2014 Jul - Ethical reflections on end-of-life signs and symptoms in the intensive care setting: a place for neuromuscular blockers?

Daubin C, Haddad L, Folscheid D, Boyer A, Chalumeau-Lemoine L, Guisset O, Hubert P, Pillot J, Robert R, Dreyfuss D.; Ann Intensive Care. 2014 Jul 8;4:23.

The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sight" because the physical manifestations are hard to watch and can lead to subjective interpretation and irrational fears...

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2014 Aug - Myocardial depression in sepsis: From pathogenesis to clinical manifestations and treatment

Antonucci E, Fiaccadori E, Donadello K, Taccone FS, Franchi F, Scolletta S. J Crit Care. 2014 Aug;29(4):500-511.

The cardiovascular system plays a key role in sepsis, and septic myocardial depression is a common finding associated with increased morbidity and mortality. Myocardial depression during sepsis is not clearly defined, but it can perhaps be best described as a global (systolic and diastolic) dysfunction of both the left and right sides of the heart...

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2014 Jul - A comparison of different diagnostic criteria of acute kidney injury in critically ill patients

Xuying Luo, Li Jiang, Bin Du, Ying Wen, Meiping Wang, Xiuming Xi; Critical Care 2014, 18:R144 (8 July 2014)

Introduction: Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) proposed a new definition and classification of acute kidney injury (AKI) based on the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage renal failure) and AKIN (Acute Kidney Injury Network) criteria but the comparison of three criteria in critically ill patients is rare.

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2014 Jun - Anemia and red blood cell transfusion in critically ill cardiac patients

Du Pont-Thibodeau G, Harrington K and Lacroix J Annals of Intensive Care 2014, 4:16 (2 June 2014)

Anemia and red blood cell (RBC) transfusion occur frequently in hospitalized patients with cardiac disease. In this narrative review, we report the epidemiology of anemia and RBC transfusion in hospitalized adults and children (excluding premature neonates) with cardiac disease, and on the outcome of anemic and transfused cardiac patients...

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2014 Jun - Continuous glucose control in the ICU: report of a 2013 round table meeting

Jan Wernerman, Thomas Desaive, Simon Finfer, Luc Foubert, Anthony Furnary, Ulrike Holzinger, Roman Hovorka, Jeffrey Joseph, Mikhail Kosiborod, James Krinsley, Dieter Mesotten, Stanley Nasraway, Olav Rooyackers, Marcus J Schultz, Tom Van Herpe, Robert A Vigersky, Jean-Charles Preiser Critical Care 2014, 18:226 (13 June 2014)

Achieving adequate glucose control in critically ill patients is a complex but important part of optimal patient management. Until relatively recently, intermittent measurements of blood glucose have been the only means of monitoring blood glucose levels. With growing interest in the possible beneficial effects of continuous over intermittent monitoring and the development of several continuous glucose monitoring (CGM) systems, a round table conference was convened to discuss and, where possible, reach consensus on the various aspects related to glucose monitoring and management using these systems.

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2014 Jun - Standard operating procedures for antibiotic therapy and the occurrence of acute kidney injury: a prospective, clinical, non-interventional, observational study

Irit Nachtigall, Sascha Tafelski, Karsten Günzel, Alexander Uhrig, Robert Powollik, Andrey Tamarkin, Klaus D Wernecke, Claudia Spies Critical Care 2014, 18:R120 (12 June 2014)

Introduction: Acute kidney injury (AKI) occurs in 7% of hospitalized and 66% of Intensive Care Unit (ICU) patients. It increases mortality, hospital length of stay, and costs. The aim of this study was to investigate, whether there is an association between adherence to guidelines (standard operating procedures (SOP)) for potentially nephrotoxic antibiotics and the occurrence of AKI.

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2014 Jun - Higher clinical success in patients with ventilator-associated pneumonia due to methicillin-resistant Staphylococcus aureus treated with linezolid compared with vancomycin: results from the IMPACT-HAP study

Paula Peyrani, Timothy L Wiemken, Robert Kelley, Marcus J Zervos, Daniel H Kett, Thomas M File, Gary E Stein, Kimbal D Ford, Ernesto G Scerpella, Verna Welch, Julio A Ramirez Critical Care 2014, 18:R118 (10 June 2014)

Introduction: Controversy exists regarding optimal treatment for ventilator-associated pneumonia (VAP) due to methicillin-resistant Staphylococcus aureus (MRSA). The primary objective of this study was to compare clinical success of linezolid versus vancomycin for the treatment of patients with MRSA VAP.

