Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.7
3.0
Journals
JCM
Special Issues
Clinical Updates on Respiratory and Intensive Care Research
share announcement

Clinical Updates on Respiratory and Intensive Care Research

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

Deadline for manuscript submissions: closed (15 February 2024) | Viewed by 5772

Special Issue Editor

Dr. Vincenzo Russotto

E-Mail Website
Guest Editor
Department of Anesthesia and Critical Care, University Hospital San Luigi Gonzaga, University of Turin, 10043 Orbassano, Italy
Interests: critical care medicine; intensive care medicine; resuscitation; cardiopulmonary resuscitation; sepsis; airway management; mechanical ventilation; CPR; emergency management

Special Issue Information

Dear Colleagues,

The fields of respiratory and intensive care have been the focus of huge research efforts during these last years of COVID-19 pandemic.

This crisis forced healthcare workers to reconsider resource allocation, the humanization of care and the most effective and safe strategies for respiratory and critical care support.

This period led to the development of a new research approach based on adaptive trial design, the evaluation of a number of treatment options simultaneously and the efficient incorporation of the principles of personalized medicine into trials that have already been applied for years in other fields of medicine, such as oncology and hematology.

Additionally, this crisis has emphasized the importance of controlling hyperinflammatory states; of providing noninvasive respiratory support, with the risk of self-inflicted lung injury always in mind; the feasibility of awake pronation during noninvasive ventilatory support; and the efficiency of incorporating humanity into daily care.

This Special Issue aims to focus on the most recent advances in respiratory and intensive care research, highlighting topics from noninvasive respiratory support to airway management and from invasive ventilation to extracorporeal life support.

We invite all researchers working in relevant areas to submit original articles and reviews to this Special Issue which, beginning from our recent experiences, is conceived as a step forward towards better care for critically ill patients.

Dr. Vincenzo Russotto
Guest Editor

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

  • airway management
  • critical care medicine
  • intensive care medicine
  • respiratory
  • anesthesia
  • cardiopulmonary resuscitation

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

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

Published Papers (4 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

Jump to: Other

15 pages, 659 KiB  
Article
Factors Associated with Nutritional Risk Assessment in Critically Ill Patients Using the Malnutrition Universal Screening Tool (MUST)
by Blanca Cecilia Díaz Chavarro, Guillermo Molina-Recio, Jorge Karim Assis Reveiz and Manuel Romero-Saldaña
J. Clin. Med. 2024, 13(5), 1236; https://doi.org/10.3390/jcm13051236 - 21 Feb 2024
Cited by 1 | Viewed by 1554
Abstract
Background: Malnutrition is an underdiagnosed condition that negatively affects the clinical outcomes of patients, being associated with an increased risk of adverse events, increased hospital stay, and higher mortality. Therefore, nutritional assessment is a required and necessary process in patient care. The [...] Read more.
Background: Malnutrition is an underdiagnosed condition that negatively affects the clinical outcomes of patients, being associated with an increased risk of adverse events, increased hospital stay, and higher mortality. Therefore, nutritional assessment is a required and necessary process in patient care. The objective of this study was to identify the factors associated with nutritional risk by applying the Malnutrition Universal Screening Tool (MUST) scale in a population of critically ill patients. Methods: This was an observational, analytical, and retrospective study. Sociodemographic, clinical, hematological, and biochemical variables and their relationship with nutritional risk and mortality were analyzed. Results: Of 630 patients, the leading cause of admission was pathologies of the circulatory and respiratory system (50%); 28.4% were at high nutritional risk; and mortality was 11.6% and associated with nutritional risk, hemoglobin, and plasma urea nitrogen. Conclusions: The presence of gastrointestinal symptoms and the type of nutritional support received during hospitalization could increase the likelihood of presenting a medium/high nutritional risk, while polycythemia reduced this probability. An associative model was found to determine nutritional risk with an adequate specificity and diagnostic validity index. Full article
(This article belongs to the Special Issue Clinical Updates on Respiratory and Intensive Care Research)
►▼ Show Figures

