2016 Nov - Clinical Outcomes of Extended versus Intermittent Infusion of Piperacillin/Tazobactam in Critically Ill Patients: A Prospective Clinical Trial
Fan SY, Shum HP, Cheng WY, Chan YH, Leung SM, Yan WW.; Pharmacotherapy. 2016 Nov 26. doi: 10.1002/phar.1875.
STUDY OBJECTIVE: To determine whether critically ill patients receiving extended-infusion (EI) piperacillin/tazobactam would have improved clinical outcomes compared with patients receiving intermittent infusions.
2016 Sep - Prehospital therapeutic hypothermia after out-of-hospital cardiac arrest: a systematic review and meta-analysis
Nie C, Dong J, Zhang P, Liu X, Han F.; Am J Emerg Med. 2016 Sep 6.
BACKGROUND: The effectiveness and safety of the infusion of ice-cold fluids for prehospital hypothermia in cardiac arrest victims are unclear. This study assessed its effects in adult victims of out-of-hospital cardiac arrest.
2016 Nov - Therapeutic hypothermia after cardiac arrest: A systematic review/meta-analysis exploring the impact of expanded criteria and targeted temperature
Schenone AL, Cohen A, Patarroyo G, Harper L, Wang X, Shishehbor MH, Menon V, Duggal A.; Resuscitation. 2016 Nov;108:102-110.
AIMS OF THE STUDY: We aimed to determine the benefit of an expanded use of TH. We also described the impact of a targeted temperature management on outcomes at discharge.
2016 Jul - Endovascular therapy including thrombectomy for acute ischemic stroke: A systematic review and meta-analysis with trial sequential analysis
Phan K, Zhao DF, Phan S, Huo YR, Mobbs RJ, Rao PJ, Mortimer AM.; J Clin Neurosci. 2016 Jul;29:38-45.
One of the primary strategies for the management of acute ischemic stroke is intravenous (IV) thrombolysis with tissue plasminogen activator (t-PA). Over the past decade, endovascular therapies such as the use of stent retrievers to perform mechanical thrombectomy have been found to improve functional outcomes compared to t-PA alone. We aimed to reassess the functional outcomes and complications of IV thrombolysis with and without endovascular treatment for acute ischemic stroke using conventional meta-analysis and trial sequential analysis.
2016 Oct - Endovascular therapy for acute ischaemic stroke: the Pragmatic Ischaemic Stroke Thrombectomy Evaluation (PISTE) randomised, controlled trial.
Muir KW, Ford GA, Messow CM, Ford I, Murray A, Clifton A, Brown MM, Madigan J, Lenthall R, Robertson F, Dixit A, Cloud GC, Wardlaw J, Freeman J, White P; PISTE Investigators..; J Neurol Neurosurg Psychiatry. 2016 Oct 18.
OBJECTIVE: The Pragmatic Ischaemic Thrombectomy Evaluation (PISTE) trial was a multicentre, randomised, controlled clinical trial comparing intravenous thrombolysis (IVT) alone with IVT and adjunctive intra-arterial mechanical thrombectomy (MT) in patients who had acute ischaemic stroke with large artery occlusive anterior circulation stroke confirmed on CT angiography (CTA).
2016 Jul - Palliative care for terminally ill patients in the intensive care unit: Systematic review and metaanalysis
Martins BD, Oliveira RA, Cataneo AJ.; Palliat Support Care. 2016 Jul 27:1-8. [Epub ahead of print]
OBJECTIVE: The purpose of our systematic review was to determine whether the introduction of palliative care (PC) teams reduces length of stay and/or mortality for terminally ill patients (TIPs) in an intensive care unit (ICU).
Brass P, Hellmich M, Ladra A, Ladra J, Wrzosek A.; Cochrane Database Syst Rev. 2016 Jul 20;7:CD008045.
BACKGROUND: Tracheostomy formation is one of the most commonly performed surgical procedures in critically ill intensive care participants requiring long-term mechanical ventilation. Both surgical tracheostomies (STs) and percutaneous tracheostomies (PTs) are used in current surgical practice; but until now, the optimal method of performing tracheostomies in critically ill participants remains unclear.
