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Clinical Guidelines in Critical Care Medicine
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Clinical Guidelines in Critical Care Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 1746

Special Issue Editors

Dr. Ana Vujaklija Brajković

E-Mail Website
Guest Editor
1. Department of Internal Medicine, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
2. School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia
Interests: critical care; sepsis; acute kidney injury; vasoconstrictor agents; ultrasound; biomarkers
Dr. Andrej Markota

E-Mail Website
Guest Editor
1. Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
2. Medical Intensive Care Unit, University Medical Centre Maribor, 2000 Maribor, Slovenia
Interests: cardiopulmonary resuscitation; mechanical ventilation; sepsis; resuscitation; airway; management; cpr; critical care medicine; intensive care medicine; ventilation; emergency management
Dr. Daniela Bandic-Pavlovic

E-Mail Website
Guest Editor Assistant
1. Anesthesiology, Reanimatology and Intensive Care Medicine of Surgical Specialties, University Hospital Centre Zagreb, Kišpatićeva 12, 10000 Zagreb, Croatia
2. School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia
Interests: airway management; mechanical ventilation; critical care; sepsis, nutrition, pain and sedation management; ICU management of trauma patients

Special Issue Information

Dear Colleagues,

Patients with severe acute illness are often admitted to emergency departments and then transferred to medical or surgical intensive care units (ICU) based on the primary cause of their condition.

Both medical and surgical emergencies are numerous and necessitate rapid diagnostic and therapeutic approaches.

Sepsis is a common medical emergency. Despite advancements in sepsis recognition and treatment, the mortality remains high, reaching 40% in the ICU setting. Moreover, the number of immunocompromised (30–40%) and elderly (15%) patients is increasing, potentially necessitating modified diagnostic and therapeutic approaches.

The management of surgical emergencies such as multiple trauma patients requires prompt teamwork by numerous medical specialists.

Critically ill patients require considerable organ support ranging from vasopressor therapy, mechanical ventilation, renal replacement therapy, and nutrition.

This Special Issue aims to provide clinical guidelines, supported by laboratory and imaging data, for earlier recognition and treatment of critically ill patients. Many questions remain, including the role of potential biomarkers and imaging protocols that could enable faster and adequate treatment of this extremely vulnerable patient population.

Dr. Ana Vujaklija Brajković
Dr. Andrej Markota
Guest Editors

Dr. Daniela Bandic-Pavlovic
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • critical illness
  • immunocompromised host
  • biomarkers
  • thrombocytopenia
  • blood coagulation disorders
  • multiple trauma
  • diagnostic imaging

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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9 pages, 419 KiB  
Article
Thiamine Deficiency Is Common and Underrecognized in Emergency Department Oncology Patients
by Deepika Boopathy, Daniel Grahf, Jacob Ross, Kegham Hawatian, Jo-Ann Rammal, Katherine Alaimo and Joseph B. Miller
J. Clin. Med. 2025, 14(1), 257; https://doi.org/10.3390/jcm14010257 - 4 Jan 2025
Cited by 1 | Viewed by 1058
Abstract
Background: Wernicke’s encephalopathy can occur in oncology patients independent of alcohol use, likely resulting from poor dietary thiamine intake. High metabolic demands, such as those in acute illnesses seen in the emergency department (ED), can exacerbate thiamine deficiency. In this study, our [...] Read more.
Background: Wernicke’s encephalopathy can occur in oncology patients independent of alcohol use, likely resulting from poor dietary thiamine intake. High metabolic demands, such as those in acute illnesses seen in the emergency department (ED), can exacerbate thiamine deficiency. In this study, our objective was to assess the incidence of thiamine deficiency in ED oncology patients, which could lead to Wernicke’s encephalopathy or other thiamine deficiency disorders if left untreated. Methods: This was a single-center prospective cohort study. We included patients with acute illness and a history of active cancer management in the ED of a large, urban hospital. We also included age and sex-matched control patients with no history of cancer who sought ED care. We excluded patients with a history of alcohol use or parenteral thiamine administration before enrollment. We recorded whole blood thiamine levels to measure total body thiamine stores and collected data on clinical variables, thiamine treatment, and adverse events. Results: In total, 87 oncology and 71 control patients were included in the study. The mean age was 62.1 ± 13.7 and 58.9 ± 12.6 years, respectively, and 48% of oncology vs. 55% of control participants were female. The most common cancers represented were colon (23%), lung (25%), prostate (10%), and breast (9%). Thiamine deficiency was significantly higher in ED oncology patients (25, 28.7%) compared to controls (6, 8.5%), odds ratio 4.4 (95% CI 1.7–11.4). None of the oncology patients with deficiency received thiamine treatment in the ED. Conclusions: Our findings suggest that thiamine deficiency is prevalent in acutely ill oncology patients, yet rarely treated in the ED. Full article
(This article belongs to the Special Issue Clinical Guidelines in Critical Care Medicine)
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Review

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10 pages, 558 KiB  
Review
Tumour-Associated Microangiopathic Haemolytic Anaemia with Thrombocytopenia: A Narrative Review and Case Study
by Vedran Kovacic, Marijana Mikacic, Ivan Jerkovic, Tanja Ilic Begovic and Marina Maras
J. Clin. Med. 2025, 14(7), 2164; https://doi.org/10.3390/jcm14072164 - 22 Mar 2025
Viewed by 290
Abstract
Thrombotic microangiopathy (TMA) is a category of diseases consisting of thrombocytopenia, microangiopathic haemolytic anaemia, and widespread occlusive microvascular thrombosis. We report two cases of a thrombotic microangiopathic syndrome associated with non-invasive mucinous cysts and mucinous adenocarcinoma. TMA was treated in both cases by [...] Read more.
Thrombotic microangiopathy (TMA) is a category of diseases consisting of thrombocytopenia, microangiopathic haemolytic anaemia, and widespread occlusive microvascular thrombosis. We report two cases of a thrombotic microangiopathic syndrome associated with non-invasive mucinous cysts and mucinous adenocarcinoma. TMA was treated in both cases by surgical removal of the tumours. We hypothesise that mucin secretion in the case of non-invasive mucinous cysts and paraneoplastic secretion of antibodies in the case of mucinous adenocarcinomas are the causes of endothelial damage with thrombocytopenia and microangiopathic haemolytic anaemia. Finally, patients with TMA who exhibit unusual clinical characteristics or weak responses to plasma exchange should be examined for an underlying tumour. Tumour treatment is the preferred therapy for tumour-associated TMA. Full article
(This article belongs to the Special Issue Clinical Guidelines in Critical Care Medicine)
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