Sedation-Related Electroencephalographic Patterns in Acute Hypoxemic Respiratory Failure.

Rationale: There is no universal objective measure of the effect of sedation on brain activity and how to differentiate it from sleep. In patients with early acute hypoxemic respiratory failure (AHRF) we used the Odds Ratio Product (ORP), an electroencephalography (EEG)-based metric used to quantify the sleep-wake continuum. Despite patients behaviorally appearing asleep, we observed and quantified novel EEG patterns previously unobserved during natural sleep, and hypothesized these unnatural EEG patterns (EEG Ups ) reflect the effect of sedation.

Response to furosemide and the receipt of kidney replacement therapy in critically ill patients.

Background: The administration of furosemide can predict the likelihood of clinical deterioration in patients with early-stage acute kidney injury (AKI). This study aimed to evaluate the response to a patient's first furosemide bolus administered during ICU admission in critically ill patients, and to assess the significance of this response in predicting the need for kidney replacement therapy (KRT).

Methods: This retrospective cohort study included critically ill adult patients admitted to a tertiary care hospital ICU between 2017 and 2023 who received a first intravenous furosemide bolus with documented urine output.

Frailty at ICU admission: a potential alternative to scoring systems based on clinical observation.

Frailty is a common clinical syndrome associated with increased risks of morbidity, mortality and other adverse outcomes. It is often used by healthcare providers as a tool for estimating patients` condition and triaging for Intensive Care Unit (ICU) admission, as recommended by several national guidelines. This study aimed to evaluate the utility of observed frailty, a subjective clinical assessment by physicians, as an alternative to the validated Clinical Frailty Score (CFS) and Modified Frailty Index (MFI).

Short-Term Reactions to Oliguria in Critically Ill Patients: A Retrospective Cohort Study.

: Oliguria is common in critically ill patients and may indicate impaired kidney perfusion or acute injury, contributing to increased mortality. Effective management is essential to improve outcomes. To assess clinician reactions to oliguria and evaluate the effectiveness of fluid bolus and furosemide interventions.

Outcomes and Prognosis of COVID-19-Induced Adult Respiratory Distress Syndrome Patients Treated with Prolonged Veno-Venous Extracorporeal Membrane Oxygenation: A Retrospective Multicenter Study.

Predicting whether extracorporeal membrane oxygenation (ECMO) treatment duration affects prognosis is important both medically and economically. : We conducted a retrospective, multicenter study to better understand the outcomes of patients treated with veno-venous (VV) ECMO over a prolonged duration, analyzing data from the Israel ECMO registry. The study included all adult patients treated with VV-ECMO due to COVID-19-induced respiratory failure.

Substrate utilization of carbohydrates, fat, and protein in the late acute phase of critically ill surgical patients: A retrospective longitudinal study.

Background And Aims: Tailoring nutrition to measured energy expenditure (EE) and provision of adequate protein amounts, is considered gold standard for critically ill patients. There are currently no recommendations to measure specific substrate utilization or to adapt nutrition accordingly.

Methods: In this retrospective longitudinal study, we analyzed results of 316 simultaneous measurements of indirect calorimetry (IC) and urinary urea nitrogen (UUN) in 191 mechanically ventilated, critically ill patients, admitted to the surgical intensive care unit (SICU) in a tertiary medical center.

Predictive Hypoxemic Threshold for Tolerating the Apnea Test While Assessing Death by Neurological Criteria.

Background: The apnea test (AT) plays a vital role in diagnosing brain death by evaluating the absence of spontaneous respiratory activity. It entails disconnecting the patient from mechanical ventilation to raise the CO partial pressure and lower the pH. Occasionally, the AT is aborted because of safety concerns, such as hypoxemia and hemodynamic instability, to prevent worsening conditions.

Linear Correlation Between Mean Arterial Pressure and Urine Output in Critically Ill Patients.

