Date: 8-11 Nov 2017; Venue: Rio de Janeiro, Brazil
Date: 2 Mar 2017; Time: 18:00
Date: 19 Mar 2017; Time: 08:30-17:30; Venue: HKCEC
2017 Feb 1 - Acute Respiratory Distress Syndrome Subphenotypes Respond Differently to Randomized Fluid Management Strategy
Katie R. Famous , Kevin Delucchi , Lorraine B. Ware , Kirsten N. Kangelaris , Kathleen D. Liu , B. Taylor Thompson , and Carolyn S. Calfee ; for the ARDS Network Am. J. Resp. Crit. Care Med. Feb 1, 2017, vol. 195, no. 3: 331-338
Rationale: We previously identified two acute respiratory distress syndrome (ARDS) subphenotypes in two separate randomized controlled trials with differential response to positive end-expiratory pressure.
2017 Feb 1 - Mitigation of Ventilator-induced Diaphragm Atrophy by Transvenous Phrenic Nerve Stimulation
Steven C. Reynolds , Ramasamy Meyyappan , Viral Thakkar , Bao D. Tran , Marc-André Nolette , Gautam Sadarangani , Rodrigo A. Sandoval , Laura Bruulsema , Brett Hannigan , Jason W. Li , Elizabeth Rohrs Am. J. Resp. Crit. Care Med. Feb 1, 2017, vol. 135, no. 3: 339-348
Rationale: Ventilator-induced diaphragm dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction.
2016 Oct - β-Blockade use for Traumatic Injuries and Immunomodulation: A Review of Proposed Mechanisms and Clinical Evidence
Loftus TJ, Efron PA, Moldawer LL, Mohr AM.; Shock. 2016 Oct;46(4):341-51.
Sympathetic nervous system activation and catecholamine release are important events following injury and infection. The nature and timing of different pathophysiologic insults have significant effects on adrenergic pathways, inflammatory mediators, and the host response. Beta adrenergic receptor blockers (β-blockers) are commonly used for treatment of cardiovascular disease, and recent data suggests that the metabolic and immunomodulatory effects of β-blockers can expand their use. β-blocker therapy can reduce sympathetic activation and hypermetabolism as well as modify glucose homeostasis and cytokine expression. It is the purpose of this review to examine either the biologic basis for proposed mechanisms or to describe current available clinical evidence for the use of β-blockers in traumatic brain injury, spinal cord injury, hemorrhagic shock, acute traumatic coagulopathy, erythropoietic dysfunction, metabolic dysfunction, pulmonary dysfunction, burns, immunomodulation, and sepsis.
2017 Jan - Systematic review of β blocker, aspirin, and statin in critically ill patients: importance of severity of illness and cardiac troponin
Rothenberg FG, Clay MB, Jamali H, Vandivier-Pletsch RH.; J Investig Med. 2017 Jan 30. [Epub ahead of print]
Non-cardiac critically ill patients with type II myocardial infarction (MI) have a high risk of mortality. There are no evidence-based interventions to mitigate this risk. We systematically reviewed the literature regarding the use of medications known to reduce mortality in patients with cardiac troponin (cTn) elevation due to type I MI (β blockers, statin, and aspirin) in studies of critically ill patients without Type I MI. All PubMed publications between 1976-2/19/16 were reviewed. Search terms included: β blocker or aspirin or statin and intensive care unit (ICU) or critically ill or sepsis; 497 primary references were obtained. Inclusion criteria were as follows: (1) study population consisted of critically ill patients in the ICU with non-cardiovascular illnesses, (2) mortality end point, (3) severity of illness (or injury) was measured, and (4) the antiplatelet agent was primarily aspirin.
2016 Dec - Outcomes and survival prediction models for severe adult acute respiratory distress syndrome treated with extracorporeal membrane oxygenation
Rozencwajg S, Pilcher D, Combes A, Schmidt M.; Crit Care. 2016 Dec 5;20(1):392. Review.
Extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS) has known a growing interest over the last decades with promising results during the 2009 A(H1N1) influenza epidemic. Targeting populations that can most benefit from this therapy is now of major importance.Survival has steadily improved for a decade, reaching up to 65% at hospital discharge in the most recent cohorts. However, ECMO is still marred by frequent and significant complications such as bleeding and nosocomial infections. In addition, physiological and psychological symptoms are commonly described in long-term follow-up of ECMO-treated ARDS survivors. Because this therapy is costly and exposes patients to significant complications, seven prediction models have been developed recently to help clinicians identify patients most likely to survive once ECMO has been initiated and to facilitate appropriate comparison of risk-adjusted outcomes between centres and over time. Higher age, immunocompromised status, associated extra-pulmonary organ dysfunction, low respiratory compliance and non-influenzae diagnosis seem to be the main determinants of poorer outcome.
