ORCID (Johanna Hästbacka)
Julkaisut
2026
-
Haloperidol for Hypoactive and Hyperactive Delirium in ICU Patients-A Post Hoc Bayesian Analysis of the AID-ICU Trial
CONCLUSION: Compared with placebo, haloperidol was associated with moderate to high probabilities of benefit in both hypoactive and hyperactive delirium, with moderate probabilities of greater effects in hyperactive delirium. Further research is warranted to confirm these results. -
Association of cerebral tissue oxygen saturation with the development of delirium in circulatory shock - a prospective observational cohort study
Delirium is a frequent neuropsychiatric complication in critical illness associated with increased risk of long-term cognitive impairment and mortality. We hypothesized that lower cerebral tissue oxygen saturation (cStO2) levels measured with near infrared spectroscopy (NIRS) associate with worse outcome, including mortality, and the risk for developing delirium in circulatory shock. We conducted the prospective, observational, multi-center study (ASSESS-SHOCK, ClinicalTrials.gov: NCT03814564),... -
Use of Prokinetic Agents in Adult ICU Patients: An International Inception Cohort Study (PATIENCE)
CONCLUSIONS: Prokinetic agents were used in 13% of ICU patients, most commonly metoclopramide and more often in those with prior abdominal surgery. Prokinetic use was associated with a higher hazard of experiencing SAEs and fewer days alive out of hospital/ICU. -
Developing a Core Outcome Measurement Set for Adult ICU Patients, the CoreMS-ICU-A Protocol
CONCLUSIONS: We aim to develop a COMS for adults acutely admitted to ICU patients to facilitate the consistent use of outcomes in trials and enhance the translation of research findings into clinical practice. -
Ventilation strategies and outcomes after out-of-hospital cardiac arrest: protocol for a pre-planned sub-analysis of the STEPCARE trial
INTRODUCTION: After resuscitation from out of hospital cardiac arrest (OHCA), mechanical ventilation (MV) and respiratory management are fundamental to support patients in the intensive care unit (ICU) and to minimise secondary brain injury. Best practices for MV and association with clinical outcomes in patients with OHCA remain unclear. -
Preferences for Blood Glucose Management in Adult Intensive Care Unit Patients-An International Survey
CONCLUSIONS: Glucose management preferences varied among ICU staff, particularly in the administration of as needed doses and long-acting insulin. ICU nurses appeared more concerned about iPOC use than ICU doctors. The concerns about use of CGM appeared less common than concerns about iPOC. Most nurses and doctors would support a randomised trial on CGM versus usual care for glucose management in ICU and reported a preference for CGM to be used with a specific treatment protocol. -
Cognitive Functioning After Circulatory Shock: A Prospective Observational Study
CONCLUSION: We found cognitive impairment in more than three out of four ICU survivors immediately after ICU treatment for circulatory shock. We observed an improvement in cognitive functioning between ICU discharge and 3 months follow-up. These results have importance considering the optimal timing of information given to patients and when involving patients in decision-making. -
Early Prediction of Neurological Outcome After Cardiac Arrest-Rationale and Design of the Prospective International Observational EARLY-NEURO, a STEPCARE Substudy
CONCLUSIONS: Earlier prognostication aims to balance the avoidance of premature treatment withdrawal in patients with favorable potential against the prevention of unnecessary intervention in patients with a definitely poor prognosis. -
Severity of Illness and Mortality According to Time of Admission to Intensive Care
CONCLUSIONS: Patients admitted to intensive care during morning hours experienced higher severity of illness and higher in-hospital mortality. -
Physiotherapy provision and practice: A EuropeAn Intensive CarE Unit (ICU) survey (PEAiCE) - A profile of ICU physiotherapy in Europe
CONCLUSIONS: Physiotherapy is a well-integrated part in European ICUs with physiotherapists providing both respiratory management and mobilisation/rehabilitation techniques, although heterogeneity persists in organisation, referral pathways and the use of specific techniques. -
Executive functioning after COVID-19: Associations between self-report, informant-report, objective cognition, and psychological factors. A prospective cohort study
CONCLUSIONS: Self-reported executive functioning difficulties after COVID-19 were more strongly associated with psychological factors than with objective cognitive deficits. These findings highlight the importance of considering psychological well-being when evaluating executive functioning after COVID-19. -
Pain Management in Aneurysmatic Subarachnoid Haemorrhage: A Survey of Nordic Physicians
