This review highlights the latest advancements in imaging techniques for monitoring respiratory muscles in critically ill patients. At the bedside, conventional ultrasound has been widely adopted to measure diaphragm thickness, thickening and excursion. It has also been used to assess extradiaphragmatic respiratory muscles, including parasternal intercostal and abdominal muscles. Advanced ultrasound-derived techniques have expanded its applications, enabling the evaluation of tissue velocity (tissue Doppler imaging), stiffness (shear wave elastography), and local tissue displacement (speckle tracking). Facility-based imaging modalities such as magnetic resonance imaging and chest tomography provide complementary insights into respiratory muscles structure and function, offering valuable information for evaluating the effects of therapeutic interventions. Finally, imaging techniques have emerged as valuable tools for evaluating the metabolic demands of respiratory muscles, with advanced

Background Although potent P2Y12 inhibitors, such as ticagrelor and prasugrel, are standard treatment in patients with acute myocardial infarction (AMI), evidence for their efficacy and safety compared with clopidogrel is limited in patients with AMI complicated by cardiogenic shock. Methods Among 28,949 patients from the nationwide pooled registry of KAMIR-NIH and KAMIR-V, a total of 1482 patients (5.1%) with AMI and cardiogenic shock who underwent percutaneous coronary intervention of the culprit vessel were selected. Primary outcome was major adverse cardiovascular event (MACE, a composite of cardiac death, MI, repeat revascularization and definite stent thrombosis) and major secondary outcome was Bleeding Academic Research Consortium (BARC) type 2 or greater bleeding at 2 years. Results Among the study population, 537 patients (36.2%) received potent P2Y12 inhibitors and 945 patients (63.8%) received clopidogrel after index procedure. The risk of MACE was significantly lower in the

Introduction Albumin kinetics in septic shock have been extensively studied, but clinical recommendations remain weak. An increased transcapillary escape rate (TER) of albumin has been demonstrated, though TER does not account for lymphatic return. Mass balance calculations, considering lymphatic return, have been used to assess net albumin leakage (NAL) in major surgery but not in sepsis. Objectives This study aimed to evaluate NAL in ten ICU patients with suspected sepsis, hypothesizing a net positive leakage. Secondary aims included investigating associations between NAL and fluid overload, glycocalyx shedding products, and cytokines, as well as identifying factors associated with it. Methods This prospective, observational study included ten patients within twelve hours of ICU admission for suspected sepsis at Karolinska University Hospital Huddinge. Albumin, hematocrit, and hemoglobin levels were sampled at 0, 1, 2, 4, 8, and 24 h. NAL was estimated using mass balance calculations

Background The experience of patients under mechanical ventilation in the intensive care unit is described as complex and multifaceted, but an overarching and in-depth understanding of the experience is still missing. Aim To provide an in-depth analysis and synthesis of patients’ experience when being mechanically ventilated in intensive care units. Methods We conducted a meta-synthesis according to the methodological recommendations of Sandelowski and Barroso. Our systematic literature search in Medline, CINAHL, and Cochrane was complemented by hand and citation searches. We included only qualitative studies with a rich description of conscious patients’ experience under mechanical ventilation. Studies on children, step-down units, noninvasive ventilation and non-scientific journal articles were excluded. After the title, abstract and full-text screening by three reviewers, we performed initial, axial and selective coding and in-depth analysis in MAXQDA. The synthesis was supported by

This case report describes the successful treatment of a suicide attempt involving the ingestion of a supralethal dose of sodium azide (NaN3), presenting a prospective novel antidote and therapeutic approach. Treatment encompassed the implementation of high-volume continuous veno-venous hemofiltration (HV-CVVH) alongside the administration of levocarnitine. The latter demonstrated a substantial mitigation of lactate concentration. Comprehensive analyses of serum, ultrafiltrate, and urine revealed the efficacy of HV-CVVH in elimination of NaN3. Our case report presents a potential therapeutic approach for managing otherwise fatal NaN3 intoxications.

Standardization of terminology and definitions is essential for scientific communication. Without such standardization, some studies may use different terms to express similar conditions, and other studies may use the same term with different definitions. Such diversities in medical language creates inconsistencies in scientific reporting, thereby hindering us from properly understanding the condition. In this regard, persistent critical illness (PerCI) and chronic critical illness (CCI) are two terms