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2014 Jun - Prognostic and diagnostic value of eosinopenia, C-reactive protein, procalcitonin, and circulating cell-free DNA in critically Ill patients admitted with suspicion of sepsis

Jose Garnacho-Montero, María J Huici-Moreno, Antonio Gutiérrez-Pizarraya, Isabel López, Juan Antonio Márquez-Vácaro, Hada Macher, Juan Manuel Guerrero, Antonio Puppo-Moreno Critical Care 2014, 18:R116 (5 June 2014)

Introduction: The aims of this study were to assess the reliability of circulating cell-free DNA (cf-DNA) concentrations, compared with C-reactive protein (CRP), procalcitonin (PCT) and eosinophil count, in the diagnosis of infections in patients with systemic inflammatory response syndrome (SIRS) and their prognostic values in a cohort of critically ill patients.

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2014 May - The effect of prone positioning on mortality in patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials

Shu Ling Hu, Hong Li He, Chun Pan, Ai Ran Liu, Song Qiao Liu, Ling Liu, Ying Zi Huang, Feng Mei Guo, Yi Yang, Hai Bo Qiu Critical Care 2014, 18:R109 (28 May 2014)

Introduction: Prone positioning (PP) has been reported to improve the survival of patients with severe acute respiratory distress syndrome (ARDS). However, it is uncertain whether the beneficial effects of PP are associated with positive end-expiratory pressure (PEEP) levels and long durations of PP. In this meta-analysis, we aimed to evaluate whether the effects of PP on mortality could be affected by PEEP and the duration of PP and to identify which patients might benefit the most from PP.

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2014 May - Management of anticoagulant-related intracranial hemorrhage: an evidence-based review

Bappaditya Ray, Salah G Keyrouz Critical Care 2014, 18:223 (23 May 2014)

The increased use of anticoagulants for the prevention and treatment of thromboembolic diseases has led to a rising incidence of anticoagulant-related intracranial hemorrhage (AICH) in the aging western population. High mortality accompanies this form of hemorrhagic stroke, and significant and debilitating long-term consequences plague survivors...

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2014 May - beta-lactam antibiotic concentrations during continuous renal replacement therapy

Marjorie Beumier, Giuseppe Stefano Casu, Maya Hites, Lucie Seyler, Frederic Cotton, Jean-Louis Vincent, Frédérique Jacobs, Fabio Silvio Taccone Critical Care 2014, 18:R105 (22 May 2014)

Introduction: The use of standard doses of beta-lactam antibiotics during continuous renal replacement therapy (CRRT) may result in inadequate serum concentrations. The aim of this study was to evaluate the adequacy of unadjusted drug regimens (i.e., similar to those used in patients with normal renal function) in patients treated with CRRT and the influence of CRRT intensity on drug clearance.

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2014 May - Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial

Nassar Junior AP and Park M Annals of Intensive Care 2014, 4:14 (6 May 2014)

Background: Daily sedative interruption and intermittent sedation are effective in abbreviating the time on mechanical ventilation. Whether one is superior to the other has not yet been determined. Our aim was to compare daily interruption and intermittent sedation during the mechanical ventilation period in a low nurse staffing ICU.

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2014 Apr - Cotrimoxazole - optimal dosing in the critically ill

Brown GR Annals of Intensive Care 2014, 4:13 (28 April 2014)

The optimum dosage regimen for cotrimoxazole in the treatment of life threatening infections due to susceptible organisms encountered in critically ill patients is unclear despite decades of the drug's use. Therapeutic drug monitoring to determine the appropriate dosing for successful infection eradication is not widely available...

