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JOURNAL ARTICLE
Praleene Sivapalan, Benjamin Skov Kaas-Hansen, Tine Sylvest Meyhoff, Peter Buhl Hjortrup, Maj-Brit N Kjær, Jon Henrik Laake, Maria Cronhjort, Stephan M Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L N G Malbrain, Morten Hylander Møller, Anders Perner, Anders Granholm
BACKGROUND: Variation in usual practice in fluid trials assessing lower versus higher volumes may affect overall comparisons. To address this, we will evaluate the effects of heterogeneity in treatment intensity in the Conservative versus Liberal Approach to Fluid Therapy of Septic Shock in Intensive Care trial. This will reflect the effects of differences in site-specific intensities of standard fluid treatment due to local practice preferences while considering participant characteristics...
April 4, 2024: Acta Anaesthesiologica Scandinavica
#2
JOURNAL ARTICLE
Antonio Messina, Michelle S Chew, Daniele Poole, Lorenzo Calabrò, Daniel De Backer, Katia Donadello, Glenn Hernandez, Olfa Hamzaoui, Mathieu Jozwiak, Christopher Lai, Manu L N G Malbrain, Jihad Mallat, Sheyla Nainan Myatra, Laurent Muller, Gustavo Ospina-Tascon, Michael R Pinsky, Sebastian Preau, Bernd Saugel, Jean-Louis Teboul, Maurizio Cecconi, Xavier Monnet
PURPOSE: To provide consensus recommendations regarding hemodynamic data reporting in studies investigating fluid responsiveness and fluid challenge (FC) use in the intensive care unit (ICU). METHODS: The Executive Committee of the European Society of Intensive Care Medicine (ESICM) commissioned and supervised the project. A panel of 18 international experts and a methodologist identified main domains and items from a systematic literature, plus 2 ancillary domains...
March 14, 2024: Intensive Care Medicine
#3
JOURNAL ARTICLE
Robbert Cleymaet, Marvin D'Hondt, Thomas Scheinok, Luca Malbrain, Inneke De Laet, Karen Schoonheydt, Hilde Dits, Niels Van Regenmortel, Michael Mekeirele, Colin Cordemans, Andrea Minini, Paolo Severgnini, Wojciech Dabrowski, Adrian Wong, Manu L N G Malbrain
OBJECTIVE: To compare bioelectrical impedance analysis (BIA)-derived parameters in healthy volunteers and critically ill patients and to assess its prognostic value in an ICU patient cohort. DESIGN: Retrospective, observational data analysis. SETTING: Single centre, tertiary-level ICU (Ziekenhuis Netwerk Antwerpen, ZNA Stuivenberg Hospital). PATIENTS: 101 patients and 101 healthy subjects, participants of International Fluid Academy Days...
December 23, 2023: Life
#4
REVIEW
Jeroen Walpot, Paul Van Herck, Caroline M Van de Heyning, Johan Bosmans, Samia Massalha, João R Inácio, Hein Heidbuchel, Manu L Malbrain
Sarcopenia is a syndrome characterised by loss of skeletal muscle mass, loss of muscle quality, and reduced muscle strength, resulting in low performance. Sarcopenia has been associated with increased mortality and complications after medical interventions. In daily clinical practice, sarcopenia is assessed by clinical assessment of muscle strength and performance tests and muscle mass quantification by dual-energy X-ray absorptio-metry (DXA) or bioelectrical impedance analysis (BIA). Assessment of the skeletal muscle quantity and quality obtained by abdominal computed tomography (CT) has gained interest in the medical community, as abdominal CT is performed for various medical reasons, and quantification of the psoas and skeletal muscle can be performed without additional radiation load and dye administration...
