IntroductionIt is important to prevent the deterioration of activities of daily living to improve the long-term prognoses of patients in the intensive care unit (ICU). The patients’ conditions, along with the lack of human and technical resources, often become barriers to achieving early mobilisation after the introduction of mechanical ventilation. We plan to verify the usefulness of a mobile patient lift for early mobilisation.Methods and analysisWe will conduct a single-centre, open-label, randomised controlled trial. The inclusion criteria are as follows: age ≥18 years, independent walking before admission and expected mechanical ventilation for at least 48 hours. The participants will be randomly divided into groups with (intervention group) or without (control group) a mobile lift protocol. A mobile lift will be used in the intervention group. The primary endpoint will be the number of days required to achieve an ICU mobility scale of ≥4 (standing position). The results of the two groups will be analysed using the Student’s t-test.Ethics and disseminationThis study will be conducted in accordance with the Declaration of Helsinki and with the approval of the Toho University Omori Medical Center Ethics Committee (approval number M20259). The results of this study will be presented internationally at academic conferences and published in the literature.Trial registration numberUMIN000044965.
The objective of this single-center retrospective cohort study was to investigate the relationship between blood transfusion and persistent inflammation, immunosuppression, and catabolism syndrome (PIICS). The study was conducted at the Critical Care Center at Toho University Omori Medical Center, Japan. We included 391 patients in the PIICS group (hospitalization for > 15 days, C-reactive protein > 3.0 mg/dL or albumin < 3.0 mg/dL or lymph < 800/μL on day 14) and 762 patients in the non-PIICS group (hospitalization for > 15 days and not meeting the PIICS criteria). We performed univariate and multivariate logistic regression analyses using PIICS as the objective variable and red blood cell (RBC) or fresh frozen plasma or platelet (PLT) transfusion and other confounding factors as explanatory variables. In addition, we conducted a sensitivity analysis using propensity score matching analysis. The multivariate and propensity score analyses showed that RBC and PLT transfusions were significantly associated with PIICS. This is the first study to report an association between RBC and PLT transfusions and PIICS. Our findings have contributed to better understanding the risk factors of PIICS and suggest that physicians should consider the risk of PIICS occurrence when administering blood transfusions in intensive care unit (ICU) patients.
The objective of this single-center retrospective cohort study was to investigate the relationship between blood transfusion and persistent inflammation, immunosuppression, and catabolism syndrome (PIICS). The study was conducted at the Critical Care Center at Toho University Omori Medical Center, Japan. We included 391 patients in the PIICS group (hospitalization for > 15 days, C-reactive protein > 3.0 mg/dL or albumin < 3.0 mg/dL or lymph < 800/µL on day 14) and 762 patients in the non-PIICS group (hospitalization for > 15 days and not meeting the PIICS criteria). We performed univariate and multivariate logistic regression analyses using PIICS as the objective variable and red blood cell (RBC) or fresh frozen plasma or platelet (PLT) transfusion and other confounding factors as explanatory variables. In addition, we conducted sensitivity analysis using propensity score matching analysis. The multivariate and propensity score analyses showed that RBC and PLT transfusions were significantly associated with PIICS. This is the first study to report an association between RBC and PLT transfusions and PIICS. Our findings have contributed to better understanding the risk factors of PIICS and suggest that physicians should consider the risk of PIICS occurrence when administering blood transfusions in intensive care unit (ICU) patients.
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is applied in circulatory failure cases such as cardiogenic shock, cardiac arrest, and refractory ventricular fibrillation. V-A ECMO management includes echocardiographic assessments of cardiac function and evaluations of the peripheral circulation based on venous oxygen saturation, lactate levels, regional cerebral oxygen saturation, and central venous pressure. ECMO flow rates exceeding cardiac output result in low pulse pressure, leading to low mean blood pressure. Thus, the mean blood pressure is also used to manage organ perfusion and peripheral circulation during ECMO support.Generally, urinary liver-type fatty acid-binding protein (L-FABP) is a useful clinical marker in the monitoring of chronic kidney disease (CKD). 1 And it can serve clinically as a predictive marker for contrast medium-induced nephropathy and acute kidney injury. 2,3 In addition, urinary L-FABP-a biomarker of renal ischemia-has also been considered to reflect acute systemic ischemic injury and to be effective in the assessment of sepsis treatment. 4,5 However, no reports have discussed urinary L-FABP use during V-A ECMO management in severe ischemic injury after cardiac arrest cases.Herein, we discuss a case in which urinary L-FABP measurements were used during V-A ECMO management. | CASE HISTORYHere, we describe a 46-year-old male patient who had collapsed at home in the presence of a close relative, who called for an ambulance and started resuscitation maneuvers until the arrival of the medical team. He has no medical history. The monitor waveform showed ventricular fibrillation requiring three defibrillation shocks, endo-tracheal intubation, and transport to our hospital. Extracorporeal cardiopulmonary resuscitation was initiated on arrival due to the onset of refractory ventricular fibrillation. The interval between the onset of cardiac arrest and V-A ECMO cannulation was 45 min. After starting V-A ECMO, defibrillation was performed once. The monitor waveform became pulseless electrical activity (PEA).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.