Objective: Mean arterial pressure (MAP) plays a significant role in regulating tissue perfusion and urine output (UO). The optimal MAP target in critically ill patients remains a subject of debate. We aimed to explore the relationship between MAP and UO.

Cortisol Levels During First Admission Day Are Associated With Clinical Outcomes in Surgical Critically Ill Patients.

Importance: To explore the correlation between cortisol levels during first admission day and clinical outcomes.

Objectives: Although most patients exhibit a surge in cortisol levels in response to stress, some suffer from critical illness-related corticosteroid insufficiency (CIRCI). Literature remains inconclusive as to which of these patients are at greater risk of poor outcomes.

Kinetics of C-reactive protein during extracorporeal membrane oxygenation.

Background: The exposure of blood to the artificial circuit during extracorporeal membrane oxygenation (ECMO) can induce an inflammatory response. C-reactive protein (CRP) is a commonly used biomarker of systemic inflammation.

Methods: In this retrospective observational study, we analyzed results of daily plasma CRP measurements in 110 critically ill patients, treated with ECMO.

Two-hour indirect calorimetry measurement as a predictor of 24-hour energy expenditure in critically ill surgical patients: A longitudinal study.

Background: Measuring energy expenditure (EE) by indirect calorimetry (IC) has become the gold standard tool for critically ill patients to define energy targets and tailor nutrition. Debate remains as to the optimal duration of measurements or the optimal time of day in which to perform IC.

Methods: In this retrospective longitudinal study, we analyzed results of daily continuous IC in 270 mechanically ventilated, critically ill patients admitted to the surgical intensive care unit in a tertiary medical center and compared measurements performed at different hours of the day.

Central catheter tip migration in critically ill patients.

Objectives: Chest X-ray (CXR) is routinely required for assessing Central Venous Catheter (CVC) tip position after insertion, but there is limited data as to the movement of the tip location during hospitalization. We aimed to assess the migration of Central Venous Catheter (CVC) position, as a significant movement of catheter tip location may challenge some of the daily practice after insertion.

Design And Settings: Retrospective, single-center study, conducted in the Intensive Care and Cardiovascular Intensive Care Units in Tel Aviv Sourasky Medical Center 'Ichilov', Israel, between January and June 2019.

Outcomes of prolonged mechanical ventilation in patients who underwent bedside percutaneous dilatation tracheostomy in intermediate care units - A single center study.

Background: The number of chronic critical illness (CCI) patients requiring prolonged mechanical ventilation (PMV) is increasing worldwide, mandating health professionals to discuss interventions while considering disease trajectory. The aim of this study was to analyze the survival of CCI patients who underwent percutaneous dilatational tracheostomy (PDT) within intermediate care units.

Methods: We carried out a retrospective study of all patients who underwent PDT in our intermediate care units from 2009 to 2015.

Outcome and survival following tracheostomy in patients ≥ 85 years old.

Purpose: To evaluate percutaneous dilatational tracheostomy in patients ≥ 85 years old: its complication rate and possible risk factors. In addition, to assess prognostic factors for short, intermediate and long term survival following the procedure.

Methods: A retrospective case-control study of 72 patients ≥ 85 years who received percutaneous dilatation tracheotomy (PTD), compared to a control group of younger patients (n = 182).

Bedside percutaneous dilatational tracheostomy in patients outside the ICU: a single-center experience.

Purpose: To assess the safety of medical-ward bedside percutaneous dilatational tracheostomy (GWB-PDT).

Materials And Methods: A retrospective study of all patients who underwent elective GWB-PDT between 2009 and 2015. A joint otolaryngology-ICU team performed all GWB-PDTs.

Feasibility of a single-stage tracheostomy decannulation protocol with endoscopy in adult patients.

Objectives/hypothesis: Gradual decrease in tube size and tube capping are considered the standard of care for tracheostomy decannulation. Both of these actions result in increased airway resistance. Immediate decannulation may offer a more tolerable approach.