2023: Anaesthesiology Intensive Therapy
#5
JOURNAL ARTICLE
David Astapenko, Marek Zrzavecky, Diana Gorskaja, Radomir Hyspler, Alena Ticha, Vera Radochova, Christian Lehmann, Manu L N G Malbrain, Vladimir Cerny, Robert G Hahn
BACKGROUND: Endothelial glycocalyx (EG) plays a crucial role in maintaining the plasma proteins within the intravascular space. OBJECTIVE: We studied whether exogenous albumin protects the EG in an experimental model of EG enzymatic damage in rats. METHODS: Rats were divided into three groups of 10 animals that received (1) Evans blue (2) Evans blue + hyaluronidase, or (3) Evans blue + hyaluronidase + 20% human albumin via the tail vein...
December 7, 2023: Clinical Hemorheology and Microcirculation
#6
RANDOMIZED CONTROLLED TRIAL
Tine Sylvest Meyhoff, Anders Granholm, Peter Buhl Hjortrup, Praleene Sivapalan, Theis Lange, Jon Henrik Laake, Maria Cronhjort, Stephan M Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L N G Malbrain, Morten Hylander Møller, Anders Perner
BACKGROUND: Albumin administration is suggested in patients with sepsis and septic shock who have received large volumes of crystalloids. Given lack of firm evidence, clinical practice variation may exist. To address this, we investigated if patient characteristics or trial site were associated with albumin use in septic shock. METHODS: We conducted a post-hoc study of the CLASSIC international, randomised clinical trial of fluid volumes in septic shock. Associations between selected baseline variables and trial site with albumin use during ICU stay were assessed in Cox models considering death, ICU discharge, and loss-to-follow-up as competing events...
March 2024: Acta Anaesthesiologica Scandinavica
#7
JOURNAL ARTICLE
Salar Tayebi, Tim McKinney, Cynthia McKinney, Dipak Delvadia, Marc-Alan Levine, Edward S Spofford, Luca Malbrain, Johan Stiens, Wojciech Dabrowski, Manu L N G Malbrain
Introduction : Intra-abdominal pressure (IAP) monitoring is crucial for the detection and prevention of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). In the 1970s, air-filled catheters (AFCs) for urodynamic studies were introduced as a solution to overcome the limitations of water-perfused catheters. Recent studies have shown that for correct IAP measurement with traditional AFC, the bladder needs to be primed with 25 mL of saline solution to allow pressure wave transmission to the transducer outside of the body, which limits continuous IAP monitoring...
October 29, 2023: Sensors
#8
REVIEW
Prashant Nasa, Gunjan Chanchalani, Deven Juneja, Manu Lng Malbrain
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) play a pivotal role in the pathophysiology of severe acute pancreatitis (SAP) and contribute to new-onset and persistent organ failure. The optimal management of ACS involves a multi-disciplinary approach, from its early recognition to measures aiming at an urgent reduction of intra-abdominal pressure (IAP). A targeted literature search from January 1, 2000, to November 30, 2022, revealed 20 studies and data was analyzed on the type and country of the study, patient demographics, IAP, type and timing of surgical procedure performed, post-operative wound management, and outcomes of patients with ACS...
September 27, 2023: World Journal of Gastrointestinal Surgery
#9
JOURNAL ARTICLE
Praleene Sivapalan, Tine Sylvest Meyhoff, Peter Buhl Hjortrup, Theis Lange, Benjamin Skov Kaas-Hansen, Maj-Brit N Kjaer, Jon Henrik Laake, Maria Cronhjort, Stephan M Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L N G Malbrain, Morten Hylander Møller, Anders Perner, Anders Granholm
BACKGROUND: The CLASSIC trial assessed the effects of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock. This pre-planned study provides a probabilistic interpretation and evaluates heterogeneity in treatment effects (HTE). METHODS: We analysed mortality, serious adverse events (SAEs), serious adverse reactions (SARs) and days alive without life-support within 90 days using Bayesian models with weakly informative priors...
February 2024: Acta Anaesthesiologica Scandinavica
#10
JOURNAL ARTICLE
In Vitro Validation of a Novel Continuous Intra-Abdominal Pressure Measurement System (TraumaGuard).
