2011 Sep - Clinical and economic burden of postoperative pulmonary complications: Patient safety summit on definition, risk-reducing interventions, and preventive strategies

Shander A, Fleisher LA, Barie PS, Bigatello LM, Sladen RN, Watson CB.; Crit Care Med. 2011 Sep;39(9):2163-72.
Objective: Postoperative pulmonary complications are a major contributor to the overall risk of surgery. We convened a patient safety summit to discuss ways to enhance physician awareness of postoperative pulmonary complications, advance postoperative pulmonary complications as a substantive public health concern demanding national attention, recommend strategies to reduce the deleterious impact of postoperative pulmonary complications on clinical outcomes and healthcare costs, and establish an algorithm that will help identify patients who are at increased risk for postoperative pulmonary complications.

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2011 Sep - Necrotizing soft-tissue infections [Review]

Ustin JS, Malangoni MA.; Crit Care Med. 2011 Sep;39(9):2156-62.
Objective: To provide a contemporary review of the diagnosis and management of necrotizing soft-tissue infections.

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2011 Sep - Guidelines for the determination of brain death in infants and children: An update of the 1987 Task Force recommendations

Nakagawa TA, Ashwal S, Mathur M, Mysore MR, Bruce D, Conway EE Jr, Duthie SE, Hamrick S, Harrison R, Kline AM, Lebovitz DJ, Madden MA, Montgomery VL, Perlman JM, Rollins N, Shemie SD, Vohra A, Williams-Phillips JA; Society of Critical Care Medicine; the Section on Critical Care and Section on Neurology of the American Academy of Pediatrics; the Child Neurology Society. ;Crit Care Med. 2011 Sep;39(9):2139-2155.
Objective: To review and revise the 1987 pediatric brain death guidelines.

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2011 Sep - The Impella 2.5 and 5.0 devices for ST-elevation myocardial infarction patients presenting with severe and profound cardiogenic shock: The Academic Medical Center intensive care unit experience

Engström AE, Cocchieri R, Driessen AH, Sjauw KD, Vis MM, Baan J, de Jong M, Lagrand WK, van der Sloot JA, Tijssen JG, de Winter RJ, de Mol BA, Piek JJ, Henriques JP.; Crit Care Med. 2011 Sep;39(9):2072-9.
Objective: Cardiogenic shock remains an important therapeutic challenge, with high in-hospital mortality rates. Mechanical circulatory support may be beneficial in these patients. Since the efficacy of the intra-aortic balloon pump seems limited, new percutaneously placed mechanical left ventricular support devices, such as the Impella system, have been developed for this purpose. Our current purpose was to describe our experience with the Impella system in patients with ST-elevation myocardial infarction presenting in profound cardiogenic shock, who were admitted to our intensive care unit for mechanical ventilation.

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2011 Sep - Procalcitonin-guided interventions against infections to increase early appropriate antibiotics and improve survival in the intensive care unit: A randomized trial

Jensen JU, Hein L, Lundgren B, Bestle MH, Mohr TT, Andersen MH, Thornberg KJ, Løken J, Steensen M, Fox Z, Tousi H, Søe-Jensen P, Lauritsen AO, Strange D, Petersen PL, Reiter N, Hestad S, Thormar K, Fjeldborg P, Larsen KM, Drenck NE, Ostergaard C, Kjær J, Grarup J, Lundgren JD; for The Procalcitonin And Survival Study (PASS) Group.; Crit Care Med. 2011 Sep;39(9):2048-2058.
Objective: For patients in intensive care units, sepsis is a common and potentially deadly complication and prompt initiation of appropriate antimicrobial therapy improves prognosis. The objective of this trial was to determine whether a strategy of antimicrobial spectrum escalation, guided by daily measurements of the biomarker procalcitonin, could reduce the time to appropriate therapy, thus improving survival.

