2014 Sep - High-flow nasal cannula: recommendations for daily practice in pediatrics

Milési C, Boubal M, Jacquot A, Baleine J, Durand S, Odena MP and Cambonie G Annals of Intensive Care 2014, 4:29 (30 September 2014)

High-flow nasal cannula (HFNC) is a relatively new device for respiratory support. In pediatrics, HFNC use continues to increase as the system is easily set up and is well tolerated by patients. The use of nasal cannula adapted to the infant?s nares size to deliver heated and humidified gas at high flow rates has been associated with improvements in washout of nasopharyngeal dead space, lung mucociliary clearance, and oxygen delivery compared with other oxygen delivery systems...

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2014 Oct - Heparin therapy reduces 28-day mortality in adult severe sepsis patients: a systematic review and meta-analysis

Changsong Wang, Chunjie Chi, Lei Guo, Xiaoyang Wang, Libo Guo, Jiaxiao Sun, Bo Sun, Shanshan Liu, Xuenan Chang, Enyou Li Critical Care 2014, 18:563 (16 October 2014)

Introduction: There are approximately 19 million new cases of sepsis worldwide each year. Among them, more than one-quarter of patients die. We aimed to assess the effects of heparin on short term mortality in adult patients with sepsis and severe sepsis.

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2014 Oct - Bench-test comparison of 26 emergency and transport ventilators

Erwan L’Her, Annie Roy, Nicolas Marjanovic Critical Care 2014, 18:506 (15 October 2014)

Introduction: Numerous emergency and transport ventilators are commercialized and new generations arise constantly. The aim of this study was to evaluate a large panel of ventilators to allow clinicians to choose a device, taking into account their specificities of use.

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2014 Sep - Diagnostic and prognostic utility of soluble CD 14 subtype (presepsin) for severe sepsis and septic shock during the first week of intensive care treatment

Behnes M, Bertsch T, Lepiorz D, Lang S, Trinkmann F, Brueckmann M, Borggrefe M, Hoffmann U.; Crit Care. 2014 Sep 5;18(5):507. [Epub ahead of print]

Introduction: The aim of this study was to evaluate the diagnostic and prognostic value of presepsin in patients with severe sepsis and septic shock during the first week of ICU treatment.

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2014 Sep -Detecting acute distress and risk of future psychological morbidity in critically ill patients: Validation of the Intensive care psychological assessment tool

Wade DM, Hankins M, Smyth DA, Rhone EE, Mythen MG, Howell D, Weinman JA.; Crit Care. 2014 Sep 24;18(5):519. [Epub ahead of print]

Introduction: The psychological impact of critical illness on a patient can be severe, and frequently results in acute distress as well as psychological morbidity after leaving hospital. A UK guideline states that patients should be assessed in critical care units, both for acute distress and risk of future psychological morbidity; but no suitable method for carrying out this assessment exists. The Intensive care psychological assessment tool (IPAT) was developed as a simple, quick screening tool to be used routinely to detect acute distress, and the risk of future psychological morbidity, in critical care units.

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2014 Aug - Pulmonary vascular dysfunction in ARDS

Ryan D, Frohlich S and McLoughlin P Annals of Intensive Care 2014, 4:28 (22 August 2014)

Acute respiratory distress syndrome (ARDS) is characterised by diffuse alveolar damage and is frequently complicated by pulmonary hypertension (PH). Multiple factors may contribute to the development of PH in this setting. In this review, we report the results of a systematic search of the available peer-reviewed literature for papers that measured indices of pulmonary haemodynamics in patients with ARDS and reported on mortality in the period 1977 to 2010...

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2014 Sep - Efficacy and bleeding risk of antithrombin supplementation in septic disseminated intravascular coagulation: a secondary survey

Iba T, Saitoh D, Wada H, Asakura H.; Crit Care. 2014 Sep 15;18(5):497. [Epub ahead of print]

Introduction: In a previous report, we demonstrated a favorable trend for supplementation with antithrombin (AT) concentrate at a dosage of 3000 IU/day over 1500 IU/day for the treatment of sepsis-associated disseminated intravascular coagulation (DIC) in patients with an AT activity of 70% or less. Since the survival difference did not reach statistical significance, we planned to examine the effects in a larger number of cases with severer disease.

