Intensive Care and Life Support

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Intensive Care/ Anesthesiology".

Deadline for manuscript submissions: closed (30 April 2025) | Viewed by 694

Special Issue Editor


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Guest Editor
1. Division of Internistic Intensive Medicine with Clinical Pharmacology and Toxicology, Internal Medicine Department, University Hospital of Split, Spinciceva 1, 21000 Split, Croatia
2. School of Medicine, University of Split, Soltanska 1, 21000 Split, Croatia
Interests: intensive care; toxicology; critical care nephrology; dialysis; life support; ultrasound in intensive care
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Special Issue Information

Dear Colleagues,

Life support and intensive care are critical, complex, and important medical interventions used to sustain life or aid in recovery from serious illness or injury. The decision to use life support and intensive care is challenging, and it is important to weigh the potential benefits and risks of these interventions, as well as the patient's quality of life and prognosis. Life support and intensive care should be provided in special units (intensive care units: ICUs). While life support can be a component of intensive care, it is not always necessary. Some patients in the ICU may require only close monitoring and supportive care, while others may need a combination of life support and intensive care interventions. The scientific approaches and new trials in critical care medicine are in constant development and contribute to a better understanding of complex pathophysiological processes and thus to better treatment of critical patients.

We are pleased to invite you to contribute to the development of this dynamic medical field and to share your experiences, studies, and observations related to the provision of organ replacement in critically ill patients. In this Special Issue, original research articles and reviews are welcome. Contribution areas may include the following: mechanical ventilation, extracorporeal membrane oxygenation, cardiopulmonary resuscitation, automated external defibrillator and external pacemakers, artificial nutrition including tube feeding and parenteral nutrition, all modes of continuous renal replacement therapies, plasmapheresis, hemoperfusion and similar extracorporeal blood purification methods, hemodynamic monitoring, application of ultrasound in the ICU, administration of drugs in the ICU, etc.

I hope that your contributions to this Special Issue will have a significant impact on improving the outcome of critical patients who are treated in the ICU and need some form of life support.

I am looking forward to receiving your contributions.

Dr. Vedran Kovačić
Guest Editor

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Keywords

  • acute organ failure
  • mechanical ventilation
  • nutrition in ICU
  • renal replacement therapy
  • extracorporeal blood purification
  • extracorporeal membrane oxygenation
  • cardiopulmonary resuscitation
  • external pacing
  • hepatic support

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Published Papers (1 paper)

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Research

13 pages, 1256 KiB  
Article
Serial Changes in Vitamin D Status in Patients During Severe Acute Respiratory Distress Syndrome and Extracorporeal Membrane Oxygenation
by Martina Hermann, Jelena Poslussny, Gernot Gerger, Helmuth Haslacher, Georg Mayrhofer, Verena Eva Tretter, Mathias Maleczek and Cem Ekmekcioglu
Medicina 2025, 61(5), 901; https://doi.org/10.3390/medicina61050901 - 16 May 2025
Viewed by 493
Abstract
Background and Objectives: Therapeutic interventions, such as extracorporeal membrane oxygenation (ECMO) therapy, in patients suffering from severe acute respiratory distress syndrome (ARDS) may reduce their vitamin D levels. Many observational studies have shown associations between poor outcomes and low vitamin D levels [...] Read more.
Background and Objectives: Therapeutic interventions, such as extracorporeal membrane oxygenation (ECMO) therapy, in patients suffering from severe acute respiratory distress syndrome (ARDS) may reduce their vitamin D levels. Many observational studies have shown associations between poor outcomes and low vitamin D levels in critically ill patients. This retrospective study primarily aimed to investigate the time-dependent changes in vitamin D levels and the correlation of vitamin D levels with disease severity and inflammatory markers in patients suffering from ARDS receiving ECMO therapy. Materials and Methods: This study used a longitudinal approach to assess the serial changes and the correlations of vitamin D levels (25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D)) with disease severity and inflammatory markers in 24 invasively mechanically ventilated (IMV) patients treated using ECMO over a period of 17 days. Most of the patients in this study were suffering from severe coronavirus disease 2019 (COVID-19) (n = 19; 79%). Serial blood samples collected during routine blood draws were retrospectively analyzed to assess the dynamics of their vitamin D levels over 17 days of ICU therapy. Results: Hypovitaminosis D (25(OH)D ≤ 50 nmol/L) was prevalent in 18 (75%) patients, while values of 25(OH)D lower than 30 nmol/L were measured in 5 patients (21%), indicating severe deficiency. Additionally, 1,25(OH)2D showed a significant decrease within the first 11 days of intensive care unit (ICU) treatment (these levels dropped by 28%; p = 0.03) and then remained at similar levels throughout the observational period; 25(OH)D levels remained largely unchanged during the observation period. We observed that 25(OH)D showed a significant negative correlation with C-reactive protein (CRP) (p = 0.04), and that 25(OH)D and 1,25(OH)2D levels did not show correlations with disease severity. Conclusions: Patients suffering from severe COVID-19 ARDS showed a significant decrease in their 1,25(OH)2D levels from day 0 to day 11 in the ICU. Therefore, routine vitamin D substitution and monitoring in critically ill patients, especially for patients suffering from ARDS treated with ECMO, should be carried out to prevent hypovitaminosis D. In addition, vitamin D may be associated with inflammation. Further studies are necessary to elucidate the mechanisms behind these retrospective observations. Full article
(This article belongs to the Special Issue Intensive Care and Life Support)
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