2014 Mar - Lung injury and its prognostic significance in acute liver failure

Audimoolam VK, McPhail MJ, Wendon JA, Willars C, Bernal W, Desai SR, Auzinger G.; Crit Care Med. 2014 Mar;42(3):592-600.

OBJECTIVE: Hypoxemia is a feared complication of acute liver failure, and high oxygen requirements will frequently lead to removal of patients from the transplant list. As data regarding the prevalence and outcome of acute respiratory distress syndrome in acute liver failure are scant and hypoxemia being a commonly encountered systemic complication, we analyzed radiological, gas exchange, and ventilator data in consecutive patients admitted with acute liver failure.

Read more ...

2014 Mar - B-type natriuretic Peptide and risk of acute kidney injury in patients hospitalized with acute coronary syndromes

Moltrasio M, Cabiati A, Milazzo V, Rubino M, De Metrio M, Discacciati A, Rumi P, Marana I, Marenzi G.; Crit Care Med. 2014 Mar;42(3):619-24.

OBJECTIVES: To investigate whether admission B-type natriuretic peptide levels predict the development of acute kidney injury in acute coronary syndromes.

Read more ...

2014 Mar - Evaluating the Efficacy and Safety of Two Doses of the Polyclonal Anti-Tumor Necrosis Factor-α Fragment Antibody AZD9773 in Adult Patients With Severe Sepsis and/or Septic Shock: Randomized, Double-Blind, Placebo-Controlled Phase IIb Study

Bernard GR, Francois B, Mira JP, Vincent JL, Dellinger RP, Russell JA, Larosa SP, Laterre PF, Levy MM, Dankner W, Schmitt N, Lindemann J, Wittebole X.; Crit Care Med. 2014 Mar;42(3):504-11.

OBJECTIVE: This trial compared the efficacy/safety of two IV doses of AZD9773, a polyclonal antibody to tumor necrosis factor-α, in adult patients with severe sepsis/septic shock.

Read more ...

2014 Feb - Inhaled Nitric Oxide Does Not Reduce Mortality in Patients With Acute Respiratory Distress Syndrome Regardless of Severity: Systematic Review and Meta-Analysis

Adhikari NK, Dellinger RP, Lundin S, Payen D, Vallet B, Gerlach H, Park KJ, Mehta S, Slutsky AS, Friedrich JO.; Crit Care Med. 2014 Feb;42(2):404-12.

Objective:  Treatment with inhaled nitric oxide improves oxygenation but not survival in mechanically ventilated patients with acute respiratory distress syndrome, but the effect may depend on the severity of hypoxemia. Our objective was to determine whether nitric oxide reduces hospital mortality in patients with severe acute respiratory distress syndrome (Pao2/Fio2 ≤ 100 mm Hg) but not in patients with mild-moderate acute respiratory distress syndrome (100 < Pao2/Fio2 ≤ 300 mm Hg) at the time of randomization.

Read more ...

2014 Feb - Association Between Hyperoxia and Mortality After Stroke: A Multicenter Cohort Study

Rincon F, Kang J, Maltenfort M, Vibbert M, Urtecho J, Athar MK, Jallo J, Pineda CC, Tzeng D, McBride W, Bell R.; Crit Care Med. 2014 Feb;42(2):387-96.

Objective:  To test the hypothesis that hyperoxia was associated with higher in-hospital mortality in ventilated stroke patients admitted to the ICU.

Read more ...

2014 Feb - Macrolides and Mortality in Critically Ill Patients With Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis

Sligl WI, Asadi L, Eurich DT, Tjosvold L, Marrie TJ, Majumdar SR.; Crit Care Med. 2014 Feb;42(2):420-32.

Objective:  Some studies suggest better outcomes with macrolide therapy for critically ill patients with community-acquired pneumonia. To further explore this, we performed a systematic review of studies with mortality endpoints that compared macrolide therapy with other regimens in critically ill patients with community-acquired pneumonia.

Read more ...