CONCLUSIONS: In the Nordic countries, paracetamol, opioids, and NSAIDs were reported as the most frequently used analgesics in the management of aSAH related pain in the ICU. Use of gabapentinoids was commonly reported by Danish respondents, unlike respondents from other Nordic countries. Neurosurgeons reported that they rarely prescribe opioids at hospital discharge. -
Ultrasound Use in Anesthesiology and Intensive Care in the Nordic Countries-An International Survey on Availability, Frequency of Use, Operator Training, and Assessment
Ultrasound is increasingly used in anesthesia and intensive care medicine for procedural guidance and patient assessment. However, training and formal skills assessment vary, and there is limited knowledge about current ultrasound practices in the Nordic countries. This study aims to survey the availability, daily clinical use, and current state of ultrasound training and skills assessment among anesthesiologists across the Nordic countries. An online cross-sectional survey, designed according... -
Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021-2022): a cross-sectional analysis of the European Sepsis Care Survey
BACKGROUND: Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals. -
Association of MMP-9 and TIMP-1 concentration with neurological outcome after cardiac arrest and resuscitation - a substudy of the COMACARE trial
CONCLUSION: OHCA patients had higher plasma concentrations of MMP-9 and TIMP-1 than elective surgery patients. However, the concentrations showed no association with outcome.
2025
-
Blood culture practices and microbiological capacity for sepsis diagnostics in Europe (2021-2022): a cross-sectional analysis of the European Sepsis Care Survey
BACKGROUND: Blood cultures (BCs) are key diagnostic elements for sepsis patients. Accurate preanalytical procedures are substantial, and results should be available as soon as possible to guide adequate antimicrobial treatment. This study aimed to evaluate BC collection practices and diagnostic capacity across European hospitals. -
Association of MMP-9 and TIMP-1 concentration with neurological outcome after cardiac arrest and resuscitation - a substudy of the COMACARE trial
CONCLUSION: OHCA patients had higher plasma concentrations of MMP-9 and TIMP-1 than elective surgery patients. However, the concentrations showed no association with outcome. -
Impact of 24/7 blood culture processing on diagnostic turnaround times and delays in effective and optimal antimicrobial therapy in bloodstream infections: a retrospective cohort study
CONCLUSION: Combining 24/7 workflow with a mRDT provides substantial reductions in blood culture TATs. However, a minority of patients benefited from the rapid diagnostics in terms of effective therapy initiation, and early antimicrobial therapy optimization requires active antimicrobial stewardship. -
Targeted Tissue Perfusion Versus Macrocirculatory-Guided Standard Care in Patients With Septic Shock: A Randomized Clinical Trial-The TARTARE-2S Trial
CONCLUSIONS: In ICU patients with septic shock and lactate greater than 3 mmol/L, targeting tissue perfusion and allowing lower than recommended MAP did not increase the number of days alive with normal lactate and without vasopressor/inotropic drugs at 30 days. No additional safety concerns with the TTP strategy were detected compared with SC. -
Selected Serious Adverse Events in a Cohort of Adult ICU Patients: Protocol for a Sub-Study of the PATIENCE Cohort
CONCLUSION: This sub-study will use data from the international PATIENCE cohort study to provide epidemiological data on the occurrence of SAEs potentially related to prokinetic use in adult ICU patients. -
Accuracy of EEG Slow Wave Activity in Predicting Favorable Outcome in Patients With Hypoxic Brain Injury-A Protocol for a Substudy of the STEPCARE Trial
CONCLUSION: The study will compare the accuracy of SWA measured using C-Trend Index with the gold standard, visual analysis of cEEG, in predicting favorable functional outcome after OHCA. The study will also assess the effect of the sedation intervention of the STEPCARE trial on the predictive accuracy of C-Trend Index. If the accuracy of the C-Trend Index is non-inferior to the comparator's, it may provide a feasible and easy-to-learn bedside method, especially in hospitals with limited... -
Long-Term Outcomes After Cardiac Arrest: Protocol for the Extended Follow-Up Sub-Study of the STEPCARE Trial
CONCLUSION: These detailed long-term outcomes will explore the possible benefits or risks of fever, sedation, and blood pressure management in post-OHCA survivors. Additionally, this study will explore survivorship after cardiac arrest from various perspectives, including different causes of arrest. -
Regional sepsis care in Catalonia: comparative insights from a secondary analysis of the European Sepsis Care Survey
No abstract -
Innate Immune Response After Cardiac Arrest (INNATUS): A Study Protocol for an Observational Single-Center Pilot Study