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2014 Apr - The plasma level and biomarker value of neutrophil gelatinase-associated lipocalin in critically ill patients with acute kidney injury are not affected by continuous venovenous hemofiltration and anticoagulation applied

Louise Schilder, S Azam Nurmohamed, Pieter M ter Wee, Nanne J Paauw, Armand RJ Girbes, Albertus Beishuizen, Robert HJ Beelen, AB Johan Groeneveld Critical Care 2014, 18:R78 (22 April 2014)

Introduction: Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury (AKI) and levels reflect severity of disease in critically ill patients. However, continuous venovenous hemofiltration (CVVH) may affect plasma levels by clearance or release of NGAL by activated neutrophils in the filter, dependent on the anticoagulation regimen applied. We therefore studied handling of NGAL by CVVH in patients with AKI.

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2014 May - Time from admission to initiation of surgery for source control is a critical determinant of survival in patients with gastrointestinal perforation with associated septic shock

Takeo Azuhata, Kosaku Kinoshita, Daisuke Kawano, Tomonori Komatsu, Atsushi Sakurai, Yasutaka Chiba, Katsuhisa Tanjho Critical Care 2014, 18:R87 (2 May 2014)

Introduction: We developed a protocol to initiate surgical source control immediately after admission (early source control) and perform initial resuscitation using early goal-directed therapy (EGDT) for gastrointestinal (GI) perforation with associated septic shock. This study evaluated the relationship between the time from admission to initiation of surgery and the outcome of the protocol.

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2014 Apr - Guideline-concordant administration of prothrombin complex concentrate and vitamin K is associated with decreased mortality in patients with severe bleeding under vitamin K antagonist treatment (EPAHK study)

Karim Tazarourte, Bruno Riou, Benjamin Tremey, Charles-Marc Samama, Éric Vicaut, Bernard Vigué Critical Care 2014, 18:R81 (24 April 2014)

Introduction: In vitamin K antagonist (VKA)-treated patients with severe hemorrhage, guidelines recommend prompt VKA reversal with prothrombin complex concentrate (PCC) and vitamin K. The aim of this observational cohort study was to evaluate the impact of guideline concordant administration of PCC and vitamin K on 7-day mortality.

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2014 Apr - Carbon monoxide poisoning in the 21st century

Angela L Chiew, Nicholas A Buckley Critical Care 2014, 18:221 (28 April 2014)

The world has experienced some very large shifts in the epidemiology of carbon monoxide poisoning, but it remains one of the most important toxicological global causes of morbidity and mortality. The diagnosis can be quickly confirmed with blood gases (pulse oximeters lack both sensitivity and specificity). Several strong predictors for serious neurological sequelae (prolonged loss of consciousness and elevated S100B) and reduced life expectancy (elevated troponin) are now reasonably well established...

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2014 Apr - Adjuvant selenium supplementation in the form of sodium selenite in postoperative critically ill patients with severe sepsis

Yasser Sakr, Vivian PL Maia, Clesar Santos, Julia Stracke, Mohamed Zeidan, Ole Bayer, Konrad Reinhart Critical Care 2014, 18:R68 (9 April 2014)

Introduction: Plasma selenium (Se) concentrations are reduced in critically ill surgical patients and lower plasma Se concentrations are associated with worse outcomes. We investigated whether adjuvant Se supplementation in the form of sodium selenite could improve outcomes in surgical patients with sepsis.

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2014 Apr - Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies

You-Dong Wan, Tong-Wen Sun, Quan-Cheng Kan, Fang-Xia Guan, Shu-Guang Zhang Critical Care 2014, 18:R71 (11 April 2014)

Introduction: Observational data have suggested that statin therapy may reduce mortality in patients with infection and sepsis; however, results from randomized studies are contradictory and do not support the use of statins in this context. Here, we performed a meta-analysis to investigate the effects of statin therapy on mortality from infection and sepsis.

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2014 Apr - Continuous venovenous hemofiltration versus extended daily hemofiltration in patients with septic acute kidney injury: a retrospective cohort study

Zhiping Sun, Hong Ye, Xia Shen, Hongdi Chao, Xiaochun Wu, Junwei Yang Critical Care 2014, 18:R70 (9 April 2014)

Introduction: Whether continuous venovenous hemofiltration (CVVHF) is superior to extended daily hemofiltration (EDHF) for the treatment of septic AKI is unknown. We compared the effect of CVVHF (greater than 72 hours) with EDHF (8 to 12 hours daily) on renal recovery and mortality in patients with severe sepsis or septic shock and concurrent acute kidney injury (AKI).

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