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 Advances in Critical Care Medicine
share announcement

Clinical Advances 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: 20 May 2025 | Viewed by 20684

Special Issue Editor

Prof. Dr. Pietro Caironi

E-Mail Website
Guest Editor
1. Department of Anesthesia and Critical Care, AOU S. Luigi Gonzaga, Orbassano, Turin, Italy
2. Department of Oncology, University of Turin, Turin, Italy
Interests: anesthesia; critical care; respiratory failure; critical care medicine; sepsis; lung

Special Issue Information

Dear Colleagues,

Critical care medicine is one of the most complex and challenging disciplines of medicine. From the recent COVID-19 pandemic and considering the high lethality of the most common diseases encountered in intensive care units such as sepsis and acute respiratory distress syndrome (ARDS), critical care medicine continuously seeks better therapeutic strategies aimed at predicting and identifying the occurrence of severe pathological disorders early, better supporting failing organs and systems, accelerating organ recovery, and improving long-term functional outcomes and the quality of life. Despite intense efforts during the last decades, critical care medicine still faces pathological conditions characterized by high mortality and morbidity. Moreover, the increase in life expectancy and lack of resources in low-income countries make caring for the critically ill even more challenging, raising relevant questions regarding cost-effectiveness and sustainability. Accordingly, this Special Issue is calling for original research and systematic reviews that have investigated potential novel aspects of critical care medicine, including the application of artificial intelligence to specific aspects of diagnosis, monitoring and treatment, the need and use of big data derived from large platform databases for epidemiological and therapeutic studies, the sustainability of the critical care system, data on long-term functional organ recovery and outcomes, and any other relevant and novel aspects of specific diseases characterizing critical care medicine, such as sepsis, ARDS, trauma, etc.

Prof. Dr. Pietro Caironi
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

  • critical care
  • artificial intelligence
  • extra-corporeal life support
  • mechanical ventilation
  • sepsis
  • infection
  • airway management
  • acute kidney injury
  • biomarkers
  • trauma

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 policies can be found here.

Published Papers (6 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: Review, Other

11 pages, 912 KiB  
Article
Does the Intensity of Therapy Correspond to the Severity of Acute Respiratory Distress Syndrome (ARDS)?
by Domenico Nocera, Stefano Giovanazzi, Tommaso Pozzi, Valentina Ghidoni, Beatrice Donati, Giulia Catozzi, Rosanna D’Albo, Martina Caronna, Ilaria Grava, Gaetano Gazzè, Francesca Collino, Silvia Coppola, Simone Gattarello, Mattia Busana, Federica Romitti, Onnen Moerer, Michael Quintel, Luigi Camporota and Luciano Gattinoni
J. Clin. Med. 2024, 13(23), 7084; https://doi.org/10.3390/jcm13237084 - 23 Nov 2024
Viewed by 1551
Abstract
Objectives: The intensity of respiratory treatment in acute respiratory distress syndrome (ARDS) is traditionally adjusted based on oxygenation severity, as defined by the mild, moderate, and severe Berlin classifications. However, ventilator-induced lung injury (VILI) is primarily determined by ventilator settings, namely tidal volume, [...] Read more.
Objectives: The intensity of respiratory treatment in acute respiratory distress syndrome (ARDS) is traditionally adjusted based on oxygenation severity, as defined by the mild, moderate, and severe Berlin classifications. However, ventilator-induced lung injury (VILI) is primarily determined by ventilator settings, namely tidal volume, respiratory rate, and positive end-expiratory pressure (PEEP). All these variables, along with respiratory elastance, are included in the concept of mechanical power. The aim of this study is to investigate whether applied mechanical power is proportional to oxygenation severity. Methods: We analyzed 291 ARDS patients (71 mild, 155 moderate, and 65 severe). We defined low, middle, and high mechanical power by dividing the entire population into tertiles with a similar number of patients. In each oxygenation class, we measured computed tomography (CT) anatomy, gas exchange, respiratory mechanics, mechanical power, and mortality rate. Results: ARDS severity was proportional to lung anatomy impairment, as defined by quantitative CT scans (i.e., lung volume and well-aerated tissue decreased across the ARDS classes, while respiratory elastance increased, as did mortality). Mechanical power, however, was similarly distributed across the severity classes, as the decrease in tidal volume in severe ARDS was offset by an increase in respiratory rate. Within each ARDS class, mortality increased from low to high mechanical power (roughly 1% for each J/min increase). Conclusions: Both lung severity and mechanical power independently impact mortality rates. It is tempting to speculate that ARDS severity primarily reflects the natural course of the disease, while mechanical power primarily reflects the risk of VILI. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Figure 1

