions. We hypothesised that CENP applied regionally to the thorax or the abdomen only, increases t...

Authors: Martin Scharffenberg, Jakob Wittenstein, Moritz Herzog, Sebastian Tauer, Luigi Vivona, Raphael Theilen, Thomas Bluth, Thomas Kiss, Thea Koch, Giuseppe Fiorentino, Marcelo Gama de Abreu and Robert Huhle

Liver–lung interactions in acute respiratory distress syndrome

Patients with liver diseases are at high risk for the development of acute respiratory distress syndrome (ARDS). The liver is an important organ that regulates a complex network of mediators and modulates orga...

Authors: Raquel Herrero, Gema Sánchez, Iris Asensio, Eva López, Antonio Ferruelo, Javier Vaquero, Laura Moreno, Alba de Lorenzo, Rafael Bañares and José A. Lorente

Alkaline phosphatase in pulmonary inflammation—a translational study in ventilated critically ill patients and rats

Alkaline phosphatase (AP), a dephosphorylating enzyme, is involved in various physiological processes and has been shown to have anti-inflammatory effects.

Authors: Jenny Juschten, Sarah A. Ingelse, Lieuwe D. J. Bos, Armand R. J. Girbes, Nicole P. Juffermans, Tom van der Poll, Marcus J. Schultz and Pieter Roel Tuinman

Prognostic classification based on P/F and PEEP in invasively ventilated ICU patients with hypoxemia—insights from the MARS study

Outcome prediction in patients with acute respiratory distress syndrome (ARDS) greatly improves when patients are reclassified based on predefined arterial oxygen partial pressure to fractional inspired oxygen...

Authors: Fabienne D. Simonis, Laura R. A. Schouten, Olaf L. Cremer, David S. Y. Ong, Gabriele Amoruso, Gilda Cinella, Marcus J. Schultz and Lieuwe D. Bos

Therapeutic application of recombinant human ADAMTS-13 improves shock reversal and coagulation status in a trauma hemorrhage and transfusion rat model

In hemorrhaging trauma patients, the endothelium is activated, resulting in excessive endothelial synthesis of von Willebrand Factor (vWF), which may enhance micro-thrombi formation, resulting in obstruction o...

Authors: Mathijs R. Wirtz, Daan P. van den Brink, Joris J. T. H. Roelofs, J. Carel Goslings and Nicole P. Juffermans

Effects of higher PEEP and recruitment manoeuvres on mortality in patients with ARDS: a systematic review, meta-analysis, meta-regression and trial sequential analysis of randomized controlled trials

In patients with acute respiratory distress syndrome (ARDS), lung recruitment could be maximised with the use of recruitment manoeuvres (RM) or applying a positive end-expiratory pressure (PEEP) higher than wh...

Authors: Lorenzo Ball, Ary Serpa Neto, Valeria Trifiletti, Maura Mandelli, Iacopo Firpo, Chiara Robba, Marcelo Gama de Abreu, Marcus J. Schultz, Nicolò Patroniti, Patricia R. M. Rocco and Paolo Pelosi

Impact of downstream effects of glucocorticoid receptor dysfunction on organ function in critical illness-associated systemic inflammation

Glucocorticoids (GCs) are stress hormones that regulate developmental and physiological processes and are among the most potent anti-inflammatory drugs to suppress chronic and acute inflammation. GCs act throu...

Authors: Martin Wepler, Jonathan M. Preuss, Tamara Merz, Oscar McCook, Peter Radermacher, Jan P. Tuckermann and Sabine Vettorazzi

H₂S in acute lung injury: a therapeutic dead end(?)

This review addresses the plausibility of hydrogen sulfide (H₂S) therapy for acute lung injury (ALI) and circulatory shock, by contrasting the promising preclinical results to the present clinical reality. The re...

Authors: Tamara Merz, Nicole Denoix, Martin Wepler, Holger Gäßler, David A. C. Messerer, Clair Hartmann, Thomas Datzmann, Peter Radermacher and Oscar McCook

Fluids in ARDS: more pros than cons

In acute respiratory distress syndrome (ARDS), increased pulmonary vascular permeability makes the lung vulnerable to edema. The use of conservative as compared to liberal fluid strategies may increase the num...

