Plasma endostatin and its association with new-onset acute kidney injury in critical care.

Background: Endostatin is a promising biomarker for predicting acute kidney injury (AKI) and mortality in the intensive care unit (ICU). We investigated plasma endostatin levels at ICU admission as predictors of new-onset AKI within 48 h after ICU admission, renal replacement therapy (RRT) within 7 days after ICU admission, and 30-day mortality.

Methods: A retrospective multicentre study was performed with admissions to four ICUs.

Plasma endostatin at intensive care admission is independently associated with acute kidney injury, dialysis, and mortality in COVID-19.

Background: Critical COVID-19 is associated with high mortality, and acute kidney injury (AKI) is common. Endostatin has emerged as a promising prognostic biomarker for predicting AKI and mortality in intensive care. This study aimed to investigate plasma endostatin at intensive care unit (ICU) admission as a biomarker for AKI, renal replacement therapy (RRT), and 90-day mortality in COVID-19.

Exploring the impact of age on the predictive power of the National Early Warning score (NEWS) 2, and long-term prognosis among patients reviewed by a Rapid Response Team: A prospective, multi-centre study.

Aim: To explore the impact of age on the discriminative ability of the National Early Warning Score (NEWS) 2 in prediction of unanticipated Intensive Care Unit (ICU) admission, in-hospital cardiac arrest (IHCA) and mortality within 24 hours of Rapid Response Team (RRT) review. Furthermore, to investigate 30- and 90-day mortality, and the discriminative ability of NEWS 2 in prediction of long-term mortality among RRT-reviewed patients.

Methods: Prospective, multi-centre study based on 830 complete cases.

Prolonged Fatigue and Mental Health Challenges in Critical COVID-19 Survivors.

The aim of this study was to investigate the development of fatigue and mental illness between 3 and 12 months after critical COVID-19 and explore risk factors for long-lasting symptoms. A prospective, multicenter COVID-19 study in southern Sweden, including adult patients (≥18 years) with rtPCR-confirmed COVID-19 requiring intensive care. Survivors were invited to a follow-up at 3 and 12 months, where patient-reported symptoms were assessed using the Modified Fatigue Impact Scale (MFIS), the Hospital Anxiety and Depression Scale (HADS) and the Posttraumatic Stress Disorder Checklist version 5 (PCL-5).

Increasing plasma calprotectin (S100A8/A9) is associated with 12-month mortality and unfavourable functional outcome in critically ill COVID-19 patients.

Background: Calprotectin (S100A8/A9) is a pro-inflammatory mediator primarily released from neutrophils. Previous studies have revealed associations between plasma calprotectin, disease severity and in-hospital mortality in unselected COVID-19 patients.

Objective: We aimed to assess whether plasma calprotectin dynamics during the first week of intensive care are associated with mortality and functional outcome in critically ill COVID-19 patients.

[The Swecrit Biobank, associated clinical registries, and machine learning (artificial intelligence) improve critical care knowledge].

The unique Swecrit Biobank and its associated clinical registries for sepsis, ARDS, cardiac arrest, trauma, and COVID-19 include more than 150,000 blood samples and descriptions of critically ill patients. These assets provide a unique opportunity to research and improve the care of the most seriously ill patients through biomarker analyses, proteomic studies, and genetic and epigenetic studies using modern machine learning techniques (artificial intelligence). Interested researchers are invited to submit their proposals and participate.

Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19: a prospective multicenter study.

Background: Neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and total-tau protein (tau) are novel blood biomarkers of neurological injury, and may be used to predict outcomes in critical COVID-19.

Methods: A prospective multicentre cohort study of 117 consecutive and critically ill COVID-19 patients in six intensive care units (ICUs) in southern Sweden between May and November 2020. Serial NfL, GFAP and tau were analysed in relation to mortality, the Glasgow Outcome Scale Extended (GOSE) and the physical (PCS) and mental (MCS) components of health-related quality of life at one year.

Rapid response team activation prior to in-hospital cardiac arrest: Areas for improvements based on a national cohort study.

Introduction: Rapid response teams (RRTs) are designed to improve the "chain of prevention" of in-hospital cardiac arrest (IHCA). We studied the 30-day survival of patients reviewed by RRTs within 24 hours prior to IHCA, as compared to patients not reviewed by RRTs.

Methods: A nationwide cohort study based on the Swedish Registry of Cardiopulmonary Resuscitation, between January 1st, 2014, and December 31st, 2021.

Protocolised reduction of non-resuscitation fluids versus usual care in patients with septic shock (REDUSE): a protocol for a multicentre feasibility trial.

Introduction: Administration of large volumes of fluids is associated with poor outcome in septic shock. Recent data suggest that non-resuscitation fluids are the major source of fluids in the intensive care unit (ICU) patients suffering from septic shock. The present trial is designed to test the hypothesis that a protocol targeting this source of fluids can reduce fluid administration compared with usual care.

Intensive care unit burden is associated with increased mortality in critically ill COVID-19 patients.

Background: Traditional models to predict intensive care outcomes do not perform well in COVID-19. We undertook a comprehensive study of factors affecting mortality and functional outcome after severe COVID-19.

Methods: In this prospective multicentre cohort study, we enrolled laboratory-confirmed, critically ill COVID-19 patients at six ICUs in the Skåne Region, Sweden, between May 11, 2020, and May 10, 2021.

Mechanical complications after central venous catheterisation in the ultrasound-guided era: a prospective multicentre cohort study.

Background: Limited data are available on the incidence of mechanical complications after ultrasound-guided central venous catheterisation. We aimed to determine the incidence of mechanical complications in hospitals where real-time ultrasound guidance is clinical practice for central venous access and to identify variables associated with mechanical complications.

