Diagnostics in Critical Care

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (20 August 2024) | Viewed by 2924

Special Issue Editor

Special Issue Information

Dear Colleagues,

Early screening and recognition of severe medical and surgical illnesses, advanced and rush prehospital care of urgent conditions, organized immediate care in trauma centers and development of in-hospital rapid response teams has led to an increase of intensive care patients and survival of severe conditions in the last few decades. In the intensive care setting, bedside diagnostic tools are essential for good quality of care, early recognition of complications and treatment of critically ill patients. Due to very unstable patients, complex monitoring and often diverse robust organ support systems (extracorporeal heart, lungs kidneys, liver support, etc.) diagnostics need to be brought to the patient's bed. Intensive care treatment of medical patients, patients after cardiothoracic or major abdominal surgery, polytraumatized and all other critically ill patients is currently incomprehensible without continuously sophisticated monitoring, bedside ultrasonography, diverse radiologic diagnostic techniques, point of care coagulation management and laboratory and other diagnostic modalities. In the time of the COVID-19 pandemic, the information on the use of different radiologic techniques, on revolutionary use of ultrasonography in lungs investigation, diverse laboratory tests primarily for COVID-19 diagnosis and furthermore for early recognition of potentially fatal complications and their prevention is increasing and should be properly addressed.

Furthermore, diagnostic techniques are rapidly emerging as an important and irreplaceable tool in the hands of intensive care physicians; therefore, the main goal of this second volume Special Issue is to update on and summarize diverse diagnostic modalities and diagnostic approaches in the intensive care setting, specially focusing on the point of care approach.

Dr. Sasa Rajsic
Guest Editor

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Keywords

  • intensive care
  • critical care
  • critically ill
  • point of care
  • bedside
  • monitoring
  • ultrasonography
  • radiologic diagnostic
  • coagulation
  • COVID-19
  • emergency
  • prehospital

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Published Papers (2 papers)

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Research

12 pages, 959 KiB  
Article
The Accuracy of the Passive Leg Raising Test Using the Perfusion Index to Identify Preload Responsiveness—A Single Center Study in a Resource-Limited Setting
by Marialessia Casazzo, Luigi Pisani, Rabiul Alam Md Erfan Uddin, Abdus Sattar, Rashed Mirzada, Abu Shahed Mohammad Zahed, Shoman Sarkar, Anupam Barua, Sujat Paul, Mohammad Abul Faiz, Abdullah Abu Sayeed, Stije J. Leopold, Sue J. Lee, Mavuto Mukaka, Mohammed Abul Hassan Chowdhury, Ketsanee Srinamon, Marja Schilstra, Asok Kumar Dutta, Salvatore Grasso, Marcus J. Schultz, Aniruddha Ghose, Arjen Dondorp and Katherine Plewesadd Show full author list remove Hide full author list
Diagnostics 2025, 15(1), 103; https://doi.org/10.3390/diagnostics15010103 - 4 Jan 2025
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Abstract
Background: We investigated the accuracy of predicting preload responsiveness by means of a passive leg raising test (PLR) using the perfusion index (PI) in critically ill patients showing signs of hypoperfusion in a resource-limited setting. Methods: We carried out a prospective observational single [...] Read more.
Background: We investigated the accuracy of predicting preload responsiveness by means of a passive leg raising test (PLR) using the perfusion index (PI) in critically ill patients showing signs of hypoperfusion in a resource-limited setting. Methods: We carried out a prospective observational single center study in patients admitted for sepsis or severe malaria with signs of hypoperfusion in Chattogram, Bangladesh. A PLR was performed at baseline, and at 6, 24, 48, and 72 h. Preload responsiveness assessed through PI was compared to preload responsiveness assessed through cardiac index (CI change ≥5%), as reference test. The primary endpoint was the accuracy of preload responsiveness prediction of PLR using PI at baseline; secondary endpoints were the accuracies at 6, 24, 48, and 72 h. Receiver operating characteristic (ROC) curves were constructed. Results: The study included 34 patients admitted for sepsis with signs of hypoperfusion and 10 patients admitted for severe malaria. Of 168 PLR tests performed, 143 had reliable PI measurements (85%). The best identified PI change cutoff to discriminate responders from non–responders was 9.7%. The accuracy of PLR using PI in discriminating a preload responsive patient at baseline was good (area under the ROC 0.87 95% CI 0.75–0.99). The test showed high sensitivity and negative predictive value, with comparably lower specificity and positive predictive value. Compared to baseline, the AUROC of PLR using PI was lower at 6, 24, 48, and 72 h. Restricting the analysis to sepsis patients did not change the findings. Conclusions: In patients with sepsis or severe malaria and signs of hypoperfusion, changes in PI after a PLR test detected preload responsiveness. The diagnostic accuracy was better when PI changes were measured at baseline. Full article
(This article belongs to the Special Issue Diagnostics in Critical Care)
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12 pages, 2780 KiB  
Article
ECMO in Myocardial Infarction-Associated Cardiogenic Shock: Blood Biomarkers as Predictors of Mortality
by Thomas Senoner, Benedikt Treml, Robert Breitkopf, Ulvi Cenk Oezpeker, Nicole Innerhofer, Christine Eckhardt, Aleksandra Radovanovic Spurnic and Sasa Rajsic
Diagnostics 2023, 13(24), 3683; https://doi.org/10.3390/diagnostics13243683 - 17 Dec 2023
Cited by 3 | Viewed by 1555
Abstract
Background: Veno-arterial extracorporeal membrane oxygenation (va-ECMO) can provide circulatory and respiratory support in patients with cardiogenic shock. The main aim of this work was to investigate the association of blood biomarkers with mortality in patients with myocardial infarction needing va-ECMO support. Methods: We [...] Read more.
Background: Veno-arterial extracorporeal membrane oxygenation (va-ECMO) can provide circulatory and respiratory support in patients with cardiogenic shock. The main aim of this work was to investigate the association of blood biomarkers with mortality in patients with myocardial infarction needing va-ECMO support. Methods: We retrospectively analyzed electronic medical charts from patients receiving va-ECMO support in the period from 2008 to 2021 at the Medical University Innsbruck, Department of Anesthesiology and Intensive Care Medicine. Results: Of 188 patients, 57% (108/188) survived to discharge, with hemorrhage (46%) and thrombosis (27%) as the most frequent adverse events. Procalcitonin levels were markedly higher in non-survivors compared with survivors during the observation period. The multivariable model identified higher blood levels of procalcitonin (HR 1.01, p = 0.002) as a laboratory parameter associated with a higher risk of mortality. Conclusions: In our study population of patients with myocardial infarction-associated cardiogenic shock, deceased patients had increased levels of inflammatory blood biomarkers throughout the whole study period. Increased procalcitonin levels have been associated with a higher risk of mortality. Future studies are needed to show the role of procalcitonin in patients receiving ECMO support. Full article
(This article belongs to the Special Issue Diagnostics in Critical Care)
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