2011 Jun - Infectious complications in out-of-hospital cardiac arrest patients in the therapeutic hypothermia era

Mongardon N, Perbet S, Lemiale V, Dumas F, Poupet H, Charpentier J, Péne F, Chiche JD, Mira JP, Cariou A.; Crit Care Med. 2011 Jun;39(6):1359-1364.
Objectives: Infectious complications are frequently reported in critically ill patients, especially after cardiac arrest. Recent and widespread use of therapeutic hypothermia has raised concerns about increased septic complications, but no specific reappraisal has been performed. We investigated the infectious complications in cardiac arrest survivors and assessed their impact on morbidity and long-term outcome.

Read more ...

2011 Jun - Renal effects of synthetic colloids and crystalloids in patients with severe sepsis: A prospective sequential comparison

Bayer O, Reinhart K, Sakr Y, Kabisch B, Kohl M, Riedemann NC, Bauer M, Settmacher U, Hekmat K, Hartog CS.; Crit Care Med. 2011 Jun;39(6):1335-42.
Objectives: Hydroxyethyl starch 200 is associated with renal impairment in sepsis, but hydroxyethyl starch 130/0.4 and gelatin are considered to be less harmful. We hypothesized that fluid therapy with only crystalloids would decrease the incidence of acute kidney injury.

Read more ...

2011 Jun - Utilization patterns and patient outcomes associated with use of rescue therapies in acute lung injury

Walkey AJ, Wiener RS.; Crit Care Med. 2011 Jun;39(6):1322-8.
Objectives: To investigate the practice patterns and clinical outcomes associated with use of rescue therapies in patients with acute lung injury.

Read more ...

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

Banerjee R, Naessens JM, Seferian EG, Gajic O, Moriarty JP, Johnson MG, Meltzer DO.; Crit Care Med. 2011 Jun;39(6):1257-62.
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.

Read more ...

2011 May - Critical care management of patients with end-stage liver disease [Review]

Read more ...

2011 May - Outcomes, long-term quality of life, and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support

Mirabel M, Luyt CE, Leprince P, Trouillet JL, Léger P, Pavie A, Chastre J, Combes A.;Critical Care Medicine. 39(5):1029-1035, May 2011.
OBJECTIVE:This study was designed to evaluate the outcomes, health-related quality of life, and frequencies of anxiety, depression, and posttraumatic stress disorder symptoms in patients with fulminant myocarditis rescued by mechanical circulatory assistance, because these major components of outcome evaluation after serious illnesses have not yet been assessed in this setting.

Read more ...

2011 Apr - Critical care in resource-poor settings: Lessons learned and future directions

Riviello ED, Letchford S, Achieng L, Newton MW.; Critical Care Medicine. 39(4):860-867, April 2011.
CONTEXT:: Critical care faces the same challenges as other aspects of healthcare in the developing world. However, critical care faces an additional challenge in that it has often been deemed too costly or complicated for resource-poor settings. This lack of prioritization is not justified. Hospital care for the sickest patients affects overall mortality, and public health interventions depend on community confidence in healthcare to ensure participation and adherence.

Read more ...

2011 Apr - Current role of emergency ultrasound of the chest [Review]

Reissig A, Copetti R, Kroegel C.; Critical Care Medicine. 39(4):839-845, April 2011.
OBJECTIVE:
Chest sonography has gained clinical significance in the diagnosis of various pulmonary, pleural, cardiac, and mediastinal emergency conditions.

Read more ...

2011 Apr - Aspiration-induced lung injury [Review]

Raghavendran K, Nemzek J, Napolitano LM, Knight PR.; Critical Care Medicine. 39(4):818-826, April 2011.
OBJECTIVE:
Aspiration of oropharyngeal or gastric contents into the lower respiratory tract is a common event in critically ill patients and can lead to pneumonia or pneumonitis. Aspiration pneumonia is the leading cause of pneumonia in the intensive care unit and is one of the leading risk factors for acute lung injury and acute respiratory distress syndromes.

Read more ...

2011 Apr - Accuracy and reliability of a subcutaneous continuous glucose-monitoring system in critically ill patients

Brunner R, Kitzberger R, Miehsler W, Herkner H, Madl C, Holzinger U.; Critical Care Medicine. 39(4):659-664, April 2011.
BACKGROUND:
Continuous glucose monitoring has been proposed to optimize glucose control in critically ill patients. To achieve strict glucose regulation, accurate and reliable continuous glucose-monitoring systems are essential.

Read more ...

2011 Apr - The impact of enhanced cleaning within the intensive care unit on contamination of the near-patient environment with hospital pathogens: A randomized crossover study in critical care units in two hospitals

Wilson AP, Smyth D, Moore G, Singleton J, Jackson R, Gant V, Jeanes A, Shaw S, James E, Cooper B, Kafatos G, Cookson B, Singer M, Bellingan G.; Critical Care Medicine. 39(4):651-658, April 2011.
OBJECTIVES: To determine the effect of enhanced cleaning of the near-patient environment on the isolation of hospital pathogens from the bed area and staff hands.

