2014 Feb - A systematic review and pooled analysis of CPR-associated cardiovascular and thoracic injuries

Miller AC, Rosati SF, Suffredini AF, Schrump DS.; Resuscitation. 2014 Feb 10

OBJECTIVE: The incidence of thoracic injuries resulting from cardiopulmonary resuscitation (CPR) is not well characterized. We describe a case in which a CPR-associated atrial rupture was identified with ultrasound and successfully managed in the intensive care unit with a bedside thoracotomy and atrial repair. We then describe a systematic review with pooled data analysis of CPR-associated cardiovascular, pulmonary, pleural, and thoracic wall injuries.

Read more ...

2014 May - First Experience With a New Miniaturized Pump-Driven Venovenous Extracorporeal CO2 Removal System (iLA Activve): A Retrospective Data Analysis

Hermann A, Staudinger T, Bojic A, Riss K, Wohlfarth P, Robak O, Sperr WR, Schellongowski P.; ASAIO J. 2014 May-Jun;60(3):342-7.

iLA Activve is a new minimally invasive device for extracorporeal CO2 removal (ECCO2-R) using a miniaturized pump, a special gas exchange membrane, and a double-lumen cannula. We retrospectively analyzed our experiences in 12 patients with hypercapnic respiratory failure undergoing ECCO2-R...

Read more ...

2014 May - Management of cardiac arrest caused by acute massive pulmonary thromboembolism: importance of percutaneous cardiopulmonary support

Cho YH, Kim WS, Sung K, Jeong DS, Lee YT, Park PW, Kim DK.; ASAIO J. 2014 May-Jun;60(3):280-3.

Cardiac arrest caused by acute pulmonary embolism is associated with high patient mortality. We reviewed patients who had cardiac arrest caused by acute pulmonary embolism. Between January 2001 and September 2013, we identified 20 patients at our institution with a confirmative diagnosis of acute pulmonary thromboembolism and cardiac arrest. Percutaneous cardiopulmonary support (PCPS) and surgical embolectomy are the standard course of care for patients with shock or cardiac arrest caused by pulmonary thromboembolism at our institution...

Read more ...

2014 May - ECMO for Adult Respiratory Failure: Current Use and Evolving Applications

Agerstrand CL, Bacchetta MD, Brodie D.; ASAIO J. 2014 May-Jun;60(3):255-62.

Extracorporeal membrane oxygenation (ECMO) is increasingly being used to support adults with severe forms of respiratory failure. Fueling the explosive growth is a combination of technological improvements and accumulating, although controversial, evidence. Current use of ECMO extends beyond its most familiar role in the support of patients with severe acute respiratory distress syndrome (ARDS) to treat patients with various forms of severe hypoxemic or hypercapnic respiratory failure, ranging from bridging patients to lung transplantation to managing pulmonary hypertensive crises...

Read more ...

2014 May - Insensible water loss through adult extracorporeal membrane oxygenation circuit: an in vitro study

LL Chang, OY Tam, AMC Kwan, HP Shum, KC Chan, WW Yan; ASAIOJ 8 May 2014 [Epub ahead of print]

Patients on extracorporeal membrane oxygenation (ECMO) are critically ill and fluid balance need to be managed as accurately as possible. Previous studies have focused on insensible water loss through neonatal ECMO circuit and showed that water loss through the ECMO circuit was correlated with the sweep gas flow rates. Current study is the first study focusing on insensible water loss through adult ECMO circuit.

Read more ...

2014 Apr - Therapeutic hypothermia reduces middle cerebral artery flow velocity in patients with severe aneurysmal subarachnoid hemorrhage

Seule M, Muroi C, Sikorski C, Hugelshofer M, Winkler K, Keller E.; Neurocrit Care. 2014 Apr;20(2):255-62.

BACKGROUND: Transcranial Doppler (TCD) is widely used to detect and follow up cerebral vasospasm after subarachnoid hemorrhage (SAH). Therapeutic hypothermia might influence blood flow velocities assessed by TCD. The aim of the study was to evaluate the effect of hypothermia on Doppler blood flow velocity after SAH.

Read more ...

2014 Apr -Human albumin administration in subarachnoid hemorrhage: results of an international survey

Suarez JI, Martin RH, Calvillo E, Zygun D, Flower O, Wong GK, Bershad EM, Venkatasubba Rao CP, Georgiadis A, Jichici D, Leroux PD.;Neurocrit Care. 2014 Apr;20(2):277-86.

