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Topic Review
Electrical Impedance Tomography
Electrical Impedance Tomography (EIT) is a non-invasive bedside imaging technique that provides real-time lung ventilation information on critically ill patients. EIT can potentially become a valuable tool for optimising mechanical ventilation, especially in patients with acute respiratory distress syndrome (ARDS).
  • 1.2K
  • 27 Oct 2023
Topic Review
Mechanisms of Carbapenem Resistance
Carbapenem antibiotics are the most effective antimicrobials for the treatment of infections caused by the most resistant bacteria. They belong to the category of β-lactams that include the penicillins, cephalosporins, monobactams and carbapenems. This class of antimicrobials has a broader spectrum of activity than most other beta-lactams antibiotics and are the most effective against Gram-positive and Gram-negative bacteria. All β-lactams antibiotics have a similar molecular structure: the carbapenems together with the β-lactams. 
  • 1.2K
  • 13 Apr 2022
Topic Review
Iron Deficiency and Anemia Diagnostics
Anemia, iron deficiency and other hematinic deficiencies are a major cause of perioperative transfusion needs and are associated with increased morbidity and mortality. Anemia can be caused either by decreased production of hemoglobin or red blood cells or by increased consumption and blood loss. Decreased production can involve anything from erythropoietin or vitamin B12 insufficiency to absolute or functional lack of iron. 
  • 1.2K
  • 14 Oct 2021
Topic Review
COVID-19-Related Acute Respiratory Distress Syndrome
Lower respiratory tract invasion by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) results in widespread damage of type II alveolar and pulmonary capillary endothelial cells, disruption of the alveolar-capillary barrier, activation of coagulation, and diffuse thrombogenesis amplified by recruited monocytes and neutrophils and concurrent hypofibrinolysis. These pathobiological mechanisms are associated with a distinct form of acute respiratory distress syndrome (ARDS), characterized by relatively high lung compliance, progressively worsening hypoxemia, low potential for lung recruitment, hyperperfusion of nonaerated lung tissue, and diffuse small-vessel thrombosis.
  • 1.1K
  • 14 Oct 2022
Topic Review
ML Application in ICU (MIMIC_Database)
Modern Intensive Care Units (ICUs) provide continuous monitoring of critically ill patients susceptible to many complications affecting morbidity and mortality. ICU settings require a high staff-to-patient ratio and generates a sheer volume of data. For clinicians, the real-time interpretation of data and decision-making is a challenging task. Machine Learning (ML) techniques in ICUs are making headway in the early detection of high-risk events due to increased processing power and freely available datasets such as the Medical Information Mart for Intensive Care (MIMIC). We conducted a systematic literature review to evaluate the effectiveness of applying ML in the ICU settings using the MIMIC dataset. A total of 322 articles were reviewed and a quantitative descriptive analysis was performed on 61 qualified articles that applied ML techniques in ICU settings using MIMIC data. We assembled the qualified articles to provide insights into the areas of application, clinical variables used, and treatment outcomes that can pave the way for further adoption of this promising technology and possible use in routine clinical decision-making.
  • 1.1K
  • 22 Mar 2021
Topic Review
Extracorporeal Cytokine Removal
Cytokine removal can attenuate dysregulated immune response caused vasoplegia, leading to quicker hemodynamic stabilization and shock reversal. The most frequently used criteria to define shock reversal include normalization of serum lactate (<2.2 mmol/L) coupled with a significant (≥90%) reduction in norepinephrine dose requirements. The current paper has summarized the available data, which indicate the important contribution of early hemoadsorption in achieving rapid hemodynamic stabilization in patients with refractory vasoplegic shock.
  • 1.1K
  • 07 Jul 2021
Topic Review
Prone Positioning and COVID-19-Related Acute Respiratory Distress
The prone position is a non-invasive technique resulting from the mobilization of the patient, where the person is lying horizontally face down. This technique has been used since the 1970s, but it has gained great relevance in the last year owing to the COVID-19 pandemic with the use of invasive mechanical ventilation.
