2014 Sep - Sepsis Severity Score: An Internationally Derived Scoring System From the Surviving Sepsis Campaign Database

Osborn TM, Phillips G, Lemeshow S, Townsend S, Schorr CA, Levy MM, Dellinger RP.; Crit Care Med. 2014 Sep;42(9):1969-76.

Objective: As the Surviving Sepsis Campaign was assessing patient-level data over multiple countries, we sought to evaluate the use of a pragmatic and parsimonious severity-of-illness scoring system for patients with sepsis in an attempt to provide appropriate comparisons with practical application.

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2014 Aug - Minimizing Door-to-Balloon Time Is Not the Most Critical Factor in Improving Clinical Outcome of ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

Ho YC, Tsai TH, Sung PH, Chen YL, Chung SY, Yang CH, Chen SM, Chen CJ, Fang HY, Wu CJ, Yip HK.; Crit Care Med. 2014 Aug;42(8):1788-96.

Objectives: We tested the hypothesis that, as compared with conventional door-to-balloon, shortened door-to-balloon time would further improve 30-day outcome in ST-elevation myocardial infarction patients undergoing primary stenting.

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2014 Aug - Randomized Controlled Trial Comparing Cerebral Perfusion Pressure–Targeted Therapy Versus Intracranial Pressure–Targeted Therapy for Raised Intracranial Pressure due to Acute CNS Infections in Children

Kumar R, Singhi S, Singhi P, Jayashree M, Bansal A, Bhatti A.; Crit Care Med. 2014 Aug;42(8):1775-87.

Objective: In children with acute CNS infection, management of raised intracranial pressure improves mortality and neuromorbidity. We compared cerebral perfusion pressure–targeted approach with the conventional intracranial pressure–targeted approach to treat raised intracranial pressure in these children.

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2014 Aug - Empiric Antibiotic Treatment Reduces Mortality in Severe Sepsis and Septic Shock From the First Hour: Results From a Guideline-Based Performance Improvement Program

Ferrer R, Martin-Loeches I, Phillips G, Osborn TM, Townsend S, Dellinger RP, Artigas A, Schorr C, Levy MM.; Crit Care Med. 2014 Aug;42(8):1749-55.

Objectives: Compelling evidence has shown that aggressive resuscitation bundles, adequate source control, appropriate antibiotic therapy, and organ support are cornerstone for the success in the treatment of patients with sepsis. Delay in the initiation of appropriate antibiotic therapy has been recognized as a risk factor for mortality. To perform a retrospective analysis on the Surviving Sepsis Campaign database to evaluate the relationship between timing of antibiotic administration and mortality.

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2014 Aug - Timing of Renal Replacement Therapy and Patient Outcomes in the Randomized Evaluation of Normal Versus Augmented Level of Replacement Therapy Study

Jun M, Bellomo R, Cass A, Gallagher M, Lo S, Lee J; Randomized Evaluation of Normal Versus Augmented Level of Replacement Therapy (RENAL) Study Investigators. Crit Care Med. 2014 Aug;42(8):1756-65.

Objectives: To explore the relationship between timing of continuous renal replacement therapy commencement and clinical outcomes in critically ill patients with acute kidney injury. The primary outcomes were all-cause mortality at 28 and 90 days.

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2014 Jul - Chlorhexidine-Impregnated Dressing for Prevention of Catheter-Related Bloodstream Infection: A Meta-Analysis

Safdar N, O'Horo JC, Ghufran A, Bearden A, Didier ME, Chateau D, Maki DG. Crit Care Med. 2014 Jul;42(7):1703-13.

Objective: To assess the efficacy of a chlorhexidine-impregnated dressing for prevention of central venous catheter–related colonization and catheter-related bloodstream infection using meta-analysis.

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2014 Jul - A Comparison of Severe Hemodynamic Disturbances Between Dexmedetomidine and Propofol for Sedation in Neurocritical Care Patients

Erdman MJ, Doepker BA, Gerlach AT, Phillips GS, Elijovich L, Jones GM. Crit Care Med. 2014 Jul;42(7):1696-702.

