2012 Nov 1 - Reversal of Immunoparalysis in Humans In Vivo: A Double-Blind, Placebo-controlled, Randomized Pilot Study
Abstract
Rationale: Reversal of sepsis-induced immunoparalysis may reduce the incidence of secondary infections and improve outcome. Although IFN-γ and granulocyte-macrophage colony–stimulating factor (GM-CSF) restore immune competence of ex vivo stimulated leukocytes of patients with sepsis, effects on immunoparalysis in vivo are not known.
2012 Oct 15 - Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients
Abstract
Rationale: Choice and intensity of early (first 48 h) sedation may affect short- and long-term outcome.
2012 Oct 1 - Impact of Intensive Care Unit Organ Failures on Mortality during the Five Years after a Critical Illness
Abstract
Rationale: The relationship between organ failure during critical illness and long-term survival is uncertain, especially among intensive care unit (ICU) survivors.
2012 Oct 1 - Recommendations to Limit Life Support: A National Survey of Critical Care Physicians
Abstract
Rationale: There is debate about whether physicians should routinely provide patient surrogates with recommendations about limiting life support.
2012 Oct 1 - End-of-Life Care in the Intensive Care Unit: Can We Simultaneously Increase Quality and Reduce Costs?
Abstract
The incidence and costs of critical illness are increasing in the United States at a time when there is a focus both on limiting the rising costs of healthcare and improving the quality of end-of-life care. More than 25% of healthcare costs are spent in the last year of life, and approximately 20% of deaths occur in the intensive care unit (ICU). Consequently, there has been speculation that end-of-life care in the ICU represents an important target for cost savings.
2012 Sep 15 - Monocytes Control Second-Phase Neutrophil Emigration in Established Lipopolysaccharide-induced Murine Lung Injury
Abstract
Rationale: Acute lung injury (ALI) is an important cause of morbidity and mortality, with no currently effective pharmacological therapies. Neutrophils have been specifically implicated in the pathogenesis of ALI, and there has been significant research into the mechanisms of early neutrophil recruitment, but those controlling the later phases of neutrophil emigration that characterize disease are poorly understood.
2012 Aug 15 - Predicting Cognitive Sequelae in Survivors of Critical Illness with Cognitive Screening Tests
Abstract
Rationale: Survivors of critical illness have a high rate of cognitive impairments that may persist years after hospital discharge. Data are lacking regarding whether cognitive screening tests administered at hospital discharge can be used to predict which critically ill patients are likely to have long-term cognitive sequelae.
2012 Aug 15 - Viral Infection in Patients with Severe Pneumonia Requiring Intensive Care Unit Admission
Abstract
Rationale: The role of viruses in pneumonia in adults and the impact of viral infection on mortality have not been elucidated. Previous studies have significant limitations in that they relied predominantly on upper respiratory specimens.
2012 Aug 1 - Interleukin 5 Is Protective during Sepsis in an Eosinophil-Independent Manner
Abstract
Rationale: The immune response in sepsis is characterized by overt immune dysfunction. Studies indicate immunostimulation represents a viable therapy for patients. One study suggests a potentially protective role for interleukin 5 (IL-5) in sepsis; however, the loss of eosinophils in this disease presents a paradox.
2012 Jul 1 - A Clinical Algorithm to Diagnose Invasive Pulmonary Aspergillosis in Critically Ill Patients
Abstract
Rationale: The clinical relevance of Aspergillus-positive endotracheal aspirates in critically ill patients is difficult to assess.
2012 Jul 1 - Combination Biomarkers to Diagnose Sepsis in the Critically Ill Patient
Abstract
Rationale: Although the outcome of sepsis benefits from the prompt administration of appropriate antibiotics on correct diagnosis, the assessment of infection in critically ill patients is often a challenge for clinicians. In this setting, simple biomarkers, especially when used in combination, could prove useful.
2012 Jul 1 - Mitogen-activated Protein Kinase Phosphatase-1 Modulates Regional Effects of Injurious Mechanical Ventilation in Rodent Lungs
Abstract
Rationale: Mechanical ventilation induces heterogeneous lung injury by mitogen-activated protein kinase (MAPK) and nuclear factor-κB. Mechanisms regulating regional injury and protective effects of prone positioning are unclear.
2012 Jun 15 - The Adult Respiratory Distress Syndrome Cognitive Outcomes Study: Long-Term Neuropsychological Function in Survivors of Acute Lung Injury
Abstract
Rationale: Cognitive and psychiatric morbidity is common and potentially modifiable after acute lung injury (ALI). However, practical measures of neuropsychological function for use in multicenter trials are lacking.
2012 Jun 1 - Inflammasome-regulated Cytokines Are Critical Mediators of Acute Lung Injury
Abstract
Rationale: Despite advances in clinical management, there are currently no reliable diagnostic and therapeutic targets for acute respiratory distress syndrome (ARDS). The inflammasome/caspase-1 pathway regulates the maturation and secretion of proinflammatory cytokines (e.g., IL-18). IL-18 is associated with injury in animal models of systemic inflammation.
2012 May 15 - Fever Control Using External Cooling in Septic Shock: A Randomized Controlled Trial
Abstract
Rationale: Fever control may improve vascular tone and decrease oxygen consumption, but fever may contribute to combat infection.
2012 May 15 - Refusal of Intensive Care Unit Admission Due to a Full Unit: Impact on Mortality
Abstract
Rationale: Intensive care unit (ICU) beds are a scarce resource, and patients denied intensive care only because the unit is full may be at increased risk of death.
2012 May 1 - The Epidemiology of Intensive Care Unit Readmissions in the United States
Abstract
Rationale: The incidence of intensive care unit (ICU) readmissions across the United States is unknown.
2012 Apr 15 - Activation of Mitochondrial Biogenesis by Heme Oxygenase-1–mediated NF-E2–related Factor-2 Induction Rescues Mice from Lethal Staphylococcusaureus Sepsis
Abstract
Rationale: Mitochondrial damage is an important component of multiple organ failure syndrome, a highly lethal complication of severe sepsis that lacks specific therapy. Mitochondrial quality control is regulated in part by the heme oxygenase-1 (HO-1; Hmox1) system through the redox-regulated NF-E2–related factor-2 (Nrf2) transcription factor, but its role in mitochondrial biogenesis in Staphylococcus aureus sepsis is unknown.
2012 Apr 15 - Fresh Red Blood Cell Transfusion and Short-Term Pulmonary, Immunologic, and Coagulation Status A Randomized Clinical Trial
Abstract
Rationale: Transfusion-related pulmonary complications are leading causes of morbidity and mortality attributed to transfusion. Observational studies suggest an important role for red blood cell (RBC) storage duration in these adverse outcomes.
2012 Apr 15 - Spurious Inferences about Long-Term Outcomes The Case of Severe Sepsis and Geriatric Conditions
Abstract
Rationale: Survivors of critical illness suffer significant limitations and disabilities.