2017 Apr - Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
Witteveen E, Sommers J, Wieske L, Doorduin J, van Alfen N, Schultz MJ, van Schaik IN, Horn J, Verhamme C.; Ann Intensive Care. 2017 Dec;7(1):40. doi: 10.1186/s13613-017-0263-8. Epub 2017 Apr 5.
BACKGROUND: Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW.
2017 Apr - Earlier versus later initiation of renal replacement therapy among critically ill patients with acute kidney injury: a systematic review and meta-analysis of randomized controlled trials
Lai TS, Shiao CC, Wang JJ, Huang CT, Wu PC, Chueh E, Chueh SJ, Kashani K, Wu VC.; Ann Intensive Care. 2017 Dec;7(1):38. doi: 10.1186/s13613-017-0265-6. Epub 2017 Apr 5.
BACKGROUND: Although the optimal timing of initiation of renal replacement therapy (RRT) in critically ill patients with acute kidney injury has been extensively studied in the past, it is still unclear.
; Current Opinion in Critical Care . 23(2):175-179, April 2017.
Purpose of review: In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. This review provides an overview of these new clinical data and also explores new areas of investigation for HFOV in adults.
; Current Opinion in Critical Care . 23(2):143-148, April 2017.
Purpose of review: The gut has long been hypothesized to be the ‘motor’ of multiple organ dysfunction syndrome. This review serves as an update on new data elucidating the role of the gut as the propagator of organ failure in critical illness.
Date: 13-14 May 2017; Venue: Room N101, 1/ F New Wing, HKCEC
; Current Opinion in Critical Care . 23(2):128-133, April 2017.
Purpose of review: Although rare, central nervous system (CNS) infections are increasingly being recognized in immunocompromised patients. The goal of the present review is to provide a practical diagnostic approach for the intensivist, and to briefly discuss some of the most prevalent conditions.
; Current Opinion in Critical Care . 23(2):115-121, April 2017.
Purpose of review: Therapeutic hypothermia (i.e. induced body core temperature ≈ 33–35°C) in neurological patients with cerebrovascular disease and traumatic brain injury is a controversially discussed issue in the literature. In this review, we have included the most recently published research covering the use of therapeutic hypothermia and targeted temperature management in neurologic diseases and translated the results into a clinical decision support for the professional healthcare community.
; Current Opinion in Critical Care . 23(2):110-114, April 2017.
Purpose of review: Intracranial pressure (ICP) monitoring and treatment is central in the management of traumatic brain injury. Despite 4 decades of clinical use, several aspects remain controversial, including the indications for ICP and treatment options.
; Current Opinion in Critical Care . 23(2):87-93, April 2017.
Purpose of review: Subarachnoid hemorrhage from a ruptured aneurysm (aSAH) is a complex disorder with the potential to have devastating effects on the brain as well as other organ systems. After more than 3 decades of research, the underlying pathophysiologic mechanisms remain incompletely understood and important questions remain regarding the evaluation and management of these patients. The purpose of this review is to analyze the recent literature and improve our understanding of certain key clinical aspects.
; Current Opinion in Critical Care . 23(2):81-86, April 2017.
Purpose of review: Severe ischemic or hemorrhagic stroke is a devastating cerebrovascular disease often demanding critical care. Optimal management of blood pressure (BP) in the acute phase is controversial. The purpose of this review is to display insights from recent studies on BP control in both conditions.
Hajera Amatullah , Yuexin Shan , Brittany L. Beauchamp , Patricia L. Gali , Sahil Gupta , Tatiana Maron-Gutierrez , Edwin R. Speck , Alison E. Fox-Robichaud , Jennifer L. Y. Tsang , Shirley H. J. Mei , and Tak W. Mak Patricia R. M. Rocco , John W. Semple , Haibo Zhang , Pingzhao Hu , John C. Marshall , Duncan J. Stewart , Mary-Ellen Harper , Patricia C. Liaw , W. Conrad Liles , and Claudia C. dos Santos on behalf of the Canadian Critical Care Translational Biology Group Am. J. Resp. Crit. Care Med. Apr 1, 2017, vol. 195, no. 7: 889-905
Rationale: Effective and rapid bacterial clearance is a fundamental determinant of outcomes in sepsis. DJ-1 is a well-established reactive oxygen species (ROS) scavenger.