BACKGROUND: Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in the care of SAH patients to determine current practice of ALB administration in SAH.

Read more ...

2014 Apr - Glibenclamide in cerebral ischemia and stroke

Simard JM, Sheth KN, Kimberly WT, Stern BJ, Del Zoppo GJ, Jacobson S, Gerzanich V.; Neurocrit Care. 2014 Apr;20(2):319-33

The sulfonylurea receptor 1 (Sur1)-transient receptor potential 4 (Trpm4) channel is an important molecular element in focal cerebral ischemia. The channel is upregulated in all cells of the neurovascular unit following ischemia, and is linked to microvascular dysfunction that manifests as edema formation and secondary hemorrhage, which cause brain swelling...

Read more ...

2014 Apr - The Use of Regional Citrate Anticoagulation Continuous Venovenous Haemofiltration in Extracorporeal Membrane Oxygenation

Shum HP, Ming-Chit Kwan A, Chan KC, Yan WW.; ASAIO J. 2014 Apr 10. [Epub ahead of print]

Patients on extracorporeal membrane oxygenation (ECMO) frequently requires continuous renal replacement therapy (CRRT). Additional anticoagulation for the CRRT circuit is usually not employed, but this may increases the risk of clot embolisation, which shortens oxygenator lifespan and increases patient's risk. We report our experience on the use of regional citrate anticoagulation continuous venovenous haemofiltration (RCA-CVVH) connected to an ECMO circuit, which could be useful during low heparin / heparin-free ECMO situations.

Read more ...

2014 Feb - Plasma endothelin-1 as screening marker for cerebral vasospasm after subarachnoid hemorrhage

Bellapart J, Jones L, Bandeshe H, Boots R.; Neurocrit Care. 2014 Feb;20(1):77-83.

BACKGROUND: Cerebral vasospasm complicating subarachnoid hemorrhage causes ischemic stroke and worsens the neurological outcome. The potential role of endothelin-1 in vasospasm pathogenesis may provide therapeutic opportunities. A recent meta-analysis however, did not support the use of endothelin antagonists. Apart from clinical assessment, transcranial Doppler and interval angiography, there are no sensitive screening markers for evolving vasospasm. We investigate the ability of serial measurement of endothelin-1 to predict the development of vasospasm following subarachnoid hemorrhage.

Read more ...

2014 Feb - Red blood cell transfusion increases the risk of thrombotic events in patients with subarachnoid hemorrhage

Kumar MA, Boland TA, Baiou M, Moussouttas M, Herman JH, Bell RD, Rosenwasser RH, Kasner SE, Dechant VE.; Neurocrit Care. 2014 Feb;20(1):84-90.

BACKGROUND AND PURPOSE: Red blood cell transfusion (RBCT) may increase the risk of thrombotic events (TE) in patients with subarachnoid hemorrhage (SAH) through changes induced by storage coupled with SAH-related hypercoagulability. We sought to investigate the association between RBCT and the risk of TE in patients with SAH.

Read more ...

2013 Dec - Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy

Hotchkiss RS, Monneret G, Payen D.; Nat Rev Immunol. 2013 Dec;13(12):862-74.

Sepsis - which is a severe life-threatening infection with organ dysfunction - initiates a complex interplay of host pro-inflammatory and anti-inflammatory processes. Sepsis can be considered a race to the death between the pathogens and the host immune system, and it is the proper balance between the often competing pro- and anti-inflammatory pathways that determines the fate of the individual...

Read more ...

2013 Sep - Active chest compression-decompression for cardiopulmonary resuscitation

Lafuente-Lafuente C, Melero-Bascones M.; Cochrane Database Syst Rev. 2013 Sep 20;9:CD002751.

BACKGROUND: Active compression-decompression cardiopulmonary resuscitation (ACDR CPR) uses a hand-held suction device, applied mid-sternum, to compress the chest then actively decompress the chest after each compression. Randomised controlled trials testing this device have shown discordant results.

Read more ...

2013 Sep - Intravenous immunoglobulin for treating sepsis, severe sepsis and septic shock

Alejandria MM, Lansang MA, Dans LF, Mantaring JB 3rd.; Cochrane Database Syst Rev. 2013 Sep 16;9:CD001090.

