World Journal of Critical Care Medicine

BACKGROUND Earlier meta-analyses demonstrated conflicting results on whether high-flow nasal cannula (HFNC) reduces rate of intubation in the postoperative period when compared to conventional oxygen therapy (COT). Since then, newer studies have come out, so an updated comparison of these two modalities is warranted. AIM To determine whether HFNC reduces the rate of reintubation compared to COT. …

Sepsis and septic shock are complex, heterogeneous syndromes associated with high morbidity and mortality despite advances in critical care management. Conventional biomarkers used in clinical practice lack specificity and prognostic accuracy to measure and monitor the dynamic metabolic abnormalities occurring in these conditions. Metabolomics, the comprehensive analysis of low-molecular weight m…

BACKGROUND Noise in intensive care units (ICUs) frequently exceeds recommended levels [the World Health Organization (WHO) recommends equivalent continuous noise level (Leq) < 35 dB], arising from alarms, equipment, and staff activity. Elevated sound can disrupt patients' sleep, increase stress, and impair recovery. AIM To identify the extent of noise exposure in the ICU. METHODS This observat…

BACKGROUND Although obstetric patients account for only 1%-2% of general intensive care unit (ICU) admissions, they constitute a distinct population with unique physiological characteristics and risk profiles. Therefore, understanding the clinical profile of these patients is essential for their appropriate management. AIM To evaluate clinical characteristics, outcomes, and mortality predictors a…

We read the study by Aggarwal et al recently published in World Journal of Critical Care Medicine , assessing the emergency endotracheal intubation (ETI) using two different equipment in critically ill patients and applaud it for choosing a crucial aspect of acute care. ETI remains a high-risk procedure in such patients with significant morbidity. The randomized design and objective outcome measu…

The randomized controlled trial by Aggarwal et al recently published in World Journal of Critical Care Medicine, compared the intubating laryngeal mask airway (ILMA) with the Camera Macintosh video laryngoscope (VL) for emergency intubation in critically ill adults. In this randomized cohort of 58 patients, the VL demonstrated a higher first-attempt success rate, shorter intubation time, and supe…

Point of care ultrasound (POCUS) has become an invaluable tool in the management of critically ill patients, offering real-time diagnostic insights into cardiovascular, pulmonary, and abdominal pathophysiology. In the critical care setting, timely diagnosis is essential to manage life-threatening conditions. The integration of artificial intelligence (AI) into POCUS has been a transformative tech…

BACKGROUND Dexmedetomidine is a selective α2-adrenergic receptor agonist widely used for sedation and anxiolysis in intensive care units (ICUs). Abrupt discontinuation after prolonged infusion may induce withdrawal symptoms because of sympathetic rebound. Although sinus tachycardia and hypertension are common manifestations, clinically significant tachyarrhythmias have rarely been reported in adu…

BACKGROUND Several studies have reported sex differences in resuscitation outcomes in critically ill adults, but whether these differences are associated with endotracheal intubation practices is not known. AIM To investigate sex differences in serious outcomes among critically ill adults undergoing endotracheal intubation in the emergency department. METHODS In this observational study, we enrol…

BACKGROUND Studies of short-term mental health (MH) outcomes among frontline (FL) healthcare workers (HCWs) during the pandemic have been extensively published and have reached dramatically variable conclusions. Long-term MH outcomes in this population have received less study. A synthesis of available data on long-term MH outcomes among FL HCWs associated with the coronavirus disease 2019 (COVID…

BACKGROUND Urolithiasis is one of the most prevalent condition with evolving management strategies. While extracorporeal shock wave lithotripsy (ESWL) and ureteroscopic lithotripsy (URSL) are common minimally invasive treatments, their comparative efficacy, safety, and impact on quality of life (QoL) require continuous evaluation. AIM To compare the clinical efficacy, safety, patient satisfaction…

The cascade of events initiated by traumatic brain injury (TBI) has been a major focus of research. Despite significant advances, a deeper understanding of both favorable and unfavorable factors is still needed in this special cohort, especially concerning non-neurological complications - such as respiratory dysfunction, cardiovascular issues, sepsis, and acute kidney injury (AKI). This underscor…

The coronavirus disease 2019 (COVID-19) pandemic placed unprecedented strain on emergency departments (ED), demanding rapid, reliable, and widely accessible tools to guide early clinical decision-making. While computed tomography offers high sensitivity for detecting pulmonary involvement, its routine use is limited by cost, logistics, and patient volume. In this context, chest radiography despit…

BACKGROUND Sepsis is associated with impaired tissue perfusion and elevated serum lactate, a key prognostic marker. Magnesium plays a vital role in cellular energy metabolism and may enhance lactate clearance in sepsis. AIM To investigate the impact of magnesium on the clearance of lactate in critically sick patients with sepsis. METHODS In this triple-blind, randomized trial, 138 adult patients …

BACKGROUND Tropical acute febrile illness (TAFI) is a major illness with a large number of intensive care unit (ICU) admissions in tropical regions. It is frequently complicated by acute kidney injury (AKI) and associated poor outcomes. The data on the predictors of outcomes, in terms of in-hospital mortality and renal outcomes, amongst critically-ill TAFI patients from our region remain limited.…

BACKGROUND Polytrauma is associated with the release of various biomarkers, including interleukin (IL)-6, a proinflammatory cytokine with prognostic value. AIM To evaluate the association between IL-6 measured within the first 24 hours of admission and the injury severity score (ISS) among adult polytrauma patients and to explore the link between early IL-6 levels and in-hospital mortality. METHO…

Peripheral venous catheters (PVCs) are almost always present in patients in the intensive care unit. Still, they are seldom used to administer vesicant or irritant drugs, including vasoactive agents, due to concerns about extravasation and local tissue injury. However, emerging evidence indicates that PVCs are safe and effective for this purpose, offering distinct clinical advantages and obviatin…

Dengue fever is one of the most common mosquito-borne viral diseases and poses a significant health threat. The primary management involves hydration tailored to the disease stage and severity. Although many cases are mild, dengue can rapidly progress within hours. Complications such as plasma leakage and bleeding are difficult to detect through routine clinical assessment alone. In this context,…

BACKGROUND Ketone bodies, especially β-hydroxybutyrate, have shown the potential to improve hemodynamic outcomes such as cardiac output (CO) and left ventricular ejection fraction (LVEF) in patients with heart failure (HF). However, the overall effectiveness of ketone body supplementation in this population remains uncertain. Therefore, we conducted this systematic review and meta-analysis to eva…

BACKGROUND Perineal necrotizing soft tissue infections (P-NSTI) are aggressive and potentially fatal conditions. Surgical fecal diversion (SFD) is often used to reduce contamination, but whether non-diversion provides comparable outcomes remains uncertain. We hypothesized that non-diversion does not confer worse outcomes than SFD. AIM To evaluate clinical outcomes of non-diversion compared with S…