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All Topic Review Biography
Topic Review
Adjunctive Hemoadsorption Therapy with CytoSorb in Septic/Vasoplegic Shock
There are no approved therapies to modulate the excessive immune response and limit hyperinflammation with the goal of preventing related organ failure and death. In this context, extracorporeal blood purification therapies aiming at the alteration of the host inflammatory response through broad-spectrum, non-selective removal of inflammatory mediators have come into focus. A novel hemoadsorption device (CytoSorb®, CytoSorbents Inc., Princeton, NJ, USA) has shown promising results in patients with hyperinflammation from various origins. Although a significant body of literature exists, there is ongoing research to address many important remaining questions, including the optimal selection of patient groups who might benefit the most, optimal timing for therapy initiation, optimal schedule for adsorber exchanges and therapy duration, as well as an investigation into the potential removal of concomitant antibiotics and other medications. 
  • 180
  • 04 Dec 2023
Topic Review
Adults Supplemental Parenteral Nutrition at End of Life
“End of life” is a stage defined by the existence of an irreversible prognosis that ends with a person’s death. One of the aspects of interest regarding end of life focuses on parenteral nutrition, which is usually administered in order to avoid malnutrition and associated complications.
  • 155
  • 20 Feb 2024
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. 
  • 375
  • 20 Dec 2022
Topic Review
Angiotensin Converting Enzyme II
Angiotensin converting enzyme II (ACE2), a type I transmembrane mono-carboxypeptidase of renin angiotensin system (RAS), in involved in conversion of angiotensin I (Ang I) and angiotensin II (Ang II) to angiotensin (1-9) and angiotensin (1-7), respectively. This enzyme, as the receptor of SARS-CoV-2, plays a crucial role in the virus entrance into the host cells. The docking of the S protein to this receptor, eventually leads to the fusion of the virus membrane with the host cell plasma membrane to release the viral genome into the cell cytoplasm.
  • 692
  • 16 May 2023
Topic Review
Antibiotic Therapy of Sepsis Stewardship
The main recent change observed in the field of critical patient infection has been the universal awareness of the need to make better use of antimicrobials, especially in the most seriously ill patients, beyond the application of simple formulas and rigid protocols. The greatest challenge, therefore, of decision making in this context lies in determining an effective, optimal, and balanced empirical antibiotic treatment. This is sepsis stewardship.
  • 174
  • 07 Feb 2024
Topic Review
Anticoagulation Strategies in Patients with Extracorporeal Membrane Oxygenation
The use of extracorporeal membrane oxygenation (ECMO) has recently increased exponentially. ECMO has become the preferred mode of organ support in refractory respiratory or circulatory failure. The fragile balance of haemostasis physiology is massively altered by the patient’s critical condition and specifically the aetiology of the underlying disease. Furthermore, an application of ECMO conveys another disturbance of haemostasis due to blood-circuit interaction and the presence of an oxygenator. 
  • 178
  • 06 Oct 2023
Topic Review
Antiviral Drugs against COVID-19
Several FDA-approved available antiviral drugs, alone or in combination, have been screened clinically for their extended use since the early phase of the current pandemic to find a safe and effective treatment option against COVID-19, and many clinical trials of these antiviral drugs are still ongoing. However, an in-depth understanding is required from current clinical literature reports to execute integrated approaches between computational and experimental methods to guarantee high success rates of repositioned drugs. Moreover, multiple challenges associated with repurposed drugs have been identified, including dose adjustments, route of administration, acute/chronic toxicity, appropriate delivery systems, etc..
  • 731
  • 27 Sep 2021
Topic Review
Artificial Intelligence in the Intensive Care Unit
The development of artificial intelligence (AI) allows for the construction of technologies capable of implementing functions that represent the human mind, senses, and problem-solving skills, leading to automation, rapid data analysis, and acceleration of tasks. These solutions has been initially implemented in medical fields relying on image analysis; however, technological development and interdisciplinary collaboration allows for the introduction of AI-based enhancements to further medical specialties. During the COVID-19 pandemic, novel technologies established on big data analysis experienced a rapid expansion. Yet, despite the possibilities of advancements with these AI technologies, there are number of shortcomings that need to be resolved to assert the highest and the safest level of performance, especially in the setting of the intensive care unit (ICU). Within the ICU, numerous factors and data affect clinical decision making and work management that could be managed by AI-based technologies. Early detection of a patient’s deterioration, identification of unknown prognostic parameters, or even improvement of work organization are a few of many areas where patients and medical personnel can benefit from solutions developed with AI.
  • 211
  • 05 Jun 2023
Topic Review
Basic Signs and Complete Lung Ultrasound Examination
Lung ultrasound (LUS) has become a part of the daily examination of physicians working in intensive, sub-intensive, and general medical wards. The easy access to hand-held ultrasound machines in wards where they were not available in the past facilitated the widespread use of ultrasound, both for clinical examination and as a guide to procedures. The integration of bedside ultrasonography in the daily clinical activity of intensivists could reduce the risk of radiation exposure, need of patient transport, and hospital costs and may redirect patient’s management. A qualitative LUS approach is based on interpreting artifacts (A- and B-lines) and real images to distinguish between normal and pathological context. If a qualitative approach gives important information on the morphological assessment of the lung for the diagnosis, a quantitative approach allows us to extend the utility of the examination to lung monitoring.
  • 249
  • 30 May 2023
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. 
  • 512
  • 30 Aug 2022
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