Objective: Previous studies have shown that the lactate/albumin ratio (LAR) can be a prognostic biomarker in intensive care unit (ICU) patients. However, the usefulness of LAR in predicting mortality and guiding intensive care unit admission in hospitalized patients due to community-acquired pneumonia (CAP) remains unclear. This study aims to evaluate the predictive value of the LAR compared to Pneumonia Severity Index (PSI), Confusion, urea, respiratory rate, blood pressure, 65 years or older (CURB-65), and quick-Sequential Organ Failure Assessment (q-SOFA) scores in determining the need for ICU admission and mortality among hospitalized patients with CAP. Methods: Adult patients diagnosed and hospitalized with community-acquired pneumonia between July 2021 and July 2023 were included. Patients’ demographics, comorbidities, disease severity scores, laboratory findings at the admission and outcomes were recorded. Patients were grouped and compared according to admission place (ward or ICU). Results: PSI, CURB-65, q-SOFA scores, and LAR were higher in ICU patients than in those admitted to the ward. Regarding the ICU admission, the AUC values for PSI, CURB-65, q-SOFA and LAR were 0.794 (95% CI: 0.737–0.843) (p < 0.001), 0.825 (95% CI: 0.771–0.870) (p < 0.001), 0.755 (0.690–0.813) (p < 0.001), and 0.749 (95% CI: 0.689–0.802) (p < 0.001), respectively. Regarding the mortality, the AUC values for PSI, CURB-65, q-SOFA, and LAR were 0.722 (95% CI: 0.661–0.778) (p < 0.001), 0.743 (95% CI: 0.683–0.797) (p < 0.001), 0.645 (0.575–0.711) (p: 0.02), 0.761 (95% CI: 0.702–0.814) (p < 0.001), respectively. There wasn’t any difference detected in pairwise comparisons of ROC curves. Conclusion: In this study, LAR was found to be a good predictor of ICU admissions and mortality in hospitalized patients with CAP and was non-inferior to PSI, CURB-65, or q-SOFA scores.

There are limited data on the long-term outcomes of COVID-19 from different parts of the world. To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Retrospective, observational cohort. Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P < .001), lactate level >2 mmol/L (2.78 [1.93-4.01], P < .001), age ≥60 years (2.45 [1.48-4.06)], P < .001), cardiac arrhythmia during ICU stay (2.01 [1.27-3.20], P = .003), vasopressor treatment (1.94 [1.32-2.84], P = .001), positive fluid balance of ≥600 mL/day (1.68 [1.21-2.34], P = .002), PaO₂/FiO₂ ratio of ≤150 mmHg (1.66 [1.18-2.32], P = .003), and ECOG score ≥1 (1.42 [1.00-2.02], P = .050). Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.

Oxygen inhalation therapy,chronic obstructive pulmonary disease,pneumonia,critical care,intensive care,critically ill

There is no ideal method for determination of positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS) patients. We compared the effects of end-expiratory lung volume (...

Extracorporeal blood purification (EBP) therapies have shown promise as potential rescue treatments for patientswith septic shock. However, precise evidence regarding their effectiveness is lacking. This case-control study aimed to evaluate the 28-day survival benefit of a resin cartridge-based EBP therapy compared to conventional therapies in patients with septic shock.Materials and methods: The study sample was collected retrospectively from the medical records of patients admitted to the intensivecare unit (ICU) between 2015 and 2020. The study included patients with septic shock aged ≥18 years who had ICU stays >96 h andexcluded those lost to follow-up by 28 days or readmitted. First, 28-day survival was compared between EBP patients and 1:1 matchedconventionally treated controls. Second, the EBP patients were evaluated for clinical and laboratory improvements within 72 h of EBPtherapy.Results: Of 3742 patients, 391 were included in this study, of whom 129 received EBP therapy and had a 28-day survival rate of 44%,compared to 262 matched controls who received conventional therapy alone and had a survival rate of 33% (p = 0.001, log-rank =0.05, number needed to treat = 8, and odds ratio = 1.7). After receiving EBP therapy for 72 h, improvements were observed in theSequential Organ Failure Assessment scores (p < 0.05), shock indices (p < 0.05), partial pressure of oxygen in the arterial blood to the fractionof inspiratory oxygen concentration ratios (p < 0.001), vasopressor requirements (p < 0.001), pH (p < 0.05), lactate levels (p < 0.001), andC-reactive protein levels (p < 0.05).Conclusion: The findings suggest that administering resin cartridge-based EBP therapy to patients with septic shock may improve theirsurvival compared to conventional therapies.

Objective: Glycemic variability (GV) is associated with increased morbidity and mortality in critically ill patients. This study aimed to contribute to the knowledge on the subject and to investigate the situation in our intensive care patient population. Method: Patients who were admitted to the Intensive Care Unit (ICU) between January 2015 and August 2020 were screened using the hospital’s database. The following data were collected: demographic characteristics of the patients, comorbidities, APACHE II scores, SOFA scores, mean amplitude of glycemic excursions (MAGE) based on daily blood glucose measurements from the first day of ICU admission until discharge up to the 28th day of their stay, length of stay (LOS), and 28-day mortality status. Results: In this study, 136 patients were enrolled and divided into high (n=70) and low GV (n=66). No differences were found between the two groups in terms of age, gender, comorbidity, APACHE II, mean SOFA scores, treatments, ICU LOS, and mortality. MAGE was higher in nonsurvivors (78.8 ±32.2) compared to survivors (65.4 ±22.5) (t=-2.78, p= 0.005). Regarding the mortality, the AUC value for GV was 0.611 (p=0.02) for MAGE >61 mg/dl, with a sensitivity of 68.5% and specificity of 50%. Patients were grouped according to GV (MAGE>65) and the presence of diabetes mellitus (DM). Mortality was highest in patients with high GV and without DM (53.3%). Conclusion: In this study, MAGE levels were higher in non-survivors than survivors, and glycemic variability was moderately associated with mortality. Patients with high GV and without DM had a higher mortality rate compared to those with DM.