10 pages, 501 KiB  
Article
Enhancing ICU Outcomes Through Intelligent Monitoring Systems: A Comparative Study on Ventilator-Associated Events
by Jui-Fang Liu, Mei-Ying Kang, Hui-Ling Lin and Shih-Feng Liu
J. Clin. Med. 2024, 13(21), 6600; https://doi.org/10.3390/jcm13216600 - 3 Nov 2024
Viewed by 1633
Abstract
Background: Using intelligent monitoring systems can potentially improve the identification and management of ventilator-associated events (VAEs). This single-center retrospective observational study evaluated the impact of implementing intelligent monitoring systems on the clinical outcomes of patients with VAEs in an ICU setting. Method: An [...] Read more.
Background: Using intelligent monitoring systems can potentially improve the identification and management of ventilator-associated events (VAEs). This single-center retrospective observational study evaluated the impact of implementing intelligent monitoring systems on the clinical outcomes of patients with VAEs in an ICU setting. Method: An intelligent VAE monitoring system was integrated into electronic medical records to continuously collect patient data and alert attending physicians when a ventilated patient met the criteria for a ventilator-associated condition, which was defined as an increase of at least three cm H2O in positive end expiratory pressure (PEEP), an increase of at least 0.20 in the fraction of inspired oxygen (FiO2), or the FiO2 being over baseline for at least two consecutive days. This study covered two phases, consisting of before using the intelligent monitoring system (2021–2022) and during its use (2023–2024). Results: The results showed that patients monitored with the intelligent system experienced earlier VAE detection (4.96 ± 1.86 vs. 7.77 ± 3.35 days, p < 0.001), fewer ventilator-associated condition (VAC) occurrences, and a shorter total duration of VACs. Additionally, the system significantly reduced ventilator days, antibiotic use, and 14-day mortality. Conclusions: Intelligent monitoring systems enhance VAE management, improve clinical outcomes, and provide valuable insights into the future of critical care medicine. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Figure 1

Review

Jump to: Research, Other

16 pages, 550 KiB  
Review
Crossing Age Boundaries: The Unifying Potential of Presepsin in Sepsis Diagnosis Across Diverse Age Groups
by Edmilson Leal Bastos de Moura and Rinaldo Wellerson Pereira
J. Clin. Med. 2024, 13(23), 7038; https://doi.org/10.3390/jcm13237038 - 21 Nov 2024
Viewed by 822
Abstract
Sepsis is a pervasive condition that affects individuals of all ages, with significant social and economic consequences. The early diagnosis of sepsis is fundamental for establishing appropriate treatment and is based on warning scores and clinical characteristics, with positive microbiological cultures being the [...] Read more.
Sepsis is a pervasive condition that affects individuals of all ages, with significant social and economic consequences. The early diagnosis of sepsis is fundamental for establishing appropriate treatment and is based on warning scores and clinical characteristics, with positive microbiological cultures being the gold standard. Research has yet to identify a single biomarker to meet this diagnostic demand. Presepsin is a molecule that has the potential as a biomarker for diagnosing sepsis. In this paper, we present a narrative review of the diagnostic and prognostic performance of presepsin in different age groups. Given its particularities, it is identified that presepsin is a potential biomarker for sepsis at all stages of life. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Figure 1

17 pages, 2463 KiB  
Review
Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit
by Camilo Pérez, Diana Diaz-Caicedo, David Fernando Almanza Hernández, Lorena Moreno-Araque, Andrés Felipe Yepes and Jorge Armando Carrizosa Gonzalez
J. Clin. Med. 2024, 13(18), 5344; https://doi.org/10.3390/jcm13185344 - 10 Sep 2024
Cited by 3 | Viewed by 14641
Abstract
Shock is a life-threatening condition that requires prompt recognition and treatment to prevent organ failure. In the intensive care unit, shock is a common presentation, and its management is challenging. Critical care ultrasound has emerged as a reliable and reproducible tool in diagnosing [...] Read more.
Shock is a life-threatening condition that requires prompt recognition and treatment to prevent organ failure. In the intensive care unit, shock is a common presentation, and its management is challenging. Critical care ultrasound has emerged as a reliable and reproducible tool in diagnosing and classifying shock. This comprehensive review proposes an ultrasound-based protocol for the hemodynamic assessment of shock to guide its management in the ICU. The protocol classifies shock as either low or high cardiac index and differentiates obstructive, hypovolemic, cardiogenic, and distributive etiologies. In distributive shock, the protocol proposes a hemodynamic-based approach that considers the presence of dynamic obstruction, fluid responsiveness, fluid tolerance, and ventriculo-arterial coupling. The protocol gives value to quantitative measures based on critical care ultrasound to guide hemodynamic management. Using critical care ultrasound for a comprehensive hemodynamic assessment can help clinicians diagnose the etiology of shock and define the appropriate treatment while monitoring the response. The protocol’s use in the ICU can facilitate prompt recognition, diagnosis, and management of shock, ultimately improving patient outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Figure 1

