2015 Jun - Burn wound healing and treatment: review and advancements

Matthew Rowan, Leopoldo Cancio, Eric Elster, David Burmeister, Lloyd Rose, Shanmugasundaram Natesan, Rodney Chan, Robert Christy, Kevin Chung Critical Care 2015, 19:243 (12 June 2015)

Burns are a prevalent and burdensome critical care problem. The priorities of specialized facilities focus on stabilizing the patient, preventing infection, and optimizing functional recovery. Research on burns has generated sustained interest over the past few decades, and several important advancements have resulted in more effective patient stabilization and decreased mortality, especially among young patients and those with burns of intermediate extent.

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2015 Jun - Effects of fluid administration on renal perfusion in critically ill patients

Mouhamed Moussa, Sabino Scolletta, David Fagnoul, Pierre Pasquier, Alexandre Brasseur, Fabio Taccone, Jean-Louis Vincent, Daniel De Backer Critical Care 2015, 19:250 (12 June 2015)

Introduction: Fluid administration is a first-line therapy for acute kidney injury associated with circulatory failure. Although aimed at increasing renal perfusion in these patients, this intervention may improve systemic hemodynamics without necessarily ameliorating intra-renal flow distribution or urine output. We used Doppler techniques to investigate the effects of fluid administration on intra-renal hemodynamics and the relationship between changes in renal hemodynamics and urine output. We hypothesized that, compared to systemic hemodynamic variables, changes in renal hemodynamics would better predict increase in urine output after fluid therapy.

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2015 Jun - Rapid response systems: a systematic review and meta-analysis

Ritesh Maharaj, Ivan Raffaele, Julia Wendon Critical Care 2015, 19:254 (12 June 2015)

Introduction: Although rapid response system teams have been widely adopted by many health systems, their effectiveness in reducing hospital mortality is uncertain. We conducted a meta-analysis to examine the impact of rapid response teams on hospital mortality and cardiopulmonary arrest.

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2015 Jun - A randomized controlled trial on the effects of goal directed therapy on the inflammatory response open abdominal aortic aneurysm repair

Funk DJ, HayGlass KT, Koulack J, Harding G, Boyd A, Brinkman R.; Crit Care. 2015 Jun 10;19(1):247. [Epub ahead of print]

INTRODUCTION: Goal directed therapy (GDT) has been shown in numerous studies to decrease perioperative morbidity and morality. The mechanism of benefit of GDT however, has not been clearly elucidated. Targeted resuscitation of the vascular endothelium with GDT might alter the postoperative inflammatory response and be responsible for the decreased complications with this therapy.

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2015 May - Restrictive and liberal red cell transfusion strategies in adult patients: reconciling clinical data with best practice

Marek A Mirski, Steven M Frank, Daryl J Kor, Jean-Louis Vincent, David R Holmes Critical Care 2015, 19:202 (5 May 2015)

Red blood cell (RBC) transfusion guidelines correctly promote a general restrictive transfusion approach for anemic hospitalized patients. Such recommendations have been derived from evaluation of specific patient populations, and it is important to recognize that engaging a strict guideline approach has the potential to incur harm if the clinician fails to provide a comprehensive review of the patient’s physiological status in determining the benefit and risks of transfusion.

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2015 May - Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

Arham Ali, David N Herndon, Ashish Mamachen, Samir Hasan, Clark R Andersen, Ro-Jon Grogans, Jordan L Brewer, Jong O Lee, Jamie Heffernan, Oscar E Suman, Celeste C Finnerty Critical Care 2015, 19:217 (4 May 2015)

Introduction Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults.

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2015 Apr - Intravenous fish oil lipid emulsions in critically ill patients: an updated systematic review and meta-analysis

Manzanares W, Langlois PL, Dhaliwal R, Lemieux M, Heyland DK. Crit Care. 2015 Apr 16;19(1):167.

INTRODUCTION: Intravenous fish oil (FO) lipid emulsions (LEs) are rich in ω-3 polyunsaturated fatty acids, which exhibit anti-inflammatory and immunomodulatory effects. We previously demonstrated that FO-containing LEs may be able to decrease mortality and ventilation days in patients who are critically ill. Since 2014, several additional randomized controlled trials (RCTs) of FO-containing LEs have been published. Therefore, the purpose of this systematic review was to update our previous systematic review with the aim of elucidating the efficacy of FO-containing LEs on clinical outcomes of patients who are critically ill.