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2011 Sep - The value of positive end-expiratory pressure and Fio2 criteria in the definition of the acute respiratory distress syndrome

Britos M, Smoot E, Liu KD, Thompson BT, Checkley W, Brower RG; for the National Institutes of Health Acute Respiratory Distress Syndrome Network Investigators.; Crit Care Med. 2011 Sep;39(9):2025-2030.
Objectives: The criteria that define acute lung injury and the acute respiratory distress syndrome include PaO2/Fio2 but not positive end-expiratory pressure or Fio2. PaO2/Fio2 ratios of some patients increase substantially after mechanical ventilation with positive end-expiratory pressure of 5–10 cm H2O, and the mortality of these patients may be lower than those whose PaO2/Fio2ratios remain <200. Also, PaO2/Fio2 may increase when Fio2 is raised from moderate to high levels, suggesting that patients with similar PaO2/Fio2 ratios but different Fio2 levels have different risks of mortality. The primary purpose of this study was to assess the value of adding baseline positive end-expiratory pressure and Fio2 to PaO2/Fio2 for predicting mortality of acute lung injury/acute respiratory distress syndrome patients enrolled in Acute Respiratory Distress Syndrome Network clinical trials. We also assessed effects of two study interventions on clinical outcomes in subsets of patients with mild and severe hypoxemia as defined by PaO2/Fio2.

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2011 Aug - Cardiac abnormalities in severe acute dichlorvos poisoning

He X, Li C, Wei D, Wu J, Shen L, Wang T.; Crit Care Med. 2011 Aug;39(8):1906-12.
Objective: Patients with organophosphorus poisoning sometimes die suddenly during rigorous treatment, possibly from myocardial injury. This study sought to elucidate the mechanisms underlying organophosphorus poisoning-induced cardiotoxicity.

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2011 Aug - Subglottic secretion drainage for the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis

Muscedere J, Rewa O, McKechnie K, Jiang X, Laporta D, Heyland DK.; Crit Care Med. 2011 Aug;39(8):1985-91.
Background and Purpose: Aspiration of secretions containing bacterial pathogens into the lower respiratory tract is the main cause of ventilator-associated pneumonia. Endotracheal tubes with subglottic secretion drainage can potentially reduce this and, therefore, the incidence of ventilator-associated pneumonia. New evidence on subglottic secretion drainage as a preventive measure for ventilator-associated pneumonia has been recently published and to consider the evidence in totality, we conducted an updated systematic review and meta-analysis.

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2011 Aug - Understanding the potential role of statins in pneumonia and sepsis

Yende S, Milbrandt EB, Kellum JA, Kong L, Delude RL, Weissfeld LA, Angus DC.;Crit Care Med. 2011 Aug;39(8):1871-8.
Objective: To examine the association of statin use with clinical outcomes and circulating biomarkers in community-acquired pneumonia and sepsis.

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2011 Aug - Impact of previous antibiotic therapy on outcome of Gram-negative severe sepsis

Johnson MT, Reichley R, Hoppe-Bauer J, Dunne WM, Micek S, Kollef M.;Crit Care Med. 2011 Aug;39(8):1859-65.
Objective: To determine whether exposure to antimicrobial agents in the previous 90 days resulted in decreased bacterial susceptibility and increased hospital mortality in patients with severe sepsis or septic shock attributed to Gram-negative bacteremia.

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2011 Jul - Procalcitonin for reduced antibiotic exposure in the critical care setting: A systematic review and an economic evaluation [Review]

Heyland DK, Johnson AP, Reynolds SC, Muscedere J.; Crit Care Med. 2011 Jul;39(7):1792-9.
OBJECTIVE: Procalcitonin may be associated with reduced antibiotic usage compared to usual care. However, individual randomized controlled trials testing this hypothesis were too small to rule out harm, and the full cost-benefit of this strategy has not been evaluated. The purpose of this analysis was to evaluate the effect of a procalcitonin-guided antibiotic strategy on clinical and economic outcomes.

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2011 Jul - Hyperbaric oxygen in the critically ill [Review]

Weaver LK.; Crit Care Med. 2011 Jul;39(7):1784-91.
OBJECTIVE:  To review aspects of hyperbaric medicine pertinent to treating critically ill patients with hyperbaric oxygen in both monoplace and multiplace chambers.

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2011 Jul - Early continuous hypertonic saline infusion in patients with severe cerebrovascular disease

Hauer EM, Stark D, Staykov D, Steigleder T, Schwab S, Bardutzky J.; Crit Care Med. 2011 Jul;39(7):1766-72.
OBJECTIVE: To study the safety and the effects of early continuous hypertonic saline infusion in patients with cerebral edema and underlying cerebrovascular disease.