BACKGROUND: The treatment of cardiac arrest (CA) patients is often complicated by post-cardiac arrest syndrome (PCAS), which involves a systemic inflammatory response. Increased levels of certain inflammatory markers (e.g., interleukin-6 and procalcitonin) are associated with higher mortality and worse neurological outcomes. Previous studies have focused on the prognostic value of individual markers, whereas the interplay between inflammatory mediators in the setting of CA remains largely... -
Platelet transfusion practice in the intensive care unit: the Nine-I international platelet transfusion survey
CONCLUSION: Platelet transfusion practice in the ICU is heterogeneous, both between and within countries; guidelines are often not used, and there is often uncertainty about the clinical indication. -
Neurofilament light chain evaluated with a new automated commercially available method for outcome prediction in out-of-hospital cardiac arrest patients
CONCLUSION: The Atellica NfL assay accuracy appears well comparable to that obtained using the more laborious Simoa method. Further larger studies are needed to determine cut-off values in heterogenous populations of cardiac arrest patients. -
Cognitive functioning and brain MRI findings six months after acute COVID-19. A prospective observational study
CONCLUSION: We observed a significant association between the presence of CMBs and lower cognitive scores, regardless of COVID-19 history. However, our results do not support CMBs to be independently associated with cognitive functioning. Additionally, WMH burden was associated with lower cognitive scores. -
Response-Letter to the Editor: Consensus Statements on End-Of-Life Care in ICU
No abstract -
Preferences on the Use of Prokinetic Agents in Adult Intensive Care Unit Patients-An International Survey
CONCLUSION: This international survey found practice variations in the symptoms reportedly used to assess feeding intolerance. Metoclopramide was the preferred prokinetic agent, followed by erythromycin. Most respondents supported a future randomised trial. -
Subjective cognitive, psychiatric, and fatigue symptoms two years after COVID-19: A prospective longitudinal cohort study
CONCLUSIONS: Two years after COVID-19, particularly self-reported cognitive symptoms and fatigue remained clinically significant, but also some recovery was evident in depression, anxiety, and post-traumatic stress.
2024
-
Prokinetic agents in adult intensive care unit patients (PATIENCE)-An international inception cohort study protocol
CONCLUSION: The outlined international cohort study will provide valuable epidemiological data on the use of prokinetic agents in adult, acutely admitted ICU patients. -
Preferences for albumin use in adult intensive care unit patients with shock: An international survey
CONCLUSIONS: In this international survey, the reported preferences for the use of albumin in adult ICU patients with shock varied considerably among surveyed ICU physicians. The support for a future randomised trial was high. -
Complete blood count, coagulation biomarkers, and lung function 6 months after critical COVID-19
CONCLUSION: Only a few patients had normal CBC and coagulation biomarker values 6 months after critical COVID-19. A weak negative correlation between DLCOc% and FVIII suggests that deranged coagulation activity may be associated with reduced diffusing capacity. -
Syndecan-1 Levels and Early Positive Fluid Balance Are Associated With Disease Severity in Acute Pancreatitis
CONCLUSIONS: SAP is associated with high positive fluid balance in the early stages of treatment. Although increased in SAP, syndecan-1 was not independently associated with SAP when controlling for fluid balance and Acute Physiology and Chronic Health Evaluation II score. -
The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial
CONCLUSION: As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption. -
Effect of level of sedation on outcomes in critically ill adult patients: a systematic review of clinical trials with meta-analysis and trial sequential analysis
BACKGROUND: Sedation is routinely administered to critically ill patients to alleviate anxiety, discomfort, and patient-ventilator asynchrony. However, it must be balanced against risks such as delirium and prolonged intensive care stays. This study aimed to investigate the effects of different levels of sedation in critically ill adults. -
Authors' response: "Brain magnetic resonance imaging findings six months after critical COVID-19: A prospective cohort study"
No abstract -
Physicians' perceptions of intensive care patients' 1-year prognoses compared to realistic prognoses
CONCLUSION: Finnish anesthesiologists commonly misestimate the long-term prognoses of ICU patients, more often underestimating than overestimating the likelihood of 1-year survival. More education about critically ill patients' prognoses and better prediction tools are needed. -
Factors associated with fever after cardiac arrest: A post-hoc analysis of the FINNRESUSCI study