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2015 Apr - Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia

Richard M Lyon, Zane B Perkins, Debamoy Chatterjee, David J Lockey, Malcolm Q Russell, on behalf of Kent, Surrey & Sussex Air Ambulance Trust Critical Care 2015, 19:134 (1 April 2015)

Introduction: Rapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and standardised RSI protocol may improve the safety and effectiveness of the procedure. A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to compare the safety and effectiveness of a traditional RSI protocol using etomidate and suxamethonium with a modified RSI protocol using fentanyl, ketamine and rocuronium.

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2015 Apr - Fluid overload at start of continuous renal replacement therapy is associated with poorer clinical condition and outcome: a prospective observational study on the combined use of bioimpedance vector analysis and serum N-terminal pro-B-type natr

Haiyan Chen, Buyun Wu, Dehua Gong, Zhihong Liu Critical Care 2015, 19:135 (2 April 2015)

Introduction: It is unclear whether the fluid status, as determined by bioimpedance vector analysis (BIVA) combined with serum N-terminal pro-B-type natriuretic peptides (NT-pro-BNP) measurement, is associated with treatment outcome among patients receiving continuous renal replacement therapy (CRRT). Our objective was to answer it.

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2015 Feb - Sleeping on a problem: the impact of sleep disturbance on intensive care patients - a clinical review

Delaney LJ, Van Haren F and Lopez V Annals of Intensive Care 2015, 5:3 (26 February 2015)

Sleep disturbance is commonly encountered amongst intensive care patients and has significant psychophysiological effects, which protract recovery and increases mortality. Bio-physiological monitoring of intensive care patients reveal alterations in sleep architecture, with reduced sleep quality and continuity...

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2015 Mar - Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis

Andrew J Boyle, Stefania Di Gangi, Umar I Hamid, Linda-Jayne Mottram, Lia McNamee, Griania White, LJ Cross, James J McNamee, Cecilia M O’Kane, Daniel F McAuley Critical Care 2015, 19:109 (23 March 2015)

Introduction: Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but the effect of aspirin on established ARDS is unknown.

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2015 Mar - Timing for deep vein thrombosis chemoprophylaxis in traumatic brain injury: an evidence-based review

Hiba Abdel-Aziz, C Dunham, Rema J Malik, Barbara M Hileman Critical Care 2015, 19:96 (24 March 2015)

Multiple studies have addressed deep vein thrombosis chemoprophylaxis timing in traumatic brain injuries. However, a precise time for safe and effective chemoprophylaxis is uncertain according to experts. A comprehensive literature review on brain injuries was performed to delineate temporal proportions for 1) spontaneous intracranial hemorrhage (ICH) progression, 2) post-chemoprophylaxis ICH expansion, and 3) post-chemoprophylaxis deep vein thrombosis...

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2015 Mar - Colistin and tobramycin resistance during long- term use of selective decontamination strategies in the intensive care unit: a post hoc analysis

Bastiaan Wittekamp, Evelien Oostdijk, Anne de Smet, Marc Bonten Critical Care 2015, 19:113 (25 March 2015)

Introduction: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) have been shown to improve intensive care unit (ICU) patients’ outcomes. The aim of this study was to determine the effects of long-term use of SDD and SOD on colistin and tobramycin resistance among gram-negative bacteria.

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2015 Mar - Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized control trial

Rong-Fang Hu, Xiao-Ying Jiang, Kathleen M Hegadoren, You-Hua Zhang Critical Care 2015, 19:115 (27 March 2015)

Introduction: Intensive care unit (ICU) environmental factors such as noise and light have been cited as important causes of sleep deprivation in critically ill patients. Previous studies indicated that using earplugs and eye masks can improve REM sleep in healthy subjects in simulated ICU environment, and improve sleep quality in ICU patients. This study aimed to determine the effects of using earplugs and eye masks with relaxing background music on sleep, melatonin and cortisol levels in ICU patients.

