Bibliometric Analysis of Scientific Output Growth in the Field of Lung Transplantation.

BACKGROUND: Lung transplantation (LT) has recently emerged as a scientifically validated curative therapeutic modality for patients afflicted with end-stage lung disease. This study aimed to conduct a global bibliometric analysis of research articles on LT between 1983 and 2021. METHODS: Employing the Web of Science database, a bibliometric analysis was conducted to assess the expansion of scientific output within the field of LT. We searched specific bibliometric characteristics such as language, and year of publication, first author, institutional affiliation, main publishing journals, and highly cited articles. Additionally, we made comparisons of the most productive countries. The VOSviewer program and the open-source visualization software Biblioshiny (version 2.0) were used to perform the bibliometric analysis. RESULTS: We identified 10,467 articles on LT published between 1983 and 2021, of which 94.898% were published in the Science Citation Index Expanded. The articles were from 101 different research areas. The publications were from 81 different countries globally, and mostly from the United States (41.196%), Germany (7.118%), and Canada (6.372%). The Journal of Heart and Lung Transplantation was the most published journal. Four thousand seven hundred and ninety three of the publications were published in the last 10 years with a 78,781 citation number in total. The highest number of publications and citations was in 2021. CONCLUSION: The majority of cutting-edge research findings are focused on only a few developed nations, and exchanges with emerging nations are still in their infancy. The United States has a strong, commanding position among the active countries in LT.

Mortality predictors on the day of healthcare-associated Acinetobacter baumanni bacteremia in intensive care unit.

INTRODUCTION: Mortality of healthcare-associated Acinetobacter baumannii bacteremia can be 50-60% in intensive care units (ICUs). We aimed to determine the risk factors for 28-day mortality in patients with sepsis due to A. baumannii bacteremia during their ICU follow-up. METHODOLOGY: Demographic characteristics, disease severity scores on admission and bacteremia day (BD), resistance status, invasive interventions, and laboratory values showing the infection and severity of the BD, were compared between groups with and without mortality as a retrospective cohort study in the ICU of a tertiary hospital. RESULTS: Of a total of 2411 patients, there were 192 cases of bacteremia. After applying the exclusion criteria, 39 patients were recruited for the study, 25 of whom died (mortality rate 64.1%). Higher age, Simplified Acute Physiology Score II (SAPS II) on admission and high Sequential Organ Failure Assessment Score (SOFA), Red Blood Cell Distribution Width (RDW) (p < 0.001), and C-Reactive Protein (CRP) (p = 0.002) on the BD and invasive intervention in follow-up were associated with mortality. When CRP and RDW were both positive, sensitivity was 72%, specificity was 100%, negative predictive value was 33%, and positive predictive value was 100% for the 28-day mortality after BD. Based on multivariate analysis, CRP and RDW values on the BD were independent risk factors for mortality. CONCLUSIONS: It is critical to monitor SOFA, RDW, and CRP values in older ICU patients with SAPS II scores and who undergo invasive intervention in follow-up. Increases in these parameters may indicate bacteremia with high mortality due to A. baumannii.

A Novel Method for Ultrasound-Guided Central Catheter Placement-Supraclavicular Brachiocephalic Vein Catheterization Versus Jugular Catheterization: A Prospective Randomized Study.