CONCLUSIONS: Half of OHCA patients not treated with TTM developed fever. We found no association between fever and outcome. -
PeptiVAX: A new adaptable peptides-delivery platform for development of CTL-based, SARS-CoV-2 vaccines
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a threat to public health and the global economy, necessitating the development of various vaccination strategies. Mutations in the SPIKE protein gene, a crucial component of mRNA and adenovirus-based vaccines, raised concerns about vaccine efficacy, prompting the need for rapid vaccine updates. To address this, we leveraged PeptiCRAd, an oncolytic vaccine based on tumor antigen decorated oncolytic adenoviruses,... -
Long-term outcomes with haloperidol versus placebo in acutely admitted adult ICU patients with delirium
CONCLUSIONS: In acutely admitted adult ICU patients with delirium, haloperidol treatment reduced mortality at 1-year follow-up, but did not statistically significantly improve HRQoL. -
Brain magnetic resonance imaging findings six months after critical COVID-19: A prospective cohort study
CONCLUSION: Age and supplementary oxygen days were independently associated with CMBs; COVID-19 status showed no association. Accumulation of risk factors in the ICU group may explain the higher prevalence of CMBs. -
Correction: Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)
No abstract -
Hazardous alcohol consumption and perioperative complications in a cardiac surgery patient. A retrospective study
CONCLUSION: Cardiac surgery patients with a history of hazardous alcohol consumption are younger than other patients and are predominantly men. Hazardous alcohol consumption is associated with an increased risk of severe postoperative infections and ICU re-admissions. -
A novel score for predicting 1-year mortality of intensive care patients
CONCLUSION: Our score based on data available at intensive care unit admission predicted 1-year mortality with fairly good discrimination. Most survivors achieved good functional recovery.
2023
-
Brain magnetic resonance imaging findings six months after critical COVID-19: A prospective cohort study
CONCLUSION: Age and supplementary oxygen days were independently associated with CMBs; COVID-19 status showed no association. Accumulation of risk factors in the ICU group may explain the higher prevalence of CMBs. -
Hazardous alcohol consumption and perioperative complications in a cardiac surgery patient. A retrospective study
CONCLUSION: Cardiac surgery patients with a history of hazardous alcohol consumption are younger than other patients and are predominantly men. Hazardous alcohol consumption is associated with an increased risk of severe postoperative infections and ICU re-admissions. -
The effect of higher or lower mean arterial pressure on kidney function after cardiac arrest: a post hoc analysis of the COMACARE and NEUROPROTECT trials
CONCLUSION: Any AKI occurred in four out of ten OHCA patients. We found no difference in the incidence of AKI between the patients treated with lower and those treated with higher MAP after CA. Higher age, non-shockable initial rhythm, and longer time to ROSC were associated with shorter time to AKI. -
Health-related quality of life after surviving intensive care for COVID-19: a prospective multicenter cohort study
In survivors of severe coronavirus disease 2019 (COVID-19) incomplete mental and physical recovery may considerably impact daily activities and health-related quality of life (HRQoL). HRQoL can be evaluated with the RAND-36 questionnaire, a multidimensional instrument that assesses physical and mental aspects of health in eight dimensions. The objective was to investigate HRQoL in intensive care patients previously treated for COVID-19 at three Nordic university hospitals, in a prospective... -
Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)
CONCLUSION: Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic. -
A novel score for predicting 1-year mortality of intensive care patients
CONCLUSION: Our score based on data available at intensive care unit admission predicted 1-year mortality with fairly good discrimination. Most survivors achieved good functional recovery. -
Risk of malignant disease in 1-year sepsis survivors, a registry-based nationwide follow-up study
CONCLUSION AND RELEVANCE: Compared to general population, incidence of cancer is increased in 1-year sepsis survivors. Variation in the findings depending on follow-up time suggests that factors other than sepsis alone are involved. Surveillance for malignant disease may be warranted in sepsis survivors. -
A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure
CONCLUSIONS: The responses from this international survey suggest that there is clinical equipoise for the preferred ventilator mode in patients with AHRF of moderate severity. We found strong support for a randomised trial comparing modes of ventilation in patients with moderate AHRF. -