Methods: All central venous catheter insertions in patients ≥16 yr at four emergency care hospitals in Sweden from March 2, 2019 to December 31, 2020 were eligible for inclusion.

The predictive power of the National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team: A prospective multi-centre trial.

Aim: Early identification of patients at risk of serious adverse events (SAEs) is of vital importance, yet it remains a challenging task. We investigated the predictive power of National Early Warning Score (NEWS) 2, as compared to NEWS, among patients assessed by a Rapid response team (RRT).

Methods: Prospective, observational cohort study on 898 consecutive patients assessed by the RRTs in 26 Swedish hospitals.

Circulating dipeptidyl peptidase 3 on intensive care unit admission is a predictor of organ dysfunction and mortality.

Background: Our aim was to investigate the prognostic potential of circulating dipeptidyl peptidase 3 (cDPP3) to predict mortality and development of organ dysfunction in a mixed intensive care unit (ICU) population, and for this reason, we analysed prospectively collected admission blood samples from adult ICU patients at four Swedish hospitals. Blood samples were stored in a biobank for later batch analysis. The association of cDPP3 levels with 30-day mortality and Sequential Organ Failure Assessment (SOFA) scores on day two was investigated before and after adjustment for the simplified acute physiology score III (SAPS-3), using multivariable (ordinal) logistic regression.

Plasma proenkephalin A 119-159 on intensive care unit admission is a predictor of organ failure and 30-day mortality.

Background: Proenkephalin A 119-159 (penKid) has been suggested as a marker of renal failure and poor outcome. We aimed to investigate the association of penKid on ICU admission with organ dysfunction and mortality in a mixed ICU population. In this retrospective, observational study, admission penKid levels from prospectively collected blood samples of consecutive patients admitted to four Swedish ICUs were analysed.

Plasma proenkephalin A 119-159 and dipeptidyl peptidase 3 on admission after cardiac arrest help predict long-term neurological outcome.

Background: A large proportion of adult survivors of cardiac arrest have a poor neurological outcome. Guidelines recommend multimodal neuro-prognostication no earlier than 72-96 h after cardiac arrest. There is great interest in earlier prognostic markers, including very early markers at admission.

Circulating bioactive adrenomedullin as a marker of sepsis, septic shock and critical illness.

Background: Biomarkers can be of help to understand critical illness and to identify and stratify sepsis. Adrenomedullin is a vasoactive hormone, with reported prognostic and potentially therapeutic value in sepsis. The primary aim of this study was to investigate the association of circulating bioactive adrenomedullin (bio-ADM) levels at intensive care unit (ICU) admission with mortality in sepsis patients and in a general ICU population.

Sepsis is underreported in Swedish intensive care units: A retrospective observational multicentre study.

Background: Sepsis is a common indication for admission to the intensive care unit (ICU). Since definitions vary across studies, comparisons of prevalence and outcomes have been challenging. We aimed to compare sepsis according to ICU discharge codes with sepsis according to Sepsis-3 criteria and to investigate the epidemiology of sepsis in the ICU.

In-hospital cardiac arrest and preceding National Early Warning Score (NEWS): A retrospective case-control study.

We aimed to describe and evaluate the National Early Warning Score (NEWS) in the 24 hours preceding an in-hospital cardiac arrest among general somatic ward patients.The 24 hours preceding the in-hospital cardiac arrest were divided into four timespans and analysed by a medical record review of 127:254 matched case-control patients. The median NEWS ranged from 3 (2-6) to 6 (3-9) points for cases vs 1 (0-3) to 1 (0-3) point for controls.

National Early Warning Score: A survey of registered nurses' perceptions, experiences and barriers.

Aims & Objectives: To describe registered nurses' perceptions, experiences and barriers for using the National Early Warning Score in relation to their work experience and medical affiliation.

Background: Indications of inconsistencies in adherence to the National Early Warning Score have emerged.

Design: Web-based questionnaire study.

Survey of non-resuscitation fluids administered during septic shock: a multicenter prospective observational study.

Background: The indication, composition and timing of administration of non-resuscitation fluid in septic shock have so far received little attention and accordingly the potential to reduce this source of fluid is unknown. The objective of the study was to quantify and characterize non-resuscitation fluid administered to patients with septic shock.

Methods: This prospective observational study was performed in eight intensive care units in Sweden and Canada during 4 months in 2018.

Research protocol for mechanical complications after central venous catheterisation: a prospective controlled multicentre observational study to determine incidence and risk factors of mechanical complications within 24 hours after cannulation.

Introduction: Central venous catheterisation is a common procedure in intensive care therapy and the use of central venous catheters is essential for treatment of many medical disorders. Although rare, central venous catheterisation is associated with mechanical complications that can be life-threatening if untreated. Real-time ultrasound guidance reduces the incidence of mechanical complications when compared with the anatomic landmark method.

Rasch analysis of the Patient Participation in Rehabilitation Questionnaire (PPRQ).

Objective: To evaluate the Patient Participation in Rehabilitation Questionnaire (PPRQ) according to Rasch measurement theory.

Method: Five hundred twenty-two post-discharge patients from a neurological rehabilitation unit were included. The PPRQ questionnaire comprises 20 items rated by a cohort of 522 patients about their experiences of participating in rehabilitation.

The National Early Warning Score predicts mortality in hospital ward patients with deviating vital signs: A retrospective medical record review study.

Aims And Objectives: To evaluate whether the scale used for assessment of hospital ward patients could predict in-hospital and 30-day mortality amongst those with deviating vital signs; that is, that patients classified as medium or high risk would have increased risk of in-hospital and 30-day mortality compared to patients with low risk.

Background: The National Early Warning Score (NEWS) is a widely adopted scale for assessing deviating vital signs. A clinical risk scale that comes with the NEWS divides the risk for critical illness into three risk categories, low, medium and high.