Figure 1

11 pages, 1104 KiB  
Article
Electrical Impedance Tomography during Abdominal Laparoscopic Surgery: A Physiological Pilot Study
by Michela Rauseo, Savino Spadaro, Lucia Mirabella, Antonella Cotoia, Donato Laforgia, Gennaro Gaudino, Francesca Vinella, Giuseppe Ferrara, Adriana Gattullo, Livio Tullo and Gilda Cinnella
J. Clin. Med. 2023, 12(23), 7467; https://doi.org/10.3390/jcm12237467 - 1 Dec 2023
Cited by 1 | Viewed by 1111
Abstract
Background: Both general anesthesia and pneumoperitoneum insufflation during abdominal laparoscopic surgery can lead to atelectasis and impairment in oxygenation. Setting an appropriate level of external PEEP could reduce the occurrence of atelectasis and induce an improvement in gas exchange. However, in clinical practice, [...] Read more.
Background: Both general anesthesia and pneumoperitoneum insufflation during abdominal laparoscopic surgery can lead to atelectasis and impairment in oxygenation. Setting an appropriate level of external PEEP could reduce the occurrence of atelectasis and induce an improvement in gas exchange. However, in clinical practice, it is common to use a fixed PEEP level (i.e., 5 cmH2O), irrespective of the dynamic respiratory mechanics. We hypothesized setting a PEEP level guided by EIT in order to obtain an improvement in oxygenation and respiratory system compliance in lung-healthy patients than can benefit a personalized approach. Methods: Twelve consecutive patients scheduled for abdominal laparoscopic surgery were enrolled in this prospective study. The EIT Timpel Enlight 1800 was applied to each patient and a dedicated pneumotachograph and a spirometer flow sensor, integrated with EIT, constantly recorded respiratory mechanics. Gas exchange, respiratory mechanics and hemodynamics were recorded at five time points: T0, baseline; T1, after induction; T2, after pneumoperitoneum insufflation; T3, after a recruitment maneuver; and T4, at the end of surgery after desufflation. Results: A titrated mean PEEP of 8 cmH2O applied after a recruitment maneuver was successfully associated with the “best” compliance (58.4 ± 5.43 mL/cmH2O), with a low percentage of collapse (10%), an acceptable level of hyperdistention (0.02%). Pneumoperitoneum insufflation worsened respiratory system compliance, plateau pressure, and driving pressure, which significantly improved after the application of the recruitment maneuver and appropriate PEEP. PaO2 increased from 78.1 ± 9.49 mmHg at T0 to 188 ± 66.7 mmHg at T4 (p < 0.01). Other respiratory parameters remained stable after abdominal desufflation. Hemodynamic parameters remained unchanged throughout the study. Conclusions: EIT, used as a non-invasive intra-operative monitor, enables the rapid assessment of lung volume and regional ventilation changes in patients undergoing laparoscopic surgery and helps to identify the “optimal” PEEP level in the operating theatre, improving ventilation strategies. Full article
(This article belongs to the Special Issue Clinical Updates on Respiratory and Intensive Care Research)
►▼ Show Figures

