2015 Sep - Postextubation laryngeal edema and stridor resulting in respiratory failure in critically ill adult patients: updated review
Wouter Pluijms, Walther van Mook, Bastiaan Wittekamp, Dennis Bergmans Critical Care 2015, 19:295 (23 September 2015)
Endotracheal intubation is frequently complicated by laryngeal edema, which may present as postextubation stridor or respiratory difficulty or both. Ultimately, postextubation laryngeal edema may result in respiratory failure with subsequent reintubation. Risk factors for postextubation laryngeal edema include female gender, large tube size, and prolonged intubation. Although patients at low risk for postextubation respiratory insufficiency due to laryngeal edema can be identified by the cuff leak test or laryngeal ultrasound, no reliable test for the identification of high-risk patients is currently available.
2015 Sep - Monitoring of serum lactate level during cardiopulmonary resuscitation in adult in-hospital cardiac arrest
Chih-Hung Wang, Chien-Hua Huang, Wei-Tien Chang, Min-Shan Tsai, Ping-Hsun Yu, Yen-Wen Wu, Kuan-Yu Hung, Wen-Jone Chen Critical Care 2015, 19:344 (21 September 2015)
Introduction: Serum lactate level may correlate with no-flow and low-flow status during cardiac arrest. Current guidelines have no recommended durations for cardiopulmonary resuscitation (CPR) before transition to the next strategy. We hypothesized that the lactate level measured during CPR could be associated with the survival probability and accordingly be useful in estimating the optimal duration for CPR.
2015 Sep - Dynamics of end expiratory lung volume after changing positive end-expiratory pressure in acute respiratory distress syndrome patients
Aude Garnero, David Tuxen, Gaëlle Corno, Jacques Durand-Gasselin, Carol Hodgson, Jean-Michel Arnal Critical Care 2015, 19:340 (18 September 2015)
Introduction: Lung recruitment maneuvers followed by an individually titrated positive end-expiratory pressure (PEEP) are the key components of the open lung ventilation strategy in acute respiratory distress syndrome (ARDS). The staircase recruitment maneuver is a step-by-step increase in PEEP followed by a decremental PEEP trial. The duration of each step is usually 2 minutes without physiologic rationale.
2015 Sep - Daily laxative therapy reduces organ dysfunction in mechanically ventilated patients: a phase II randomized controlled trial
Rodrigo de Azevedo, Flávio Freitas, Elaine Ferreira, Luciano Pontes de Azevedo, Flávia Machado Critical Care 2015, 19:329 (16 September 2015)
Introduction: Constipation is a common problem in intensive care units. We assessed the efficacy and safety of laxative therapy aiming to promote daily defecation in reducing organ dysfunction in mechanically ventilated patients.
2015 Sep - Recent knowledge on the pathophysiology of septic acute kidney injury - a narrative review
Hoi-Ping Shum, Wing-Wa Yan, Tak Mao Chan; Journal of Critical Care, Published online: September 21 2015
Sepsis is the commonest cause of acute kidney injury (AKI) in critically ill patients. Its pathophysiology is complex and not well understood. Until recently, it was believed that kidney hypoperfusion is the major contributor of septic AKI. However, recent publications have improved our understanding on this topic. We now know that its mechanisms included the following: 1) renal macro- and micro-circulatory disturbance, 2) surge of inflammatory markers and oxidative stress, 3) coagulation cascade activation, and 4) bioenergetics adaptive response with controlled cell cycle arrest aiming to prevent cell death. Uncovering these complicated mechanisms may facilitate the development of more appropriate therapeutic measures in the future.
Shoemaker JK, Fraser DD.; J Crit Care. 2015 Aug;30(4):664-72. doi: 10.1016/j.jcrc.2015.03.032. Epub 2015 Apr 8. Review.
Early mobilization of critically ill patients is beneficial, suggesting that it should be incorporated into daily clinical practice. Early passive, active, and combined progressive mobilizations can be safely initiated in intensive care units (ICUs). Adult patients receiving early mobilization have fewer ventilator-dependent days, shorter ICU and hospital stays, and better functional outcomes.
2015 Aug - Pharmacologic prevention and treatment of delirium in intensive care patients: A systematic review
Serafim RB, Bozza FA, Soares M, do Brasil PE, Tura BR, Ely EW, Salluh JI.; J Crit Care. 2015 Aug;30(4):799-807. doi: 10.1016/j.jcrc.2015.04.005. Epub 2015 Apr 17.
Purpose: The purpose of the study is to determine if pharmacologic approaches are effective in prevention and treatment of delirium in critically ill patients.
Annals of Intensive Care 2015, 5:21 (12 August 2015)
The burden of multidrug resistance in Gram-negative bacilli (GNB) now represents a daily issue for the management of antimicrobial therapy in intensive care unit (ICU) patients. In Enterobacteriaceae, the dramatic increase in the rates of resistance to third-generation cephalosporins mainly results from the spread of plasmid-borne extended-spectrum beta-lactamase (ESBL), especially those belonging to the CTX-M family.
2015 Aug - Venous thromboembolism in the ICU: main characteristics, diagnosis and thromboprophylaxis
Clémence Minet, Leila Potton, Agnès Bonadona, Rébecca Hamidfar-Roy, Claire Somohano, Maxime Lugosi, Jean-Charles Cartier, Gilbert Ferretti, Carole Schwebel, Jean-François Timsit Critical Care 2015, 19:287 (18 August 2015)
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep venous thrombosis (DVT), is a common and severe complication of critical illness. Although well documented in the general population, the prevalence of PE is less known in the ICU, where it is more difficult to diagnose and to treat.