Read more ...

2011 Mar - Antibiotic dosing during sustained low-efficiency dialysis: Special considerations in adult critically ill patients

Bogard KN, Peterson NT, Plumb TJ, Erwin MW, Fuller PD, Olsen KM.; Crit Care Med. 2011 Mar;39(3):560-70.
OBJECTIVE: : To address issues of antibiotic dosing during sustained low-efficiency dialysis by using available pharmacokinetic data, intermittent and continuous renal replacement therapy dialysis guidelines, and our experience with sustained low-efficiency dialysis.

Read more ...

2011 Mar - Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: A meta-analysis of randomized clinical trials

Kamel H, Navi BB, Nakagawa K, Hemphill JC 3rd, Ko NU.; Crit Care Med. 2011 Mar;39(3):554-9.
OBJECTIVES: : Randomized trials have suggested that hypertonic saline solutions may be superior to mannitol for the treatment of elevated intracranial pressure, but their impact on clinical practice has been limited, partly by their small size. We therefore combined their findings in a meta-analysis.

Read more ...

2011 Mar - Effect of transcutaneous electrical muscle stimulation on muscle volume in patients with septic shock

Poulsen JB, Møller K, Jensen CV, Weisdorf S, Kehlet H, Perner A.; Crit Care Med. 2011 Mar;39(3):456-61.
OBJECTIVE: : Intensive care unit admission is associated with muscle wasting and impaired physical function. We investigated the effect of early transcutaneous electrical muscle stimulation on quadriceps muscle volume in patients with septic shock.

Read more ...

2011 Mar - A comparison of intravascular and surface cooling techniques in comatose cardiac arrest survivors

Tømte O, Drægni T, Mangschau A, Jacobsen D, Auestad B, Sunde K; Crit Care Med. 2011 Mar;39(3):443-9.
OBJECTIVES: : Mild therapeutic hypothermia after out-of-hospital cardiac arrest is usually achieved either by surface cooling or by core cooling via the patient's bloodstream. We compared modern core (Coolgard) and surface (Arctic Sun) cooling devices with a zero hypothesis of equal cooling, complications, and neurologic outcomes.

Read more ...

2011 Mar - Comparison of norepinephrine-dobutamine to epinephrine for hemodynamics, lactate metabolism, and organ function variables in cardiogenic shock. A prospective, randomized pilot study

Levy B, Perez P, Perny J, Thivilier C, Gerard A.; Crit Care Med. 2011 Mar;39(3):450-5.
OBJECTIVE: : There is no study that has compared, in a randomized manner, which vasopressor is most suitable in optimizing both systemic and regional hemodynamics in cardiogenic shock patients. Hence, the present study was designed to compare epinephrine and norepinephrine-dobutamine in dopamine-resistant cardiogenic shock.

Read more ...

2011 Feb - The role of albumin as a resuscitation fluid for patients with sepsis: A systematic review and meta-analysis

Delaney AP, Dan A, McCaffrey J, Finfer S.; Crit Care Med. 2011 Feb;39(2):386-91.
OBJECTIVE: : To assess whether resuscitation with albumin-containing solutions, compared with other fluids, is associated with lower mortality in patients with sepsis.

Read more ...

2011 Feb - Is plasma arginine concentration decreased in patients with sepsis? A systematic review and meta-analysis

Davis JS, Anstey NM.; Crit Care Med. 2011 Feb;39(2):380-5.
INTRODUCTION: : L-arginine is a conditionally essential amino acid that plays an important role in immune and vascular function in sepsis. Plasma concentrations of L-arginine are decreased after trauma or surgery but have been variably reported to be normal or decreased in patients with sepsis.

Read more ...

2011 Feb - Decreased mortality resulting from a multicomponent intervention in a tertiary care medical intensive care unit

Netzer G, Liu X, Shanholtz C, Harris A, Verceles A, Iwashyna TJ.; Crit Care Med. 2011 Feb;39(2):284-93
OBJECTIVE: : To evaluate whether a multicomponent intervention, particularly increasing staff, can achieve reductions in patient mortality in an already high-intensity, Leapfrog-compliant medical intensive care unit.

Read more ...

2011 Feb - Regional citrate anticoagulation in patients with liver failure supported by a molecular adsorbent recirculating system

Faybik P, Hetz H, Mitterer G, Krenn CG, Schiefer J, Funk GC, Bacher A.; Crit Care Med. 2011 Feb;39(2):273-9.
OBJECTIVE: : Regional citrate anticoagulation has emerged as a promising method in critically ill patients at high risk of bleeding. However, in patients with liver failure, citrate accumulation may lead to acid-base and electrolyte imbalances, notably of calcium. The aim of this study was to evaluate the feasibility and safety of regional citrate anticoagulation during liver support using a molecular adsorbent recirculating system as well as its effects on electrolyte and acid-base balance in patients with liver failure.

Read more ...