OBJECTIVES: To assess the superiority of a novel ultrasound-guided central venous catheterization technique, supraclavicular brachiocephalic catheterization, compared to jugular vein catheterization. DESIGN: Prospective randomized trial. SETTING: Operating rooms and intensive care unit. PARTICIPANTS: Eighty-six patients with central catheter placement were included in the present study. INTERVENTIONS: In the brachiocephalic group, ultrasound-guided catheterization of the brachiocephalic vein was performed via the supraclavicular route using needle-in-plane and syringe-free techniques. In the jugular group, ultrasound-guided catheterization of the internal jugular vein was performed using the needle-out-of-plane technique. MEASUREMENTS AND MAIN RESULTS: Measurements included number of needle insertion attempts, ultrasonography times, and cannulation times. Additionally, ultrasound visibility of the veins, needle, guidewire, and catheter, as well as ease of the procedure, were assessed. Mean cannulation time was 27.65 ± 25.36 seconds in Group B and 28.16 ± 21.72 seconds in Group J. The overall success rate was 97.6% in Group B and 97.7% in Group J. The mean ease score of the cannulation procedure was 8.78 ± 1.13 in Group B and 8.67 ± 1.23 in Group J. No significant differences were detected between groups. The mean ultrasonography time was 11.98 ± 6.91 seconds in Group B and 2.88 ± 1.47 seconds in Group J. Ultrasound visibility of the brachiocephalic, jugular, and subclavian veins, as well as the needle and the guidewire, were good; however, visibility of the catheter was poor. CONCLUSIONS: Although not superior to the standard internal jugular approach, the novel supraclavicular approach proved to be a noninferior method for central venous cannulation.

Where is the Guidewire? Confirmation of Central Catheter Placement in the Brachiocephalic Vein Using Y-shape Visualization by Ultrasound.

Central venous catheter placement with ultrasound guidance improves the success rate and reduces the number of puncture attempts and complications. Y-shape visualization of central veins using an endocavity micro-convex ultrasound probe is a new technique, which has been used for brachiocephalic vein cannulation. Since the jugular, subclavian, and brachiocephalic veins can be visualized in a single view using the Y-shape technique, it can also be used to confirm the correct placement of the catheter or guidewire. We aimed to present a case in which the location of the guidewire was verified by Y-shape visualization with an endocavity micro-convex probe after a cannulation attempt. Successful internal jugular vein catheterization was achieved with the assistance of the Y-shape imaging technique and the patient was avoided from multiple cannulation attempts.

A Rare Vascular Anomaly during Central Venous Catheterization: A Persistent Left-Sided Superior Vena Cava.

A persistent left-sided superior vena cava (PLSVC) is the most frequent abnormality of the venous system; however, it is not a very well-known variation among physicians. Herein we report the case of a patient with a PLSVC who was diagnosed after central venous catheterization (CVC). An 80-year-old man was admitted to the emergency room with cardiopulmonary arrest. After the return of spontaneous circulation, CVC was blindly performed from the left jugular vein without any complications. However, routine chest X-ray after catheterization revealed that the catheter was moving down directly to the left heart. Thoracic computed tomography showed the right brachiocephalic vein draining into the left brachiocephalic vein and forming the left superior vena cava in front of the aortic arch. The left superior vena cava merged into the right atrium after crossing the left pulmonary artery. CVC is widely used in clinical practice, and therefore clinicians should be aware of possible variations in central veins, particularly during blind catheterization.

A rare cause of noninvasive ventilation failure: tracheal stenosis.

Noninvasive ventilation is the first line treatment of choice in acute respiratory failure in many diseases including post-extubation respiratory failure. Herein we report a case unresponsive to noninvasive ventilation due to tracheal stenosis. A 49- year -old female was admitted to intensive care unit after successful resuscitation of cardiac arrest. During the follow-up, she was extubated on 16th day and then transferred to the coronary ward. Four days later, she started to have progressive dyspnea and difficulty in breathing. Arterial blood gas evaluation showed respiratory acidosis with moderate hypercapnia. Noninvasive ventilation was initiated with the diagnosis of cardiogenic pulmonary edema however she did not respond to noninvasive ventilation therapy. Pulmonary consultation revealed that she had a new onset stridor. She had an urgent fiberoptic bronchoscopy which revealed severe tracheal stenosis. Tracheal stenosis should be considered in patients who do not respond to noninvasive ventilation after extubation like in our case.

Mortality Related Risk Factors in High-Risk Pulmonary Embolism in the ICU.

Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50-1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96-463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01-0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.