‌VIEW IN BROWSER

‌Review the Latest Research in Critical Care

Exclusively for SCCM Select and Professional members, Critical Pulse contains late-breaking and important information to help your practice.

Invasive Fungal Infections Are a Burden in ICUs

A systematic review and meta-analysis of 34 studies comprising 655,169 critically ill patients, published in BMC Infectious Diseases, aimed to determine the prevalence of invasive fungal infections (IFI) in ICUs and assess regional and procedural variations. The pooled prevalence of IFI was 5% (95% CI, 3%-7%). Aspergillus spp. accounted for 10% and Candida spp. for 3%. Regional prevalence ranged from 3% in high-income countries to 21% in lower- and middle-income countries. Standardized diagnostic criteria and region-specific strategies are crucial to improving patient outcomes.

Thrombocytopenia Associated With Enhanced Mortality and Worse Clinical Outcomes in Patients With Sepsis and Septic Shock

A systematic review and meta-analysis of 12 studies in BMC Anesthesiology found that patients with thrombocytopenia (TCP) and either sepsis or septic shock had significantly higher risks of ICU mortality (OR, 1.93; 95% CI,1.6-2.33; P < 0.01). and 28-day mortality (OR, 1.98; 95% CI,1.67- 2.35; P < 0.00001). Furthermore, patients with severe TCP (platelet count < 50 × 109/L) had even higher odds of ICU mortality (OR, 3.38; 95% CI, 2.25-5.08; P < 0.00001). Major bleeding events were significantly more frequent in patients with TCP (OR, 3.26; 95% CI, 2.26-4.72; P < 0.01).

C-Reactive Protein-to-Albumin Ratio Associated With Poor Outcomes in Patients With Stroke

A meta-analysis in Scientific Reports elucidated the association between C-reactive protein-to-albumin ratio (CAR) and prognosis in patients with stroke. Nine studies with 2954 patients were included. The pooled results demonstrated that elevated CAR was associated with poor functional outcomes in patients who had had a stroke (OR, 2.24; 95% CI, 1.81-2.78; P < 0.00001). Similarly, elevated CAR was associated with mortality in patients with stroke (OR, 2.11; 95% CI, 1.51-2.94; P < 0.0001). CAR has prognostic value for poor functional outcomes and mortality in patients with stroke.

Dexmedetomidine Reduces Postoperative Delirium Following Cardiac Surgery

A systematic review and meta-analysis of 31 RCTs in Anaesthesia Critical Care & Pain Medicine evaluated the efficacy of dexmedetomidine (DEX) in preventing delirium after cardiac surgery. Delirium incidence was significantly lower in the DEX group compared with placebo or other treatments (RR, 0.61; 95% CI, 0.49-0.75; P < 0.001). This protective effect remained across subgroup analyses based on age, control type, delirium assessment method, and after excluding trials at high risk of bias. DEX use was associated with a shorter ICU length of stay (MD, –0.14 days; 95% CI, –1.28 to –0.04; P < 0.01). Trial sequential analysis confirmed the result's robustness. However, DEX increased bradycardia risk (RR, 1.53; 95% CI, 1.05-2.21; P = 0.02). No significant differences were found in mortality, intubation duration, hospital length of stay, atrial fibrillation, or hypotension.

NLP Techniques Show Promise for Early Detection of Cognitive Impairment

A systematic review and meta-analysis of 51 studies in Mayo Clinic Proceedings Digital Health evaluated the effectiveness of different natural language processing (NLP) techniques for early detection of cognitive decline through speech and language analysis. Combined linguistic and acoustic approaches achieved the highest diagnostic accuracy (average 87%; AUC, 0.89) compared with linguistic-only (83%; AUC, 0.85) or acoustic-only approaches (80%; AUC, 0.82). Lexical diversity, syntactic complexity, and semantic coherence were consistently strong predictors across cognitive conditions. Larger, standardized studies are needed to establish clinical utility.

TyG Index Predicts Risk of CKD

A systematic review and meta-analysis of 33 studies in Clinical Nutrition ESPEN evaluated the association between the triglyceride-glucose (TyG) index and risk of developing CKD across diverse populations. The meta-analysis revealed a significant association between a higher TyG index and an increased risk of CKD (pooled effect size [ES], 1.67; 95% CI, 1.51-1.86, P < 0.001) when analyzed as a categorical variable. A similar significant association was observed when the TyG index was assessed as a continuous variable (pooled ES, 1.44; 95% CI, 1.28-1.62, P < 0.001). Subgroup analyses indicated that this association was consistent across various study designs, geographic regions, and population characteristics. The findings suggest that the TyG index is a reliable predictor of CKD risk and may be a valuable tool for the early identification of individuals at high risk.

‌This message was sent to: sccmcommunity@sccm.org

Your Member Type: Nonmember

Communications Preferences or Unsubscribe | Privacy Policy | Contact SCCM 

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