Critical Care Medicine Journals Research Articles

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2023

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from 2023 (January–November 2023). The journals reviewed include anesthesia journals, critical care medicine journals, neurosurgical journals as well as high-impact medical journals such as the Lancet, Journal of American Medical Association, New England Journal of Medicine, and Stroke. The summary of important articles will serve to update the knowledge of neuroanesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical patients.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Fair Use of Augmented Intelligence and Artificial Intelligence in the Preparation and Review of Submissions to the Society of Critical Care Medicine Journals: Critical Care Medicine, Pediatric Critical Care Medicine, and Critical Care Explorations.

Unveiling the Hidden Burden: Mapping the Landscape of Post-Intensive Care Syndrome Research. A Bibliometric Study and Visualization Analysis.

BACKGROUND Post-intensive care syndrome (PICS) has become a major concern for patients and their families due to the rising number of ICU admissions. We conducted a bibliometric analysis to identify hotspots and trends in PICS research. MATERIAL AND METHODS We searched for PICS-related publications in the Web of Science Core Collection up to May 1, 2022. We used CiteSpace, VOSviewer, and Scimago Graphica to analyze collaboration among countries, institutions, and authors, and to identify research hotspots and frontiers. RESULTS Our analysis included 294 research papers on PICS, with the United States leading the field with 146 published papers. Collaboration among institutions and authors was active mainly in the Americas, Europe, and Australia. Highly cited researchers were members of the Outcomes After Critical Illness and Surgery (OACIS) Group, with Ramona O Hopkins as the most published author. Research topics focused on septic shock, COVID-19, qualitative research, and rehabilitation, with publications primarily in critical care medicine journals. Keyword analysis revealed that the main research focus included stress disorders, quality of life, mechanical ventilation, acute lung injury, risk factors, and descriptive studies during hospitalization. CONCLUSIONS PICS research is limited, focusing primarily on short-term clinical effects and lacking long-term prognostic observations and multinational studies. Increased collaboration among countries and regions is necessary to advance research in this field. Hotspots in research focus on prognosis and an integrated approach to management.

Women as a Growing Force in Critical Care Medicine-the Journal, Profession, and Society.

Women as a Growing Force in Critical Care Medicine-the Journal, Profession, and Society.

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2022

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from the year 2022 (January–November 2022). The journals reviewed include anesthesia journals, critical care medicine journals, neurosurgical journals as well as high-impact medical journals such as the Lancet, Journal of American Medical Association (JAMA), New England Journal of Medicine (NEJM), and Stroke. The summary of important articles will serve to update the knowledge of neuroanesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical cases.

295: PUBLICATION BIAS: A PILOT STUDY ON THE LAST DECADE OF CRITICAL CARE MEDICINE LITERATURE

Introduction: Publication bias exists when the results of a study, based on the strength of the study findings influence the decision to publish it. This means that studies that have statistically significant or positive results get published more when compared to studies with statistically insignificant or negative results. Although publication bias has been reported in the literature for decades, there is evidence suggesting that this bias may be on the rise. Our study aims to uncover the inherent bias that exists in critical care medicine within the last 10 years. Methods: This is an observational study. Articles from renowned Critical Care Journals with high impact factors were randomly selected. These articles proposed a new intervention, care modality, or biomarker in critical care medicine. We analyzed a total of 500 studies within the last 10 years from the New England Journal of Medicine (NEJM), American Journal of Respiratory and Critical Care Medicine (AJRCCM), and Critical Care Forum (ccforum), Chest journal, and Critical Care Medicine (CCM). The articles were categorized into positive and negative results depending on the results. Case reports, Case series, Systemic reviews, and Meta-analyses were excluded. Results: We evaluated total of 500 articles (NEJM = 141, AJRCCM = 87, ccforum = 100, Chest Journal = 25, CCM = 147). The number of studies published with positive results were 85, 56, 67, 18, and 114 respectively with a total of (n = 340/500, 68 %). The studies published with negative results were 56, 31, 33, 7, and 33 with a total of (n = 160/500, 32%). We confirmed our result with a 5x2 chi contingency table. Our chi-square was 10.8 with a two-tailed p-value of .03 (significant at p < .05). We re-confirmed our result with a sign test, as repeated measures with paired values (positive and negative) of five journals. The z-value was 2.2 and the two-tailed p-value was .025 (significant at p < 0.05). Our results were limited by the small sample size, one specialty, and an uneven number of articles from each journal. Conclusions: Studies with positive results have higher rates of publication when compared to studies with negative results. Publication bias was found in renowned journals of critical care medicine. There is a need to eliminate this to minimize the impact of grey literature.