BACKGROUND: Mortality from sepsis and septic shock remains high. Results of trials on intravenous immunoglobulins (IVIG) as adjunctive therapy for sepsis have been conflicting. This is an update of a Cochrane review that was originally published in 1999 and updated in 2002 and 2010.

Read more ...

2014 Jan - Inotropic agents and vasodilator strategies for acute myocardial infarction complicated by cardiogenic shock or low cardiac output syndrome

Unverzagt S, Wachsmuth L, Hirsch K, Thiele H, Buerke M, Haerting J, Werdan K, Prondzinsky R.; Cochrane Database Syst Rev. 2014 Jan 2;1:CD009669. [Epub ahead of print]

BACKGROUND: The recently published German-Austrian S3 Guideline for the treatment of infarct related cardiogenic shock (CS) revealed a lack of evidence for all recommended therapeutic measures.

Read more ...

2014 Jan - Beta lactam antibiotic monotherapy versus beta lactam-aminoglycoside antibiotic combination therapy for sepsis

Paul M, Lador A, Grozinsky-Glasberg S, Leibovici L.;Cochrane Database Syst Rev. 2014 Jan 7;1:CD003344. [Epub ahead of print]

BACKGROUND: Optimal antibiotic treatment for sepsis is imperative. Combining a beta lactam antibiotic with an aminoglycoside antibiotic may provide certain advantages over beta lactam monotherapy.

Read more ...

2014 Jan - Efficacy of coupled plasma filtration adsorption (CPFA) in patients with septic shock: A multicenter randomised controlled clinical trial

Livigni S, Bertolini G, Rossi C, Ferrari F, Giardino M, Pozzato M, Remuzzi G; GiViTI: Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva (Italian Group for the Evaluation of Interventions in Intensive Care Medicine) is an independent collaboration network of Italian Intensive Care units.; BMJ Open. 2014 Jan 8;4(1):e003536.

OBJECTIVES: Coupled plasma filtration adsorption (CPFA, Bellco, Italy), to remove inflammatory mediators from blood, has been proposed as a novel treatment for septic shock. This multicenter, randomised, non-blinded trial compared CPFA with standard care in the treatment of critically ill patients with septic shock.

Read more ...

2013 Dec - European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia

Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C, Gyssens IC, Kern WV, Klyasova G, Marchetti O, Engelhard D, Akova M; ECIL4, a joint venture of EBMT, EORTC, ICHS, ESGICH/ESCMID and ELN.; Haematologica. 2013 Dec;98(12):1826-35.

Owing to increasing resistance and the limited arsenal of new antibiotics, especially against Gram-negative pathogens, carefully designed antibiotic regimens are obligatory for febrile neutropenic patients, along with effective infection control. The Expert Group of the 4(th) European Conference on Infections in Leukemia has developed guidelines for initial empirical therapy in febrile neutropenic patients...

Read more ...

2013 Dec - Vasopressin for cerebral perfusion pressure management in patients with severe traumatic brain injury: Preliminary results of a randomized controlled trial

Van Haren RM, Thorson CM, Ogilvie MP, Valle EJ, Guarch GA, Jouria JA, Busko AM, Harris LT, Bullock MR, Jagid JR, Livingstone AS, Proctor KG.; J Trauma Acute Care Surg. 2013 Dec;75(6):1024-30

BACKGROUND: After traumatic brain injury (TBI), catecholamines (CAs) may be needed to maintain adequate cerebral perfusion pressure (CPP), but there are no recommended alternative vasopressor therapies. This is an interim report of the first study to test the hypothesis that arginine vasopressin (AVP) is a safe and effective alternative to CAs for the management of CPP in patients with severe TBI.

Read more ...

2013 Nov - Assessment of quality of life and functional outcome in patients sustaining moderate and major trauma: A multicentre, prospective cohort study

Rainer TH, Yeung JH, Cheung SK, Yuen YK, Poon WS, Ho HF, Kam CW, Cattermole GN, Chang A, So FL, Graham CA.; Injury. 2013 Nov 21. pii: S0020-1383(13)00531-7

BACKGROUND: Trauma care systems aim to reduce both death and disability, yet there is little data on post-trauma health status and functional outcome.

Read more ...