2012 May - Practice Variations in the Management of Status Epilepticus

Cook AM, Castle A, Green A, Lesch C, Morrison C, Rhoney D, Parker D Jr, Tesoro E, Brophy G, Goodwin H, Gokun J, Makii J, McAllen K, Bledsoe K, Sangha K, Weant K, Liang N, Murphy-Human T.; Neurocrit Care. 2012 May 8. [Epub ahead of print]
BACKGROUND: Numerous anticonvulsant agents are now available for treating status epilepticus (SE). However, a paucity of data is available to guide clinicians in the initial treatment of seizures or SE. This study describes the current strategies being employed to treat SE in the USA.

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2012 Apr - Chlorhexidine body washing to control antimicrobial-resistant bacteria in intensive care units: a systematic review

Derde LP, Dautzenberg MJ, Bonten MJ.; Intensive Care Med. 2012 Apr 12. [Epub ahead of print]
PURPOSE: Infections caused by antimicrobial-resistant bacteria (AMRB) are increasing worldwide, especially in intensive care units (ICUs). Chlorhexidine body washing (CHG-BW) has been proposed as a measure to limit the spread of AMRB. We have systematically assessed the evidence on the effectiveness of CHG-BW in reducing colonization and infection with AMRB in adult ICU patients.

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2012 Mar - Chest radiography in the ICU: Part 2, Evaluation of cardiovascular lines and other devices

Godoy MC, Leitman BS, de Groot PM, Vlahos I, Naidich DP.; AJR Am J Roentgenol. 2012 Mar;198(3):572-81. Review.
OBJECTIVE: In this pictorial essay, we discuss and illustrate normal and aberrant positioning of the cardiovascular support and monitoring devices frequently used in critically ill patients, including central venous catheters, pulmonary artery catheters, left atrial catheters, transvenous pacemakers, automatic implantable cardioverter defibrillators, intraaortic counterpulsation balloon pump, and ventricular assist devices, as well as their inherent complications.

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2012 Mar - Chest radiography in the ICU: Part 1, Evaluation of airway, enteric, and pleural tubes

Godoy MC, Leitman BS, de Groot PM, Vlahos I, Naidich DP.; AJR Am J Roentgenol. 2012 Mar;198(3):563-71. Review.
OBJECTIVE: In this pictorial essay, we discuss and illustrate normal and aberrant positioning of nonvascular support and monitoring devices frequently used in critically ill patients, including endotracheal and tracheostomy tubes, chest tubes, and nasogastric and nasoenteric tubes, as well as their inherent complications.

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2012 Apr - Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion

Carson JL, Carless PA, Hebert PC.; Cochrane Database Syst Rev. 2012 Apr 18;4:CD002042.
BACKGROUND: Most clinical practice guidelines recommend restrictive red cell transfusion practices, with the goal of minimising exposure to allogeneic blood. The purpose of this review is to compare clinical outcomes in patients randomised to restrictive versus liberal transfusion thresholds (triggers).

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2012 Apr - Recombinant human activated protein C for severe sepsis in neonates

Kylat RI, Ohlsson A.; Cochrane Database Syst Rev. 2012 Apr 18;4:CD005385.
BACKGROUND: Sepsis is a common problem in preterm and term infants. The incidence of neonatal sepsis has declined, but mortality remains high. Recombinant human activated protein C (rhAPC) possess a broad spectrum of activity modulating coagulation and inflammation. In septic adults it may reduce mortality, but no significant benefit has been reported in children with severe sepsis.

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2012 Apr - Glucocorticoids for the treatment of anaphylaxis

Choo KJ, Simons FE, Sheikh A.; Cochrane Database Syst Rev. 2012 Apr 18;4:CD007596.
BACKGROUND: Anaphylaxis is a serious hypersensitivity reaction that is rapid in onset and may result in death. Anaphylaxis guidelines recommend glucocorticoids for the treatment of people experiencing anaphylaxis. 

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2012 Apr - Antifibrinolytic therapy to reduce haemoptysis from any cause

Prutsky G, Domecq JP, Salazar CA, Accinelli R.; Cochrane Database Syst Rev. 2012 Apr 18;4:CD008711.
BACKGROUND: Haemoptysis is a common pathology around the world, occurring with more frequency in low-income countries. It has different etiologies, many of which have infectious characteristics. Antifibrinolytic agents are commonly used to manage bleeding from different sources, but their usefulness in pulmonology is unclear.

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2012 Apr - Pathophysiology of ventilator-associated lung injury

Rocco PR, Dos Santos C, Pelosi P.; Curr Opin Anaesthesiol. 2012 Apr;25(2):123-30.
Purpose of review: Mechanical ventilation is essential for the support of critically ill patients, but may aggravate lung damage, leading to ventilator-associated lung injury (VALI). VALI results from a succession of events beginning with mechanical alteration of lung parenchyma, because of disproportionate stress and strain. The resulting structural tension initiates a biological inflammatory cascade; however, tension can reach the limits of stress, triggering the destruction of structures. This article reviews and discusses the ongoing research into the mechanisms of VALI and their implications for the management of ventilated patients.

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2012 Apr - Potential use of melatonin in sleep and delirium in the critically ill

Bellapart J, Boots R.; Br J Anaesth. 2012 Apr;108(4):572-80.
Intensive care delirium is a well-recognized complication in critically ill patients. Delirium is an independent risk factor for death in the intensive care unit (ICU), leading to oversedation, increased duration of mechanical ventilation, and increased length of stay. Although there has not been a direct causal relationship shown between sleep deprivation and delirium, many studies have demonstrated that critically ill patients have an altered sleep pattern, abnormal levels of melatonin, and loss of circadian rhythms...