Figure 1

11 pages, 1298 KiB  
Article
Clinical Utility of Pepsin and Bile Acid in Tracheal Secretions for Accurate Diagnosis of Aspiration in ICU Patients
by Dirk Bandorski, Khodr Tello, Harun Erdal, Janine Sommerlad, Jochen Wilhelm, Istvan Vadasz, Matthias Hecker, Dieter Walmrath, Werner Seeger, Ekaterina Krauss and Stefan Kuhnert
J. Clin. Med. 2023, 12(17), 5466; https://doi.org/10.3390/jcm12175466 - 23 Aug 2023
Viewed by 1135
Abstract
Background: Aspiration of stomach content or saliva in critical conditions—e.g., shock, intoxication, or resuscitation—can lead to acute lung injury. While various biomarkers in bronchoalveolar lavage fluids have been studied for diagnosing aspiration, none have been conclusively established as early indicators of lung damage. [...] Read more.
Background: Aspiration of stomach content or saliva in critical conditions—e.g., shock, intoxication, or resuscitation—can lead to acute lung injury. While various biomarkers in bronchoalveolar lavage fluids have been studied for diagnosing aspiration, none have been conclusively established as early indicators of lung damage. This study aims to evaluate the diagnostic value of pepsin, bile acid, and other biomarkers for detecting aspiration in an intensive care unit (ICU). Materials and methods: In this study, 50 ICU patients were enrolled and underwent intubation before admission. The evaluation of aspiration was based on clinical suspicion or documented instances of observed events. Tracheal secretion (TS) samples were collected within 6 h after intubation using sterile suction catheters. Additional parameters, including IL-6, pepsin, and bile acid, were determined for analysis. Pepsin levels were measured with an ELISA kit, while bile acid, uric acid, glucose, IL-6, and pH value in the tracheal secretion were analyzed using standardized lab methods. Results: The 50 patients admitted to the ICU with various diagnoses. The median survival time for the entire cohort was 52 days, and there was no significant difference in survival between patients with aspiration pneumonia (AP) and those with other diagnoses (p = 0.69). Among the AP group, the average survival time was 50.51 days (±8.1 SD; 95% CI 34.63–66.39), while patients with other diagnoses had a mean survival time of 32.86 days (±5.1 SD; 95% CI 22.9–42.81); the survival group comparison did not yield statistically significant results. The presence of pepsin or bile acid in TS patients did not significantly impact survival or the diagnosis of aspiration. The p-values for the correlations between pepsin and bile acid with the aspiration diagnosis were p = 0.53 and p > 0.99, respectively; thus, pepsin and bile acid measurements did not significantly affect survival outcomes or enhance the accuracy of diagnosing aspiration pneumonia. Conclusions: The early and accurate diagnosis of aspiration is crucial for optimal patient care. However, based on this study, pepsin concentration alone may not reliably indicate aspiration, and bile acid levels also show limited association with the diagnosis. Further validation studies are needed to assess the clinical usefulness and reliability of gastric biomarkers in diagnosing aspiration-related conditions. Such future studies would provide valuable insights for improving aspiration diagnosis and enhancing patient care. Full article
(This article belongs to the Special Issue Clinical Updates on Respiratory and Intensive Care Research)
►▼ Show Figures

Figure 1

Other

Jump to: Research

15 pages, 2552 KiB  
Systematic Review
Association between Boarding of Frail Individuals in the Emergency Department and Mortality: A Systematic Review
by Pasquale Iozzo, Noemi Spina, Giovanna Cannizzaro, Valentina Gambino, Agostina Patinella, Stefano Bambi, Ercole Vellone, Rosaria Alvaro and Roberto Latina
J. Clin. Med. 2024, 13(5), 1269; https://doi.org/10.3390/jcm13051269 - 23 Feb 2024
Viewed by 903
Abstract
(1) Background: Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) Methods: To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. [...] Read more.
(1) Background: Older patients who attend emergency departments are frailer than younger patients and are at a high risk of adverse outcomes; (2) Methods: To conduct this systematic review, we adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We systematically searched literature from PubMed, Embase, OVID Medline®, Scopus, CINAHL via EBSCOHost, and the Cochrane Library up to May 2023, while for grey literature we used Google Scholar. No time restrictions were applied, and only articles published in English were included. Two independent reviewers assessed the eligibility of the studies and extracted relevant data from the articles that met our predefined inclusion criteria. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the studies; (3) Results: Evidence indicates that prolonged boarding of frail individuals in crowded emergency departments (Eds) is associated with adverse outcomes, exacerbation of pre-existing conditions, and increased mortality risk; (4) Conclusions: Our results suggest that frail individuals are at risk of longer ED stays and higher mortality rates. However, the association between the mortality of frail patients and the amount of time a patient spends in exposure to the ED environment has not been fully explored. Further studies are needed to confirm this hypothesis. Full article
(This article belongs to the Special Issue Clinical Updates on Respiratory and Intensive Care Research)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-4
Back to TopTop