2017 Jan - The effects of performance status one week before hospital admission on the outcomes of critically ill patients
Zampieri FG, Bozza FA, Moralez GM, Mazza DD, Scotti AV, Santino MS, Ribeiro RA, Rodrigues Filho EM, Cabral MM, Maia MO, D'Alessandro PS, Oliveira SV, Menezes MA, Caser EB, Lannes RS, Alencar Neto MS, Machado MM, Sousa MF, Salluh JI, Soares M.; Intensive Care Med. 2017 Jan;43(1):39-47.
Purpose: To assess the impact of performance status (PS) impairment 1 week before hospital admission on the outcomes in patients admitted to intensive care units (ICU).
2017 Jan - Glycemic control, mortality, and hypoglycemia in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials
Yamada T, Shojima N, Noma H, Yamauchi T, Kadowaki T.; Intensive Care Med. 2017 Jan;43(1):1-15.
Purpose: It is unclear whether tight glycemic control is warranted in all critically ill adults. We employed network meta-analysis to examine the risk of mortality and hypoglycemia associated with different glycemic control targets in critically ill adults.
Martin-Loeches I, J Schultz M, Vincent JL, Alvarez-Lerma F, Bos LD, Solé-Violán J, Torres A, Rodriguez A.; Intensive Care Med. 2017 Jan;43(1):48-58.
Background: Co-infection is frequently seen in critically ill patients with influenza, although the exact rate is unknown. We determined the rate of co-infection, the risk factors and the outcomes associated with co-infection in critically ill patients with influenza over a 7-year period in 148 Spanish intensive care units (ICUs).
2016 Dec - Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study
Laffey JG, Bellani G, Pham T, Fan E, Madotto F, Bajwa EK, Brochard L, Clarkson K, Esteban A, Gattinoni L, van Haren F, Heunks LM, Kurahashi K, Laake JH, Larsson A, McAuley DF, McNamee L, Nin N, Qiu H, Ranieri M, Rubenfeld GD, Thompson BT, Wrigge H, Slutsky AS, Pesenti A; LUNG SAFE Investigators and the ESICM Trials Group..; Intensive Care Med. 2016 Dec;42(12):1865-1876.
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality.
2016 Dec - Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review
Burnham JP, Kirby JP, Kollef MH.; Intensive Care Med. 2016 Dec;42(12):1899-1911.
PURPOSE: To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis.
2016 Dec - Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis
Ouweneel DM, Schotborgh JV, Limpens J, Sjauw KD, Engström AE, Lagrand WK, Cherpanath TG, Driessen AH, de Mol BA, Henriques JP.; Intensive Care Med. 2016 Dec;42(12):1922-1934.
PURPOSE: Veno-arterial extracorporeal life support (ECLS) is increasingly used in patients during cardiac arrest and cardiogenic shock, to support both cardiac and pulmonary function. We performed a systematic review and meta-analysis of cohort studies comparing mortality in patients treated with and without ECLS support in the setting of refractory cardiac arrest and cardiogenic shock complicating acute myocardial infarction.
2016 Dec - Venoarterial extracorporeal membrane oxygenation for refractory cardiogenic shock post-cardiac arrest
de Chambrun MP, Bréchot N, Lebreton G, Schmidt M, Hekimian G, Demondion P, Trouillet JL, Leprince P, Chastre J, Combes A, Luyt CE.; Intensive Care Med. 2016 Dec;42(12):1999-2007.
PURPOSE: To describe the characteristics, outcomes, and risk factors associated with poor outcome of venoarterial extracorporeal membrane oxygenation (VA-ECMO)-treated patients with refractory shock post-cardiac arrest.
2016 Oct - Effect of early postextubation high-flow nasal cannula vs conventional oxygen therapy on hypoxaemia in patients after major abdominal surgery: a French multicentre randomised controlled trial (OPERA)
Futier E, Paugam-Burtz C, Godet T, Khoy-Ear L, Rozencwajg S, Delay JM, Verzilli D, Dupuis J, Chanques G, Bazin JE, Constantin JM, Pereira B, Jaber S; OPERA study investigators..; Intensive Care Med. 2016 Oct 22.
PURPOSE: High-flow nasal cannula (HFNC) oxygen therapy is attracting increasing interest in acute medicine as an alternative to standard oxygen therapy; however, its use to prevent hypoxaemia after major abdominal surgery has not been evaluated. Our trial was designed to close this evidence gap.
Cillóniz C, Torres A, Niederman M, van der Eerden M, Chalmers J, Welte T, Blasi F.; Intensive Care Med. 2016 Sep;42(9):1374-86.
Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.
Teboul JL, Saugel B, Cecconi M, De Backer D, Hofer CK, Monnet X, Perel A, Pinsky MR, Reuter DA, Rhodes A, Squara P, Vincent JL, Scheeren TW.; Intensive Care Med. 2016 Sep;42(9):1350-9
Over the last decade, the way to monitor hemodynamics at the bedside has evolved considerably in the intensive care unit as well as in the operating room. The most important evolution has been the declining use of the pulmonary artery catheter along with the growing use of echocardiography and of continuous, real-time, minimally or totally non-invasive hemodynamic monitoring techniques. This article, which is the result of an agreement between authors belonging to the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine, discusses the advantages and limits of using such techniques with an emphasis on their respective place in the hemodynamic management of critically ill patients with hemodynamic instability.