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2014 Sep - Traditional landmark versus ultrasound guided tracheal puncture during percutaneous dilatational tracheostomy in adult intensive care patients: a randomised controlled trial

Rudas M, Seppelt I, Herkes R, Hislop R, Rajbhandari D, Weisbrodt L.; Crit Care. 2014 Sep 18;18(5):514. [Epub ahead of print]

Introduction: Long-term ventilated intensive care patients frequently require tracheostomy. Although overall risks are low, serious immediate and late complications still arise. Real-time ultrasound guidance has been proposed to decrease complications and improve accuracy of the tracheal puncture. We aimed to compare procedural safety and efficacy of real-time ultrasound guidance with the traditional landmark approach during percutaneous dilatational tracheostomy (PDT).

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2014 Sep - Sodium bicarbonate in the prevention of cardiac surgery-associated acute kidney injury: a systematic review and meta-analysis

Tie HT, Luo MZ, Luo MJ, Zhang M, Wu QC, Wan JY.; Crit Care. 2014 Sep 12;18(5):517. [Epub ahead of print]

Introduction: Sodium bicarbonate (SBIC) was reported to be a promising approach to prevent cardiac surgery-associated acute kidney injury (CSA-AKI). However, the results remain controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of SBIC on the prevention of CSA-AKI in adult patients undergoing cardiac surgery.

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2014 Sep - In-hospital mortality following treatment with red blood cell transfusion or inotropic therapy during early goal-directed therapy for septic shock: a retrospective propensity-adjusted analysis

Mark DG, Morehouse JW, Hung YY, Kene MV, Elms AR, Liu V, Ballard DW, Vinson DR.; Crit Care. 2014 Sep 12;18(5):496. [Epub ahead of print]

Introduction: We sought to investigate whether treatment of subnormal (<70%) central venous oxygen saturation (ScvO2) with inotropes or red blood cell (RBC) transfusion during early goal-directed therapy (EGDT) for septic shock is independently associated with in-hospital mortality.

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2014 Sep - Sepsis-associated hyperlactatemia

Mercedes Garcia-Alvarez, Paul Marik, Rinaldo Bellomo Critical Care 2014, 18:503 (9 September 2014)

There is overwhelming evidence that sepsis and septic shock are associated with hyperlactatemia (sepsis-associated hyperlactatemia (SAHL)). SAHL is a strong independent predictor of mortality and its presence and progression are widely appreciated by clinicians to define a very high-risk population. Until recently, the dominant paradigm has been that SAHL is a marker of tissue hypoxia...

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2014 Aug - Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial

Daphne T Boom, Marjolein K Sechterberger, Saskia Rijkenberg, Susanne Kreder, Rob J Bosman, Jos PJ Wester, Ilse van Stijn, J Hans DeVries, Peter HJ van der Voort Critical Care 2014, 18:453 (20 August 2014)

Introduction: Glucose measurement in intensive care medicine is performed intermittently with the risk of undetected hypoglycemia. The workload for the ICU nursing staff is substantial. Subcutaneous continuous glucose monitoring (CGM) systems are available and may be able to solve some of these issues in critically ill patients.

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2014 Aug - Citrate anticoagulation versus systemic heparinisation in continuous venovenous hemofiltration in critically ill patients with acute kidney injury: a multi-center randomized clinical trial

Louise Schilder, S Nurmohamed, Frank H Bosch, Ilse M Purmer, Sylvia S den Boer, Cynthia G Kleppe, Marc G Vervloet, Albertus Beishuizen, Armand Girbes, Pieter M ter Wee, AB Groeneveld Critical Care 2014, 18:472 (16 August 2014)

Introduction: Because of ongoing controversy, renal and vital outcomes are compared between systemically administered unfractionated heparin and regional anticoagulation with citrate-buffered replacement solution in predilution mode, during continuous venovenous hemofiltration (CVVH) in critically ill patients with acute kidney injury (AKI).

