Critical Care Commons^™

Association Of Obesity And Body Mass Index Classification With Glycemic Control In Adults Who Are Critically Ill Receiving Parenteral Nutrition: A Retrospective Study., Erika L Mackie, Melissa Dang, Kimberly Sharpe, Justin Delic, James M Hollands, Song Oh, Stacy Pasciolla, Laura Pontiggia, Diana Solomon, Angela Bingham

Ambulatory and Primary Care Articles

BACKGROUND: Hyperglycemia is a complication of parenteral nutrition (PN), which can be exacerbated in patients with obesity. Limited data exist on glycemic control in this population. This study aims to evaluate the association of obesity and body mass index (BMI) classification with glycemic control in patients who are critically ill initiated receiving PN.

METHODS: This is a retrospective study of patients who are critically ill receiving PN from January 2013 to February 2024. The primary outcome was glycemic control in patients with BMI ≥ 30 kg/m

RESULTS: The study included 220 patients with BMI ≥ 30 kg/m

CONCLUSION: Patients who …

Characteristics And Outcomes Of Patients With Cardiogenic Shock And Clinically Significant Valvular Heart Disease: From The Critical Care Cardiology Trials Network., Anthony P Carnicelli, P Elliott Miller, David D Berg, Nijat Aliyev, Carlos L Alviar, Erin A Bohula, Sunit-Preet Chaudhry, Meshe Chonde, Christine Chow, Howard A Cooper, Lori B Daniels, Christopher B Fordyce, Shahab Ghafghazi, Michael J Goldfarb, Kari L Gorder, Madeleine M Hamilton, Ryan R Keane, Michael C Kontos, Jonathan J Kusner, Evan Leibner, Daniel B Loriaux, Venu Menon, Raunak M Nair, L Kristin Newby, Mary-Tiffany Oduah, Michael G Palazzolo, Harsh Patolia, Jacob B Pierce, Matthew J Pierce, Brian J Potter, Alastair Proudfoot, Robert O Roswel, Gregory Schnell, Jeffrey Shaw, Kiran Sidhu, Shashank S Sinha, Anubodh S Varshney, Jason N Katz, Sean Van Diepen, David A Morrow

Heart and Vascular Articles

BACKGROUND: Cardiogenic shock (CS) can be complicated by severe valvular heart disease (VHD). We analyzed cardiac intensive care unit (CICU) admissions according to VHD status.

METHODS AND RESULTS: The Critical Care Cardiology Trials Network is a multicenter network of tertiary CICUs. Centers contributed data from consecutive admissions during 2-month annual snapshots from 2017-2023. CS admissions were classified as having CS attributed to VHD, CS with noncausative VHD or CS without severe VHD. Demographics and therapies were compared. Unadjusted and adjusted odds ratios for in-hospital mortality were calculated. We analyzed 5242 admissions with CS (4.1% attributed to VHD, 18.8% with noncausative …

Does Mean Arterial Pressure Augmentation Improve Neurological Recovery Of Blunt Spinal Cord Injuries: An East Multicenter Trial., Aimee Lariccia, Stephanie Doris, Bhairav Shah, Tanisha Kashikar, Erik Teicher, Lindsey Perea, Jennifer Huber, Malia Eischen, H Akin Erol, Michael Steven Farrell, Lauren Colom, Stephanie Scott, Brian Daley, James Bardes, Gregory Schaefer, Melissa Moncrief, William Devoe, Ryan Peter Dumas, Caitlin Anne Fitzgerald, William Brigode, John D Berne, Dalier R Mederos, Scott Armen, Melissa Linskey Dougherty, Asanthi Ratnasekera, Emily Alberto, Alison Smith, Bradley M Dennis, Stephen Gadomski, Jeffry Nahmias, Claudia Alvarez, Salina Wydo, Jennifer Schweinsburg, Carlos H Palacio, M Chance Spalding, Joshua Hill

Trauma and Acute Care Articles

BACKGROUND: Treatment of blunt traumatic spinal cord injuries (SCIs) often includes maintaining elevated mean arterial blood pressures (MAP) to enhance perfusion to the spinal cord. Optimal hyperperfusion protocols and treatment algorithms have yet to be delineated due to a paucity of large volume prospective studies. This study aims to identify predictors of neurological improvement in American Spinal Injury Association (ASIA) impairment score following blunt SCI.