Authors: Renata de S. Mendes, Paolo Pelosi, Marcus J. Schultz, Patricia R. M. Rocco and Pedro L. Silva

Metabolic substrate utilization in stress-induced immune cells

Immune cell activation leads to the acquisition of new functions, such as proliferation, chemotaxis, and cytokine production. These functional changes require continuous metabolic adaption in order to sustain ...

Authors: Xiaomin Zhang, Fabian Zink, Felix Hezel, Josef Vogt, Ulrich Wachter, Martin Wepler, Maurizio Loconte, Christine Kranz, Andreas Hellmann, Boris Mizaikoff, Peter Radermacher and Clair Hartmann

Comparative effects of flow vs. volume-controlled one-lung ventilation on gas exchange and respiratory system mechanics in pigs

Flow-controlled ventilation (FCV) allows expiratory flow control, reducing the collapse of the airways during expiration. The performance of FCV during one-lung ventilation (OLV) under intravascular normo- and...

Authors: Jakob Wittenstein, Martin Scharffenberg, Xi Ran, Diana Keller, Pia Michler, Sebastian Tauer, Raphael Theilen, Thomas Kiss, Thomas Bluth, Thea Koch, Marcelo Gama de Abreu and Robert Huhle

Ischaemic stroke-induced distal organ damage: pathophysiology and new therapeutic strategies

Acute ischaemic stroke is associated with a high risk of non-neurological complications, which include respiratory failure, cardiovascular dysfunction, kidney and liver injury, and altered immune and endocrine...

Authors: Chiara Robba, Denise Battaglini, Cynthia S. Samary, Pedro L. Silva, Lorenzo Ball, Patricia R. M. Rocco and Paolo Pelosi

Extracellular vesicles as regulators of kidney function and disease

Extracellular vesicles (EVs) are small, lipid bilayer-delimited particles of cellular origin that recently gained increasing attention for their potential use as diagnostic biomarkers, and beyond that for thei...

Authors: Felix Behrens, Johannes Holle, Wolfgang M. Kuebler and Szandor Simmons

Role of the adaptive immune response in sepsis

Sepsis is a syndrome of shock and dysfunction of multiple vital organs that is caused by an uncontrolled immune response to infection and has a high mortality rate. There are no therapies for sepsis, and it ha...

Authors: Jack Brady, Shahd Horie and John G. Laffey

Pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest

Post cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of ga...

Authors: Chiara Robba, Dorota Siwicka-Gieroba, Andras Sikter, Denise Battaglini, Wojciech Dąbrowski, Marcus J. Schultz, Evert de Jonge, Chloe Grim, Patricia RM Rocco and Paolo Pelosi

Changes in left ventricular electromechanical relations during targeted hypothermia

Targeted hypothermia, as used after cardiac arrest, increases electrical and mechanical systolic duration. Differences in duration of electrical and mechanical systole are correlated to ventricular arrhythmias...

Authors: Kristin Wisløff-Aase, Viesturs Kerans, Kristina Haugaa, Per Steinar Halvorsen, Helge Skulstad and Andreas Espinoza

ESICM LIVES 2020

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Transcriptional profiling of leukocytes in critically ill COVID19 patients: implications for interferon response and coagulation

COVID19 is caused by the SARS-CoV-2 virus and has been associated with severe inflammation leading to organ dysfunction and mortality. Our aim was to profile the transcriptome in leukocytes from critically ill...

Authors: Sean E. Gill, Claudia C. dos Santos, David B. O’Gorman, David E. Carter, Eric K. Patterson, Marat Slessarev, Claudio Martin, Mark Daley, Michael R. Miller, Gediminas Cepinskas and Douglas D. Fraser

Endotoxemia and circulating bacteriome in severe COVID-19 patients

When severe, COVID-19 shares many clinical features with bacterial sepsis. Yet, secondary bacterial infection is uncommon. However, as epithelium is injured and barrier function is lost, bacterial products ent...