Salar Tayebi, Robert Wise, Ashkan Zarghami, Luca Malbrain, Ashish K Khanna, Wojciech Dabrowski, Johan Stiens, Manu L N G Malbrain
Introduction: Intra-abdominal pressure (IAP) has been recognized as an important vital sign in critically ill patients. Due to the high prevalence and incidence of intra-abdominal hypertension in surgical (trauma, burns, cardiac) and medical (sepsis, liver cirrhosis, acute kidney injury) patients, continuous IAP (CIAP) monitoring has been proposed. This research was aimed at validating a new CIAP monitoring device, the TraumaGuard from Sentinel Medical Technologies, against the gold standard (height of a water column) in an in vitro setting and performing a comparative analysis among different CIAP measurement technologies (including two intra-gastric and two intra-bladder measurement devices)...
September 28, 2023: Journal of Clinical Medicine
#11
REVIEW
Manu L N G Malbrain, Pietro Caironi, Robert G Hahn, Juan V Llau, Marcia McDougall, Luís Patrão, Emily Ridley, Alan Timmins
Although effective and appropriate fluid management is a critical aspect of quality care during hospitalization, the widespread adoption of consistent policies that ensure adequate fluid stewardship has been slow and heterogenous. Despite evidence-based guidelines on fluid management being available, clinical opinions continue to diverge on important aspects of care in this setting, and the consistency of guideline implementation is far from ideal. A multidisciplinary panel of leading practitioners and experts convened to discuss best practices for ongoing staff education, intravenous fluid therapy, new training technologies, and strategies to track the success of institutional fluid stewardship efforts...
September 25, 2023: Annals of Intensive Care
#12
JOURNAL ARTICLE
Tayyba N Aslam, Thomas L Klitgaard, Christian A O Ahlstedt, Finn H Andersen, Michelle S Chew, Marie O Collet, Maria Cronhjort, Stine Estrup, Ole K Fossum, Shirin K Frisvold, Hans-Joerg Gillmann, Anders Granholm, Trine M Gundem, Kristin Hauss, Jacob Hollenberg, Maria E Huanca Condori, Johanna Hästbacka, Bror A Johnstad, Eric Keus, Maj-Brit N Kjaer, Pål Klepstad, Mette Krag, Reidar Kvåle, Manu L N G Malbrain, Christian S Meyhoff, Matt Morgan, Anders Møller, Carmen A Pfortmueller, Lone M Poulsen, Andrew C Robertson, Joerg C Schefold, Olav L Schjørring, Martin Siegemund, Martin I Sigurdsson, Fredrik Sjövall, Kristian Strand, Thomas Stueber, Wojciech Szczeklik, Rebecka R Wahlin, Helge L Wangberg, Karl-Andre Wian, Sine Wichmann, Kristin Hofsø, Morten H Møller, Anders Perner, Bodil S Rasmussen, Jon H Laake
BACKGROUND: When caring for mechanically ventilated adults with acute hypoxaemic respiratory failure (AHRF), clinicians are faced with an uncertain choice between ventilator modes allowing for spontaneous breaths or ventilation fully controlled by the ventilator. The preferences of clinicians managing such patients, and what motivates their choice of ventilator mode, are largely unknown. To better understand how clinicians' preferences may impact the choice of ventilatory support for patients with AHRF, we issued a survey to an international network of intensive care unit (ICU) researchers...
September 22, 2023: Acta Anaesthesiologica Scandinavica
#13
JOURNAL ARTICLE
Jeroen Walpot, Paul Van Herck, Caroline M Van de Heyning, Johan Bosmans, Samia Massalha, Manu L N G Malbrain, Hein Heidbuchel, João R Inácio
Over the last two decades, the potential role of epicardial adipocyte tissue (EAT) as a marker for major adverse cardiovascular events has been extensively studied. Unlike other visceral adipocyte tissues (VAT), EAT is not separated from the adjacent myocardium by a fascial layer and shares the same microcirculation with the myocardium. Adipocytokines, secreted by EAT, interact directly with the myocardium through paracrine and vasocrine pathways. The role of the Randle cycle, linking VAT accumulation to insulin resistance, and the relevance of blood flow and mitochondrial function of VAT, are briefly discussed...