Wan S, Roberts MA, Mount P.; Cochrane Database Syst Rev. 2016 Aug 9;8:CD010741
BACKGROUND: The ideal intravenous fluid for kidney transplantation has not been defined, despite the common use of normal saline during the peri-operative period. The high chloride content of normal saline is associated with an increased risk of hyperchloraemic metabolic acidosis, which may in turn increase the risk of hyperkalaemia and delayed graft function. Balanced electrolyte solutions have a lower chloride content which may decrease this risk and avoid the need for dialysis due to hyperkalaemia in the immediate post-transplant period. Randomised controlled trials (RCTs) addressing this issue have used biochemical outcomes to compare fluids and have been underpowered to address patient-centred outcomes such as delayed graft function.
2016 Aug - Protein Requirements in the Critically Ill: A Randomized Controlled Trial Using Parenteral Nutrition
Ferrie S, Allman-Farinelli M, Daley M, Smith K.; JPEN J Parenter Enteral Nutr. 2016 Aug;40(6):795-805.
BACKGROUND: Current recommendations for higher protein/amino acid provision in the critically ill are based on weak evidence. This double-blinded randomized controlled trial aimed to compare standard amino acid intake with the higher level recommended as the minimum for critically ill patients.
2016 Mar - Catheter impregnation, coating or bonding for reducing central venous catheter-related infections in adults
Lai NM, Chaiyakunapruk N, Lai NA, O'Riordan E, Pau WS, Saint S.; Cochrane Database Syst Rev. 2016 Mar 16;3:CD007878.
BACKGROUND: The central venous catheter (CVC) is essential in managing acutely ill patients in hospitals. Bloodstream infection is a major complication in patients with a CVC. Several infection control measures have been developed to reduce bloodstream infections, one of which is impregnation of CVCs with various forms of antimicrobials (either with an antiseptic or with antibiotics). This review was originally published in June 2013 and updated in 2016.
Ullman AJ, Cooke ML, Mitchell M, Lin F, New K, Long DA, Mihala G, Rickard CM.; Cochrane Database Syst Rev. 2015 Sep 10;9:CD010367.
BACKGROUND: Central venous catheters (CVCs) play a vital role in the management of acute and chronic illness. Dressings and securement devices must ensure CVCs do not dislodge or fall out, provide a barrier protection from microbial colonisation and infection, and be comfortable for the patient. There is a large range of dressing and securement products available for clinicians to use.
2016 Feb - Frequency of dressing changes for central venous access devices on catheter-related infections
Gavin NC, Webster J, Chan RJ, Rickard CM.; Cochrane Database Syst Rev. 2016 Feb 1;2:CD009213.
BACKGROUND: People admitted to intensive care units and those with chronic health care problems often require long-term vascular access. Central venous access devices (CVADs) are used for administering intravenous medications and blood sampling. CVADs are covered with a dressing and secured with an adhesive or adhesive tape to protect them from infection and reduce movement. Dressings are changed when they become soiled with blood or start to come away from the skin. Repeated removal and application of dressings can cause damage to the skin. The skin is an important barrier that protects the body against infection. Less frequent dressing changes may reduce skin damage, but it is unclear whether this practice affects the frequency of catheter-related infections.
2016 May - Prevention and therapy of leg ischaemia in extracorporeal life support and extracorporeal membrane oxygenation with peripheral cannulation
von Segesser L, Marinakis S, Berdajs D, Ferrari E, Wilhelm M, Maisano F.; Swiss Med Wkly. 2016 May 6;146:w14304.
Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) have been around for a long time, but it is only in recent years, with the advent of acute respiratory distress syndrome consecutive to influenza A (H1N1) infection, that these life-saving technologies have seen a broader application. Although the results of ECLS and ECMO are perceived as generally encouraging, there are still disturbing complications related to peripheral cannulation in general and, more specifically, to cannulation in the groin.