Authors: Phatadon Sirivongrangson, Win Kulvichit, Sunchai Payungporn, Trairak Pisitkun, Ariya Chindamporn, Sadudee Peerapornratana, Prapaporn Pisitkun, Suwalak Chitcharoen, Vorthon Sawaswong, Navaporn Worasilchai, Sarinya Kampunya, Opass Putcharoen, Thammasak Thawitsri, Nophol Leelayuwatanakul, Napplika Kongpolprom, Vorakamol Phoophiboon…

Flow-controlled ventilation during EVLP improves oxygenation and preserves alveolar recruitment

Ex vivo lung perfusion (EVLP) is a widespread accepted platform for preservation and evaluation of donor lungs prior to lung transplantation (LTx). Standard lungs are ventilated using volume-controlled ventila...

Authors: Sofie Ordies, Michaela Orlitova, Tobias Heigl, Annelore Sacreas, Anke Van Herck, Janne Kaes, Berta Saez, Arno Vanstapel, Laurens Ceulemans, Bart M. Vanaudenaerde, Robin Vos, Johny Verschakelen, Geert M. Verleden, Stijn E. Verleden, Dirk E. Van Raemdonck and Arne P. Neyrinck

Autonomic nervous system activity and the risk of nosocomial infection in critically ill patients with brain injury

Nosocomial infection contributes to adverse outcome after brain injury. This study investigates whether autonomic nervous system activity is associated with a decreased host immune response in patients followi...

Authors: Mathijs R. Wirtz, Jiri Moekotte, Kirsten Balvers, Marjolein M. Admiraal, Jean-Francois Pittet, Joe Colombo, Brant M. Wagener, J. Carel Goslings and Nicole Juffermans

SARS-CoV-2 analysis on environmental surfaces collected in an intensive care unit: keeping Ernest Shackleton’s spirit

Intensive care unit workers are at high risk of acquiring COVID-19 infection, especially when performing invasive techniques and certain procedures that generate aerosols (< 5 μm). Therefore, one of the object...

Authors: Dolores Escudero, José Antonio Boga, Javier Fernández, Lorena Forcelledo, Salvador Balboa, Rodrigo Albillos, Iván Astola, Emilio García-Prieto, Marta Elena Álvarez-Argüelles, Gabriel Martín, Josu Jiménez and Fernando Vázquez

Hydrocortisone decreases lethality and inflammatory cytokine and nitric oxide production in rats challenged with B. anthracis cell wall peptidoglycan

Lethal B. anthracis infection produces high proinflammatory peptidoglycan (PGN) burdens in hosts. We investigated whether the lethality and inflammation anthrax PGN can produce are related.

Authors: Yan Li, Xizhong Cui, Joseph Shiloach, Jeffrey Wang, Dante A. Suffredini, Wanying Xu, Wancang Liu, Yvonne Fitz, Junfeng Sun and Peter Q. Eichacker

Does hemofiltration protect the brain after head trauma? An experimental study in rabbits

Traumatic brain injury (TBI) is one of the most frequent and severe neurological diseases. In the last few decades, significant advances have been made in TBI pathophysiology and monitoring, however new treatm...

Authors: Enrique Martinez-Gonzalez, Dolores Garcia-Olmo, Empar Mayordomo-Aranda, Maria Granada-Picazo, Monica Gomez-Juarez and Jeronimo Moreno-Cuesta

Fill the critical care discovery pipeline with ICMx!

Authors: Nicole P. Juffermans and Marcin Osuchowski

Regional venous–arterial CO₂ to arterial–venous O₂ content difference ratio in experimental circulatory shock and hypoxia

Venous–arterial carbon dioxide (CO₂) to arterial–venous oxygen (O₂) content difference ratio (Cv-aCO₂/Ca-vO₂) > 1 is supposed to be both sensitive and specific for anaerobic metabolism. What regional hemodynamic ...

Authors: Thiago Domingos Corrêa, Adriano José Pereira, Jukka Takala and Stephan Mathias Jakob

Veno-venous ECMO as a platform to evaluate lung lavage and surfactant replacement therapy in an animal model of severe ARDS

There are limited therapeutic options directed at the underlying pathological processes in acute respiratory distress syndrome (ARDS). Experimental therapeutic strategies have targeted the protective systems t...