  • 1.1K
  • 15 Nov 2021
Topic Review
Endocrine Challenges with Continuous-Flow LVADs
Heart failure (HF) remains a leading cause of morbidity, hospitalization, and mortality worldwide. Advancement of mechanical circulatory support technology has led to the use of continuous-flow left ventricular assist devices (LVADs), reducing hospitalizations, and improving quality of life and outcomes in advanced HF. Recent studies have highlighted how metabolic and endocrine dysfunction may be a consequence of, or associated with, HF, and may represent a novel (still neglected) therapeutic target in the treatment of HF. On the other hand, it is not clear whether LVAD support, may impact the outcome by also improving organ perfusion as well as improving the neuro-hormonal state of the patients, reducing the endocrine dysfunction. Moreover, endocrine function is likely a major determinant of human homeostasis, and is a key issue in the recovery from critical illness. Care of the endocrine function may contribute to improving cardiac contractility, immune function, as well as infection control, and rehabilitation during and after a LVAD placement.
  • 1.1K
  • 02 Jul 2021
Topic Review
Advanced and Invasive Cardiopulmonary Resuscitation Techniques
Despite numerous promising innovations, the chance of survival from sudden cardiac arrest has remained virtually unchanged. Technological advances have been made, user-friendly portable devices have been developed, and advanced invasive procedures have been described that could improve this unsatisfactory situation. Technical aids, such as feedback systems or automated mechanical cardiopulmonary resuscitation (CPR) devices, can improve chest compression quality. The latter, as well as extracorporeal CPR, might serve as a bridge to treatment (with extracorporeal CPR even as a bridge to recovery). Sonography may be used to improve thoracic compressions on the one hand and to rule out potentially reversible causes of cardiac arrest on the other. Resuscitative endovascular balloon occlusion of the aorta might enhance myocardial and cerebral perfusion. Minithoracostomy, pericardiocentesis, or clamshell thoracotomy might resolve reversible causes of cardiac arrest. 
  • 1.1K
  • 20 Dec 2022
Topic Review
Treatment Advances in Sepsis and Septic Shock
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection, and it affects over 25 million people every year. Even more severe, septic shock is a subset of sepsis defined by persistent hypotension, and hospital mortality rates are higher than 40%. As new pathophysiological mechanisms have been uncovered, immunostimulatory therapy has emerged as a promising path forward. Highly investigated treatment strategies include cytokines and growth factors, immune checkpoint inhibitors, and even cellular therapies.
  • 1.1K
  • 04 May 2023
Topic Review
Zinc Functions
Zinc is a structural component of proteins, functions as a catalytic co-factor in DNA synthesis and transcription of hundreds of enzymes, and has a regulatory role in protein–DNA interactions of zinc-finger proteins.
  • 1.1K
  • 15 Nov 2023
Topic Review
Blood Stream Infections
Blood Stream Infections (BSIs) are defined by positive blood culture or cultures (with an isolate of the same species grown in at least one blood culture bottle) in a patient with systemic signs of infection (i.e., a patient who has evidence of one or more of the symptoms or signs, which are fever (body temperature > 38 °C), hypothermia (body temperature < 36 °C), chills, hypotension, oliguria, or high lactate levels).
  • 1.1K
  • 23 Nov 2021
Topic Review
Thyroid Storm Complicated with Myocardial Involvement and Shock
Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The myocardial involvement in terms of injury, dysrhythmia, cardiomyopathy, failure, and cardiogenic shock (CS) during TS and the modalities of treatment and their efficiency, including pharmacological, mechanical, and surgical options are explored.
  • 1.0K
  • 27 Sep 2023
Topic Review
Consequence of Alveolar Hyperoxia and Systemic Hyperoxaemia
Acute hypoxic respiratory failure (AHRF) is a prominent feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) critical illness. The need for a high FiO2 to normalise arterial hypoxemia and tissue hypoxia can result in alveolar hyperoxia. This in turn can lead to local alveolar oxidative stress with associated inflammation, alveolar epithelial cell apoptosis, surfactant dysfunction, pulmonary vascular abnormalities, resorption atelectasis, and impairment of innate immunity predisposing to secondary bacterial infections. While oxygen is a life-saving treatment, alveolar hyperoxia may exacerbate pre-existing lung injury.