2014 Feb - Are Autopsy Findings Still Relevant to the Management of Critically Ill Patients in the Modern Era?

Fröhlich S, Ryan O, Murphy N, McCauley N, Crotty T, Ryan D.; Crit Care Med. 2014 Feb;42(2):336-43.

Objectives:  The purpose of this study was to determine the accuracy of clinical diagnoses compared to autopsy findings in critically ill patients in the current medical era.

Read more ...

2014 Feb - Adjuvant Treatment With a Mammalian Target of Rapamycin Inhibitor, Sirolimus, and Steroids Improves Outcomes in Patients With Severe H1N1 Pneumonia and Acute Respiratory Failure

Wang CH, Chung FT, Lin SM, Huang SY, Chou CL, Lee KY, Lin TY, Kuo HP.; Crit Care Med. 2014 Feb;42(2):313-21.

Objectives:  Severe H1N1 pneumonia with acute respiratory failure results in infiltration of lungs due to the presence of hyperactive immune cells. Rapamycin and corticosteroids inhibit this immune response by blocking the activation of T and B cells.

Read more ...

2014 Feb - Timing of Limitations in Life Support in Acute Lung Injury Patients: A Multisite Study

Turnbull AE, Ruhl AP, Lau BM, Mendez-Tellez PA, Shanholtz CB, Needham DM.; Crit Care Med. 2014 Feb;42(2):296-302.

Objective:  Substantial variability exists in the timing of limitations in life support for critically ill patients. Our objective was to investigate how the timing of limitations in life support varies with changes in organ failure status and time since acute lung injury onset.

Read more ...

2014 Feb - Incidence and Outcomes Associated With Early Heart Failure Pharmacotherapy in Patients With Ongoing Cardiogenic Shock

van Diepen S, Reynolds HR, Stebbins A, Lopes RD, Džavík V, Ruzyllo W, Geppert A, Widimsky P, Ohman EM, Parrillo JE, Dauerman HL, Baran DA, Hochman JS, Alexander JH.; Crit Care Med. 2014 Feb;42(2):281-8.

Objectives:  Guidelines recommend β-blockers and renin-angiotensin-aldosterone system blockers to improve long-term survival in hemodynamically stable myocardial infarction patients with a reduced left ventricular ejection fraction. The prevalence and outcomes associated with β and renin-angiotensin-aldosterone system blocker therapy in patients with ongoing cardiogenic shock is unknown.

Read more ...

2014 Feb - Therapeutic Hypothermia and the Risk of Infection: A Systematic Review and Meta-Analysis

Geurts M, Macleod MR, Kollmar R, Kremer PH, van der Worp HB.; Crit Care Med. 2014 Feb;42(2):231-42

Observational studies suggest that infections are a common complication of therapeutic hypothermia. We performed a systematic review and meta-analysis of randomized trials to examine the risk of infections in patients treated with hypothermia.

Read more ...

2013 Nov - Augmented Renal Clearance in the ICU: Results of a Multicenter Observational Study of Renal Function in Critically Ill Patients With Normal Plasma Creatinine Concentrations

Udy AA, Baptista JP, Lim NL, Joynt GM, Jarrett P, Wockner L, Boots RJ, Lipman J.; Crit Care Med. 2013 Nov 6. [Epub ahead of print]

OBJECTIVE: To describe the prevalence and natural history of augmented renal clearance in a cohort of recently admitted critically ill patients with normal plasma creatinine concentrations.

Read more ...

2014 Jan - Left Ventricular Assist Device Management in the ICU

Pratt AK, Shah NS, Boyce SW.; Crit Care Med. 2014 Jan;42(1):158-68.

Objectives: To review left ventricular assist device physiology, initial postoperative management, common complications, trouble shooting and management of hypotension, and other common ICU problems.

Read more ...

2014 Jan - Preliminary Report on Cardiac Dysfunction After Isolated Traumatic Brain Injury

Prathep S, Sharma D, Hallman M, Joffe A, Krishnamoorthy V, Mackensen GB, Vavilala MS.; Crit Care Med. 2014 Jan;42(1):142-7.