Competencies for Point-of-care Ultrasonography in ICU: An ISCCM Expert Panel Practice Recommendation.

How to cite this article: Srinivasan S, Kumar PG, Govil D, Gupta S, Kumar V, Pichamuthu K, et al. Competencies for Point-of-care Ultrasonography in ICU: An ISCCM Expert Panel Practice Recommendation. Indian J Crit Care Med 2022;26(S2):S7-S12.

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2021

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from 2021 (January–December 2021). The journals reviewed include anesthesia journals, critical care medicine journals, neurology, and neurosurgical journals as well as high-impact medical journals such as the Lancet, Journal of American Medical Association, New England Journal of Medicine, and Stroke. This summary of important articles will serve to update the knowledge of anesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical care patients. In addition, some of the important narrative reviews that are of interest to neuroanesthesiologists are also listed.

AN UNUSUAL CASE OF RECURRENT HYPERTRIGLYCERIDEMIC PANCREATITIS

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Hypertriglyceridemia (HTG) induced recurrent acute pancreatitis (RAP) is a rare entity. Its occurrence with normal pancreatic enzyme levels has not been commonly reported. Herein, we report a case of RAP secondary to hypertriglyceridemia with normal blood lipase level. CASE PRESENTATION: A 48-year old male with a history of hypertriglyceridemia presented with a 72-hour history of right upper quadrant (RUQ) and epigastric abdominal pain. He had hypertriglyceridemic pancreatitis 5 years ago, however was not compliant with treatment. On presentation, he was febrile with RUQ and epigastric tenderness. His laboratory investigations revealed: white cell 10.59 x 10^9/L, sodium 133mmol/L, carbon dioxide 18mmol/L, creatinine 0.7 mg/dL, glucose 138 mg/dL calcium 8.8mg/dL; albumin 4.2g/dL, total bilirubin 1.9mg/dL, alanine transferase 37u/L, aspartate transferase 60u/L, alkaline phosphatase 138 u/L. Triglycerides were significantly elevated at >2,625mg/dL with serum lipase 113 u/L (normal 23-300). CT scan of the abdomen and pelvis revealed extensive inflammatory stranding centered at the head and uncinate process of the pancreas, consistent with acute pancreatitis. He received intravenous crystalloids, opioids and continuous insulin infusion which was discontinued on day 4 once triglyceride level was <500. He was started on gemfibrozil and discharged home. DISCUSSION: With an incidence of 13–45/100,000 acute pancreatitis is one of the most common diagnoses for contacting emergency services and for hospitalization in Europe and the USA. Acute pancreatitis (AP) is defined by two of three criteria: typical belt-like abdominal pain, elevated serum lipase level three times above the normal threshold, or radiological imaging signs of pancreatitis. RAP is defined as 2 or more attacks of AP without any evidence of chronic pancreatitis. HTG is the third-most common, possibly underestimated and missed, cause of AP and it accounts for 1%–7% of cases. Serum amylase can be normal hypertriglyceridemia-induced pancreatitis, but lipase is more sensitive and specific than amylase for diagnosis of AP. Normal lipase levels in HTG induced AP, as in this case, is rare. Several studies have reported a negative predictive value of serum lipase in diagnosing acute pancreatitis to be between 94 and 100 percent. CONCLUSIONS: Though uncommon, HTG induced Acute Pancreatitis can present with normal biomarkers, and if suspicion is high, imaging should be pursued to confirm or exclude the diagnosis. REFERENCE #1: Weiss, F. U., Laemmerhirt, F., & Lerch, M. M. (2019). Etiology and Risk Factors of Acute and Chronic Pancreatitis. Visceral medicine, 35(2), 73–81. https://doi.org/10.1159/000499138 REFERENCE #2: Kumar, P., Ghosh, A., Sinha, N., & Tonk, R. S. (2018). Secondary Hypertriglyceridemia Causing Recurrent Acute Pancreatitis with Normal Pancreatic Enzymes. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(5), 381–383. https://doi.org/10.4103/ijccm.IJCCM_353_17 REFERENCE #3: Shah, A. M., Eddi, R., Kothari, S. T., Maksoud, C., DiGiacomo, W. S., & Baddoura, W. (2010). Acute pancreatitis with normal serum lipase: a case series. JOP : Journal of the pancreas, 11(4), 369–372 DISCLOSURES: No relevant relationships by Janeen Grant-Sittol, source=Web Response No relevant relationships by Fausto Lisung, source=Web Response No relevant relationships by Anna-Belle Robertson, source=Web Response No relevant relationships by Rani Sittol, source=Web Response

Assessment of the effect of amantadine in patients with traumatic brain injury: A meta-analysis.

