The Accuracy of Dynamic Parameters for Prediction of Fluid Responsiveness in Elderly Patients with Septic Shock.

Purpose: Assessed the accuracy of stroke volume variation (SVV), pulse pressure variation (PPV), and dynamic arterial elastance (Eadyn) in predicting fluid responsiveness (FR) and mean arterial pressure (MAP) response in elderly patients with septic shock.

Patients And Methods: Mechanically ventilated patients aged over 65 with septic shock were enrolled. SVV, PPV, and Eadyn were recorded before and after FR testing (≥10% increase in cardiac output following a passive leg raise test or fluid challenge).

Unsupervised machine learning clustering approach for hospitalized COVID-19 pneumonia patients.

Background: Identification of distinct clinical phenotypes of diseases can guide personalized treatment. This study aimed to classify hospitalized COVID-19 pneumonia subgroups using an unsupervised machine learning approach.

Methods: We included hospitalized COVID-19 pneumonia patients from July to September 2021.

Low incidence of deep vein thrombosis in critically ill medical patients in Thais: a prospective study.

Background: Critically ill medical patients face a heightened risk of developing venous thromboembolism. In Thailand, routine thromboprophylaxis is not employed. The incidence of deep vein thrombosis (DVT) in the medical intensive care unit (ICU) has not been elucidated in the Thai population.

Expiratory flow limitation during mechanical ventilation: real-time detection and physiological subtypes.

Background: Tidal expiratory flow limitation (EFL) complicates the delivery of mechanical ventilation but is only diagnosed by performing specific manoeuvres. Instantaneous analysis of expiratory resistance (Rex) can be an alternative way to detect EFL without changing ventilatory settings. This study aimed to determine the agreement of EFL detection by Rex analysis and the PEEP reduction manoeuvre using contingency table and agreement coefficient.

Effect of the Ramathibodi Rapid Response System Triggered by the Ramathibodi Early Warning Score and Clinical Warning Signs on in-Hospital Mortality and the Incidence of Cardiopulmonary Resuscitation in Adult Hospitalized Patients.

Purpose: The Ramathibodi Rapid Response System (RRRS), implemented in March 2017, aims to identify and respond to patients with deteriorating conditions outside the ICU. It employs the Ramathibodi early warning score and clinical signs to monitor all admitted patients, providing expert physician monitoring and early treatment for stabilization and appropriate care triage. This study assesses the RRRS's effectiveness in reducing in-hospital mortality and CPR events outside the ICU.

The ratio of respiratory rate to diaphragm thickening fraction for predicting extubation success.

Background: Several parameters are used to predict successful extubation but their accuracy varies among studies. We hypothesized that combining conventional and diaphragmatic parameters would be more effective than using just one. Our primary objective was to evaluate the performance of the respiratory rate in relation to the diaphragm thickening fraction (RR/DTF) ratio to predict the success of extubation.

Relationship between lung ultrasound and electrical impedance tomography as regional assessment tools during PEEP titration in acute respiratory distress syndrome caused by multi-lobar pneumonia: a pilot study.

Acute respiratory distress syndrome (ARDS) caused by multilobar pneumonia (MLP) is markedly different from typical ARDS in pathology, imaging characteristics, and lung mechanics. Regional lung assessment is required. We aimed to analyze the relationship between two regional assessment tools, lung ultrasound (LUS) and electrical impedance tomography (EIT) during positive end-expiratory pressure (PEEP) titration, and determine an appropriate PEEP level.

Spontaneous tension hemothorax in a severe COVID-19 patient receiving ECMO therapy: The other side of COVID-19-associated coagulopathy.

As opposed to widely recognized Coronavirus Disease 2019 (COVID-19)-associated thrombotic events, the unusual but serious bleeding complications in COVID-19 patients are worth-mentioned. Here, we describe a 44-year-old man afflicted by COVID-19 pneumonia with acute respiratory distress syndrome (ARDS) and submassive pulmonary embolism. The patient's condition initially improved with the prescription of ECMO, tocilizumab, and hemoadsorption, however, he later developed spontaneous tension hemothorax, which is considered rare but devastating in the setting of COVID-19.

The efficacy of the WhisperFlow CPAP system versus high flow nasal cannula in patients at risk for postextubation failure: A Randomized controlled trial.