Objective: The aim of this study was to examine cardiac dysfunction during the first 2 weeks after isolated traumatic brain injury and its association with in-hospital mortality.

Read more ...

2014 Jan - Treatment With Neuromuscular Blocking Agents and the Risk of In-Hospital Mortality Among Mechanically Ventilated Patients With Severe Sepsis

Steingrub JS, Lagu T, Rothberg MB, Nathanson BH, Raghunathan K, Lindenauer PK.; Crit Care Med. 2014 Jan;42(1):90-6.

Objectives: Recent trials suggest that treatment with neuromuscular blocking agents may improve survival in patients requiring mechanical ventilation for acute respiratory distress syndrome. We examined the association between receipt of a neuromuscular blocking agent and in-hospital mortality among mechanically ventilated patients with severe sepsis.

Read more ...

2014 Jan - Bundle of Measures for External Cerebral Ventricular Drainage-Associated Ventriculitis

Chatzi M, Karvouniaris M, Makris D, Tsimitrea E, Gatos C, Tasiou A, Mantzarlis K, Fountas KN, Zakynthinos E.; Crit Care Med. 2014 Jan;42(1):66-73.

Objective: To assess the prevalence and outcome of external cerebral ventricular drainage-associated ventriculitis in neurocritical patients before and after the implementation of a bundle of external cerebral ventricular drainage-associated ventriculitis control measures.

Read more ...

2014 Jan - Percutaneous Coronary Intervention for Nonculprit Vessels in Cardiogenic Shock Complicating ST-Segment Elevation Acute Myocardial Infarction

Yang JH, Hahn JY, Song PS, Song YB, Choi SH, Choi JH, Lee SH, Jeong MH, Choi DJ, Kim YJ, Gwon HC.; Crit Care Med. 2014 Jan;42(1):17-25.

Objectives: We investigated the clinical impact of multivessel percutaneous coronary intervention in ST-segment elevation myocardial infarction complicated by cardiogenic shock with multivessel disease.

Read more ...

2014 Jan - Effect of Oropharyngeal Povidone-Iodine Preventive Oral Care on Ventilator-Associated Pneumonia in Severely Brain-Injured or Cerebral Hemorrhage Patients: A Multicenter, Randomized Controlled Trial

Seguin P, Laviolle B, Dahyot-Fizelier C, Dumont R, Veber B, Gergaud S, Asehnoune K, Mimoz O, Donnio PY, Bellissant E, Malledant Y; Study of Povidone Iodine to Reduce Pulmonary Infection in Head Trauma and Cerebral Hemorrhage Patients (SPIRIT) ICU Study and AtlanRéa Groups.; Crit Care Med. 2014 Jan;42(1):1-8.

Objective: To evaluate the efficacy and safety of oral care with povidone-iodine on the occurrence of ventilator-associated pneumonia in a high-risk population.

Read more ...

2014 Jan - Variation in Diagnostic Testing in ICUs: A Comparison of Teaching and Nonteaching Hospitals in a Regional System

Spence J, Bell DD, Garland A.; Crit Care Med. 2014 Jan;42(1):9-16.

Objectives: To explore variation in the use of diagnostic testing in ICUs, with emphasis on differences between teaching and nonteaching ICUs.

Read more ...

2013 Dec - Troponin Elevation in Severe Sepsis and Septic Shock: The Role of Left Ventricular Diastolic Dysfunction and Right Ventricular Dilatation

Landesberg G, Jaffe AS, Gilon D, Levin PD, Goodman S, Abu-Biah A, Beeri R, Weissman C, Sprung CL, Landesberg A.

Crit Care Med. 2013 Dec 20. [Epub ahead of print]

OBJECTIVE: Serum troponin concentrations predict mortality in almost every clinical setting they have been examined, including sepsis. However, the causes for troponin elevations in sepsis are poorly understood. We hypothesized that detailed investigation of myocardial dysfunction by echocardiography can provide insight into the possible causes of troponin elevation and its association with mortality in sepsis.

Read more ...