2023: Anaesthesiology Intensive Therapy
#14
JOURNAL ARTICLE
David Astapenko, Radomir Hyspler, Alena Tich, Adela Tomasova, Pavel Navratil, Marek Zrzavecky, Bhavya Byreddy, Petr Sedlacek, Vera Radochova, Roman Skulec, Robert G Hahn, Christian Lehmann, Manu L N G Malbrain, Vladimir Cerny
BACKGROUND: Hydrogen is a potent antioxidant agent that can easily be administered by inhalation. The aim of the study was to evaluate whether hydrogen protects the endothelial glycocalyx layer after successful cardiopulmonary resuscitation (CPR). METHODS: Fourteen anesthetized pigs underwent CPR after induced ventricular fibrillation. During CPR and return of spontaneous circulation, 2% hydrogen gas was administered to seven pigs (hydrogen group) and seven constituted a control group...
September 2, 2023: Clinical Hemorheology and Microcirculation
#15
JOURNAL ARTICLE
Robert Wise, Reitze Rodseth, Ester Párraga-Ros, Rafael Latorre, Octavio López Albors, Laura Correa-Martín, Francisco M Sánchez-Margallo, Irma Eugenia Candanosa-Aranda, Jan Poelaert, Gregorio Castellanos, Manu L N G Malbrain
BACKGROUND: Intra-abdominal hypertension and abdominal compartment syndrome are common with clinically significant consequences. We investigated the pathophysiological effects of raised IAP as part of a more extensive exploratory animal study. The study design included both pneumoperitoneum and mechanical intestinal obstruction models. METHODS: Forty-nine female swine were divided into six groups: a control group (Cr; n = 5), three pneumoperitoneum groups with IAPs of 20mmHg (Pn20; n = 10), 30mmHg (Pn30; n = 10), 40mmHg (Pn40; n = 10), and two mechanical intestinal occlusion groups with IAPs of 20mmHg (MIO20; n = 9) and 30mmHg (MIO30; n = 5)...
2023: PloS One
#16
REVIEW
Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G Shelat, Richard Ten Broek, Gian Luca Baiocchi, Ernest E Moore, Ibrahima Sall, Mauro Podda, Luigi Bonavina, Igor A Kryvoruchko, Philip Stahel, Kenji Inaba, Philippe Montravers, Boris Sakakushev, Gabriele Sganga, Paolo Ballestracci, Manu L N G Malbrain, Jean-Louis Vincent, Manos Pikoulis, Solomon Gurmu Beka, Krstina Doklestic, Massimo Chiarugi, Marco Falcone, Elena Bignami, Viktor Reva, Zaza Demetrashvili, Salomone Di Saverio, Matti Tolonen, Pradeep Navsaria, Miklosh Bala, Zsolt Balogh, Andrey Litvin, Andreas Hecker, Imtiaz Wani, Andreas Fette, Belinda De Simone, Rao Ivatury, Edoardo Picetti, Vladimir Khokha, Edward Tan, Chad Ball, Carlo Tascini, Yunfeng Cui, Raul Coimbra, Michael Kelly, Costanza Martino, Vanni Agnoletti, Marja A Boermeester, Nicola De'Angelis, Mircea Chirica, Walt L Biffl, Luca Ansaloni, Yoram Kluger, Fausto Catena, Andrew W Kirkpatrick
Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment...
