2014 Apr - Exploring the heterogeneity of effects of corticosteroids on acute respiratory distress syndrome: a systematic review and meta-analysis

Sheng-Yuan Ruan, Hsien-Ho Lin, Chun-Ta Huang, Ping-Hung Kuo, Huey-Dong Wu, Chong-Jen Yu Critical Care 2014, 18:R63 (7 April 2014)

Introduction: The effectiveness of corticosteroid therapy on the mortality of acute respiratory distress syndrome (ARDS) remains under debate. We aimed to explore the grounds for the inconsistent results in previous studies and update the evidence.

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2014 Apr - Hemostasis during the early stages of trauma: comparison with disseminated intravascular coagulation

Akiko Oshiro, Yuichiro Yanagida, Satoshi Gando, Naomi Henzan, Isao Takahashi, Hiroshi Makise Critical Care 2014, 18:R61 (3 April 2014)

Introduction: We tested two hypotheses that disseminated intravascular coagulation (DIC) and acute coagulopathy of trauma-shock (ACOTS) in the early phase of trauma are similar disease entities and that the DIC score on admission can be used to predict the prognosis of patients with coagulopathy of trauma.

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2014 Apr - Prediction of mortality in adult patients with severe acute lung failure receiving veno-venous extracorporeal membrane oxygenation: a prospective observational study

Tone Bull Enger, Alois Philipp, Vibeke Videm, Matthias Lubnow, Alexander Wahba, Marcus Fischer, Christof Schmid, Thomas Bein, Thomas Müller Critical Care 2014, 18:R67 (9 April 2014)

Introduction: Veno-venous extracorporeal membrane oxygenation (vvECMO) can be a life-saving therapy in patients with severe acute lung failure refractory to conventional therapy. Nevertheless, vvECMO is a procedure associated with high costs and resource utilization. The aim of this study was to assess published models for prediction of mortality following vvECMO and optimize an alternative model.

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2014 Mar - Impact of compliance with infection management guidelines on outcome in patients with severe sepsis: a prospective observational multi-center study

Frank Bloos, Daniel Thomas-Rüddel, Hendrik Rüddel, Christoph Engel, Daniel Schwarzkopf, John C Marshall, Stephan Harbarth, Philipp Simon, Reimer Riessen, Didier Keh, Karin Dey, Manfred Weiß, Susanne Toussaint, Dirk Schädler, Andreas Weyland, Maximillian Ragaller, Konrad Schwarzkopf, Jürgen Eiche, Gerhard Kuhnle, Heike Hoyer, Christiane Hartog, Udo Kaisers, Konrad Reinhart Critical Care 2014, 18:R42 (3 March 2014)

Introduction: Current sepsis guidelines recommend antimicrobial treatment (AT) within one hour after onset of sepsis-related organ dysfunction (OD) and surgical source control within 12 hours. The objective of this study was to explore the association between initial infection management according to sepsis treatment recommendations and patient outcome.

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2014 Mar - Accuracy and limitations of continuous glucose monitoring using spectroscopy in critically Ill patients

van Hooijdonk RTM, Winters T, Fischer JC, van Dongen-Lases EC, Krinsley JS, Preiser JC and Schultz MJ Annals of Intensive Care 2014, 4:8 (6 March 2014)

Background: OptiScanner devices, continuous glucose monitoring devices that perform automated blood draws via a central venous catheter and create plasma through centrifugation, measure plasma glucose levels through mid-infrared spectroscopy at the bedside. The objective of this study was to determine accuracy and practicality of the devices in critically ill patients attempting glycemic control.

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2014 Feb - Optimal care and design of the tracheal cuff in the critically ill patient

Jaillette E, Martin-Loeches I, Artigas A and Nseir S Annals of Intensive Care 2014, 4:7 (27 February 2014)

Despite the increasing use of non-invasive ventilation and high-flow nasal-oxygen therapy, intubation is still performed in a large proportion of critically ill patients. The aim of this narrative review is to discuss recent data on long-term intubation-related complications, such as microaspiration, and tracheal ischemic lesions. These complications are common in critically ill patients, and are associated with substantial morbidity and mortality...