Other

Jump to: Research, Review

12 pages, 1874 KiB  
Systematic Review
Mortality in Critically Ill Patients with Liberal Versus Restrictive Transfusion Thresholds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with Trial Sequential Analysis
by Daniel Arturo Jiménez Franco, Camilo Andrés Pérez Velásquez and David Rene Rodríguez Lima
J. Clin. Med. 2025, 14(6), 2049; https://doi.org/10.3390/jcm14062049 - 18 Mar 2025
Viewed by 715
Abstract
Background/Objectives: Anemia is common in critically ill patients, yet red blood cell (RBC) transfusion without active bleeding does not consistently improve outcomes and carries risks such as pulmonary injury, fluid overload, and increased costs. Optimal transfusion thresholds remain debated, with some guidelines [...] Read more.
Background/Objectives: Anemia is common in critically ill patients, yet red blood cell (RBC) transfusion without active bleeding does not consistently improve outcomes and carries risks such as pulmonary injury, fluid overload, and increased costs. Optimal transfusion thresholds remain debated, with some guidelines recommending a restrictive target of 7 g/dL instead of a more liberal target of 9 g/dL. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines, searching PubMed, EMBASE, and LILACS from January 1995 to October 2024. Thirteen randomized controlled trials involving 13,705 critically ill adults were included, with 6855 assigned to liberal and 6850 to restrictive transfusion strategies. The risk of bias was assessed using the Cochrane Risk of Bias Tool 2, and the pooled effect sizes were estimated with a random-effects model. We registered the protocol in PROSPERO International Prospective Register of Systematic Reviews (CDR42024589225). Results: No statistically significant difference was observed in 30-day mortality between restrictive and liberal strategies (odds ratio [OR] 1.02; 95% confidence interval [CI], 0.83–1.25; I2 = 49%). Similarly, no significant differences emerged for the 90-day or 180-day mortality, hospital or intensive care unit (ICU) length of stay, dialysis requirement, or incidence of acute respiratory distress syndrome (ARDS). However, patients in the restrictive group received significantly fewer RBC units. The trial sequential analysis (TSA) indicated that the evidence accrued was insufficient to definitively confirm or exclude an effect on the 30-day mortality, as the required sample size was not reached. Conclusions: In conclusion, while our meta-analysis found no statistically significant difference in the short-term mortality between restrictive and liberal transfusion strategies, larger trials are needed to fully determine whether any clinically meaningful difference exists in critically ill populations. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Graphical abstract

9 pages, 1000 KiB  
Case Report
Bilateral Serratus Plane Block in a Critically Ill, Mechanically Ventilated Patient with Multiple Rib Fractures Due to Severe Thoracic Trauma: Case Report and Literature Review
by Francesco Baccoli, Beatrice Brunoni, Francesco Zadek, Alessandra Papoff, Lorenzo Paveri, Vito Torrano, Roberto Fumagalli and Thomas Langer
J. Clin. Med. 2025, 14(6), 1864; https://doi.org/10.3390/jcm14061864 - 10 Mar 2025
Viewed by 573
Abstract
Background/Objectives: Effective pain management in polytrauma patients with rib fractures is essential, particularly in the critical care setting. While epidural analgesia is considered the gold standard, it is not always feasible, necessitating alternative locoregional approaches. We present the case of a polytrauma [...] Read more.
Background/Objectives: Effective pain management in polytrauma patients with rib fractures is essential, particularly in the critical care setting. While epidural analgesia is considered the gold standard, it is not always feasible, necessitating alternative locoregional approaches. We present the case of a polytrauma patient with multiple, bilateral rib fractures and severe chest pain that hindered weaning from mechanical ventilation. A bilateral Serratus Anterior Plane Block (SAPB) was performed, with catheters placed for continuous administration of local anesthetics. Pain relief was immediate, enabling a rapid weaning from mechanical ventilation, safe extubation, and subsequent discharge to rehabilitation. A review of the literature on this technique in critically ill patients with thoracic trauma and multiple rib fractures is also presented. Methods: We conducted a literature search up to November 2024, identifying studies evaluating the use of SAPB in critically ill patients with chest trauma and rib fractures. Results: Eight studies were identified, including a total of 197 cases, of which only 3 involved a bilateral SAPB. Studies and published case reports demonstrated significant variability in analgesic protocols and reported outcomes. Notably, only two papers addressed specifically its role in facilitating weaning from mechanical ventilation. Conclusions: Pain control is fundamental in managing severe chest trauma. This case and the reviewed literature suggest that the SAPB is a promising option when epidural analgesia is contraindicated or impractical. However, further studies are needed to define its place in clinical practice and optimize its use in critically ill patients. Full article
(This article belongs to the Special Issue Clinical Advances in Critical Care Medicine)
►▼ Show Figures

Graphical abstract

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-6
Back to TopTop