2016 Sep - Milrinone for cardiac dysfunction in critically ill adult patients: a systematic review of randomised clinical trials with meta-analysis and trial sequential analysis
Koster G, Bekema HJ, Wetterslev J, Gluud C, Keus F, van der Horst IC.; Intensive Care Med. 2016 Sep;42(9):1322-35.
INTRODUCTION: Milrinone is an inotrope widely used for treatment of cardiac failure. Because previous meta-analyses had methodological flaws, we decided to conduct a systematic review of the effect of milrinone in critically ill adult patients with cardiac dysfunction.
2016 Sep - Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and renal recovery
Truche AS, Darmon M, Bailly S, Clec'h C, Dupuis C, Misset B, Azoulay E, Schwebel C, Bouadma L, Kallel H, Adrie C, Dumenil AS, Argaud L, Marcotte G, Jamali S, Zaoui P, Laurent V, Goldgran-Toledano D, Sonneville R, Souweine B, Timsit JF; OUTCOMEREA Study Group.; Intensive Care Med. 2016 Sep;42(9):1408-17
PURPOSE: The best renal replacement therapy (RRT) modality remains controversial. We compared mortality and short- and long-term renal recovery between patients treated with continuous RRT and intermittent hemodialysis.
2016 Jul - Ultrasonography evaluation during the weaning process: the heart, the diaphragm, the pleura and the lung
Mayo P, Volpicelli G, Lerolle N, Schreiber A, Doelken P, Vieillard-Baron A.; Intensive Care Med. 2016 Jul;42(7):1107-17.
Purpose: On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support.
2016 Aug - Mortality and pulmonary mechanics in relation to respiratory system and transpulmonary driving pressures in ARDS
Baedorf Kassis E, Loring SH, Talmor D.; Intensive Care Med. 2016 Aug;42(8):1206-13
Purpose: The driving pressure of the respiratory system has been shown to strongly correlate with mortality in a recent large retrospective ARDSnet study. Respiratory system driving pressure [plateau pressure−positive end-expiratory pressure (PEEP)] does not account for variable chest wall compliance. Esophageal manometry can be utilized to determine transpulmonary driving pressure. We have examined the relationships between respiratory system and transpulmonary driving pressure, pulmonary mechanics and 28-day mortality.
2016 Aug - Systematic review of cardiac output measurements by echocardiography vs. thermodilution: the techniques are not interchangeable
Wetterslev M, Møller-Sørensen H, Johansen RR, Perner A.; Intensive Care Med. 2016 Aug;42(8):1223-33.
Purpose: Echocardiography is frequently used in the hemodynamic evaluation of critically ill patients, but inaccurate measurements may lead to wrong clinical decisions. The aim of our systematic review was to investigate the interchangeability of echocardiography with thermodilution technique in measuring cardiac output and its changes.
Pesenti A, Musch G, Lichtenstein D, Mojoli F, Amato MB, Cinnella G, Gattinoni L, Quintel M.; Intensive Care Med. 2016 May;42(5):686-98.
PURPOSE: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS).
Papazian L, Corley A, Hess D, Fraser JF, Frat JP, Guitton C, Jaber S, Maggiore SM, Nava S, Rello J, Ricard JD, Stephan F, Trisolini R, Azoulay E.; Intensive Care Med. 2016 Mar 11. [Epub ahead of print]
Oxygen therapy can be delivered using low-flow, intermediate-flow (air entrainment mask), or high-flow devices. Low/intermediate-flow oxygen devices have several drawbacks that cause critically ill patients discomfort and translate into suboptimal clinical results. These include limitation of the FiO2 (due to the high inspiratory flow often observed in patients with respiratory failure), and insufficient humidification and warming of the inspired gas. High-flow nasal cannula oxygenation (HFNCO) delivers oxygen flow rates of up to 60 L/min and over the last decade its effect on clinical outcomes has widely been evaluated, such as in the improvement of respiratory distress, the need for intubation, and mortality.
2016 Apr - Withholding and withdrawal of life-sustaining treatments in low-middle-income versus high-income Asian countries and regions
Phua J, Joynt GM, Nishimura M, Deng Y, Myatra SN, Chan YH, Binh NG, Tan CC, Faruq MO, Arabi YM, Wahjuprajitno B, Liu SF, Hashemian SM, Kashif W, Staworn D, Palo JE, Koh Y.; Intensive Care Med. 2016 Apr 12. [Epub ahead of print]
PURPOSE: To compare the attitudes of physicians towards withholding and withdrawing life-sustaining treatments in intensive care units (ICUs) in low-middle-income Asian countries and regions with those in high-income ones, and to explore differences in the role of families and surrogates, legal risks, and financial considerations between these countries and regions.
2016 Feb - Antithrombin III for critically ill patients: a systematic review with meta-analysis and trial sequential analysis
Allingstrup M, Wetterslev J, Ravn FB, Møller AM, Afshari A.; Intensive Care Med. 2016 Feb 9. [Epub ahead of print]
PURPOSE: Antithrombin III (AT III) is an anticoagulant with anti-inflammatory properties. We assessed the benefits and harms of AT III in critically ill patients.
Giani M, Scaravilli V, Colombo SM, Confalonieri A, Leo R, Maggioni E, Avalli L, Vargiolu A, Citerio G.; Intensive Care Med. 2016 Jan;42(1):72-81.
Purpose: To evaluate the feasibility and efficacy of an apnea test (AT) technique that combines the application of positive end expiratory pressure (PEEP) with subsequent pulmonary recruitment in a large cohort of brain-dead patients.