2015 Aug - Recommendations for the Critical Care Management of Devastating Brain Injury: Prognostication, Psychosocial, and Ethical Management

Souter MJ, Blissitt PA, Blosser S, Bonomo J, Greer D, Jichici D, Mahanes D, Marcolini EG, Miller C, Sangha K, Yeager S.; Neurocrit Care. 2015 Aug;23(1):4-13.

Devastating brain injuries (DBIs) profoundly damage cerebral function and frequently cause death. DBI survivors admitted to critical care will suffer both intracranial and extracranial effects from their brain injury. The indicators of quality care in DBI are not completely defined, and despite best efforts many patients will not survive, although others may have better outcomes than originally anticipated.

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2015 Aug - Relationship of Troponin T and Age- and Sex-Adjusted BNP Elevation Following Subarachnoid Hemorrhage with 30-Day Mortality

Duello KM, Nagel JP, Thomas CS, Blackshear JL, Freeman WD.; Neurocrit Care. 2015 Aug;23(1):59-65.

Background: Troponin and brain natriuretic peptide (BNP) levels are predictors of mortality following subarachnoid hemorrhage (SAH). Prior studies used strict cutoffs for BNP elevation; however, normal levels of BNP are increased in older persons and women. We explored the association of troponin elevation and BNP elevation adjusted for sex and age with 30-day mortality.

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2015 Sep - Mechanical chest compression for out of hospital cardiac arrest: Systematic review and meta-analysis

Gates S, Quinn T, Deakin CD, Blair L, Couper K, Perkins GD.; Resuscitation. 2015 Sep;94:91-7. doi: 10.1016/j.resuscitation.2015.07.002. Epub 2015 Jul 17.

AIM: To summarise the evidence from randomised controlled trials of mechanical chest compression devices used during resuscitation after out of hospital cardiac arrest.

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2015 Sep - Gender and survival after sudden cardiac arrest: A systematic review and meta-analysis

Bougouin W, Mustafic H, Marijon E, Murad MH, Dumas F, Barbouttis A, Jabre P, Beganton F, Empana JP, Celermajer DS, Cariou A, Jouven X.; Resuscitation. 2015 Sep;94:55-60. doi: 10.1016/j.resuscitation.2015.06.018. Epub 2015 Jul 2.

Background: Conflicting results exist regarding the impact of gender on early survival after sudden cardiac arrest (SCA). We aimed to assess the association between female gender and early SCA survival.

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2015 Sep - Cerebral oximetry and return of spontaneous circulation after cardiac arrest: A systematic review and meta-analysis

Sanfilippo F, Serena G, Corredor C, Benedetto U, Maybauer MO, Al-Subaie N, Madden B, Oddo M, Cecconi M.; Resuscitation. 2015 Sep;94:67-72. doi: 10.1016/j.resuscitation.2015.06.023. Epub 2015 Jul 6

AIM: The prediction of return of spontaneous circulation (ROSC) during resuscitation of patients suffering of cardiac arrest (CA) is particularly challenging. Regional cerebral oxygen saturation (rSO2) monitoring through near-infrared spectrometry is feasible during CA and could provide guidance during resuscitation.

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2015 Jul - Vasopressors in septic shock: a systematic review and network meta-analysis

Zhou F, Mao Z, Zeng X, Kang H, Liu H, Pan L, Hou PC.; Ther Clin Risk Manag. 2015 Jul 14;11:1047-59.

OBJECTIVE: Vasopressor agents are often prescribed in septic shock. However, their effects remain controversial. We conducted a systematic review and Bayesian network meta-analysis to compare the effects among different types of vasopressor agents.

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2015 Aug - Treatment of acute stroke: an update

Mikulik R, Wahlgren N. ;J Intern Med. 2015 Aug;278(2):145-65.

Stroke is the second leading cause of global mortality after coronary heart disease, and a major cause of neurological disability. About 17 million strokes occur worldwide each year. Patients with stroke often require long-term rehabilitation following the acute phase, with ongoing support from the community and nursing home care. Thus, stroke is a devastating disease and a major economic burden on society.

