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New Insights of Respiratory and Critical Care Research
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New Insights of Respiratory and Critical Care Research

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Intensive Care".

Deadline for manuscript submissions: closed (20 September 2023) | Viewed by 7834

Special Issue Editors

Prof. Dr. Lixin Xie

E-Mail Website
Guest Editor
College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing, China
Interests: lung injury and repair; respiratory support; infection and immune imbalance; respiratory rehabilitation
Prof. Dr. Longxiang Su

E-Mail Website
Guest Editor
Department of Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
Interests: sepsis; ARDS; hemodynamics; transomics; mechanical ventilation; big data; artificial intelligence

Special Issue Information

Dear Colleagues,

With the global spread of COVID-19, respiratory and critical care practices have increasingly drawn public attention, and their improvement is a challenge facing the research community. Looking at the development in this field over the past ten years, we believe that there are several potential directions that are worth exploring, including new discoveries of omics technologies for respiratory and critical care contexts; new understanding of the roles of organoids in lung injury and repair mechanisms; exploration of pathophysiological changes in acute respiratory failure and severe respiratory distress by bedside visualization; respiratory support methods for lung protection and damage; new revelations surrounding the roles of data and artificial intelligence in the diagnosis and treatment in respiratory and critical care contexts.

Prof. Dr. Lixin Xie
Prof. Dr. Longxiang Su
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • critical care
  • ARDS
  • ARF
  • sepsis
  • omics
  • organoids
  • mechanical ventilation
  • respiratory support
  • respiratory visualization
  • artificial intelligence

Published Papers (5 papers)