Higher versus lower blood pressure targets after cardiac arrest: Systematic review with individual patient data meta-analysis
CONCLUSIONS: Targeting a higher MAP compared to a lower MAP is unlikely to reduce mortality or improve neurologic recovery after CA. Only a large treatment effect above 25% (RR < 0.75) could be excluded, and future studies are needed to investigate if relevant but lower treatment effect exists. Targeting a higher MAP was not associated with any increase in adverse effects. -
Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study
CONCLUSIONS: In ICU patients, AF occurred in one of six and was associated with different conditions. AF was associated with worse outcomes while not statistically significantly associated with 90-day mortality in the adjusted analyses. We observed variations in the diagnostic and management strategies for AF. -
Haloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID-ICU trial
CONCLUSIONS: We found high probabilities of benefits and low probabilities of harm with haloperidol treatment compared with placebo in acutely admitted, adult ICU patients with delirium for the primary and most secondary outcomes. -
Cardiac magnetic resonance -detected myocardial injury is not associated with long-term symptoms in patients hospitalized due to COVID-19
CONCLUSIONS: Myocardial scar suggestive of possible previous myocarditis was detected in almost one-third of hospital-treated COVID-19 patients. It was not associated with the need for ICU treatment, greater symptomatic burden, or ventricular dysfunction at 9 months follow-up. Thus, post-acute myocarditis scar on COVID-19 patients seems to be a subclinical imaging finding and does not commonly require further clinical evaluation. -
Associations of subjective and objective cognitive functioning after COVID-19: A six-month follow-up of ICU, ward, and home-isolated patients
CONCLUSIONS: One-third of COVID-19 patients, regardless of the acute disease severity, reported high levels of subjective cognitive dysfunction which was not associated with results from objective cognitive screening but with psychological and demographic factors. Our study stresses the importance of thorough assessment of patients reporting long-term subjective symptoms, screening for underlying mental health related factors such as PTSD or depression.
2022
-
Level of sedation in critically ill adult patients: a protocol for a systematic review with meta-analysis and trial sequential analysis
INTRODUCTION: It is standard of care to provide sedation to critically ill patients to reduce anxiety, discomfort and promote tolerance of mechanical ventilation. Given that sedatives can have differing effects based on a variety of patient and pharmacological characteristics, treatment approaches are largely based on targeting the level of sedation. The benefits of differing levels of sedation must be balanced against potential adverse effects including haemodynamic instability, causing... -
Non-interventional follow-up versus fluid bolus in RESPONSE to oliguria in hemodynamically stable critically ill patients: a randomized controlled pilot trial
CONCLUSIONS: Follow-up approach to oliguria compared to administering a fluid bolus of 500 mL crystalloid in oliguric patients improved urine output less frequently but lead to lower cumulative fluid balance. Trial registration clinical. -
Haloperidol for the Treatment of Delirium in ICU Patients
CONCLUSIONS: Among patients in the ICU with delirium, treatment with haloperidol did not lead to a significantly greater number of days alive and out of the hospital at 90 days than placebo. (Funded by Innovation Fund Denmark and others; AID-ICU ClinicalTrials.gov number, NCT03392376; EudraCT number, 2017-003829-15.). -
Platelet transfusions and thrombocytopenia in intensive care units: Protocol for an international inception cohort study (PLOT-ICU)
CONCLUSION: The outlined international PLOT-ICU cohort study will provide contemporary epidemiological data on the burden and clinical significance of thrombocytopenia in adult ICU patients and describe the current platelet transfusion practice. -
Long-term cognitive functioning is impaired in ICU-treated COVID-19 patients: a comprehensive controlled neuropsychological study
CONCLUSIONS: ICU-treated COVID-19 patients, compared to patients with less severe acute COVID-19 or non-COVID controls, showed more severe long-term cognitive impairment. Among those with more than 12 years of education, impairment existed particularly in the domains of attention and for men, of executive functions. -
Lung function and exercise capacity 6 months after hospital discharge for critical COVID-19
CONCLUSION: A significant number of patients had persisting lung function impairment and radiological abnormalities at 6 months after critical COVID-19. Reduced exercise capacity was rare. -
Updated competency-based training in intensive care: next step towards a healthcare union in Europe?