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2015 Aug - Canadian Stroke Best Practice Recommendations: Hyperacute Stroke Care Guidelines, Update 2015

Casaubon LK, Boulanger JM, Blacquiere D, Boucher S, Brown K, Goddard T, Gordon J, Horton M, Lalonde J, LaRivière C, Lavoie P, Leslie P, McNeill J, Menon BK, Moses B, Penn M, Perry J, Snieder E, Tymianski D, Foley N, Smith EE, Gubitz G, Hill MD, Glasser E, Lindsay P; Heart and Stroke Foundation of Canada Canadian Stroke Best Practices Advisory Committee.; Int J Stroke. 2015 Aug;10(6):924-40

The 2015 update of the Canadian Stroke Best Practice Recommendations Hyperacute Stroke Care guideline highlights key elements involved in the initial assessment, stabilization, and treatment of patients with transient ischemic attack (TIA), ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and acute venous sinus thrombosis. The most notable change in this 5th edition is the addition of new recommendations for the use of endovascular therapy for patients with acute ischemic stroke and proximal intracranial arterial occlusion.

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2015 Jun - 2015 AHA/ASA Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke As

Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, Johnston KC, Johnston SC, Khalessi AA, Kidwell CS, Meschia JF, Ovbiagele B, Yavagal DR; American Heart Association Stroke Council.; Stroke. 2015 Jun 29. pii: STR.0000000000000074. [Epub ahead of print]

PURPOSE: The aim of this guideline is to provide a focused update of the current recommendations for the endovascular treatment of acute ischemic stroke. Where there is overlap, the recommendations made here supersede those of previous guidelines.

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2015 Jul - Gut failure in critical care: old school versus new school

Sertaridou E, Papaioannou V, Kolios G, Pneumatikos I.; Ann Gastroenterol. 2015 Jul-Sep;28(3):309-322.

The concept of bacterial translocation and gut-origin sepsis as causes of systemic infectious complications and multiple organ deficiency syndrome in surgical and critically ill patients has been a recurring issue over the last decades attracting the scientific interest. Although gastrointestinal dysfunction seemingly arises frequently in intensive care unit patients, it is usually underdiagnosed or underestimated, because the pathophysiology involved is incompletely understood and its exact clinical relevance still remains controversial with an unknown yet probably adverse impact on the patients' outcome.

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2015 Jun - Dobutamine Therapy is Associated with Worse Clinical Outcomes Compared with Nesiritide Therapy for Acute Decompensated Heart Failure: A Systematic Review and Meta-Analysis

Wang XC, Zhu DM, Shan YX. ;Am J Cardiovasc Drugs. 2015 Jun 28. [Epub ahead of print]

BACKGROUND: Inotropes and natriuretic peptides are essential components of current therapeutic options for acute decompensated heart failure (ADHF). This systematic review examines the therapeutic effectiveness of dobutamine and brain natriuretic peptide, nesiritide, in reducing mortality and readmission rates for ADHF treatment.

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2015 Jun - Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials

Suppan L, Tramèr MR, Niquille M, Grosgurin O, Marti C. Br J Anaesth. 2015 Jun 30.  [Epub ahead of print]

BACKGROUND: Immobilization of the cervical spine worsens tracheal intubation conditions. Various intubation devices have been tested in this setting. Their relative usefulness remains unclear.

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2015 Apr - Acquired factor V inhibitor in a patient receiving venous-venous extracorporeal membrane oxygenation for Legionella pneumonia

Lam KW, Au Yeung KW, Lai KY.; Hong Kong Med J. 2015 Apr;21(2):187.e1-2.

We report a rare complication of factor V deficiency in a patient having Legionella pneumonia. This patient also had other complications like severe acute respiratory distress syndrome, acute kidney injury, and septic shock that required venous-venous extracorporeal membrane oxygenation support.

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2015 Jun - Propofol versus thiopental sodium for the treatment of refractory status epilepticus

Prabhakar H, Kalaivani M.; Cochrane Database Syst Rev. 2015 Jun 25;6:CD009202.

BACKGROUND: This is an updated version of the original Cochrane review published in Issue 8, 2012.Failure to respond to antiepileptic drugs in patients with uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective. However, there is a substantial lack of evidence as to which of the two drugs is better in terms of clinical outcome.