Hendrik Helmerhorst, Marcus Schultz, Peter van der Voort, Evert de Jonge, David van Westerloo Critical Care 2015, 19:284 (17 August 2015)
Oxygen administration is uniformly used in emergency and intensive care medicine and has life-saving potential in critical conditions. However, excessive oxygenation also has deleterious properties in various pathophysiological processes and consequently both clinical and translational studies investigating hyperoxia during critical illness have gained increasing interest.
2015 Aug - Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis
Arthur van Zanten, Rupinder Dhaliwal, Dominique Garrel, Daren Heyland Critical Care 2015, 19:294 (18 August 2015)
Introduction: Glutamine (GLN) has been suggested to have a beneficial influence on outcomes of critically ill patients. However, recent large-scale trials have suggested harm associated with GLN supplementation. Recently, systematic reviews on the use of parenteral GLN have been published; however, less information is available on the role of enteral GLN. Therefore, the aim of this systematic review was to study the effects of enteral GLN supplementation in patients with critical illness.
Greet Hermans, Greet Van den Berghe Critical Care 2015, 19:274 (5 August 2015)
A substantial number of patients admitted to the ICU because of an acute illness, complicated surgery, severe trauma, or burn injury will develop a de novo form of muscle weakness during the ICU stay that is referred to as “intensive care unit acquired weakness” (ICUAW). This ICUAW evoked by critical illness can be due to axonal neuropathy, primary myopathy, or both. Underlying pathophysiological mechanisms comprise microvascular, electrical, metabolic, and bioenergetic alterations, interacting in a complex way and culminating in loss of muscle strength and/or muscle atrophy.
Joseph Paonessa, Thomas Brennan, Marco Pimentel, Daniel Steinhaus, Mengling Feng, Leo Celi Critical Care 2015, 19:288 (7 August 2015)
Introduction: Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database.
2015 Aug - Bioelectrical impedance vector analysis in critically ill patients: a prospective, clinician-blinded investigation
Sarah Jones, Aiko Tanaka, Glenn Eastwood, Helen Young, Leah Peck, Rinaldo Bellomo, Johan Mårtensson Critical Care 2015, 19:290 (12 August 2015)
Introduction: Assessment of fluid status in critically ill patients is challenging. We aimed to assess the feasibility and validity of bioelectrical impedance vector analysis (BIVA) as a measure of hydration in critically ill patients.
2015 Jul - Adverse events associated with poor neurological outcome during targeted temperature management and advanced critical care after out-of-hospital cardiac arrest
Young-Min Kim, Chun Youn, Soo Kim, Byung Lee, In Cho, Gyu Cho, Kyung Jeung, Sang Oh, Seung Choi, Jong Shin, Kyoung-Chul Cha, Joo Oh, Hyeon Yim, Kyu Park, on behalf of the Korean Hypothermia Network Investigators Critical Care 2015, 19:283 (22 July 2015)
Introduction: The aim of this study was to investigate the association of adverse events (AEs) during targeted temperature management (TTM) and other AEs and concomitant treatments during the advanced critical care period with poor neurological outcome at hospital discharge in adult out-of-hospital cardiac arrest (OHCA) patients.
Amal Jubran Critical Care 2015, 19:272 (16 July 2015)
Pulse oximetry is universally used for monitoring patients in the critical care setting. This article updates the review on pulse oximetry that was published in 1999 in Critical Care.
2015 Jun - Vancomycin continuous infusion versus intermittent infusion during continuous venovenous hemofiltration: slow and steady may win the race
Annals of Intensive Care 2015, 5:10 (8 May 2015)
Background: Vancomycin during continuous venovenous hemofiltration (CVVH) is either administered by intermittent infusion (II) or continuous infusion (CI). In this patient population, the best method to rapidly achieve target serum concentrations of 15 mcg/ml to 25 mcg/ml remains to be elucidated. We hypothesized that CI would achieve a target serum level of 15 mcg/ml to 25 mcg/ml within 24 h of the initiation of therapy more consistently than II.
Annals of Intensive Care 2015, 5:17 (1 July 2015)
Unlike for septic shock, there are no specific international recommendations regarding the management of cardiogenic shock (CS) in critically ill patients. We present herein recommendations for the management of cardiogenic shock in adults, developed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system by an expert group of the French-Language Society of Intensive Care (Société de Réanimation de Langue Française (SRLF)), with the participation the French Society of Anesthesia and Intensive Care (SFAR), the French Cardiology Society (SFC), the French Emergency Medicine Society (SFMU), and the French Society of Thoracic and Cardiovascular Surgery (SFCTCV).
2015 Jun - Efficiency of a mechanical device in controlling tracheal cuff pressure in intubated critically ill patients: a randomized controlled study
Annals of Intensive Care 2015, 5:12 (2 June 2015)
Background: Cuff pressure (Pcuff) control is mandatory to avoid leakage of oral secretions passing the tracheal tube and tracheal ischemia. The aim of the present trial was to determine the efficacy of a mechanical device (PressureEasy®) in the continuous control of Pcuff in patients intubated with polyvinyl chloride (PVC)-cuffed tracheal tubes, compared with routine care using a manometer.
2015 Jul - A conceptual framework: the early and late phases of skeletal muscle dysfunction in the acute respiratory distress syndrome
D. Files, Michael Sanchez, Peter Morris Critical Care 2015, 19:266 (2 July 2015)
Patients with acute respiratory distress syndrome (ARDS) often develop severe diaphragmatic and limb skeletal muscle dysfunction. Impaired muscle function in ARDS is associated with increased mortality, increased duration of mechanical ventilation, and functional disability in survivors. In this review, we propose that muscle dysfunction in ARDS can be categorized into an early and a late phase.