Purpose: Compare the efficacy(reintubation rate) between a high-flow nasal cannula(HFNC) and the WhisperFlow CPAP system in patients at risk for postextubation failure.

Material And Methods: RCT was conducted in patients who had at least one high-risk criterion for postextubation failure. All patients were randomly assigned to CPAP or HFNC for 48 h.

Association between age-related factors and extubation failure in elderly patients.

Background: Elderly patients are being increasingly admitted to the intensive care unit (ICU) for mechanical ventilation. Previous studies demonstrated that 20% to 35% of elderly patients were reintubated within 48 to 72 hours after extubation. Given the age-related physiologic changes and multiple comorbidities in elderly patients, the current conventional parameters for predicting extubation outcomes may not be applicable to this population.

The impact of introducing the early warning scoring system and protocol on clinical outcomes in tertiary referral university hospital.

Purpose: The aim of this study was to evaluate the impact of a hospital protocol in response to patient deterioration in general wards, stratified using the national early warning score (NEWS), on primary patient outcomes of in-hospital mortality and percentage of patients transferred to the intensive care unit (ICU).

Patients And Methods: We conducted a prospective observational cohort study among adult medical patients admitted to a university hospital in Bangkok. A 4-month pre-protocol period (November 2015 to February 2016) was assigned to a control group and a protocol period (March 2016 to June 2016) was allocated to a protocol group.

Respiratory monitoring in adult intensive care unit.

The mortality of patients with respiratory failure has steadily decreased with the advancements in protective ventilation and treatment options. Although respiratory monitoring per se has not been proven to affect the mortality of critically ill patients, it plays a crucial role in patients' care, as it helps to titrate the ventilatory support. Several new monitoring techniques have recently been made available at the bedside.

Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis.

Background: Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking.

The Correlation Between Arterial Lactate and Venous Lactate in Patients With Sepsis and Septic Shock.

Background: Applying peripheral venous lactate instead of arterial lactate in clinical practice is questionable because of deviation between both values. We aimed to find the relationship between the arterial lactate and the peripheral venous lactate before reasoned that the venous lactate could be used in substitution to the arterial lactate in sepsis.

Methods: We conducted a prospective, cross-sectional study at a university hospital.

Lactate and combined parameters for triaging sepsis patients into intensive care facilities.

Purpose: To find predictors of intensive care unit (ICU) requirement within the first 48 hours in newly diagnosed sepsis patients presenting at the emergency department.

Materials And Methods: Analysis of a prospective observational cohort was performed. We recruited new sepsis patients at the emergency department, and collected baseline characteristics and parameters.

Transthoracic ultrasound assessment of B-lines for identifying the increment of extravascular lung water in shock patients requiring fluid resuscitation.

Introduction: Several studies have shown that the number of B-lines was related to the amount of extravascular lung water (EVLW). In our study, we aimed to demonstrate the magnitude of the incremental B-lines in shock patients with positive net fluid balance and the association with gas exchange impairment.

Materials And Methods: We performed trans-thoracic ultrasound at admission (T0) and at follow-up period (TFL) to demonstrate the change of B lines (ΔB-lines) after fluid therapy.

Predicting laryngeal edema in intubated patients by portable intensive care unit ultrasound.

Purpose: The purpose of this study is to determine the diagnostic accuracy of portable ultrasound for detection of laryngeal edema (LE) in intubated patients.

Materials And Methods: We conducted a prospective, observational study from December 2010 to September 2011. We measured air column width differences (ACWD) in planned extubation patients admitted in intensive care unit by ultrasound.

Association between admission delay and adverse outcome of emergency medical patients.

Aim: To determine whether admission delay (lead-time) and other factors are associated with hospital mortality rates of emergency medical patients.

Methods: Patients presenting with emergency conditions during August to November 2009, and admitted to medical wards, including intensive care units, were enrolled. The time each patient spent in the ED, and other parameters were recorded.

Identifying non-tuberculous mycobacterium lung diseases in acid-fast bacilli positive patients.

We conducted a case-control study by comparing the clinical and radiographic features of acid-fast bacilli positive patients with pulmonary tuberculosis (PTB) to those with non-tuberculous mycobacterium (NTM) lung diseases diagnosed according to American Thoracic Society (ATS) criteria. The occurrence of NTM lung disease was associated with persistence in symptoms after the fifth month of treatment (p=0.018), middle lobe involvement (p<0.