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2015 May - Protective versus Conventional Ventilation for Surgery: A Systematic Review and Individual Patient Data Meta-analysis

Serpa Neto A, Hemmes SN, Barbas CS, Beiderlinden M, Biehl M, Binnekade JM, Canet J, Fernandez-Bustamante A, Futier E, Gajic O, Hedenstierna G, Hollmann MW, Jaber S, Kozian A, Licker M, Lin WQ, Maslow AD, Memtsoudis SG, Reis Miranda D, Moine P, Ng T, Paparella D, Putensen C, Ranieri M, Scavonetto F, Schilling T, Schmid W, Selmo G, Severgnini P, Sprung J, Sundar S, Talmor D, Treschan T, Unzueta C, Weingarten TN, Wolthuis EK, Wrigge H, Gama de Abreu M, Pelosi P, Schultz MJ.; Anesthesiology. 2015 May 15

BACKGROUND: Recent studies show that intraoperative mechanical ventilation using low tidal volumes (VT) can prevent postoperative pulmonary complications (PPCs). The aim of this individual patient data meta-analysis is to evaluate the individual associations between VT size and positive end-expiratory pressure (PEEP) level and occurrence of PPC.

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2015 JMun - Exercise rehabilitation following intensive care unit discharge for recovery from critical illness

Connolly B, Salisbury L, O'Neill B, Geneen L, Douiri A, Grocott MP, Hart N, Walsh TS, Blackwood B; ERACIP Group.; Cochrane Database Syst Rev. 2015 Jun 22;6:CD008632.

BACKGROUND: Skeletal muscle wasting and weakness are significant complications of critical illness, associated with degree of illness severity and periods of reduced mobility during mechanical ventilation. They contribute to the profound physical and functional deficits observed in survivors. These impairments may persist for many years following discharge from the intensive care unit (ICU) and can markedly influence health-related quality of life. Rehabilitation is a key strategy in the recovery of patients after critical illness. Exercise-based interventions are aimed at targeting this muscle wasting and weakness. Physical rehabilitation delivered during ICU admission has been systematically evaluated and shown to be beneficial. However, its effectiveness when initiated after ICU discharge has yet to be established.

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2015 Jun -Endotracheal intubation versus supraglottic airway placement in out-of-hospital cardiac arrest: A meta-analysis

Benoit JL, Gerecht RB, Steuerwald MT, McMullan JT.; Resuscitation. 2015 May 23;93:20-26.

OBJECTIVE: Overall survival from out-of-hospital cardiac arrest (OHCA) is less than 10%. After initial bag-valve mask ventilation, 80% of patients receive an advanced airway, either by endotracheal intubation (ETI) or placement of a supraglottic airway (SGA). The objective of this meta-analysis was to compare patient outcomes for these two advanced airway methods in OHCA patients treated by Emergency Medical Services (EMS).

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2015 Jun - Open Lung Biopsy among Critically Ill, Mechanically Ventilated Patients: A Meta-Analysis

Wong AK, Walkey AJ. Ann Am Thorac Soc. 2015 Jun 11. [Epub ahead of print]

RATIONALE: Open lung biopsy may be performed to guide therapy in mechanically ventilated patients with diagnostic uncertainty regarding etiology of pulmonary infiltrates. Current evidence for open lung biopsy in mechanically ventilated patients comes from single center case series.

OBJECTIVES: We performed a meta-analysis of case series to determine diagnoses, complications, and changes in therapy following lung biopsy in critically ill patients requiring mechanical ventilation.

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2015 Jul - Introducing Final-Year Medical Students to Pocket-Sized Ultrasound Imaging: Teaching Transthoracic Echocardiography on a 2-Week Anesthesia Rotation

Ho AM, Critchley LA, Leung JY, Kan PK, Au SS, Ng SK, Chan SK, Lam PK, Choi GY, Wai JK, Lee AP, Chan SO.; Teach Learn Med. 2015 Jul-Sep;27(3):307-13.

PROBLEM: The availability of less expensive and smaller ultrasound machines has enabled the use of ultrasound in virtually all major medical/surgical disciplines. Some medical schools have incorporated point-of-care ultrasound training into their undergraduate curriculum, whereas many postgraduate programs have made ultrasound training a standard. The Chinese University of Hong Kong has charged its Department of Anaesthesia and Intensive Care to spearhead the introduction of ultrasound into the final-year medical curriculum by introducing handheld transthoracic echocardiography as part of perioperative assessment.

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2015 May - How can we ensure effective antibiotic dosing in critically ill patients receiving different types of renal replacement therapy?

Jamal JA, Mueller BA, Choi GY, Lipman J, Roberts JA.; Diagn Microbiol Infect Dis. 2015 May;82(1):92-103.

Determining appropriate antibiotic dosing for critically ill patients receiving renal replacement therapy (RRT) is complex. Worldwide unstandardized and heterogeneous prescribing of RRT as well as altered patient physiology and pathogen susceptibility all cause drug disposition to be much different to that seen in non-critically ill patients.

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