2017 Apr - Are there any reasons to change our behavior in necrotizing fasciitis with the advent of new antibiotics?
Menichetti F, Giuliano S, Fortunato S. Curr Opin Infect Dis. 2017 Apr;30(2):172-179
PURPOSE OF REVIEW: The treatment of necrotizing fasciitis requires a multifaceted approach, consisting of surgical source control with immediate surgical debridement along with life support, clinical monitoring, and antimicrobial therapy. Many drugs are now available for the treatment of this life-threatening infectious disease, and the purpose of this review is to provide the reader with an updated overview of the newest therapeutic options.
John A. Kellum , Florentina E. Sileanu , Azra Bihorac , Eric A. J. Hoste , and Lakhmir S. Chawla Am. J. Resp. Crit. Care Med. Mar 15, 2017, vol. 195, no. 6: 784-791
Rationale: Little is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery.
2017 Mar 15 - Sevoflurane for Sedation in Acute Respiratory Distress Syndrome. A Randomized Controlled Pilot Study
Matthieu Jabaudon , Pierre Boucher , Etienne Imhoff , Russell Chabanne , Jean-Sébastien Faure , Laurence Roszyk , Sandrine Thibault , Raiko Blondonnet , Gael Clairefond , Renaud Guérin , and Sébastien Perbet Sophie Cayot , Thomas Godet , Bruno Pereira , Vincent Sapin , Jean-Etienne Bazin , Emmanuel Futier , and Jean-Michel Constantin Am. J. Resp. Crit. Care Med. Mar 15, 2017, vol. 195, no. 6: 792-800
Rationale: Sevoflurane improves gas exchange, and reduces alveolar edema and inflammation in preclinical studies of lung injury, but its therapeutic effects have never been investigated in acute respiratory distress syndrome (ARDS).
Gaëtan Béduneau , Tài Pham , Frédérique Schortgen , Lise Piquilloud , Elie Zogheib , Maud Jonas , Fabien Grelon , Isabelle Runge , Nicolas Terzi , Steven Grangé , and Guillaume Barberet Pierre-Gildas Guitard , Jean-Pierre Frat , Adrien Constan , Jean-Marie Chretien , Jordi Mancebo , Alain Mercat , Jean-Christophe M. Richard , and Laurent Brochard for the WIND (Weaning according to a New Definition) Study Group and the REVA (Réseau Européen de Recherche en Ventilation Artificielle) Network Am. J. Resp Crit. Care Med. Mar 15, 2017, vol. 195, no. 6: 772-783
Rationale: The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials.
Poulakou G, Giannitsioti E, Tsiodras S.; Curr Opin Infect Dis. 2017 Apr;30(2):158-171.
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs.
2017 Mar - Prehospital Hypertonic Fluid Resuscitation for Trauma Patients: a Systematic Review and Meta-analysis
de Crescenzo C, Gorouhi F, Salcedo ES, Galante JM.; J Trauma Acute Care Surg. 2017 Mar 2.
BACKGROUND: Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mmHg.
2016 Nov - Recruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation
Hodgson C, Goligher EC, Young ME, Keating JL, Holland AE, Romero L, Bradley SJ, Tuxen D.; Cochrane Database Syst Rev. 2016 Nov 17;11:CD006667. Review.
BACKGROUND: Recruitment manoeuvres involve transient elevations in airway pressure applied during mechanical ventilation to open ('recruit') collapsed lung units and increase the number of alveoli participating in tidal ventilation. Recruitment manoeuvres are often used to treat patients in intensive care who have acute respiratory distress syndrome (ARDS), but the effect of this treatment on clinical outcomes has not been well established. This systematic review is an update of a Cochrane review originally published in 2009.