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Research

11 pages, 626 KiB  
Article
Nutritional State, Immunological and Biochemical Parameters, and Mortality in the ICU: An Analytical Study
by Blanca Cecilia Díaz Chavarro, Manuel Romero-Saldaña, Jorge Karim Assis Reveiz and Guillermo Molina-Recio
J. Clin. Med. 2023, 12(13), 4177; https://doi.org/10.3390/jcm12134177 - 21 Jun 2023
Viewed by 1091
Abstract
Intensive care unit (ICU) hospitalization involves critically ill patients with multiple diseases and possible complications, including malnutrition, which increases hospital stay and mortality. Therefore, identifying the patient’s prior nutritional state, following up during hospitalization, and implementing early intervention positively affect patient’s vital situations [...] Read more.
Intensive care unit (ICU) hospitalization involves critically ill patients with multiple diseases and possible complications, including malnutrition, which increases hospital stay and mortality. Therefore, identifying the patient’s prior nutritional state, following up during hospitalization, and implementing early intervention positively affect patient’s vital situations at discharge. The objective of this study is to determine the nutritional state of patients admitted to an ICU in Cali (Colombia) in 2019 and its association with immunological and biochemical parameters and mortality observed during hospitalization. This was an observational, analytical, and retrospective study of patients admitted to an ICU in a clinic in Cali (Colombia) from 1 January to 31 March 2019. The association between their nutritional state and outcome variables such as hospital stay, immunological and biochemical function, and mortality was analyzed. Logistic regression was used to predict patients’ vital status at hospital discharge. In terms of the nutritional level, low weight was observed in 17.5% patients, and overweight/obesity was observed in 53.5% of the population. Nutritional state was associated with leukocytosis. The patients with lymphocytosis had longer hospital stays than those with normal lymphocyte ranges. Age, blood leukocytes, and creatinine and potassium levels increased the risk of mortality. Lymphocyte values have been used as predictors of severity and hospitalization time. The scientific literature has also evidenced a higher leukocyte count in people with obesity, and such leukocytosis is associated with the risk of mortality. The results of blood and laboratory tests determining kidney function and blood electrolytes allow for the prediction of mortality risk in critically ill patients. Full article
(This article belongs to the Special Issue New Insights of Respiratory and Critical Care Research)
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12 pages, 1733 KiB  
Article
Evaluation of Different Contrast Agents for Regional Lung Perfusion Measurement Using Electrical Impedance Tomography: An Experimental Pilot Study
by Thomas Muders, Benjamin Hentze, Steffen Leonhardt and Christian Putensen
J. Clin. Med. 2023, 12(8), 2751; https://doi.org/10.3390/jcm12082751 - 07 Apr 2023
Cited by 5 | Viewed by 1407
Abstract
Monitoring regional blood flow distribution in the lungs appears to be useful for individually optimizing ventilation therapy. Electrical impedance tomography (EIT) can be used at the bedside for indicator-based regional lung perfusion measurement. Hypertonic saline is widely used as a contrast agent but [...] Read more.
Monitoring regional blood flow distribution in the lungs appears to be useful for individually optimizing ventilation therapy. Electrical impedance tomography (EIT) can be used at the bedside for indicator-based regional lung perfusion measurement. Hypertonic saline is widely used as a contrast agent but could be problematic for clinical use due to potential side effects. In five ventilated healthy pigs, we investigated the suitability of five different injectable and clinically approved solutions as contrast agents for EIT-based lung perfusion measurement. Signal extraction success rate, signal strength, and image quality were analyzed after repeated 10 mL bolus injections during temporary apnea. The best results were obtained using NaCl 5.85% and sodium-bicarbonate 8.4% with optimal success rates (100%, each), the highest signal strengths (100 ± 25% and 64 ± 17%), and image qualities (r = 0.98 ± 0.02 and 0.95 ± 0.07). Iomeprol 400 mg/mL (non-ionic iodinated X-ray contrast medium) and Glucose 5% (non-ionic glucose solution) resulted in mostly well usable signals with above average success rates (87% and 89%), acceptable signal strength (32 ± 8% and 16 + 3%), and sufficient image qualities (r = 0.80 ± 0.19 and 0.72 ± 0.21). Isotonic balanced crystalloid solution failed due to a poor success rate (42%), low signal strength (10 ± 4%), and image quality (r = 0.43 ± 0.28). While Iomeprol might enable simultaneous EIT and X-ray measurements, glucose might help to avoid sodium and chloride overload. Further research should address optimal doses to balance reliability and potential side effects. Full article
(This article belongs to the Special Issue New Insights of Respiratory and Critical Care Research)
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12 pages, 1787 KiB  
Article
Prediction of Fluid Responsiveness Using Combined End-Expiratory and End-Inspiratory Occlusion Tests in Cardiac Surgical Patients
by Jan Horejsek, Martin Balík, Jan Kunstýř, Pavel Michálek, Tomáš Brožek, Petr Kopecký, Adam Fink, Petr Waldauf and Michal Pořízka
J. Clin. Med. 2023, 12(7), 2569; https://doi.org/10.3390/jcm12072569 - 29 Mar 2023
Cited by 2 | Viewed by 1391
Abstract
End-expiratory occlusion (EEO) and end-inspiratory occlusion (EIO) tests have been successfully used to predict fluid responsiveness in various settings using calibrated pulse contour analysis and echocardiography. The aim of this study was to test if respiratory occlusion tests predicted fluid responsiveness reliably in [...] Read more.