Objective: Dexmedetomidine and propofol are commonly used sedatives in neurocritical care as they allow for frequent neurologic examinations. However, both agents are associated with significant hemodynamic side effects. The primary objective of this study is to compare the prevalence of severe hemodynamic effects in neurocritical care patients receiving dexmedetomidine and propofol.

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2014 Jul - Early Administration of Hydrocortisone Replacement After the Advent of Septic Shock: Impact on Survival and Immune Response

Katsenos CS, Antonopoulou AN, Apostolidou EN, Ioakeimidou A, Kalpakou GT, Papanikolaou MN, Pistiki AC, Mpalla MC, Paraschos MD, Patrani MA, Pratikaki ME, Retsas TA, Savva AA, Vassiliagkou SD, Lekkou AA, Dimopoulou I, Routsi C, Mandragos KE; Hellenic Sepsis Study Group. Crit Care Med. 2014 Jul;42(7):1651-7.

Objectives: To investigate the impact of early initiation of hydrocortisone therapy on the clinical course of septic shock and on cytokine release.

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2014 Jul - The Impact of Variation in Renal Replacement Therapy Settings on Piperacillin, Meropenem, and Vancomycin Drug Clearance in the Critically Ill: An Analysis of Published Literature and Dosing Regimens

Jamal JA, Udy AA, Lipman J, Roberts JA. Crit Care Med. 2014 Jul;42(7):1640-50.

Objectives: To describe the effect of different renal replacement therapy modalities and settings on the clearance of meropenem, piperacillin, and vancomycin in critically ill patients and to evaluate the frequency with which current dosing regimens achieve therapeutic concentrations.

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2014 Jul - Long-Term Survival in Patients With Severe Acute Respiratory Distress Syndrome and Rescue Therapies for Refractory Hypoxemia

Khandelwal N, Hough CL, Bansal A, Veenstra DL, Treggiari MM. Crit Care Med. 2014 Jul;42(7):1610-8.

Objectives: To describe long-term survival in patients with severe acute respiratory distress syndrome and assess differences in patient characteristics and outcomes among those who receive rescue therapies (prone position ventilation, inhaled nitric oxide, or inhaled epoprostenol) versus conventional treatment.

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2014 Jul - Association Between the Choice of IV Crystalloid and In-Hospital Mortality Among Critically Ill Adults With Sepsis

Raghunathan K, Shaw A, Nathanson B, Stürmer T, Brookhart A, Stefan MS, Setoguchi S, Beadles C, Lindenauer PK. Crit Care Med. 2014 Jul;42(7):1585-91

OBJECTIVE: Isotonic saline is the most commonly used crystalloid in the ICU, but recent evidence suggests that balanced fluids like Lactated Ringer's solution may be preferable. We examined the association between choice of crystalloids and in-hospital mortality during the resuscitation of critically ill adults with sepsis.

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2014 Jun - Conservative Oxygen Therapy in Mechanically Ventilated Patients: A Pilot Before-and-After Trial

Suzuki S, Eastwood GM, Glassford NJ, Peck L, Young H, Garcia-Alvarez M, Schneider AG, Bellomo R.; Crit Care Med. 2014 Jun;42(6):1414-22

Objectives: To assess the feasibility and safety of a conservative approach to oxygen therapy in mechanically ventilated ICU patients.

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2014 Jun - Impact of Therapeutic Strategies on the Prognosis of Candidemia in the ICU

Puig-Asensio M, Pemán J, Zaragoza R, Garnacho-Montero J, Martín-Mazuelos E, Cuenca-Estrella M, Almirante B; Prospective Population Study on Candidemia in Spain (CANDIPOP) Project, Hospital Infection Study Group (GEIH) and Medical Mycology Study Group (GEMICOMED) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and Spanish Network for Research in Infectious Diseases.; Crit Care Med. 2014 Jun;42(6):1423-32.