No abstract -
Protocol for an individual patient data meta-analysis on blood pressure targets after cardiac arrest
CONCLUSIONS: This protocol defines the performance of a systematic review on whether a higher MAP after cardiac arrest improves patient outcome. Repeating this systematic review including more data likely will allow for more certainty regarding the effect of the intervention and possible sub-groups differences. -
Agents intervening against delirium in the intensive care unit trial-Protocol for a secondary Bayesian analysis
BACKGROUND: Delirium is highly prevalent in the intensive care unit (ICU) and is associated with high morbidity and mortality. The antipsychotic haloperidol is the most frequently used agent to treat delirium although this is not supported by solid evidence. The agents intervening against delirium in the intensive care unit (AID-ICU) trial investigates the effects of haloperidol versus placebo for the treatment of delirium in adult ICU patients. -
Premorbid functional status as an outcome predictor in intensive care patients aged over 85 years
CONCLUSIONS: Poor PFS doubled the odds of death within one year. For most survivors, functional status was comparable to the premorbid status. -
Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study
CONCLUSIONS: The population with a foreign first language was at an increased risk for testing positive for SARS-CoV-2, but when hospitalized they had outcomes similar to those in the native, domestic language population. This suggests that special attention should be paid to the prevention and control of infectious diseases among language minorities. -
Management of acute atrial fibrillation in the intensive care unit: An international survey
CONCLUSION: This international survey indicated considerable practice variation among ICU doctors in the clinical management of acute AF, including the overall management strategies and the use of antiarrhythmic interventions and anticoagulants. -
GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial
CONCLUSIONS: At 48 and 72 h, serum both GFAp and tau demonstrated excellent accuracy in predicting outcomes after OHCA but were not superior to NSE. -
A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries
CONCLUSION: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention. -
New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic
CONCLUSIONS: More children with T1D had severe DKA at diagnosis during the pandemic. This was not a consequence of SARS-CoV-2 infection. Instead, it probably stems from delays in diagnosis following changes in parental behaviour and healthcare accessibility.
2021
-
APOE ε4 associates with increased risk of severe COVID-19, cerebral microhaemorrhages and post-COVID mental fatigue: a Finnish biobank, autopsy and clinical study
Apolipoprotein E ε4 allele (APOE4) has been shown to associate with increased susceptibility to SARS-CoV-2 infection and COVID-19 mortality in some previous genetic studies, but information on the role of APOE4 on the underlying pathology and parallel clinical manifestations is scarce. Here we studied the genetic association between APOE and COVID-19 in Finnish biobank, autopsy and prospective clinical cohort datasets. In line with previous work, our data on 2611 cases showed that APOE4... -
Association between first language and SARS-CoV-2 infection rates, hospitalization, intensive care admissions and death in Finland: a population-based observational cohort study
CONCLUSIONS: The population with a foreign first language was at an increased risk for testing positive for SARS-CoV-2, but when hospitalized they had outcomes similar to those in the native, domestic language population. This suggests that special attention should be paid to the prevention and control of infectious diseases among language minorities. -
Management of acute atrial fibrillation in the intensive care unit: An international survey
CONCLUSION: This international survey indicated considerable practice variation among ICU doctors in the clinical management of acute AF, including the overall management strategies and the use of antiarrhythmic interventions and anticoagulants. -
GFAp and tau protein as predictors of neurological outcome after out-of-hospital cardiac arrest: A post hoc analysis of the COMACARE trial
CONCLUSIONS: At 48 and 72 h, serum both GFAp and tau demonstrated excellent accuracy in predicting outcomes after OHCA but were not superior to NSE. -
Association of deranged cerebrovascular reactivity with brain injury following cardiac arrest: a post-hoc analysis of the COMACARE trial