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2014 Mar - Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study

Hagemo JS, Stanworth S, Juffermans NP, Brohi K, Cohen MJ, Johansson PI, Røislien J, Eken T, Næss PA, Gaarder C.; Crit Care. 2014 Mar 26;18(2):R52. [Epub ahead of print]

INTRODUCTION: Exsanguination due to trauma-induced coagulopathy is a continuing challenge in emergency trauma care. Fibrinogen is a crucial factor for haemostatic competence, and may be the factor that reaches critically low levels first. Early fibrinogen substitution is advocated by a number of authors. Little evidence exists regarding the indications for fibrinogen supplementation in the acute phase. This study aims to estimate the prevalence of hypofibrinogenaemia in a multi-center trauma population, and to explore how initial fibrinogen concentration relates to outcome. Also, factors contributing to low fibrinogen levels are identified.

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2014 Feb - Effects of etomidate on vasopressor use in patients with sepsis or severe sepsis: A propensity-matched analysis

Alday NJ, Jones MG, Kimmons LA, Phillips GS, McCallister JW, Doepker BA.; J Crit Care. 2014 Feb 14.

PURPOSE: The safety of single-bolus etomidate to facilitate intubation in septic patients is controversial due to its potential to suppress adrenal steroidogenesis. The purpose of this study was to evaluate the effects of etomidate on the development of shock when used as an induction agent to facilitate intubation in septic patients.

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2014 Mar - Calorie intake and patient outcomes in severe acute kidney injury: findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial

Rinaldo Bellomo, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Joanne Lee, Serigne Lo, Colin McArthur, Shay McGuiness, John Myburgh, Robyn Norton, Carlos Scheinkestel Critical Care 2014, 18:R45 (14 March 2014)

Introduction: Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes.

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2014 Mar - Procalcitonin for diagnosis of bacterial pneumonia in critically ill patients during 2009 H1N1 influenza pandemic: a prospective cohort study, systematic review and individual patient data meta-analysis

Roman Pfister, Matthias Kochanek, Timo Leygeber, Christian Brun-Buisson, Elise Cuquemelle, Mariana Benevides Paiva Machado, Enrique Piacentini, Naomi E Hammond, Paul R Ingram, Guido Michels Critical Care 2014, 18:R44 (10 March 2014)

Introduction: Procalcitonin (PCT) is helpful for diagnosing bacterial infections. The diagnostic utility of PCT has not been examined thoroughly in critically ill patients with suspected H1N1 influenza.

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2013 Dec - Subacute Kidney Injury in Hospitalized Patients

Fujii T, Uchino S, Takinami M, Bellomo R.; Clin J Am Soc Nephrol. 2013 Dec 5. [Epub ahead of print]

BACKGROUND AND OBJECTIVES: The epidemiology of AKI and CKD has been described. However, the epidemiology of progressively worsening kidney function (subacute kidney injury [s-AKI]) developing over a longer time frame than defined for AKI (7 days), but shorter than defined for CKD (90 days), is completely unknown.

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2014 Feb - Incidence and diagnosis of ventilator-associated tracheobronchitis (VAT) in the intensive care unit: an international online survey

Alejandro Rodríguez, Pedro Póvoa, Saad Nseir, Jorge Salluh, Daniel Curcio, Ignacio Martín-Loeches Critical Care 2014, 18:R32 (12 February 2014)

Introduction: Several aspects of ventilator-associated tracheobronchitis (VAT) remain poorly defined, including diagnostic criteria, overlap with ventilator-associated pneumonia (VAP) and appropriate treatment regimens. The objective of this study was to survey reported practices in the clinical and microbiological diagnosis of VAT, and to evaluate perceptions of the impact of VAT on patient outcomes.

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2014 Feb - Utility of thromboelastography and/or thromboelastometry in adults with sepsis: a systematic review

Marcella C Müller, Joost CM Meijers, Margreeth B Vroom, Nicole P Juffermans Critical Care 2014, 18:R30 (10 February 2014)

Introduction: Coagulation abnormalities are frequent in sepsis. Conventional coagulation assays however, have several limitations. There is a surge of interest in the use of point of care tests to diagnose hypo- and hypercoagulability in sepsis. We performed a systematic review of available literature to establish the value of rotational thromboelastography (TEG(R)) and thromboelastometry (ROTEM(R)) compared to standard coagulation tests to detect hyper- or hypocoagulability in sepsis patients. Furthermore the value of TEG(R)/ROTEM(R) to identify sepsis patients likely to benefit from therapies that interfere with the coagulation system was assessed.