Objectives: To determine the epidemiology of Candida bloodstream infections, variables influencing mortality, and antifungal resistance rates in ICUs in Spain.

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2014 Jun - Early multimodal outcome prediction after cardiac arrest in patients treated with hypothermia

Oddo M, Rossetti AO.; Crit Care Med. 2014 Jun;42(6):1340-7.

Objectives: Therapeutic hypothermia and pharmacological sedation may influence outcome prediction after cardiac arrest. The use of a multimodal approach, including clinical examination, electroencephalography, somatosensory-evoked potentials, and serum neuron-specific enolase, is recommended; however, no study examined the comparative performance of these predictors or addressed their optimal combination.

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2014 Jun - Arterial catheters as a source of bloodstream infection: a systematic review and meta-analysis

O'Horo JC, Maki DG, Krupp AE, Safdar N.; Crit Care Med. 2014 Jun;42(6):1334-9.

Objective: Catheter-related bloodstream infections are associated with significant costs and adverse consequences. Arterial catheters are commonly used in the critical care setting and are among the most heavily manipulated vascular access devices. We sought to evaluate the prevalence of arterial catheter-related bloodstream infection.

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2014 Jun - The interaction of vasopressin and corticosteroids in septic shock: a pilot randomized controlled trial

Gordon AC, Mason AJ, Perkins GD, Stotz M, Terblanche M, Ashby D, Brett SJ.; Crit Care Med. 2014 Jun;42(6):1325-33.

Objectives: Vasopressin and corticosteroids are both commonly used adjunctive therapies in septic shock. Retrospective analyses have suggested that there may be an interaction between these drugs, with higher circulating vasopressin levels and improved outcomes in patients treated with both vasopressin and corticosteroids. We aimed to test for an interaction between vasopressin and corticosteroids in septic shock.

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2014 May - Rehabilitation Interventions for Postintensive Care Syndrome: A Systematic Review

Mehlhorn J, Freytag A, Schmidt K, Brunkhorst FM, Graf J, Troitzsch U, Schlattmann P, Wensing M, Gensichen J.; Crit Care Med. 2014 May;42(5):1263-71.

OBJECTIVE: An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective.

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2014 May - The efficacy and safety of prone positional ventilation in acute respiratory distress syndrome: updated study-level meta-analysis of 11 randomized controlled trials

Lee JM, Bae W, Lee YJ, Cho YJ.; Crit Care Med. 2014 May;42(5):1252-62.

OBJECTIVE: The survival benefit of prone positioning during mechanical ventilation for acute respiratory distress syndrome has been a matter of debate. Recent multicenter randomized controlled trials have shown a significant reduction of 28-day and 90-day mortality associated with prone positioning during mechanical ventilation for severe acute respiratory distress syndrome. We performed an up-to-date meta-analysis on this topic and elucidated the effect of prone positioning on overall mortality and associated complications.

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2014 May - The Highs and Lows of Blood Pressure: Toward Meaningful Clinical Targets in Patients With Shock

Magder SA.; Crit Care Med. 2014 May;42(5):1241-51.

OBJECTIVE: Measurement of blood pressure is fundamental for the management of patients in shock, yet the physiological basis and meaning of blood pressure measurements are complex and often not well understood. This article is in two parts: part 1 deals with the mechanical and physiological aspects of blood pressure and its measurement and part 2 deals with the role of changes in regional resistances in the determination of tissue perfusion and bedside approaches to management of shock.

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2014 May - Hemolysis in pediatric patients receiving centrifugal-pump extracorporeal membrane oxygenation: prevalence, risk factors, and outcomes

Lou S, Maclaren G, Best D, Delzoppo C, Butt W.; Crit Care Med. 2014 May;42(5):1213-20

OBJECTIVES: To explore the prevalence and risk factors for hemolysis in children receiving extracorporeal membrane oxygenation and examine the relationship between hemolysis and adverse outcomes.

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