Authors: Robert Qaqish, Yui Watanabe, Marcos Galasso, Cara Summers, A adil Ali, Mamoru Takahashi, Anajara Gazzalle, Mingyao Liu, Shaf Keshavjee, Marcelo Cypel and Lorenzo Del Sorbo

Neuromuscular blocking agents in acute respiratory distress syndrome: updated systematic review and meta-analysis of randomized trials

Existing clinical practice guidelines support the use of neuromuscular blocking agents (NMBA) in acute respiratory distress syndrome (ARDS); however, a recent large randomized clinical trial (RCT) has question...

Authors: Nehal Tarazan, Moayad Alshehri, Sameer Sharif, Zainab Al Duhailib, Morten Hylander Møller, Emilie Belley-Cote, Mohammed Alshahrani, John Centofanti, Lauralyn McIntyre, Bandar Baw, Maureen Meade and Waleed Alhazzani

Electrolyte-based calculation of fluid shifts after infusing 0.9% saline in severe hyperglycemia

Early treatment of severe hyperglycemia involves large shifts of body fluids that entail a risk of hemodynamic instability. We studied the feasibility of applying a new electrolyte equation that estimates the ...

Authors: Robert Svensson, Joachim Zdolsek, Marcus Malm and Robert G. Hahn

Right ventricular stroke volume assessed by pulmonary artery pulse contour analysis

Stroke volume measurement should provide estimates of acute treatment responses. The current pulse contour method estimates left ventricle stroke volume. Heart-lung interactions change right ventricular stroke...

Authors: David Berger, Jan Hobi, Per W. Möller, Matthias Haenggi, Jukka Takala and Stephan M. Jakob

Letter to the Editor: Response to Luke Fletcher and Philip Peyton regarding “Predictive validity of a novel non-invasive estimation of effective shunt fraction in critically ill patients”

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

The endogenous capacity to produce proinflammatory mediators by the ex vivo human perfused lung

The ex vivo human perfused lung model has enabled optimizing donor lungs for transplantation and delineating mechanisms of lung injury. Perfusate and airspace biomarkers are a proxy of the lung response to exp...

Authors: Aleksandra Leligdowicz, James T. Ross, Nicolas Nesseler and Michael A. Matthay

Diagnostic characteristics of 11 formulae for calculating corrected flow time as measured by a wearable Doppler patch

Change of the corrected flow time (Ftc) is a surrogate for tracking stroke volume (SV) in the intensive care unit. Multiple Ftc equations have been proposed; many have not had their diagnostic characteristics ...

Authors: Jon-Émile S. Kenny, Igor Barjaktarevic, David C. Mackenzie, Andrew M. Eibl, Matthew Parrotta, Bradley F. Long and Joseph K. Eibl

The relationship between immune status as measured by stimulated ex-vivo tumour necrosis factor alpha levels and the acquisition of nosocomial infections in critically ill mechanically ventilated patients

Immunological dysfunction is common in critically ill patients but its clinical significance and the optimal method to measure it are unknown. The level of tumor necrosis factor alpha (TNF-α) after ex-vivo who...

Authors: Gabrielle Levin, J. Gordon Boyd, Andrew Day, Miranda Hunt, David M. Maslove, Patrick Norman, Nicole O’Callaghan, Stephanie Sibley and John Muscedere

The conundrum of using hyperoxia in COVID-19 treatment strategies: may intermittent therapeutic hyperoxia play a helpful role in the expression of the surface receptors ACE2 and Furin in lung tissue via triggering of HIF-1α?

Authors: Andreas Koch, Wataru Kähler, Sebastian Klapa, Bente Grams and Pieter- Jan A. M. van Ooij

A mock circulation loop to test extracorporeal CO₂ elimination setups

Extracorporeal carbon dioxide removal (ECCO₂R) is a promising yet limited researched therapy for hypercapnic respiratory failure in acute respiratory distress syndrome and exacerbated chronic obstructive pulmonar...

Authors: Leonie S. Schwärzel, Anna M. Jungmann, Nicole Schmoll, Frederik Seiler, Ralf M. Muellenbach, Joachim Schenk, Quoc Thai Dinh, Robert Bals, Philipp M. Lepper and Albert J. Omlor

Repeated measures of Heparin-binding protein (HBP) and procalcitonin during septic shock: biomarker kinetics and association with cardiovascular organ dysfunction

Heparin-binding protein (HBP) is a neutrophil-derived pro-inflammatory protein, an inducer of endothelial dysfunction and vascular permeability and a promising prognostic biomarker in sepsis. This exploratory ...

