Critical Care Medicine (Highlights)

2013 Feb - Oxygen Therapy in Critical Illness: Precise Control of Arterial Oxygenation and Permissive Hypoxemia

Martin, Daniel Stuart; Grocott, Michael Patrick William; Critical Care Medicine. 41(2):423-432, February 2013
Objective: The management of hypoxemia in critically ill patients is challenging. Whilst the harms of tissue hypoxia are well recognized, the possibility of harm from excess oxygen administration, or other interventions targeted at mitigating hypoxemia, may be inadequately appreciated...

2013 Feb - Antiplatelet Therapy Is Associated With Decreased Transfusion-Associated Risk of Lung Dysfunction, Multiple Organ Failure, and Mortality in Trauma Patients

Harr, Jeffrey N.; Moore, Ernest E.; Johnson, Jeffrey; Chin, Theresa L.; Wohlauer, Max V.; Maier, Ronald; Cuschieri, Joseph; Sperry, Jason; Banerjee, Anirban; Silliman, Christopher C.; Sauaia, Angela; Critical Care Medicine. 41(2):399-404, February 2013
Objective: To determine whether prehospital antiplatelet therapy was associated with reduced incidence of acute lung dysfunction, multiple organ failure, and mortality in blunt trauma patients.

2013 Jan - Acute Kidney Injury in the Critically Ill: Is Iodinated Contrast Medium Really Harmful?

Ehrmann S, Badin J, Savath L, Pajot O, Garot D, Pham T, Capdevila X, Perrotin D, Lakhal K.; Crit Care Med. 2013 Jan 15. [Epub ahead of print]
OBJECTIVES:: To assess whether the use of iodinated contrast medium increases the incidence of acute kidney injury in ICU patients, compared with patients not receiving iodinated contrast medium.

2013 Jan - Endocrine, Metabolic, and Morphologic Alterations of Adipose Tissue During Critical Illness

Marques, Mirna B.; Langouche, Lies; Critical Care Medicine. 41(1):317-325, January 2013
Objective: Observational studies report lower mortality in obese than in lean critically ill patients, an association referred to as the “obesity paradox.” This may suggest a possible protective role for adipose tissue during severe illness.

2013 Jan - The Role of ω-3 Fatty Acid Supplemented Parenteral Nutrition in Critical Illness in Adults: A Systematic Review and Meta-Analysis

Palmer, Andrew J.; Ho, Clement K. M.; Ajibola, Olawunmi; Avenell, Alison; Critical Care Medicine. 41(1):307-316, January 2013
Objective: To determine whether the supplementation of parenteral nutrition with ω-3 fatty acids confers treatment benefits to critically ill adult patients.

2013 Jan - Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

Barr, Juliana; Fraser, Gilles L.; Puntillo, Kathleen; Ely, E. Wesley; Gélinas, Céline; Dasta, Joseph F.; Davidson, Judy E.; Devlin, John W.; Kress, John P.; Joffe, Aaron M.; Coursin, Douglas B.; Herr, Daniel L.; Tung, Avery; Robinson, Bryce R. H.; Fontaine, Dorrie K.; Ramsay, Michael A.; Riker, Richard R.; Sessler, Curtis N.; Pun, Brenda; Skrobik, Yoanna; Jaeschke, Roman; Critical Care Medicine. 41(1):263-306, January 2013
Objective: To revise the “Clinical Practice Guidelines for the Sustained Use of Sedatives and Analgesics in the Critically Ill Adult” published in Critical Care Medicine in 2002.

2013 Jan - Fluctuations in Serum Sodium Level Are Associated With an Increased Risk of Death in Surgical ICU Patients

Sakr, Yasser; Rother, Steffen; Ferreira, Alberto Mendonca Pires; Ewald, Christian; Dünisch, Pedro; Riedemmann, Niels; Reinhart, Konrad; Critical Care Medicine. 41(1):133-142, January 2013
Objective: Dysnatremia may have an impact on outcomes in critically ill patients, but this has not been widely investigated in surgical ICU patients. We investigated the epidemiology of dysnatremia in a large cohort of surgical ICU patients and evaluated the possible influence of the time of acquisition of dysnatremia and fluctuations in serum sodium concentrations on hospital mortality in these patients.