2017 Apr 1 - Quick Sepsis-related Organ Failure Assessment, Systemic Inflammatory Response Syndrome, and Early Warning Scores for Detecting Clinical Deterioration in Infected Patients outside the Intensive Care Unit
Matthew M. Churpek , Ashley Snyder , Xuan Han , Sarah Sokol , Natasha Pettit , Michael D. Howell , and Dana P. Edelson Am. J. Resp. Crit. Care Med. Apr 1, 2017, vol. 195, no. 7: 906-911
Rationale: The 2016 definitions of sepsis included the quick Sepsis-related Organ Failure Assessment (qSOFA) score to identify high-risk patients outside the intensive care unit (ICU).
Date: 20-23 Aug 2017; Venue: Kuala Lumpur Convention Centre, Malaysia
Tài Pham , and Gordon D. Rubenfeld Am. J Resp. Crit. Care Med. Apr 1, 2017, vol 195, no. 7: 860-870
Since its first description 50 years ago, no other intensive care syndrome has been as extensively studied as acute respiratory distress syndrome (ARDS). Despite this extensive body of research, many basic epidemiologic questions remain unsolved.
2017 Apr - Can High-flow Nasal Cannula Reduce the Rate of Endotracheal Intubation in Adult Patients With Acute Respiratory Failure Compared With Conventional Oxygen Therapy and Noninvasive Positive Pressure Ventilation?: A Systematic Review and Meta-anal
Yue-Nan Ni, MM; Jian Luo, MD; He Yu, MD; Dan Liu, MD; Zhong Ni, MD; Jiangli Cheng, MD; Bin-Miao Liang, MD; Zong-An Liang, MD CHEST Apr 2017; 151(4): 764-775
Background: The effects of high-flow nasal cannula (HFNC) on adult patients with acute respiratory failure (ARF) are controversial. We aimed to further determine the effectiveness of HFNC in reducing the rate of endotracheal intubation in adult patients with ARF by comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT).
Liang Luo, MD; Ciara M. Shaver, MD, PhD; Zhiguo Zhao, PhD; Tatsuki Koyama, PhD; Carolyn S. Calfee, MD; Julie A. Bastarache, MD; Lorraine B. Ware, MD CHEST Apr 2017; 151(4): 755-763
Background: Direct (pulmonary) and indirect (extrapulmonary) ARDS are distinct syndromes with important pathophysiologic differences. The goal of this study was to determine whether clinical characteristics and predictors of mortality differ between direct or indirect ARDS.
Instructor Course: Date: 31 May - 1 Jun 2017
Provider Course: Date: 1 Jun 2017
Hayman EG, Wessell A, Gerzanich V, Sheth KN, Simard JM. Neurocrit Care. 2017 Apr;26(2):301-310.
A growing body of clinical literature emphasizes the impact of cerebral edema in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). Aneurysm rupture itself initiates global cerebral edema in up to two thirds of cases. Although cerebral edema is not a universal feature of aSAH, it portends a poor clinical course, with quantitative analysis revealing a direct correlation between cerebral edema and poor outcome, including mortality and cognitive deficits. Mechanistically, global cerebral edema has been linked to global ischemia at the time of aneurysm rupture, dysfunction of autoregulation, blood breakdown products, neuroinflammation, and hyponatremia/endocrine abnormalities. At a molecular level, several culprits have been identified, including aquaporin-4, matrix metalloproteinase-9, SUR1-TRPM4 cation channels, vascular endothelial growth factor, bradykinin, and others. Here, we review these cellular and molecular mechanisms of global cerebral edema formation in aSAH. Given the importance of edema to the outcome of patients with aSAH and its status as a highly modifiable pathological process, a better understanding of cerebral edema in aSAH promises to hasten the development of medical therapies to improve outcomes in this frequently devastating disease.
Date: 29-30 Apr 2017; Venue: Cordis Hong Kong, Langham Place