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2014 May - Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference

Richard C, Argaud L, Blet A, Boulain T, Contentin L, Dechartres A, Dejode JM, Donetti L et al. Annals of Intensive Care 2014, 4:15 (24 May 2014)

The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain...

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2014 Aug - Duration of hemodynamic effects of crystalloids in patients with circulatory shock after initial resuscitation

Nunes TSO, Ladeira RT, Bafi AT, de Azevedo LCP, Machado FR and Freitas FGR Annals of Intensive Care 2014, 4:25 (1 August 2014)

Background: In the later stages of circulatory shock, monitoring should help to avoid fluid overload. In this setting, volume expansion is ideally indicated only for patients in whom the cardiac index (CI) is expected to increase. Crystalloids are usually the choice for fluid replacement. As previous studies evaluating the hemodynamic effect of crystalloids have not distinguished responders from non-responders, the present study was designed to evaluate the duration of the hemodynamic effects of crystalloids according to the fluid responsiveness status.

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2014 Aug - Emergent severe acute respiratory distress syndrome caused by adenovirus type 55 in immunocompetent adults in 2013: a prospective observational study

Bing Sun, Hangyong He, Zheng Wang, Jiuxin Qu, Xuyan Li, Chengjun Ban, Jun Wan, Bin Cao, Zhaohui Tong, Chen Wang Critical Care 2014, 18:456 (12 August 2014)

Introduction:  Since 2008, severe cases of emerging human adenovirus type 55 (HAdV-55) in immunocompetent adults have been reported sporadically in China. The clinical features and outcome of the most critically ill patients with severe acute respiratory distress syndrome (ARDS) caused by HAdV-55 requiring invasive mechanical ventilation (IMV) and/or extracorporeal membrane oxygenation (ECMO) are lacking.

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2014 Aug - Vitamin C revisited

Heleen M Oudemans-van Straaten, Angelique Man, Monique C de Waard Critical Care 2014, 18:460 (6 August 2014)

This narrative review summarizes the role of vitamin C in mitigating oxidative injury-induced microcirculatory impairment and associated organ failure in ischemia/reperfusion or sepsis. Preclinical studies show that high-dose vitamin C can prevent or restore microcirculatory flow impairment by inhibiting activation of nicotinamide adenine dinucleotide phosphate-oxidase and inducible nitric oxide synthase, augmenting tetrahydrobiopterin, preventing uncoupling of oxidative phosphorylation, and decreasing the formation of superoxide and peroxynitrite, and by directly scavenging superoxide...

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2014 Jul - Early mobilization on continuous renal replacement therapy is safe and may improve filter life

Yi Tian Wang, Terry P Haines, Paul Ritchie, Craig Walker, Teri A Ansell, Danielle T Ryan, Phaik-Sim Lim, Sanjiv Vij, Rebecca Acs, Nigel Fealy, Elizabeth H Skinner Critical Care 2014, 18:R161 (28 July 2014)

Introduction: Patients with femoral vascular catheters for continuous renal replacement therapy are frequently restricted from mobilization despite studies demonstrating benefit. No studies have reported filter pressures during mobilization and it is unknown whether mobilization is safe or affects filter lifespan. The objective of this study was to test the safety and feasibility of mobilization in this population.

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2014 Jul - Neurologic Aspects of Cardiac Emergencies

Ng L, Wang J, Altaweel L, Athar MK.; Crit Care Clin. 2014 Jul;30(3):557-584

In this review, cardiac arrest is discussed, with a focus on neuroprognostication and the emerging data, with regard to identifying more accurate predictors of neurologic outcomes in the era of therapeutic hypothermia...

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2014 Jun - The ketamine effect on intracranial pressure in nontraumatic neurological illness

Zeiler FA, Teitelbaum J, West M, Gillman LM.; J Crit Care. 2014 Jun 4.

PURPOSE: The purpose of the study was to perform a systematic review of the literature on the use of ketamine in nontraumatic neurological illness and its effects on intracranial pressure (ICP).

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