2013 Jan - Sleep in Hypercapnic Critical Care Patients Under Noninvasive Ventilation: Conventional Versus Dedicated Ventilators

Córdoba-Izquierdo, Ana; Drouot, Xavier; Thille, Arnaud W.; Galia, Fabrice; Roche-Campo, Ferran; Schortgen, Frédérique; Prats-Soro, Enric; Brochard, Laurent; Critical Care Medicine. 41(1):60-68, January 2013
Objective: To compare sleep quality between two types of ventilators commonly used for noninvasive ventilation: conventional ICU ventilators and dedicated noninvasive ventilators; and to evaluate sleep during and between noninvasive ventilation sessions in critically ill patients.

2013 Jan - The Difference Between Critical Care Initiation Anion Gap and Prehospital Admission Anion Gap is Predictive of Mortality in Critical Illness

Lipnick, Michael S.; Braun, Andrea B.; Cheung, Joyce Ting-Wai; Gibbons, Fiona K.; Christopher, Kenneth B.; Critical Care Medicine. 41(1):49-59, January 2013
Objective: We hypothesized that the delta anion gap defined as difference between critical care initiation standard anion gap and prehospital admission standard anion gap is associated with all cause mortality in the critically ill.

2013 Jan - Implementation of Clinical Practice Guidelines for Ventilator-Associated Pneumonia: A Multicenter Prospective Study

Sinuff, Tasnim; Muscedere, John; Cook, Deborah J.; Dodek, Peter M.; Anderson, William; Keenan, Sean P.; Wood, Gordon; Tan, Richard; Haupt, Marilyn T.; Miletin, Michael; Bouali, Redouane; Jiang, Xuran; Day, Andrew G.; Overvelde, Janet; Heyland, Daren K.; fot the Canadian Critical Care Trials Group; Critical Care Medicine. 41(1):15-23, January 2013.
Objective: Ventilator-associated pneumonia is an important cause of morbidity and mortality in critically ill patients. Evidence-based clinical practice guidelines for the prevention, diagnosis, and treatment of ventilator-associated pneumonia may improve outcomes, but optimal methods to ensure implementation of guidelines in the intensive care unit are unclear. Hence, we determined the effect of educational sessions augmented with reminders, and led by local opinion leaders, as strategies to implement evidence-based ventilator-associated pneumonia guidelines on guideline concordance and ventilator-associated pneumonia rates.

2013 Jan - The Association Between ICU Readmission Rate and Patient Outcomes

Kramer, Andrew A.; Higgins, Thomas L.; Zimmerman, Jack E.; Critical Care Medicine. 41(1):24-33, January 2013.
Objective: To examine the association between ICU readmission rates and case-mix–adjusted outcomes.

2012 Dec - Probiotics in the critically ill: A systematic review of the randomized trial evidence

Petrof, Elaine O.; Dhaliwal, Rupinder; Manzanares, William; Johnstone, Jennie; Cook, Deborah; Heyland, Daren K.; Critical Care Medicine. 40(12):3290-3302, December 2012
Objective: Critical illness results in changes to the microbiology of the gastrointestinal tract, leading to a loss of commensal flora and an overgrowth of potentially pathogenic bacteria. Administering certain strains of live bacteria (probiotics) to critically ill patients may restore balance to the microbiota and have positive effects on immune function and gastrointestinal structure and function. The purpose of this systematic review was to evaluate the effect of probiotics in critically ill patients on clinical outcomes.

2012 Dec - The stress response and critical illness: A review

Cuesta, Jeronimo M.; Singer, Mervyn; Critical Care Medicine. 40(12):3283-3289, December 2012
Objectives: To describe different paradigms that define the stress response, and to postulate how stress is implicated in the pathophysiology of critical illness.

2012 Dec - Current approaches to the diagnosis of bacterial and fungal bloodstream infections in the intensive care unit [Review]

Murray, Patrick R.; Masur, Henry; Critical Care Medicine. 40(12):3277-3282, December 2012.
Healthcare systems spend considerable resources collecting and processing blood cultures for the detection of blood stream pathogens. The process is initiated with the collection of blood cultures that depend upon proper skin disinfection, collection of an adequate number of specimens and volume of blood, and prompt processing in a sensitive culture system. Complementing blood cultures and gaining in use are techniques such as nucleic acid amplification tests and mass spectroscopy that allow clinical laboratories to detect and identify organisms from blood cultures substantially faster than conventional systems...