2017 Feb - Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup
Chawla LS, Bellomo R, Bihorac A, Goldstein SL, Siew ED, Bagshaw SM, Bittleman D, Cruz D, Endre Z, Fitzgerald RL, Forni L, Kane-Gill SL, Hoste E, Koyner J, Liu KD, Macedo E, Mehta R, Murray P, Nadim M, Ostermann M, Palevsky PM, Pannu N, Rosner M, Wald R, Zarbock A, Ronco C, Kellum JA; Acute Disease Quality Initiative Workgroup 16..; Nat Rev Nephrol. 2017 Feb 27.
Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of >90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process. For patients in whom pathophysiologic processes are ongoing, the term acute kidney disease (AKD) has been proposed to define the course of disease after AKI; however, definitions of AKD and strategies for the management of patients with AKD are not currently available. In this consensus statement, the Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients. We also make recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD.
2017 Feb - Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis
Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR.; Clin Infect Dis. 2017 Feb 14.
The Infectious Diseases Society of America (IDSA) Standards and Practice Guidelines Committee collaborated with partner organizations to convene a panel of 10 experts on healthcare-associated ventriculitis and meningitis. The panel represented pediatric and adult specialists in the field of infectious diseases and represented other organizations whose members care for patients with healthcare-associated ventriculitis and meningitis (American Academy of Neurology, American Association of Neurological Surgeons, and Neurocritical Care Society). The panel reviewed articles based on literature reviews, review articles and book chapters, evaluated the evidence and drafted recommendations.
Julian deBacker, MSc; Nicholas Hart, PhD; Eddy Fan, MD, PhD Chest Feb 2017; 151(3): 697-706
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the ICU.
2017 Mar - Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection
Julian M. Williams, MBBS; Jaimi H. Greenslade, PhD; Juliet V. McKenzie, MBBS; Kevin Chu, MBBS, MS; Anthony F.T. Brown, MBChB; Jeffrey Lipman, MD Chest Feb 2017; 151(3): 586-596
Background: A proposed revision of sepsis definitions has abandoned the systemic inflammatory response syndrome (SIRS), defined organ dysfunction as an increase in total Sequential Organ Function Assessment (SOFA) score of ≥ 2, and conceived “qSOFA” (quick SOFA) as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare the diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in ED patients with infection.
2017 Mar - An Educational Intervention Optimizes the Use of Arterial Blood Gas Determinations Across ICUs From Different Specialties: A Quality-Improvement Study
Carlos D. Martínez-Balzano, MD; Paulo Oliveira, MD; Michelle O’Rourke, DAP ACBP-BC; Luanne Hills, BS, RRT; Andrés F. Sosa, MD, FCCP Chest Feb 2017; 151(3): 579-585
Background: Overuse of arterial blood gas (ABG) determinations leads to increased costs, inefficient use of staff work hours, and patient discomfort and blood loss. We developed guidelines to optimize ABG use in the ICU.
Lee E. Morrow, MD; Paul Wischmeyer, MD Chest Feb 2017; 151(2): 492-499
Clinicians have traditionally dichotomized bacteria as friendly commensals or harmful pathogens. However, the line separating the two has become blurred with the recognition that the intestinal microbiome is a complex entity in which species can shift sides—from friend to foe and back again—based on crucial factors in their local environment.
2017 Feb - Comparing Quality of Dying and Death Perceived by Family Members and Nurses for Patients Dying in US and Dutch ICUs
Rik T. Gerritsen, MD; Matty Koopmans, RN, MSc; José G.M. Hofhuis, RN, PhD; J. Randall Curtis, MD, MPH; Hanne Irene Jensen, RN, PhD; Jan G. Zijlstra, MD, PhD; Ruth A. Engelberg, PhD; Peter E. Spronk, MD, PhD Chest Feb 2017; 151(2): 298-307
Background: The Quality of Dying and Death (QODD) questionnaire is used as a self-reported measure to allow families and clinicians to assess patients’ quality of dying and death. We evaluated end-of-life (EOL) experiences as measured by the QODD completed by families and nurses in the United States and the Netherlands to explore similarities and differences in these experiences and identify opportunities for improving EOL care.