July 21, 2023: World Journal of Emergency Surgery: WJES
#17
REVIEW
Eduardo Butturini de Carvalho, Denise Battaglini, Chiara Robba, Manu L N G Malbrain, Paolo Pelosi, Patricia Rieken Macedo Rocco, Pedro Leme Silva
Patients on mechanical ventilation may receive intravenous fluids via restrictive or liberal fluid management. A clear and objective differentiation between restrictive and liberal fluid management strategies is lacking in the literature. The liberal approach has been described as involving fluid rates ranging from 1.2 to 12 times higher than the restrictive approach. A restrictive fluid management may lead to hypoperfusion and distal organ damage, and a liberal fluid strategy may result in endothelial shear stress and glycocalyx damage, cardiovascular complications, lung edema, and distal organ dysfunction...
July 21, 2023: Intensive Care Medicine Experimental
#18
COMMENT
Maj-Brit Nørregaard Kjær, Tine Sylvest Meyhoff, Praleene Sivapalan, Anders Granholm, Peter Buhl Hjortrup, Martin Bruun Madsen, Morten Hylander Møller, Ingrid Egerod, Jørn Wetterslev, Theis Lange, Maria Cronhjort, Jon Henrik Laake, Stephan M Jakob, Marek Nalos, Marlies Ostermann, Doug Gould, Maurizio Cecconi, Manu L N G Malbrain, Christian Ahlstedt, Louise Bendix Kiel, Morten H Bestle, Lars Nebrich, Thomas Hildebrandt, Lene Russell, Marianne Vang, Michael Lindhart Rasmussen, Christoffer Sølling, Anne Craveiro Brøchner, Mette Krag, Carmen Pfortmueller, Miroslav Kriz, Martin Siegemund, Giovanni Albano, Søren Rosborg Aagaard, Helle Bundgaard, Vera Crone, Sine Wichmann, Bror Johnstad, Yvonne Karin Martin, Philipp Seidel, Johan Mårtensson, Jacob Hollenberg, Mats Wistrand, Abele Donati, Enrico Barbara, Thomas Karvunidis, Alexa Hollinger, Andrea Carsetti, Nuttha Lumlertgul, Eva Joelsson-Alm, Nikolas Lambiris, Tayyba Naz Aslam, Fredrik Femtehjell Friberg, Gitte Kingo Vesterlund, Camilla Bekker Mortensen, Stine Rom Vestergaard, Sidsel Fjordbak Caspersen, Diana Bertelsen Jensen, Morten Borup, Bodil Steen Rasmussen, Anders Perner
PURPOSE: To assess long-term outcomes of restrictive versus standard intravenous (IV) fluid therapy in adult intensive care unit (ICU) patients with septic shock included in the European Conservative versus Liberal Approach to Fluid Therapy in Septic Shock in Intensive Care (CLASSIC) trial. METHODS: We conducted the pre-planned analyses of mortality, health-related quality of life (HRQoL) using EuroQol (EQ)-5D-5L index values and EQ visual analogue scale (VAS), and cognitive function using Mini Montreal Cognitive Assessment (Mini MoCA) test at 1 year...
July 2023: Intensive Care Medicine
#19
Andrea Crosignani, Stefano Spina, Francesco Marrazzo, Stefania Cimbanassi, Manu L N G Malbrain, Niels Van Regenmortel, Roberto Fumagalli, Thomas Langer
No abstract text is available yet for this article.
June 14, 2023: Annals of Intensive Care
#20
JOURNAL ARTICLE
Tine Sylvest Meyhoff, Anders Granholm, Peter Buhl Hjortrup, Praleene Sivapalan, Theis Lange, Jon Henrik Laake, Maria Cronhjort, Stephan M Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L N G Malbrain, Morten Hylander Møller, Anders Perner
BACKGROUND: Intravenous (IV) albumin is suggested for patients with septic shock who have received large amounts of IV crystalloids; a conditional recommendation based on moderate certainty of evidence. Clinical variation in the administration of IV albumin in septic shock may exist according to patient characteristics and location. METHODS: This is a protocol and statistical analysis plan for a post-hoc secondary study of the Conservative versus Liberal Approach to Fluid Therapy of Septic Shock in Intensive Care (CLASSIC) RCT of 1554 adult ICU patients with septic shock...
September 2023: Acta Anaesthesiologica Scandinavica
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