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2015 Mar - 6% Hydroxyethyl starch versus other fluids for non-septic patients in the intensive care unit: a meta-analysis of randomized controlled trials

Bin He, Bo Xu, Xiaoxing Xu, Lixia Li, Rongrong Ren, Zhiyu Chen, Jian Xiao, Bin Xu, Yingwei Wang Critical Care 2015, 19:92 (19 March 2015)

Introduction: Use of hydroxyethyl starch (HES) in septic patients is reported to increase the mortality and incidence of renal replacement therapy (RRT). However, whether or not use of HES would induce the same result in non-septic patients in the intensive care unit (ICU) remains unclear. The objective of this meta-analysis was to evaluate 6% HES versus other fluids for non-septic ICU patients.

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2015 Mar - Mechanical ventilation modes for respiratory distress syndrome in infants: a systematic review and network meta-analysis

Changsong Wang, Libo Guo, Chunjie Chi, Xiaoyang Wang, Lei Guo, Weiwei Wang, Nana Zhao, Yibo Wang, Zhaodi Zhang, Enyou Li Critical Care 2015, 19:108 (20 March 2015)

Introduction: The effects of different mechanical ventilation (MV) modes on mortality outcome in infants with respiratory distress syndrome (RDS) are not well known.

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2015 Mar - Efficacy and safety of citrate-based anticoagulation compared to heparin in patients with acute kidney injury requiring continuous renal replacement therapy: a randomized controlled trial

Fabien Stucker, Belen Ponte, James Tataw, Pierre-Yves Martin, Hannah Wozniak, Jérome Pugin, Patrick Saudan Critical Care 2015, 19:91 (18 March 2015)

Introduction: A systemic anticoagulation is often required to prevent circuit and filter clotting in ICU patients undergoing continuous renal replacement therapy (CRRT). A regional citrate-based anticoagulation (RCA) does not induce a systemic anticoagulation and prolongs the filter lifespan, but metabolic side-effects have been associated with this therapy. We conducted a randomized controlled trial with patients requiring CRRT to determine whether RCA using a balanced predilution replacement fluid is more effective than heparin in terms of renal replacement delivered dose and safety profile.

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2015 Feb - Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children: a cochrane systematic review and meta-analysis

Louise Rose, Marcus J Schultz, Chris R Cardwell, Philippe Jouvet, Danny F McAuley, Bronagh Blackwood Critical Care 2015, 19:48 (24 February 2015)

Introduction: Automated weaning systems may improve adaptation of mechanical support for a patient’s ventilatory needs and facilitate systematic and early recognition of their ability to breathe spontaneously and the potential for discontinuation of ventilation. Our objective was to compare mechanical ventilator weaning duration for critically ill adults and children when managed with automated systems versus non-automated strategies. Secondary objectives were to determine differences in duration of ventilation, intensive care unit (ICU) and hospital length of stay (LOS), mortality, and adverse events.

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2015 Feb - Do corticosteroids reduce the mortality of influenza A (H1N1) infection? a meta-analysis

Yi Zhang, Wenjie Sun, Erik R Svendsen, Song Tang, Raina C MacIntyre, Peng Yang, Daitao Zhang, Quanyi Wang Critical Care 2015, 19:46 (20 February 2015)

Introduction: Corticosteroids are used empirically in influenza A (H1N1) treatment despite lack of clear evidence for effective treatment. This study aims to assess the efficacy of corticosteroids treatment for H1N1 infection.

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2015 Feb - Metoclopramide or domperidone improves post-pyloric placement of spiral nasojejunal tubes in critically ill patients: a prospective, multicenter, open-label, randomized, controlled clinical trial

Bei Hu, Heng Ye, Cheng Sun, Yichen Zhang, Zhigang Lao, Fanghong Wu, Zhaohui Liu, Linxi Huang, Changchun Qu, Lewu Xian, Hao Wu, Yingjie Jiao, Junling Liu, Juyu Cai, Weiying Chen, Zhiqiang Nie, Zaiyi Liu, Chunbo Chen Critical Care 2015, 19:61 (13 February 2015)

Introduction: The use of prokinetic agents on post-pyloric placement of spiral nasojejunal tubes is controversial. The aim of the present study was to examine if metoclopramide or domperidone can increase the success rate of post-pyloric placement of spiral nasojejunal tubes.

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