Traumatic brain injury is a global burden. We aimed to perform a meta-analysis to determine the efficacy of amantadine for cognitive performance after traumatic brain injury. The systematic review was prospectively registered on the International Prospective Register of Systematic Reviews website under the registration number CRD42017080044. We used Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to report the steps of meta-analysis. The search included electronic databases (PubMed, PsycINFO, Embase, Cochrane Library databases, CENTRAL, ProQuest and ClinicalTrials.gov trial registry). Critical care medicine journals and clinical neurology specialty were searched using www.scimagojr.com. There was no publication date restriction. Two authors assessed studies' relevance and extracted data. Studies were assessed for quality using the Cochrane risk of bias tool. Data were analyzed using Comprehensive Meta-analysis Program versions 2.0 and 3.0. Twenty-six studies out of 3,440 records were included in the systematic review, of which only 14 clinical trials and 6 observational studies were included in the meta-analysis. Amantadine significantly enhanced the cognitive function relative to control group (mean difference [MD], 0.50; 95% confidence interval [CI], 0.33-0.66; p < 0.001, 16 studies, 1,127 participants, low certainty evidence). Consistent significant difference in favor of amantadine relative to control group was found (MD of 0.79 [95% CI, 0.34-1.24], very low certainty evidence, for cohort studies vs. MD of 0.40 [95% CI, 0.25-0.56], moderate certainty evidence, for RCTS). Starting amantadine in the first week after TBI had a significant effect on improving cognitive function (MD, 0.97; 95% CI, 0.45-1.49; 16 studies, 1,127 participants, low certainty). Amantadine showed a better effect when administered for less than 1 month (MD, 0.83; 95% CI, 0.56-1.11; low certainty) and to patients below 18 years of age (MD, 0.66; 95% CI, 0.32-0.99; low certainty) or to patients with less severe traumatic brain injury (MD, 0.40; 95% CI, 0.18-0.62; low certainty). No statistically significant difference existed between amantadine and the control concerning the adverse events (OR, 1.74; 95% CI, 0.88-3.44; p = 0.11, moderate certainty). Metaregression of the different clinical parameters, which are onset of treatment, age, and severity of traumatic brain injury, showed a statistically significant relation between onset of treatment and the effect size of amantadine. The relation between the other two parameters and the effect size of amantadine showed a marginal statistical significance. Amantadine may improve the cognitive function when used after TBI. Further research with high validity is needed to reach a solid conclusion about the use of amantadine in traumatic brain injury. Systematic review/meta-analysis, level III.

COVID-19 and resuscitation: La tournée of traditional Chinese medicine?

BACKGROUNDAs it has been established in previous publications of the author, the current extra-hospital statistics referring to cardiopulmonary resuscitation (CPR) are far from being minimally satisfactory (14%-17% success). Since the appearance of acquired immune deficiency syndrome, its application has been increasingly undermined as other subsequent pandemics (H1N1, Ebola, coronavirus disease 2019) seriously infringing lay rescuers intervention during classical CPR steps (mouth-to-mouth ventilation), forcing to modify vital support protocols. Both KI-1 Yong quan and PC-9 Zhong chong alternative rescue maneuvers could come to aid those victims of impending death situation due to both cardiac arrest or stroke, upgrading current survival rates of said unfortunate patients.AIMTo validate a complementary resuscitation maneuver originated in Chinese Medicine knowledge, carefully integrated into international CPR protocols [World Journal of Critical Care Medicine (WJCCM), August 2013].METHODSThe model to verify its statistical validity of quoted research was the Retrospective Cohort Study, which redeems the “semiotic paradigm” that gave rise to medical semiotics. Its value strives in the differential detail if the deceased patients are considered the control group instead of the patients that may be deceased. Thus, combining the semiotic paradigm with the Retrospective Cohort Study allows us to manage the collateral potential lethal effects of the random process in cases of extreme emergencies.RESULTSThe statistic results provided by the methodological analysis of this work were previously published in WJCCM August 2013, ISSN 2220-3141). In a total of 89 patients in which the Yong quan maneuver was tested, 75 survived and 14 died. In order to compare this data with the percentages of survivors in the other maneuvers, we stipulate the assumption that if 89 patients are the 100% of the sample, how many patients would survive if the survival rate is 6.4% in CPR, 30% in defibrillation and 48% in CPR + defibrillation. By this way we obtained the approximate values of patients that would survive when applying these classical resuscitation maneuvers. Then we obtained the format of the tables to perform the exact Fisher test with the help of a statistical processor; the consequent result in a valuation of P < 0.0001 was considered "extremely statistically significant".CONCLUSIONThe author herein provides a methodological–statistical analysis of such contribution which does not imply any cost at all and could even help prevent the withdrawal of classical CPR practices.