2016 Dec - Prognostic factors for extracorporeal cardiopulmonary resuscitation recipients following out-of-hospital refractory cardiac arrest. A systematic review and meta-analysis
Debaty G, Babaz V, Durand M, Gaide-Chevronnay L, Fournel E, Blancher M, Bouvaist H, Chavanon O, Maignan M, Bouzat P, Albaladejo P, Labarère J.; Resuscitation. 2016 Dec 19;112:1-10
PURPOSE: Association estimates between baseline characteristics and outcomes are imprecise and inconsistent among extracorporeal cardiopulmonary resuscitation (ECPR) recipients following refractory out-of-hospital cardiac arrest (OHCA). This systematic review and meta-analysis aimed to investigate the prognostic significance of pre-specified characteristics for OHCA treated with ECPR.
2017 Feb - Long-Term Survival in Adults Treated With Extracorporeal Membrane Oxygenation for Respiratory Failure and Sepsis
von Bahr V, Hultman J, Eksborg S, Frenckner B, Kalzén H.; Crit Care Med. 2017 Feb;45(2):164-170.
OBJECTIVE: The use of extracorporeal membrane oxygenation in adults with respiratory failure and sepsis is steadily increasing, but the knowledge on long-term survival in this group is scarce. The aim of the present study was to investigate the 5-year survival rates and causes of late death in this group of patients.
2017 Jan - Whole-body vibration to prevent intensive care unit-acquired weakness: safety, feasibility, and metabolic response
Wollersheim T, Haas K, Wolf S, Mai K, Spies C, Steinhagen-Thiessen E, Wernecke KD, Spranger J, Weber-Carstens S.: Crit Care. 2017 Jan 9;21(1):9.
Background:Intensive care unit (ICU)-acquired weakness in critically ill patients is a common and significant complication affecting the course of critical illness. Whole-body vibration is known to be effective muscle training and may be an option in diminishing weakness and muscle wasting. Especially, patients who are immobilized and not available for active physiotherapy may benefit. Until now whole-body vibration was not investigated in mechanically ventilated ICU patients. We investigated the safety, feasibility, and metabolic response of whole-body vibration in critically ill patients.
2017 Jan - The association of findings on brain computed tomography with neurologic outcomes following extracorporeal cardiopulmonary resuscitation
Ryu JA, Chung CR, Cho YH, Sung K, Suh GY, Park TK, Song YB, Hahn JY, Choi JH, Gwon HC, Choi SH, Yang JH.; Crit Care. 2017 Jan 25;21(1):15.
Background: Limited data are available on imaging predictors of neurological outcomes after extracorporeal cardiopulmonary resuscitation (ECPR). We investigated the association of initial brain computed tomography (CT) findings with neurological outcomes following ECPR.
Date: 17-21 Jul 2017; Venue: QMH
The 12th Critical Care Nephrology Course will be held on April 5 & 13, 2017, at the Pamela Youde Nethersole Eastern Hospital.
Course Fee: (included: handout, lunch on April 5, 2017 & light refreshment)
HK $2,500 (Full course: lecture and workshop) (HK$ 2,200 For Early Bird Registration before 28 Feb 2017)
HK $1,800 (Lecture only) (HK$ 1,500 For Early Bird Registration before 28 Feb 2017)
HKSCCM members may apply for the CCMF Subsidy to attend this course.
2017 Jan 15 - Incidence, Predictors, and Outcomes of New-Onset Atrial Fibrillation in Critically Ill Patients with Sepsis. A Cohort Study
Peter M. C. Klein Klouwenberg , Jos F. Frencken , Sanne Kuipers , David S. Y. Ong , Linda M. Peelen , Lonneke A. van Vught , Marcus J. Schultz , Tom van der Poll , Marc J. Bonten , and Olaf L. Cremer ; on behalf of the MARS Consortium Am. J. Resp. Crit. Care Med. Jan 15, 2017, vol. 195, no. 2: 205-211
Rationale: Patients admitted to intensive care units with sepsis are prone to developing cardiac dysrhythmias, most commonly atrial fibrillation.
2017 Jan 15 - Experiences and Expressions of Spirituality at the End of Life in the Intensive Care Unit
Marilyn Swinton, Mita Giacomini, Feli Toledo, Trudy Rose, Tracy Hand-Breckenridge, Anne Boyle, Anne Woods, France Clarke, Melissa Shears, Robert Sheppard, and Deborah Cook Am. J. Resp. Crit. Care Med. Jan 15, 2017, vol. 195, no. 2: 198-204
Rationale: The austere setting of the intensive care unit (ICU) can suppress expressions of spirituality.
2016 Dec - Passive leg raise testing effectively reduces fluid administration in septic shock after correction of non-compliance to test results
Rameau A, de With E, Boerma EC.; Ann Intensive Care. 2017 Dec;7(1):2.
Background: Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many strategies to predict ‘fluid responsiveness.’ The use of PLR testing is applicable to a wide range of clinical situations and has the potential to reduce fluid administration, since PLR testing is based upon (reversible) autotransfusion. Despite these theoretical advantages, data on the net effect on fluid balance as a result of PLR testing remain scarce.