Hemolysis and Its Clinical Implications in Septic Patients with Acute Respiratory Failure.

: Hemolysis during sepsis may be driven by patient-specific factors, including the intensity of the inflammatory response and the etiology of infection, as well as treatment-related factors, such as the use of extracorporeal life-support devices. : We evaluated the incidence of hemolysis-reflected by decreased plasma levels of haptoglobin and hemopexin-in a cohort of septic patients with acute respiratory failure ( = 50) admitted to the intensive care unit (ICU). : Hemolysis was observed in 60% of patients.

Pregnancy and COVID-19: Comparing ICU Outcomes for Pregnant and Nonpregnant Women.

Background: This study compares organ dysfunction, treatment strategies, and unfavorable outcome rates between pregnant and nonpregnant women admitted to the ICU with severe COVID-19, highlighting the increased susceptibility of pregnant women to respiratory infections due to physiological changes.

Methods: A retrospective, age-matched study was conducted at a referral center specializing in critical care for pregnant women. Data from 14 pregnant/postpartum and 11 nonpregnant women were analyzed at ICU admission and on days 3, 5, and 7.

Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey.

Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals.

Cefiderocol in the Successful Treatment of Complicated Hospital-Acquired K. pneumoniae NDM, OXA48 Intraabdominal Infection.

Background: MDR/XDR constitutes a difficult to treat bacteria in a number of infections as there are few therapeutic options. Promising drugs in such cases can be cefiderocol, aztreonam and ceftazidime/avibactam or meropenem/vaborbactam.

Case Presentation: A 72-year-old female patient with sepsis caused by KP NDM, OXA 48 was admitted to the Intensive Care Unit, immediately after an emergency graftectomy (of a recently transplanted kidney) complicated with bleeding.

Platelet Aggregation Alterations in Patients with Severe Viral Infection Treated at the Intensive Care Unit: Implications for Mortality Risk.

Severe viral infections often result in abnormal platelet function, affecting various stages of hemostasis. Activated platelets are often considered prothrombotic and more susceptible to further stimulation. However, emerging evidence suggests that initial hyperactivation is followed by platelet exhaustion and hypo-responsiveness, affecting platelet degranulation, activation, and aggregation.

Citrulline, Intestinal Fatty Acid-Binding Protein and the Acute Gastrointestinal Injury Score as Predictors of Gastrointestinal Failure in Patients with Sepsis and Septic Shock.

Gastrointestinal (GI) failure can be both a cause of sepsis and a consequence of the systemic pro-inflammatory response in sepsis. Changes in biomarkers of enterocyte damage, citrulline and I-FABP (intestinal fatty acid binding protein), may indicate altered intestinal permeability and damage. The study group consisted of patients with sepsis ( = 28) and septic shock ( = 30); the control group included patients without infection ( = 10).

Inflammasome-related Markers upon ICU Admission do not Correlate with Outcome in Critically Ill COVID-19 Patients.

Purpose: The development of targeted biological therapies for coronavirus disease 2019 (COVID-19) requires reliable biomarkers that could help indicate how patients are responding. The hyperactivation of inflammasomes by the SARS-CoV2 virus is hypothesized to contribute to a more severe course of the COVID-19 disease. Therefore, we aimed to evaluate the prognostic value of several inflammasome-related cytokines and proteins upon admission to the intensive care unit (ICU).

The Rationale and Current Status of Endotoxin Adsorption in the Treatment of Septic Shock.

Lipopolysaccharide, the main component of the outer membrane of Gram-negative bacteria is a highly potent endotoxin responsible for organ dysfunction in sepsis. It is present in the blood stream not only in Gram-negative infections, but also in Gram-positive and fungal infections, presumably due to sepsis-related disruption of the intestinal barrier. Various pathways, both extra- and intracellular, are involved in sensing endotoxin and non-canonical activation of caspase-mediated pyroptosis is considered to have a major role in sepsis pathophysiology.

Influenza in patients with respiratory failure admitted to intensive care units in Poland and the use of extracorporeal respiratory support: a survey-based multicenter study.

Background: In Poland, little is known about the most serious cases of influenza that need admittance to the intensive care unit (ICU), as well as the use of extracorporeal respiratory support.