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2012 Mar - 20-Year Experience of Prolonged Extracorporeal Membrane Oxygenation in Critically Ill Children With Cardiac or Pulmonary Failure

Gupta P, McDonald R, Chipman CW, Stroud M, Gossett JM, Imamura M, Bhutta AT.; Ann Thorac Surg. 2012 Mar 13. [Epub ahead of print]
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for life-threatening respiratory or circulatory failure. Although outcomes are favorable with short-term ECMO therapy, data on the outcomes of prolonged ECMO therapy in children are very limited. This study aimed to study morbidity and mortality associated with prolonged ECMO therapy (≥28 days) in children with refractory cardiac or pulmonary failure.

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2012 Mar - Fibrinogen depleting agents for acute ischaemic stroke [Review]

Hao Z, Liu M, Counsell C, Wardlaw JM, Lin S, Zhao X.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD000091.
BACKGROUND: Fibrinogen depleting agents reduce fibrinogen in blood plasma, reduce blood viscosity and hence increase blood flow. This may help remove the blood clot blocking the artery and re-establish blood flow to the affected area of the brain after an ischaemic stroke. The risk of haemorrhage may be less than with thrombolytic agents. This is an update of a Cochrane review first published in 1997 and last updated in 2003.

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2012 Mar - Central venous access sites for the prevention of venous thrombosis, stenosis and infection [Review]

Ge X, Cavallazzi R, Li C, Pan SM, Wang YW, Wang FL.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD004084.
BACKGROUND: Central venous access (CVA) is widely used. However, its thrombotic, stenotic and infectious complications can be life-threatening and involve high-cost therapy. Research revealed that the risk of catheter-related complications varied according to the site of CVA. It would be helpful to find the preferred site of insertion to minimize the risk of catheter-related complications. This review was originally published in 2007 and was updated in 2011.

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2012 Mar - Human recombinant activated protein C for severe sepsis [Review]

Martí-Carvajal AJ, Solà I, Lathyris D, Cardona AF.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD004388.
BACKGROUND: Sepsis is a common and frequently fatal condition. Human recombinant activated protein C (APC) has been used to reduce the high rate of death by severe sepsis or septic shock. This is an update of a Cochrane review (originally published in 2007 and updated in 2008).

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2012 Mar - Human recombinant activated factor VII for upper gastrointestinal bleeding in patients with liver diseases [Review]

Martí-Carvajal AJ, Karakitsiou DE, Salanti G.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD004887.
BACKGROUND: Mortality from upper gastrointestinal bleeding in patients with liver disease is high. Recombinant human activated factor VII (rHuFVIIa) has been suggested for patients with liver disease and upper gastrointestinal bleeding.

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2012 Mar - Recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia [Review]

Simpson E, Lin Y, Stanworth S, Birchall J, Doree C, Hyde C.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD005011.
BACKGROUND: Recombinant factor VIIa (rFVIIa) is licensed for use in patients with haemophilia and inhibitory allo-antibodies and for prophylaxis and treatment of patients with congenital factor VII deficiency. It is also used for off-license indications to prevent bleeding in operations where blood loss is likely to be high, and/or to stop bleeding that is proving difficult to control by other means. This is the third version of the 2007 Cochrane review on the use of recombinant factor VIIa for the prevention and treatment of bleeding in patients without haemophilia, and has been updated to incorporate recent trial data.

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2012 Mar - Oxygen therapy for pneumonia in adults [Review]

Zhang Y, Fang C, Dong BR, Wu T, Deng JL.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD006607.
BACKGROUND: Oxygen therapy is widely used in the treatment of lung diseases. However, the effectiveness of oxygen therapy as a treatment for pneumonia is not well known.

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2012 Mar - Early versus late tracheostomy for critically ill patients [Review]

Gomes Silva BN, Andriolo RB, Saconato H, Atallah AN, Valente O.; Cochrane Database Syst Rev. 2012 Mar 14;3:CD007271.
BACKGROUND: Long-term mechanical ventilation is the most common situation where tracheostomy is indicated for patients in intensive care units (ICU). 'Early' and 'late' tracheostomies are two categories of the timing of tracheostomy. The evidence on the advantages attributed to early over late tracheostomy is somewhat conflicting but includes shorter hospital stays and lower mortality rates.

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2012 Mar - Comparison of Equipressor Doses of Norepinephrine, Epinephrine, and Phenylephrine on Septic Myocardial Dysfunction

Ducrocq N, Kimmoun A, Furmaniuk A, Hekalo Z, Maskali F, Poussier S, Marie PY, Levy B. Anesthesiology. 2012 Mar 8. [Epub ahead of print]
BACKGROUND: Myocardial depression is a frequent event during septic shock and may mimic a cardiogenic shock state with decreased cardiac output. Nevertheless, data are scarce regarding the myocardial effects of vasopressors used to treat hypotension. In this study, the authors compared the effects of three commonly used vasopressors acting on different adrenergic receptors on myocardial function in a rodent model of septic shock, as explored with conductance catheter and positron emission tomography.

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2012 Mar - Is aggressive treatment of traumatic brain injury cost-effective?

Whitmore RG, Thawani JP, Grady MS, Levine JM, Sanborn MR, Stein SC.; J Neurosurg. 2012 Mar 6.
Objective: The objective of this study was to determine whether aggressive treatment of severe traumatic brain injury (TBI), including invasive intracranial monitoring and decompressive craniectomy, is cost-effective.

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