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2011 Jul -A phase II randomized placebo-controlled trial of omega-3 fatty acids for the treatment of acute lung injury

Stapleton RD, Martin TR, Weiss NS, Crowley JJ, Gundel SJ, Nathens AB, Akhtar SR, Ruzinski JT, Caldwell E, Curtis JR, Heyland DK, Watkins TR, Parsons PE, Martin JM, Wurfel MM, Hallstrand TS, Sims KA, Neff MJ. Crit Care Med. 2011 Jul;39(7):1655-1662.
OBJECTIVES: Administration of eicosapentaenoic acid and docosahexanoic acid, omega-3 fatty acids in fish oil, has been associated with improved patient outcomes in acute lung injury when studied in a commercial enteral formula. However, fish oil has not been tested independently in acute lung injury. We therefore sought to determine whether enteral fish oil alone would reduce pulmonary and systemic inflammation in patients with acute lung injury.

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2011 Jul - Pulmonary artery catheters: Evolving rates and reasons for use

Koo KK, Sun JC, Zhou Q, Guyatt G, Cook DJ, Walter SD, Meade MO.; Crit Care Med. 2011 Jul;39(7):1613-8.
OBJECTIVE: Randomized trials have demonstrated risks and failed to establish a clear benefit for the use of the pulmonary artery catheter. We assessed rates of pulmonary artery catheter use in multiple centers over 5 yrs, variables associated with their use, and how these variables changed over time (2002-2006).

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2011 Jun - The effect of l-alanyl-l-glutamine dipeptide supplemented total parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients

Grau T, Bonet A, Miñambres E, Piñeiro L, Irles JA, Robles A, Acosta J, Herrero I, Palacios V, Lopez J, Blesa A, Martínez P; for the Metabolism, Nutrition Working Group, SEMICYUC, Spain.Crit Care Med. 2011 Jun;39(6):1263-1268
OBJECTIVE:: The aim of this study was to assess the clinical efficacy of alanine-glutamine dipeptide-supplemented total parenteral nutrition defined by the occurrence of nosocomial infections. Secondary parameters included Sequential Organ Failure Assessment score, hyperglycemia and insulin needs, intensive care unit and hospital length of stay, and 6-month mortality.

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2011 Jun - Economic implications of nighttime attending intensivist coverage in a medical intensive care unit

Banerjee, Ritesh PhD; Naessens, James M. ScD; Seferian, Edward G. MD; Gajic, Ognjen MD; Moriarty, James P. MSc; Johnson, Matthew G. MPH; Meltzer, David O. MD, PhD. Critical Care Medicine, June 2011 - Volume 39 - Issue 6 - pp 1257-1262
Objective: Our objective was to assess the cost implications of changing the intensive care unit staffing model from on-demand presence to mandatory 24-hr in-house critical care specialist presence.

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2011 Jun - Toxic epidermal necrolysis and Stevens-Johnson syndrome: A review

Kamolz LP, Spendel S, Prandl EC.; Crit Care Med. 2011 Jun;39(6):1600-1.
Objectives: The aims of this review are to summarize the definitions, causes, and clinical course as well as the current understanding of the genetic background, mechanism of disease, and therapy of toxic epidermal necrolysis and Stevens-Johnson syndrome.

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2011 Jun - Survival of trauma patients after massive red blood cell transfusion using a high or low red blood cell to plasma transfusion ratio [Review]

Rajasekhar A, Gowing R, Zarychanski R, Arnold DM, Lim W, Crowther MA, Lottenberg R.; Crit Care Med. 2011 Jun;39(6):1507-13.
Objective: Early and aggressive treatment of trauma-associated coagulopathy through transfusion of high plasma to packed red blood cell ratios is gaining favor. Whether this strategy is associated with improved survival is unclear. We performed a systematic review to determine whether higher plasma to packed red blood cell ratios compared with lower plasma to packed red blood cell ratios were associated with a survival advantage.

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2011 Jun - Arterial catheter-related bloodstream infections: Results of an 8-year survey in a surgical intensive care unit

Pirracchio R, Legrand M, Rigon MR, Mateo J, Lukaszewicz AC, Mebazaa A, Raskine L, Le Pors MJ, Payen D.; Crit Care Med. 2011 Jun;39(6):1372-6.
Objectives: To determine whether a policy based on provisional replacement of catheters every 5 days had an impact on the incidence of arterial catheter-related bloodstream infections in a population of adult surgical intensive care unit patients.

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