2016 May - Role of Dexmedetomidine for Sedation in Neurocritical Care Patients: A Qualitative Systematic Review and Meta-analysis of Current Evidence
Tsaousi GG, Lamperti M, Bilotta F.; Clin Neuropharmacol. 2016 May-Jun;39(3):144-51.
INTRODUCTION: This systematic review appraises the clinical evidence on efficacy and safety of dexmedetomidine (DEX), as a sole sedative or as sedative adjunct in adult neurocritical care (NCC) patients.
Richards JR, Garber D, Laurin EG, Albertson TE, Derlet RW, Amsterdam EA, Olson KR, Ramoska EA, Lange RA.; Clin Toxicol (Phila). 2016 Jun;54(5):345-64
INTRODUCTION: Cocaine abuse is a major worldwide health problem. Patients with acute cocaine toxicity presenting to the emergency department may require urgent treatment for tachycardia, dysrhythmia, hypertension, and coronary vasospasm, leading to pathological sequelae such as acute coronary syndrome, stroke, and death.
2016 Jun - Preoperative hydration with 0.9% normal saline to prevent acute kidney injury after major elective open abdominal surgery: A randomised controlled trial
Serrano AB, Candela-Toha AM, Zamora J, Vera J, Muriel A, Del Rey JM, Liaño F.; Eur J Anaesthesiol. 2016 Jun;33(6):436-43
BACKGROUND: Postoperative acute kidney injury (AKI) is the second leading cause of hospital-acquired AKI. Although many preventive strategies have been tested, none of them has been totally effective.
Ghadimi K, Levy JH, Welsby IJ.; Anesth Analg. 2016 May;122(5):1287-300.
Prothrombin complex concentrates (PCCs) contain vitamin K-dependent clotting factors (II, VII, IX, and X) and are marketed as 3 or 4 factor-PCC formulations depending on the concentrations of factor VII. PCCs rapidly restore deficient coagulation factor concentrations to achieve hemostasis, but like with all procoagulants, the effect is balanced against thromboembolic risk. The latter is dependent on both the dose of PCCs and the individual patient prothrombotic predisposition.
Aronis KN, Hylek EM.; J Thromb Thrombolysis. 2016 Feb;41(2):253-72.
Non-vitamin K oral anticoagulants (NOACs) have been a major addition to our therapeutic armamentarium. They are at least as effective as warfarin in the thromboprophylaxis of non-valvular atrial fibrillation and management of thromboembolic disease, with a more favorable safety profile. Their predictable pharmacokinetics and pharmacodynamics allow for a fixed oral dosing without the need for anticoagulation monitoring. A major concern regarding NOACs is the lack of a readily available antidote to reverse their anticoagulation effect in case of life-threatening bleeding or need for emergent surgery.
Pollesello P, Parissis J, Kivikko M, Harjola VP.; Int J Cardiol. 2016 Apr 15;209:77-83.
BACKGROUND: Levosimendan is an inodilator developed for treatment of acute heart failure and other cardiac conditions where the use of an inodilator is considered appropriate. Levosimendan has been studied in different therapeutic settings including acutely decompensated chronic heart failure, advanced heart failure, right ventricular failure, cardiogenic shock, septic shock, and cardiac and non-cardiac surgery. This variety of data has been re-analysed in 25 meta-analyses from 15 different international research groups, based on different rationales to select the studies included.
Stout JE, Koh WJ, Yew WW.; Int J Infect Dis. 2016 Mar 11;45:123-134
Non-tuberculous mycobacteria (NTM) are emerging worldwide as significant causes of chronic pulmonary infection, posing a number of challenges for both clinicians and researchers. While a number of studies worldwide have described an increasing prevalence of NTM pulmonary disease over time, population-based data are relatively sparse and subject to ascertainment bias. Furthermore, the disease is geographically heterogeneous. While some species are commonly implicated worldwide (Mycobacterium avium complex, Mycobacterium abscessus), others (e.g., Mycobacterium malmoense, Mycobacterium xenopi) are regionally important.