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2020

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from the year 2020 (January–December 2020). The journals reviewed include anesthesia journals, critical care medicine journals, neurology and neurosurgical journals, as well as high-impact medical journals such as the Lancet, Journal of American Medical Association, New England Journal of Medicine, and Stroke. This summary of important articles will serve to update the knowledge of anesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical care patients. In addition, some of the important narrative reviews that are of interest to neuroanesthesiologists are also listed.

Retraction: Boldt J, Maleck WH, Fent T. Price development in important anesthesia and critical care medicine journals in comparison to journals of other disciplines. Acta Anaesthesiol Scand. 2001;45(4):458-64. https://doi.org/10.1034/j.1399-6576.2001.045004458.x.

Retraction: Boldt J, Maleck WH, Fent T. Price development in important anesthesia and critical care medicine journals in comparison to journals of other disciplines. Acta Anaesthesiol Scand. 2001;45(4):458-64. https://doi.org/10.1034/j.1399-6576.2001.045004458.x.

Impact of Altmetrics in evaluation of scientific journals, research outputs and scientists' careers: Views of editors of high impact anaesthesia, critical care and pain medicine journals.

Background and Aims:Altmetrics represent the attention of an article drawn from social and mainstream media. The aim of this survey was to investigate the views of editors of high-impact journals on the Altmetric Attention Score (AAS), the number derived from an automated algorithm including a weighted count of mainstream news and social media sources.Methods:A questionnaire related to the AAS was sent to the editors of high-impact journals, namely Anaesthesia, Critical Care Medicine (CCM) and Pain Medicine (PM). Eleven questions were related to the possible benefits and flaws of Altmetrics.Results:Of the 1,381 editors asked, 126 answered. The overall answers showed that 76% of the editors were familiar with Altmetrics, 28% knew how AAS is calculated, 12% believed that AAS should replace traditional bibliometrics, 34% favoured AAS for journal ranking, 40% believed that AAS should be used to assess an article, 44% felt that AAS should be included in researchers’ curriculum vitae and 22% felt that it should be considered for grants. Sixty-two percent of editors believed that AAS is vulnerable to manipulations, 60% proposed improvement and 16% abandonment. Positive answers were similar across the fields, except for journal ranking. Fifty-four percent of editors of the CCM journals favoured journal ranking using AAS versus 28% and 26% editors of anaesthesia and PM journals (P = 0.025 and P = 0.006, respectively).Conclusion:A high percentage of editors believed that AAS should be used to assess scholarly output and that it should be included in the researchers’ curriculum vitae. Sixty percent of responders supported the improvement of AAS.

Utility of Endotracheal Tube Cuff Pressure Monitoring in Mechanically Ventilated (MV) Children in Preventing Post-extubation Stridor (PES).

ObjectiveTo study if protocolized monitoring of endotracheal tube (ETT) cuff pressure every 6 hours is better than adjusting endotracheal tube cuff inflation by the only bedside clinical assessment.Materials and methodsThis was a single-center prospective randomized controlled study done between July 1, 2017 and March 31, 2019. Children between 1 month and 18 years, intubated with cuffed ETT by our trained doctors were included. After obtaining consent, patients were randomized into two groups, standard group (SG) and cuff pressure monitoring group (MG). Sample size was calculated with 80 patients in each group with a power of 80%, significance level (alpha 0.05 and beta 0.2). In the SG, ETT cuff inflation was adjusted by clinical assessment (bedside minimal leak technique and monitoring the percentage of leak displayed on ventilator display) at 6 hours interval. In the MG, cuff pressures were monitored by the device every 6 hours to maintain between 20 and 25 mm Hg.ResultsOut of 543 mechanically ventilated children during the study period, 266 were eligible and randomized for study. During the study, 89 patients died and 17 were left against medical advice, leaving 80 patients in each group. Incidence of post-extubation stridor (PES), re-intubation rate, ventilator-associated pneumonia (VAP) rate, ventilator days, and length of pediatric intensive care unit (PICU) stay were analyzed and found no advantage of protocolized monitoring of cuff pressures in the reduction of any of the above variables.ConclusionOur findings if confirmed by large multicentric studies can bring an end to routine ETT cuff pressure measurements and emphasize more on clinical assessment. Clinical trial registry (CTRI/2019/05/019098).Indian Journal of Critical Care Medicine (2021): 10.5005/jp-journals-10071-23737How to cite this articleShaikh F, Janaapureddy YR, Mohanty S, Reddy PK, Sachane K, Dekate PS, et al. Utility of Endotracheal Tube Cuff Pressure Monitoring in Mechanically Ventilated (MV) Children in Preventing Post-extubation Stridor (PES). Indian J Crit Care Med 2021;25(2):181–184.