Craig M. Lilly, MD, FCCP; Christine Motzkus, MPH; Teresa Rincon, RN, BSN; Shawn E. Cody, PhD, MSN/MBA, RN; Karen Landry, BS; Richard S. Irwin, MD, Master FCCP Chest Feb 2017; 151(2): 286-297
Background: ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been published to our knowledge.
2017 Feb - Estimating Ten-Year Trends in Septic Shock Incidence and Mortality in United States Academic Medical Centers Using Clinical Data
Sameer S. Kadri, MD; Chanu Rhee, MD, MPH; Jeffrey R. Strich, MD; Megan K. Morales, MD; Samuel Hohmann, PhD; Jonathan Menchaca, BA; Anthony F. Suffredini, MD; Robert L. Danner, MD; Michael Klompas, MD, MPH CHEST Feb 2017; 151(2): 278-285
Background: Reports that septic shock incidence is rising and mortality rates declining may be confounded by improving recognition of sepsis and changing coding practices. We compared trends in septic shock incidence and mortality in academic hospitals using clinical vs claims data.
Date: 29-30 Apr 2017; Venue: Cordis Hong Kong, Langham Place
2017 Mar 1 - Permissive Underfeeding or Standard Enteral Feeding in High– and Low–Nutritional-Risk Critically Ill Adults. Post Hoc Analysis of the PermiT Trial
Yaseen M. Arabi , Abdulaziz S. Aldawood , Hasan M. Al-Dorzi , Hani M. Tamim , Samir H. Haddad , Gwynne Jones , Lauralyn McIntyre , Othman Solaiman , Maram H. Sakkijha , Musharaf Sadat , Shihab Mundekkadan Am. J. Resp. Crit. Care Med. Mar 1, 2017, vol. 195, no. 5: 652-662
Rationale: The optimal nutritional strategy for critically ill adults at high nutritional risk is unclear.
2017 Mar 1 - Experimental Lung Injury Reduces Krüppel-like Factor 2 to Increase Endothelial Permeability via Regulation of RAPGEF3–Rac1 Signaling
Ru-Ting Huang, David Wu, Angelo Meliton, Myung-Jin Oh, Matthew Krause, Joyce A. Lloyd, Recep Nigdelioglu, Robert B. Hamanaka, Mukesh K. Jain, Anna Birukova, John P. Kress Am. J. Resp. Crit. Care Med. Mar 1, 2017, vol.195, no. 5: 639-651
Rationale: Acute respiratory distress syndrome (ARDS) is caused by widespread endothelial barrier disruption and uncontrolled cytokine storm. Genome-wide association studies (GWAS) have linked multiple genes to ARDS. Although mechanosensitive transcription factor Krüppel-like factor 2 (KLF2) is a major regulator of endothelial function, its role in regulating pulmonary vascular integrity in lung injury and ARDS-associated GWAS genes remains poorly understood.
2017 Feb - Sepsis Pathophysiology, Chronic Critical Illness, and Persistent Inflammation-Immunosuppression and Catabolism Syndrome
Mira JC, Gentile LF, Mathias BJ, Efron PA, Brakenridge SC, Mohr AM, Moore FA, Moldawer LL.; Crit Care Med. 2017 Feb;45(2):253-262.
OBJECTIVES: To provide an appraisal of the evolving paradigms in the pathophysiology of sepsis and propose the evolution of a new phenotype of critically ill patients, its potential underlying mechanism, and its implications for the future of sepsis management and research.
Verburg IW, Atashi A, Eslami S, Holman R, Abu-Hanna A, de Jonge E, Peek N, de Keizer NF.; Crit Care Med. 2017 Feb;45(2):e222-e231.
Objective: We systematically reviewed models to predict adult ICU length of stay.
Data Sources: We searched the Ovid EMBASE and MEDLINE databases for studies on the development or validation of ICU length of stay prediction models.