Methods: This was an electronic survey comprising ICUs in two administrative regions of Poland. The aim of the study was to determine the number of influenza patients with respiratory failure admitted to the ICU in the autumn-winter season of 2018/2019.

Immunosuppression as a Hallmark of Critical COVID-19: Prospective Study.

The dysregulation of both the innate and adaptive responses to SARS-CoV-2 have an impact on the course of COVID-19, and play a role in the clinical outcome of the disease. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subpopulations in 82 patients with COVID-19, including 31 patients with a critical course of the disease. In COVID-19 patients who required hospitalization we analyzed T cell subsets, including Treg cells, as well as TCRα/β and γ/δ, NK cells, and B cells, during the first two weeks after admission to hospital due to the SARS-CoV-2 infection, with marked reductions in leukocytes subpopulations, especially in critically ill COVID-19 patients.

Analysis of management protocols regarding ineffective maintenance of organ functions in patients treated at the Intensive Care Unit of the University Hospital in Wroclaw.

Background: Prolonged support of organ functions without therapeutic benefit represents a serious problem of therapy in intensive care units (ICUs). This kind of treatment, called "futile therapy", prolongs the process of dying and should be avoided. In Poland, the guidelines and protocol defining the best clinical practice for the avoidance of futile therapy in ICUs was published in 2014.

Surveillance of Antibiotic Prescribing in Intensive Care Units in Poland.

Antibiotic use and microbial resistance in health care-associated infections are increasing globally and causing health care problems. Intensive Care Units (ICUs) represent the heaviest antibiotic burden within hospitals, and sepsis is the second noncardiac cause of mortality in ICUs. Optimizing appropriate antibiotic treatment in the management of the critically ill in ICUs became a major challenge for intensivists.

The importance of early detection of endotoxemia.

Endotoxin is considered a key signaling molecule in the pathogenesis of sepsis and septic shock. Anti-endotoxin therapies may result in the improvement of a patient's clinical condition and lower mortality. The pressing clinical challenge is to identify patients for whom endotoxin elimination would be the most beneficial.

Elevated Serum PCT in Septic Shock With Endotoxemia Is Associated With a Higher Mortality Rate.

To examine the effect of endotoxemia on the procalcitonin (PCT) serum levels and mortality rates of adult patients with septic shock diagnosed on the day of admission to the intensive care unit (ICU).A retrospective observational study was performed over a 2-year period. Levels of PCT were compared for septic shock patients with and without endotoxemia on admission to the ICU.

Endotoxin Elimination in Patients with Septic Shock: An Observation Study.

To evaluate the effectiveness of endotoxin elimination with an adsorption column in patients with septic shock and endotoxemia. The elimination therapy was guided by a new bedside method of measuring endotoxin activity (EA). Intensive care unit (ICU) patients with septic shock and suspected Gram-negative infection were consecutively added to the study group within the first 24 h.

Advanced therapeutic methods for the treatment of meningococcal septic shock - case report.

Background: Meningitis caused by Neisseria meningitidis is primarily a disease of children and young adults. If septic shock complicates the course of meningitis, it must be treated in the intensive care unit.

Case Report: An 18 year-old man with symptoms of meningococcal meningitis and clinical features of septic shock was admitted to the ICU.

[Severe acute respiratory distress syndrome complicating type A (H1N1) influenza treated with extracorporeal CO2 removal].

Background: The influenza pandemic of 2009 was reported to be frequently associated with pulmonary complications, including ARDS. We report the case of a morbidly obese, 37-year-old, AH1N1-infected woman, who was admitted to a regional hospital because of rapidly progressing respiratory failure. She was treated successfully with high frequency oscillatory ventilation (HFOV) and low-flow extracorporeal CO2 removal.

[In-hospital medical emergency teams].

A growing number of very sick and hospital-dependent patients in an ageing population, together with a chronic lack of intensive care beds, has resulted in a significant impairment in hospital care. Acute, life-threatening symptoms are frequently missed, leading to increased mortality and morbidity. Many projects have been introduced to improve the situation; among them, the creation of early warning scoring and trigger systems, and organisation of in-hospital medical response and critical care teams.