2012 Dec - Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients

Jacobi, Judith; Bircher, Nicholas; Krinsley, James; Agus, Michael; Braithwaite, Susan S.; Deutschman, Clifford; Freire, Amado X.; Geehan, Douglas; Kohl, Benjamin; Nasraway, Stanley A.; Rigby, Mark; Sands, Karen; Schallom, Lynn; Taylor, Beth; Umpierrez, Guillermo; Mazuski, John; Schunemann, Holger; Critical Care Medicine. 40(12):3251-3276, December 2012
Objective: To evaluate the literature and identify important aspects of insulin therapy that facilitate safe and effective infusion therapy for a defined glycemic end point.

2012 Dec - Pediatric Acute Lung Injury Epidemiology and Natural History Study: Incidence and outcome of the acute respiratory distress syndrome in children

López-Fernández, Yolanda; Azagra, Amelia Martínez-de; de la Oliva, Pedro; Modesto, Vicent; Sánchez, Juan I.; Parrilla, Julio; Arroyo, María José; Reyes, Susana Beatriz; Pons-ódena, Martí; López-Herce, Jesús; Fernández, Rosa Lidia; Kacmarek, Robert M.; Villar, Jesús; Critical Care Medicine. 40(12):3238-3245, December 2012
Objectives: The incidence and outcome of the acute respiratory distress syndrome in children are not well-known, especially under current ventilatory practices. The goal of this study was to determine the incidence, etiology, and outcome of acute respiratory distress syndrome in the pediatric population in the setting of lung protective ventilation.

2012 Dec - Objective surveillance definitions for ventilator-associated pneumonia

Klompas, Michael; Magill, Shelley; Robicsek, Ari; Strymish, Judith M.; Kleinman, Ken; Evans, R. Scott; Lloyd, James F.; Khan, Yosef; Yokoe, Deborah S.; Stevenson, Kurt; Samore, Matthew; Platt, Richard; for the CDC Prevention Epicenters Program; Critical Care Medicine. 40(12):3154-3161, December 2012
Objectives: The subjectivity and complexity of surveillance definitions for ventilator-associated pneumonia preclude meaningful internal or external benchmarking and therefore hamper quality improvement initiatives for ventilated patients. We explored the feasibility of creating objective surveillance definitions for ventilator-associated pneumonia.

2012 Dec - Pulmonary embolism in mechanically ventilated patients requiring computed tomography: Prevalence, risk factors, and outcome

Minet, Clémence; Lugosi, Maxime; Savoye, Pierre Yves; Menez, Caroline; Ruckly, Stéphane; Bonadona, Agnès; Schwebel, Carole; Hamidfar-Roy, Rebecca; Dumanoir, Perrine; Ara-Somohano, Claire; Ferretti, Gilbert R.; Timsit, Jean-François; Critical Care Medicine. 40(12):3202-3208, December 2012
Objective: To estimate the rate of pulmonary embolism among mechanically ventilated patients and its association with deep venous thrombosis.

2012 Dec - Femoral venous oxygen saturation is no surrogate for central venous oxygen saturation

van Beest, Paul A.; van der Schors, Alice; Liefers, Henriëtte; Coenen, Ludo G. J.; Braam, Richard L.; Habib, Najib; Braber, Annemarije; Scheeren, Thomas W. L.; Kuiper, Michaël A.; Spronk, Peter E.; Critical Care Medicine. 40(12):3196-3201, December 2012
Objective: The purpose of our study was to determine if central venous oxygen saturation and femoral venous oxygen saturation can be used interchangeably during surgery and in critically ill patients.

2012 Dec - Effects of norepinephrine on mean systemic pressure and venous return in human septic shock

Persichini, Romain; Silva, Serena; Teboul, Jean-Louis; Jozwiak, Mathieu; Chemla, Denis; Richard, Christian; Monnet, Xavier; Critical Care Medicine. 40(12):3146-3153, December 2012
Objectives: Norepinephrine exerts venoconstriction that could increase both the mean systemic pressure and the resistance to venous return, but this has not yet been investigated in human septic shock. We examined the relative importance of both effects and the resulting effect on venous return when decreasing the dose of norepinephrine.

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