‌VIEW IN BROWSER

‌Review the Latest Research in Critical Care

SCCM knows how busy you are caring for critically ill patients. That’s why, as a Select or Professional member, you receive Critical Pulse—a concise, curated update with the latest information and insights to help you stay current and deliver the highest-quality care.

Doppler Echocardiography Shows Potential for Assessing LVFP in Critically Ill Patients on Mechanical Ventilation

A systematic review and meta-analysis published in Annals of Intensive Care evaluated accuracy of Doppler echocardiography in predicting LVFP, as assessed by pulmonary artery occlusion pressure (PAOP), in mechanically ventilated patients in the ICU. Eight prospective studies comprising 342 patients were included in the meta-analysis. The area under the receiver operating characteristic (AUROC) curve ranged from 0.69 to 0.83 for E/A ratios and from 0.60 to 0.91 for lateral E/E' ratios in predicting PAOP ≥ 18 mm Hg. Both E/A and lateral E/E' ratios showed a correlation with PAOP, with pooled correlation coefficients of 0.48 (95% CI, 0.48-0.58) and 0.72 (95% CI, 0.52-0.92), respectively. Limitations such as small sample sizes, study heterogeneity, and the use of different PAOP cutoff values to define elevated LVFP suggest the need for further research.

Sepsis Is a Trigger for a Quarter of Rapid Response Team Calls

A systematic review and meta-analysis published in Critical Care and Resuscitation synthesized evidence on the prevalence, treatment, and outcomes of sepsis during rapid response team (RRT) calls. Twenty-six studies comprising 110,909 patients and 139,076 RRT events were included. The prevalence of sepsis among all RRT calls was 23.7% (95% CI, 15.5-34.6), with no significant difference between studies including exclusively sepsis RRT calls and studies with all causes of RRT calls (32.7% vs. 21.8%; P = 0.16). Overall hospital mortality was 12.9% (95% CI, 7.3-21.7) and hospital length of stay was 18 days (95% CI, 13.9-22.1) A total of 23.3% of patients were transferred to the ICU. These findings support the need for standardized recognition protocols, escalation guidelines, and prospective trials to optimize outcomes.

Machine Learning Demonstrates High Accuracy in Detecting LV Hypertrophy

A systematic review and meta-analysis published in Journal of Medical Internet Research assessed the diagnostic accuracy of machine learning (ML)-based approaches to detect LV hypertrophy (LVH). A total of 25 studies were included in the analysis. A meta-analysis of ECG-based models exhibited a sensitivity of 0.76 (95% CI, 0.66-0.84) and a specificity of 0.84 (95% CI, 0.78-0.89). A subgroup analysis of ECG-based models revealed that the deep learning model produced a sensitivity of 0.71 (95% CI, 0.60-0.80) and a specificity of 0.79 (95% CI, 0.65-0.88). Current conclusions regarding model accuracy should be interpreted with caution as the studies included in the meta-analysis were extremely heterogeneous. Future studies should focus on constructing and testing high-performance ML models based on imaging data for LVH diagnosis.

Neurostimulation Improves Outcomes in Acute and Critically Ill Patients With Dysphagia

A systematic review and meta-analysis published in Journal of Oral Rehabilitation assessed the effectiveness of neurostimulation therapies in treating dysphagia in acute and critically ill patients. Forty-four RCTs comprising 2198 patients were included, encompassing 5 types of neurostimulation therapies: transcutaneous auricular vagus nerve stimulation (ta-VNS), neuromuscular electrical stimulation (NMES), repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and pharyngeal electrical stimulation (PES). Compared with traditional dysphagia therapy (TDT), usual care, or sham stimulation, neurostimulation therapies significantly improved swallowing function post-treatment (SMD −0.74; 95% CI, −0.90 to −0.58), increased the rate of patients regaining the ability to take food orally (RR 1.39; 95% CI, 1.12-1.74) and enhanced swallowing function at 1 month (SMD −1.28; 95% CI, −1.76 to −0.81) and 2 months (SMD −2.24; 95% CI, −3.25 to −1.23). However, neurostimulation did not show significant improvements in swallowing function at 3 months post-treatment (SMD −0.43; 95% CI, −1.08 to 0.22), decannulation (RR 3.47; 95% CI. 0.60-20.23), aspiration (RR 0.67; 95% CI, 0.36-1.26) or shortened hospital stays (MD −1.74; 95% CI, −4.78 to 1.30). The findings suggest that NMES + TDT, rTMS + TDT, NMES, tDCS + TDT, rTMS, PES + TDT and PES are effective therapies for improving swallowing function in acute and critical care patients.

Infections Leading to Outbreaks in NICUs Are Strongly Associated With Healthcare Workers

A systematic review and meta-analysis published in The Journal of Hospital Infection analyzed reported outbreaks of infections in NICUs between January 2004 and October 2024. A total of 119 studies were included, documenting 122 outbreaks across 42 countries. Temporal analysis revealed a decline in reported outbreak prevalence over time, with 55.7% reported between 2004 and 2013 and 45.1% between 2014 and 2023. Bacteria caused 80.3% of the outbreaks, with the main pathogens being Klebsiella pneumoniae and Serratia marcescens. The main risk factors were prematurity and low birth weight, with healthcare workers' hands identified as the main transmission route. implementing infection prevention and control strategies, including staff education, is crucial in preventing future outbreaks and improving patient safety.

Probiotic Supplementation Reduces Wound Infection Risk and Clinical Burden in Critically Ill Patients

A systematic review and meta-analysis published in Frontiers in Nutrition evaluated the impact of probiotic supplementation on wound-specific and systemic clinical outcomes in critically ill patients. Nineteen RCTs comprising 1384 patients were included. Probiotic supplementation significantly reduced the risk of wound infection (RR 0.52; 95% CI, 0.38-0.71), with the most pronounced benefit observed in burn patients. It also significantly reduced hospital length of stay (MD −5.24 days; 95% CI, −8.73 to −1.75), duration of antibiotic use (SMD −0.18; 95% CI, −0.25 to −0.11), and duration of mechanical ventilation (SMD −0.90; 95% CI, −1.20 to −0.60). Probiotics were associated with reduced systemic inflammation (CRP SMD −0.73; 95% CI, −1.15 to −0.32) and improved intestinal barrier function (RR 1.63; 95% CI, 1.28-2.08). Future studies should focus on standardizing interventions and evaluating long-term outcomes.

‌This message was sent to: sless@sccm.org

Your Member Type: Professional - Physician

Communications Preferences or Unsubscribe | Privacy Policy | Contact SCCM 

© Society of Critical Care Medicine. 500 Midway Drive Mount Prospect, IL 60056 USA