Development and Reporting of Prediction Models: Guidance for Authors From Editors of Respiratory, Sleep, and Critical Care Journals.

Prediction models aim to use available data to predict a health state or outcome that has not yet been observed. Prediction is primarily relevant to clinical practice, but is also used in research, and administration. While prediction modeling involves estimating the relationship between patient factors and outcomes, it is distinct from casual inference. Prediction modeling thus requires unique considerations for development, validation, and updating. This document represents an effort from editors at 31 respiratory, sleep, and critical care medicine journals to consolidate contemporary best practices and recommendations related to prediction study design, conduct, and reporting. Herein, we address issues commonly encountered in submissions to our various journals. Key topics include considerations for selecting predictor variables, operationalizing variables, dealing with missing data, the importance of appropriate validation, model performance measures and their interpretation, and good reporting practices. Supplemental discussion covers emerging topics such as model fairness, competing risks, pitfalls of "modifiable risk factors", measurement error, and risk for bias. This guidance is not meant to be overly prescriptive; we acknowledge that every study is different, and no set of rules will fit all cases. Additional best practices can be found in the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines, to which we refer readers for further details.

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2019

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from 2019 (January–November 2019). The journals reviewed included anesthesia journals, critical care medicine journals, neurosurgical journals, as well as high-impact medical journals such as the Lancet, Journal of American Medical Association, New England Journal of Medicine, and Stroke. This summary of important articles will serve to update the knowledge of anesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical cases.

Contemporary Academic Contributions From Anesthesiologists in Adult Critical Care Medicine.

Anesthesiology has a long relationship with critical care medicine (CCM). However, US anesthesiologists are less likely to practice CCM than non-US anesthesiologists. To date, no studies have compared academic contributions in CCM between US anesthesiologists and non-US anesthesiologists. The objective of our study was to use recent trends in critical care publications as a surrogate for academic contribution among US and non-US anesthesiologists. Research articles published between 2010 and 2015 in 3 anesthesiology journals (Anesthesiology, Anesthesia & Analgesia, and British Journal of Anaesthesia) and 3 multidisciplinary CCM journals (Critical Care Medicine, Intensive Care Medicine, and Journal of Critical Care) were reviewed. Author information, including the primary department appointment and geographic location for the first and senior author(s), and article details, including topic and publication type, were collected. Odds ratios for having a first or senior author from the United States were calculated. Anesthesiologists' contributions in individual journals were summarized, as were trends in anesthesiology CCM publications during the 6-year study period. A total of 3831 articles were reviewed, with 1050 (27.4%) having US authors. Eighty-two and one-half percent of CCM articles in anesthesiology journals had a US anesthesiologist as first author, and 81% had a US anesthesiologist as senior author, while fewer CCM articles in multidisciplinary journals had a US anesthesiologist as first (12.1%) or senior (12.3%) author. When considering all publications, 16.3% and 16.4% of articles had a US anesthesiologist as the first or senior author compared with articles for which non-US anesthesiologists were first (23.8%) or senior (20.9%) authors. The odds of having a US anesthesiologist as first or senior author compared to a non-US anesthesiologist for all publications were 0.6 (0.5-0.7) and 0.7 (0.6-0.9). The number of publications trended downward for both US anesthesiologists and non-US anesthesiologists during the study period. When compared to non-US anesthesiologists, US anesthesiologists had more CCM publications in anesthesiology journals and fewer publications in multidisciplinary CCM journals. The number of anesthesiology CCM publications decreased for both US and non-US anesthesiologists throughout the study period.