CONCLUSION: Impaired CVR over 48 h was more common in patients with chronic hypertension and associated with poor outcome. Decreased upper MAP bound and a narrower MAP range for maintained CVR were associated with poor outcome and more severe brain injury assessed with NfL. Trial registration ClinicalTrials.gov, NCT02698917 . -
High Oxygen Does Not Increase Reperfusion Injury Assessed with Lipid Peroxidation Biomarkers after Cardiac Arrest: A Post Hoc Analysis of the COMACARE Trial
The products of polyunsaturated fatty acid peroxidation are considered reliable biomarkers of oxidative injury in vivo. We investigated ischemia-reperfusion-related oxidative injury by determining the levels of lipid peroxidation biomarkers (isoprostane, isofuran, neuroprostane, and neurofuran) after cardiac arrest and tested the associations between the biomarkers and different arterial oxygen tensions (PaO(2)). We utilized blood samples collected during the COMACARE trial (NCT02698917). In the... -
A descriptive study of the surge response and outcomes of ICU patients with COVID-19 during first wave in Nordic countries
CONCLUSION: There was substantial variability in the critical care response in Nordic ICUs to the first wave of COVID-19 pandemic, including usage of experimental medications. While ICU mortality was low in all countries, the observed variability warrants further attention. -
Factors Associated With Rebound Hyperthermia After Targeted Temperature Management in Out-of-Hospital Cardiac Arrest Patients: An Explorative Substudy of the Time-Differentiated Therapeutic Hypothermia in Out-of-Hospital Cardiac Arrest Survivors Trial
CONCLUSIONS: One-third of targeted temperature management patients experience rebound hyperthermia, and it is more common in younger male patients with an aggravated inflammatory response and those treated with a mechanical chest compression device. Later onset of rebound hyperthermia and temperatures exceeding 38.5°C associate with unfavorable outcome. -
From Stem Cells to Populations-Using hiPSC, Next-Generation Sequencing, and GWAS to Explore the Genetic and Molecular Mechanisms of Congenital Heart Defects
Congenital heart defects (CHD) are developmental malformations affecting the heart and the great vessels. Early heart development requires temporally regulated crosstalk between multiple cell types, signaling pathways, and mechanical forces of early blood flow. While both genetic and environmental factors have been recognized to be involved, identifying causal genes in non-syndromic CHD has been difficult. While variants following Mendelian inheritance have been identified by linkage analysis in... -
Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest
CONCLUSION: EEG SWA measured with C-Trend Index during propofol sedation offers a promising practical approach for early bedside evaluation of recovery of brain function and prediction of outcome after CA. -
Male predominance in disease severity and mortality in a low Covid-19 epidemic and low case-fatality area - a population-based registry study
CONCLUSIONS: Male sex associated with higher disease severity and case-fatality. Late presentation of male fatal cases could represent different treatment-seeking behaviour or disease progression by sex. -
New-onset type 1 diabetes in Finnish children during the COVID-19 pandemic
CONCLUSIONS: More children with T1D had severe DKA at diagnosis during the pandemic. This was not a consequence of SARS-CoV-2 infection. Instead, it probably stems from delays in diagnosis following changes in parental behaviour and healthcare accessibility. -
New-onset atrial fibrillation in the intensive care unit: Protocol for an international inception cohort study (AFIB-ICU)
CONCLUSION: The outlined international AFIB-ICU inception cohort study will provide contemporary data on the incidence, risk factors, used management strategies and outcomes of NOAF in adult ICU patients. -
Prevalence and impact of hazardous alcohol use in intensive care cohort: A multicenter, register-based study
CONCLUSION: The prevalence of hazardous alcohol use in Finnish ICUs was 21%. Patients with hazardous alcohol use were more often younger and male compared with non-hazardous alcohol users. -
Overlooking the Obvious during the COVID-19 Pandemic: Dyspnoea with Asymmetric Breath Sounds in a Toddler
CONCLUSIONS: Emergency care providers are instructed to consider all patients with respiratory distress as potential COVID-19 patients. However, the clinical course of COVID-19 infection is usually mild in children. Therefore, alternative causes for serious breathing difficulty are more likely, and all differential diagnoses should be considered in the usual unbiased manner.