Authors: Jonas Tverring, Niklas Nielsen, Josef Dankiewicz, Adam Linder, Fredrik Kahn and Per Åkesson

Intravenous calcium as a pressor in a swine model of hypoxic pseudo-pulseless electrical mechanical activity—a preliminary report

Pseudo-pulseless electrical activity (pseudo-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Pseudo-PEA may const...

Authors: Alexander L. Lindqwister, Joshua W. Lampe, Jeffrey R. Gould, Christopher L. Kaufman, Karen L. Moodie and Norman A. Paradis

Vendor effects on murine gut microbiota and its influence on lipopolysaccharide-induced lung inflammation and Gram-negative pneumonia

The microbiome has emerged as an important player in the pathophysiology of a whole spectrum of diseases that affect the critically ill. We hypothesized that differences in microbiota composition across vendor...

Authors: Nora S. Wolff, Max C. Jacobs, Bastiaan W. Haak, Joris J. T. H. Roelofs, Alex F. de Vos, Floor Hugenholtz and W. Joost Wiersinga

In vivo testing of the low-flow CO₂ removal application of a compact, platform respiratory device

Non-invasive and lung-protective ventilation techniques may improve outcomes for patients with an acute exacerbation of chronic obstructive pulmonary disease or moderate acute respiratory distress syndrome by ...

Authors: Alexandra G. May, Ryan A. Orizondo, Brian J. Frankowski, Sang-Ho Ye, Ergin Kocyildirim, William R. Wagner, Jonathan D’Cunha and William J. Federspiel

Cerebral autoregulation and neurovascular coupling are progressively impaired during septic shock: an experimental study

Alteration of the mechanisms of cerebral blood flow (CBF) regulation might contribute to the pathophysiology of sepsis-associated encephalopathy (SAE). However, previous clinical studies on dynamic cerebral au...

Authors: Lorenzo Ferlini, Fuhong Su, Jacques Creteur, Fabio Silvio Taccone and Nicolas Gaspard

Unloading using Impella CP during profound cardiogenic shock caused by left ventricular failure in a large animal model: impact on the right ventricle

This study aimed to assess right ventricular (RV) function during cardiogenic shock due to acute left ventricular (LV) failure, including during LV unloading with Impella CP and an added moderate dose of norep...

Authors: Jakob Josiassen, Ole Kristian Lerche Helgestad, Nanne Louise Junker Udesen, Ann Banke, Peter Hartmund Frederiksen, Janus Adler Hyldebrandt, Henrik Schmidt, Lisette Okkels Jensen, Christian Hassager, Hanne Berg Ravn and Jacob E. Møller

A functional observational battery for evaluation of neurological outcomes in a rat model of acute bacterial meningitis

Acute bacterial meningitis is a disease with a high mortality and a high incidence of neurological sequelae in survivors. There is an acute need to develop new adjuvant therapies. To ensure that new therapies ...

Authors: Jane Fisher, Chiara Pavan, Luisa S. Ohlmeier, Bo Nilson, Iben Lundgaard, Adam Linder and Peter Bentzer

CytoSorb removes MDMA in vitro, but is it an effective therapy in vivo?

3,4-Methylenedioxymethamphetamine intoxication can result in potentially lethal multi-organ failure, for which the current treatment is largely supportive. Recently, a report of the use of the CytoSorb device ...

Authors: Patrick M. Honore, Sebastien Redant and Thomas Datzmann

The effect of positive end-expiratory pressure on cardiac output and oxygen delivery during cardiopulmonary resuscitation

Positive end-expiratory pressure (PEEP) is used to optimize oxygenation by preventing alveolar collapse. However, PEEP can potentially decrease cardiac output through cardiopulmonary interactions. The effect o...

Authors: Yosef Levenbrown, Md Jobayer Hossain, James P. Keith, Katlyn Burr, Anne Hesek and Thomas Shaffer