STUDY DESIGN: Prospective (January 10, 2021 to June 1, 2023) multicenter study included blunt SCI patients age >18 with complete neurological examination documented on hospital arrival. Patients were divided into two groups: neurological improvement and …

Is Fixation Of A Single End Of Flail Segment Rib Fractures Enough?, Anthony Perugini, James Iandoli, Nicholas Pelz, Daniel Degenova, Anthony Melaragno, Mallory Faherty, Benjamin C Taylor

OhioHealth Research Institute Articles

BACKGROUND: Segmental rib fractures in blunt thoracic trauma present with increased morbidity and mortality with an association of increased pulmonary insult and concomitant injuries. There is a paucity within the literature regarding the necessity of fixation of one or both segments of rib fractures in a flail chest. This study aimed to analyze surgical rib fixation and assess outcomes for non-fixed fractured rib ends in segmental rib fractures.

METHODS: This is a retrospective review of 125 patients who underwent open reduction internal fixation of flail segmental rib fractures at our urban Level 1 trauma center. Initial plain films and CT …

Continuous Renal Replacement Therapy For Lithium Toxicity: A Worthy Treatment To Avoid Intradialytic Hypotension And Vasopressors., Pooya Zardoost, Zachary Buckman, Joseph Weaver, Sidney Elston, Alex Prouty, Ryan Stuart, Henry L Wehrum

Ambulatory and Primary Care Articles

While intermittent hemodialysis (HD) is the most efficient method of removing lithium in patients with lithium toxicity, continuous renal replacement therapy is an acceptable alternative in the setting of intradialytic hypotension. This form of dialysis can reduce the need for vasopressors during HD, which increases mortality.

Vascular Implications Of Covid-19: Role Of Radiological Imaging, Artificial Intelligence, And Tissue Characterization: A Special Report., Narendra N Khanna, Mahesh Maindarkar, Anudeep Puvvula, Sudip Paul, Mrinalini Bhagawati, Puneet Ahluwalia, Zoltan Ruzsa, Aditya Sharma, Smiksha Munjral, Raghu Kolluri, Padukone R Krishnan, Inder M Singh, John R Laird, Mostafa Fatemi, Azra Alizad, Surinder K Dhanjil, Luca Saba, Antonella Balestrieri, Gavino Faa, Kosmas I Paraskevas, Durga Prasanna Misra, Vikas Agarwal, Aman Sharma, Jagjit Teji, Mustafa Al-Maini, Andrew Nicolaides, Vijay Rathore, Subbaram Naidu, Kiera Liblik, Amer M Johri, Monika Turk, David W Sobel, Gyan Pareek, Martin Miner, Klaudija Viskovic, George Tsoulfas, Athanasios D Protogerou, Sophie Mavrogeni, George D Kitas, Mostafa M Fouda, Manudeep K Kalra, Jasjit S Suri

Heart and Vascular Articles

The SARS-CoV-2 virus has caused a pandemic, infecting nearly 80 million people worldwide, with mortality exceeding six million. The average survival span is just 14 days from the time the symptoms become aggressive. The present study delineates the deep-driven vascular damage in the pulmonary, renal, coronary, and carotid vessels due to SARS-CoV-2. This special report addresses an important gap in the literature in understanding (i) the pathophysiology of vascular damage and the role of medical imaging in the visualization of the damage caused by SARS-CoV-2, and (ii) further understanding the severity of COVID-19 using artificial intelligence (AI)-based tissue characterization (TC). …

The First Reported Case Of Hyperreninemic Hypoaldosteronism Due To Mucopolysaccharidosis Disorder., Antony Gayed, Valerie A Schott, Laura Meltzer

Ambulatory and Primary Care Articles

Mucopolysaccharidoses (MPS) are rare genetic lysosomal storage disorders caused by a deficiency of enzymes that catalyze the breakdown of glycosaminoglycans. MPS-III, also known as Sanfilippo syndrome, is caused by a deficiency of one of four enzymes that catalyze heparan sulfate proteoglycan degradation. MPS-IIIA results from a deficiency of heparan sulfatase. The natural history of MPS-IIIA is marked by progressive neurodegeneration. A nine-year-old boy with developmental delay presented with progressive three-month functional decline culminating in emergency department presentation for lethargy and immobility. Laboratory workup revealed hepatic and renal failure, coagulopathy, pancytopenia, hypernatremia, and uremia requiring emergent dialysis. He developed hyperkalemia during …