End-expiratory occlusion (EEO) and end-inspiratory occlusion (EIO) tests have been successfully used to predict fluid responsiveness in various settings using calibrated pulse contour analysis and echocardiography. The aim of this study was to test if respiratory occlusion tests predicted fluid responsiveness reliably in cardiac surgical patients with protective ventilation. This single-centre, prospective study, included 57 ventilated patients after elective coronary artery bypass grafting who were indicated for fluid expansion. Baseline echocardiographic measurements were obtained and patients with significant cardiac pathology were excluded. Cardiac index (CI), stroke volume and stroke volume variation were recorded using uncalibrated pulse contour analysis at baseline, after performing EEO and EIO tests and after volume expansion (7 mL/kg of succinylated gelatin). Fluid responsiveness was defined as an increase in cardiac index by 15%. Neither EEO, EIO nor their combination predicted fluid responsiveness reliably in our study. After a combined EEO and EIO, a cut-off point for CI change of 16.7% predicted fluid responsiveness with a sensitivity of 61.8%, specificity of 69.6% and ROC AUC of 0.593. In elective cardiac surgical patients with protective ventilation, respiratory occlusion tests failed to predict fluid responsiveness using uncalibrated pulse contour analysis. Full article
(This article belongs to the Special Issue New Insights of Respiratory and Critical Care Research)
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12 pages, 1828 KiB  
Article
Establishment and Application of a Patient-Ventilator Asynchrony Remote Network Platform for ICU Mechanical Ventilation: A Retrospective Study
by Longxiang Su, Yunping Lan, Yi Chi, Fuhong Cai, Zhenfeng Bai, Xianlong Liu, Xiaobo Huang, Song Zhang and Yun Long
J. Clin. Med. 2023, 12(4), 1570; https://doi.org/10.3390/jcm12041570 - 16 Feb 2023
Cited by 3 | Viewed by 1925
Abstract
Background: In the process of mechanical ventilation, the problem of patient-ventilator asynchrony (PVA) is faced. This study proposes a self-developed remote mechanical ventilation visualization network system to solve the PVA problem. Method: The algorithm model proposed in this study builds a remote network [...] Read more.
Background: In the process of mechanical ventilation, the problem of patient-ventilator asynchrony (PVA) is faced. This study proposes a self-developed remote mechanical ventilation visualization network system to solve the PVA problem. Method: The algorithm model proposed in this study builds a remote network platform and achieves good results in the identification of ineffective triggering and double triggering abnormalities in mechanical ventilation. Result: The algorithm has a sensitivity recognition rate of 79.89% and a specificity of 94.37%. The sensitivity recognition rate of the trigger anomaly algorithm was as high as 67.17%, and the specificity was 99.92%. Conclusions: The asynchrony index was defined to monitor the patient’s PVA. The system analyzes real-time transmission of respiratory data, identifies double triggering, ineffective triggering, and other anomalies through the constructed algorithm model, and outputs abnormal alarms, data analysis reports, and data visualizations to assist or guide physicians in handling abnormalities, which is expected to improve patients’ breathing conditions and prognosis. Full article
(This article belongs to the Special Issue New Insights of Respiratory and Critical Care Research)
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9 pages, 1123 KiB  
Article
Hemodynamic and Respiratory Changes following Prone Position in Acute Respiratory Distress Syndrome Patients: A Clinical Study
by Maria Baka, Dimitra Bagka, Vasiliki Tsolaki, George E. Zakynthinos, Chrysi Diakaki, Konstantinos Mantzarlis and Demosthenes Makris
J. Clin. Med. 2023, 12(3), 760; https://doi.org/10.3390/jcm12030760 - 18 Jan 2023
Viewed by 1478
Abstract
Background: Limited data are available for the oxygenation changes following prone position in relation to hemodynamic and pulmonary vascular variations in acute respiratory distress syndrome (ARDS), using reliable invasive methods. We aimed to assess oxygenation and hemodynamic changes between the supine and prone [...] Read more.
Background: Limited data are available for the oxygenation changes following prone position in relation to hemodynamic and pulmonary vascular variations in acute respiratory distress syndrome (ARDS), using reliable invasive methods. We aimed to assess oxygenation and hemodynamic changes between the supine and prone posture in patients with ARDS and identify parameters associated with oxygenation improvement. Methods: Eighteen patients with ARDS under protective ventilation were assessed using advanced pulmonary artery catheter monitoring. Physiologic parameters were recorded at baseline supine position, 1 h and 18 h following prone position. Results: The change in the Oxygenation Index (ΔOI) between supine and 18 h prone significantly correlated to the concurrent change in shunt fraction (r = 0.75, p = 0.0001), to the ΔOI between supine and 1 h prone (r = 0.73, p = 0.001), to the supine acute lung injury score and the OI (r = −0.73, p = 0.009 and r = 0.69, p = 0.002, respectively). Cardiac output did not change between supine and prone posture. Moreover, there was no change in pulmonary pressure, pulmonary vascular resistances, right ventricular (RV) volumes and the RV ejection fraction. Conclusions: The present investigation provides physiologic clinical data supporting that oxygenation improvement following prone position in ARDS is driven by the shunt fraction reduction and not by changes in hemodynamics. Moreover, oxygenation improvement was not correlated with RV or pulmonary circulation changes. Full article
(This article belongs to the Special Issue New Insights of Respiratory and Critical Care Research)
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