  • 1.0K
  • 20 Nov 2023
Topic Review
TAVIs
The first TAVI was performed by Alain Cribier in an inoperable patient in 2002, and since that moment, transcatheter valve intervention has become an optimal alternative therapy to SAVR for patients with AS. TAVI was introduced in 2004 to treat comorbid patients at high surgical risk, avoiding cardiac arrest and cardiopulmonary bypass while reducing surgical trauma. During the subsequent years, modern transcatheter heart valves (THVs) have become more efficient, and the outcomes of TAVI have constantly improved.
  • 1.0K
  • 06 Sep 2021
Topic Review
Big Data in Laboratory Medicine
Laboratory medicine is a digital science. Every large hospital produces a wealth of data each day—from simple numerical results from, e.g., sodium measurements to highly complex output of “-omics” analyses, as well as quality control results and metadata. Processing, connecting, storing, and ordering extensive parts of these individual data requires Big Data techniques. Whereas novel technologies such as artificial intelligence and machine learning have exciting application for the augmentation of laboratory medicine, the Big Data concept remains fundamental for any sophisticated data analysis in large databases. To make laboratory medicine data optimally usable for clinical and research purposes, they need to be FAIR: findable, accessible, interoperable, and reusable. This can be achieved, for example, by automated recording, connection of devices, efficient ETL (Extract, Transform, Load) processes, careful data governance, and modern data security solutions. Enriched with clinical data, laboratory medicine data allow a gain in pathophysiological insights, can improve patient care, or can be used to develop reference intervals for diagnostic purposes. 
  • 1.0K
  • 30 Aug 2022
Topic Review
Prolonged Mechanical Ventilation: Outcomes and Management
Prolonged mechanical ventilation (PMV) is defined as successful extubation after more than three spontaneous breathing trials or taking more than 14 days. The pathophysiology of PMV includes the presence of an abnormal respiratory drive or ventilator-induced diaphragm dysfunction. Numerous studies have demonstrated that ventilator-induced diaphragm dysfunction is related to increases in in-hospital deaths, nosocomial pneumonia, oxidative stress, lung tissue hypoxia, ventilator dependence, and costs.
  • 1.0K
  • 24 Jun 2022
Topic Review
Peripheral Nerve Blocks of the Chest Wall
Pectoralis nerve blocks, serratus anterior plane blocks, erector spinae plane blocks, paravertebral blocks, and parasternal blocks can provide valuable supplements in the portfolio of multi-modal analgesic approaches in chest wall pain. While the indication spectrum and covered areas for some of these blocks might overlap, the feasibility and, thereby, the choice of one of these blocks might differ according to the specifics of the concrete ICU patient.
  • 992
  • 20 Feb 2024
Topic Review
Multi-Drug Resistance Bacterial Infections
It is known that bacterial infections represent a common complication during viral respiratory tract infections such as influenza, with a concomitant increase in morbidity and mortality. Nevertheless, the prevalence of bacterial co-infections and secondary infections in critically ill patients affected by coronavirus disease 2019 (COVID-19) is not well understood yet. We performed a review of the literature currently available to examine the incidence of bacterial secondary infections acquired during hospital stay and the risk factors associated with multidrug resistance.
  • 989
  • 30 Aug 2021
Topic Review
Neuromuscular Ultrasound in Intensive Care Unit-Acquired Weakness
Intensive care unit-acquired weakness (ICUAW) is one of the most common causes of muscle atrophy and functional disability in critically ill intensive care patients. Clinical examination, manual muscle strength testing and monitoring are frequently hampered by sedation, delirium and cognitive impairment. Ultrasound is a broadly accepted, non-invasive, bedside-accessible diagnostic tool and well established in various clinical applications. Hereby, neuromuscular ultrasound (NMUS), in particular, has been proven to be of significant diagnostic value in many different neuromuscular diseases. In ICUAW, NMUS has been shown to detect and monitor alterations of muscles and nerves, and might help to predict patient outcome.
  • 952
  • 22 May 2023
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