Optimizing Shock Treatments in Personalized Critical Care

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Critical Care".

Deadline for manuscript submissions: closed (25 September 2024) | Viewed by 2350

Special Issue Editors


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Guest Editor
Department of Cardiology and Intensive Care Medicine, Paracelsus Medical University of Salzburg, Salzburg, Austria
Interests: critical care; critical care outcomes; shock; sepsis; cardiopulmonary resuscitation; cardiology; infectious disease medicine

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Guest Editor
1. Department of Internal Medicine, General Hospital of Oberndorf, Oberndorf, Austria
2. Center for Public Health and Healthcare Research, Paracelsus Medical University of Salzburg, Salzburg, Austria
Interests: critical care; critical care outcomes; shock; public health; gastroenterology; hepatology
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Special Issue Information

Dear Colleagues,

The history of the word "shock" in medicine goes back nearly 300 years, and the definition of the term has changed repeatedly since then. Currently, the accepted doctrine is that shock is a life-threatening condition of circulatory failure, which causes inadequate oxygen delivery to meet cellular metabolic needs and oxygen consumption requirements, and thus ultimately cellular and tissue hypoxia.

Shock is not a single entity but an etiologically heterogeneous clinical syndrome, and is divided into four major (e.g., distributive, hypovolemic, cardiogenic, obstructive, etc.) and diverse (e.g., anaphylactic, septic, etc.) subcategories. Its incidence varies by aetiology, while mortality remains high, with studies frequently reporting fatality rates of 20–50% across all patient populations, despite advances in critical care.

As in many medical specialties, personalized medicine is becoming increasingly important in critical care, and alongside protocol-based acute care, the treatment of our patients is becoming more individualized.

We look forward to receiving numerous submissions from intensivists all around the globe addressing research on this deadly condition.

This Special Issue is designed to familiarize clinicians and researchers with the latest advances surrounding the treatment of shock in critical care from the perspective of personalized medicine.

Original research articles and review papers are welcome in this Special Issue. Research topics include, but are not limited to, the following:

  • Novel and/or established treatment options of distributive, hypovolemic, cardiogenic, and obstructive shock;
  • Optimized fluid and vasopressor management in individuals with shock;
  • The individual use of extracorporeal life support (ECLS) resources in patients with shock;
  • Antimicrobial therapeutic drug monitoring (TDM) trials in septic shock;
  • The treatment of shock in older patients;
  • Treatment goals and time-limited ICU trials in shocked patients, in whom benefits of critical care are uncertain;
  • Inflammatory and acute phase biomarkers as indicators of treatment response in shock.

Dr. Richard Rezar
Dr. Bernhard Wernly
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 Personalized Medicine is an international peer-reviewed open access monthly 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
  • critical care outcomes
  • shock
  • sepsis
  • resuscitation
  • precision medicine

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Published Papers (1 paper)

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Review

15 pages, 664 KiB  
Review
Corticosteroids in Pediatric Septic Shock: A Narrative Review
by Immacolata Rulli, Angelo Mattia Carcione, Federica D’Amico, Giuseppa Quartarone, Roberto Chimenz and Eloisa Gitto
J. Pers. Med. 2024, 14(12), 1155; https://doi.org/10.3390/jpm14121155 - 17 Dec 2024
Cited by 2 | Viewed by 1865
Abstract
Objective: A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Data Sources: [...] Read more.
Objective: A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Data Sources: Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus. Study Selection: The keywords “septic shock”, “steroids” and “children” were used. Data Extraction: Of 399 articles, 63 were selected. Data Synthesis: Regarding mortality, although the 2019 Cochrane review supports reduced mortality, benefits on long-term mortality and in patients with CIRCI (critical illness-related corticosteroid insufficiency) are not clear. Yang’s metanalysis and retrospective studies of Nichols and Atkinson show no difference or even an increase in mortality. Regarding severity, the Cochrane review claims that hydrocortisone seems to reduce the length of intensive care hospitalization but influences the duration of ventilatory and inotropic support, and the degree of multi-organ failure appears limited. Further controversies exist on adrenal function evaluation: according to literature, including the Surviving Sepsis Campaign guidelines, basal or stimulated hormonal dosages do not allow the identification of patients who could benefit from hydrocortisone therapy (poor reproducibility). Regarding side effects, muscle weakness, hypernatremia, and hyperglycemia are the most observed. Conclusions: The literature does not give certainties about the efficacy of corticosteroids in pediatric septic shock, as their influence on primary outcomes (mortality and severity) is controversial. A subgroup of patients suffering from secondary adrenal insufficiency could benefit from it, but it remains to be defined how to identify and what protocol to use to treat them. Full article
(This article belongs to the Special Issue Optimizing Shock Treatments in Personalized Critical Care)
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