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2014 Jan - The effect of continuous versus intermittent renal replacement therapy on the outcome of critically ill patients with acute renal failure (CONVINT): a prospective randomized controlled trial

Joerg C Schefold, Stephan von Haehling, Rene Pschowski, Thorsten Onno Bender, Cathrin Berkmann, Sophie Briegel, Dietrich Hasper, Achim Jörres Critical Care 2014, 18:R11 (10 January 2014)

Introduction: Acute renal failure (ARF) requiring renal replacement therapy (RRT) occurs frequently in ICU patients and significantly affects mortality rates. Previously, few large clinical trials investigated the impact of RRT modalities on patient outcomes. Here we investigate the effect of two major RRT strategies (intermittent hemodialysis (IHD) and continuous veno-venous hemofiltration (CVVH)) on mortality and renal-related outcome measures.

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2014 Jan - Albumin versus crystalloid solutions in patients with the acute respiratory distress syndrome: a systematic review and meta-analysis

Christopher Uhlig, Pedro L Silva, Stefanie Deckert, Jochen Schmitt, Marcelo Gama de Abreu Critical Care 2014, 18:R10 (9 January 2014)

Introduction: In patients with acute respiratory distress syndrome (ARDS) fluid therapy might be necessary. The aim of this systematic review and meta-analysis is to determine the effects of colloid therapy compared to crystalloids on mortality and oxygenation in adults with ARDS.

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2014 Jan - Combination of thrombin-antithrombin complex, plasminogen activator inhibitor-1, and protein C activity for early identification of severe coagulopathy in initial phase of sepsis: a prospective observational study

Kansuke Koyama, Seiji Madoiwa, Shin Nunomiya, Toshitaka Koinuma, Masahiko Wada, Asuka Sakata, Tsukasa Ohmori, Jun Mimuro, Yoichi Sakata Critical Care 2014, 18:R13 (13 January 2014)

Introduction: Current criteria for early diagnosis of coagulopathy in sepsis are limited. We postulated that coagulopathy is already complicated with sepsis in the initial phase, and severe coagulopathy or disseminated intravascular coagulation (DIC) becomes overt after progressive consumption of platelet and coagulation factors. To determine early diagnostic markers for severe coagulopathy, we evaluated plasma biomarkers for association with subsequent development of overt DIC in patients with sepsis.

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2014 Jan - High-volume hemofiltration for septic acute kidney injury: a systematic review and meta-analysis

Clark E, Molnar AO, Joannes-Boyau O, Honoré PM, Sikora L, Bagshaw SM.; Crit Care. 2014 Jan 8;18(1):R7. [Epub ahead of print]

INTRODUCTION: High-volume hemofiltration (HVHF) is an attractive therapy for the treatment of septic acute kidney injury (AKI). Small experimental and uncontrolled studies have suggested hemodynamic and survival benefits at higher doses of HVHF than those used for the high-intensity arms of the RENAL and ATN studies. Our aim was to evaluate the effects of high-volume hemofiltration (HVHF) compared with standard-volume hemofiltration (SVHF) for septic AKI.

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2014 Jan - Presepsin (soluble CD14 subtype) and procalcitonin levels for mortality prediction in sepsis: data from the Albumin Italian Outcome Sepsis trial

Masson S, Caironi P, Spanuth E, Thomae R, Panigada M, Sangiorgi G, Fumagalli R, Mauri T, Isgrò S, Fanizza C, Romero M, Tognoni G, Latini R, Gattinoni L.; Crit Care. 2014 Jan 7;18(1):R6. [Epub ahead of print]

INTRODUCTION: Sepsis, a leading cause of death in critically ill patients, is the result of complex interactions between the infecting microorganisms and the host responses that influence clinical outcomes. We evaluated the prognostic value of presepsin (sCD14-ST), a novel biomarker of bacterial infection, and compared it with procalcitonin.

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2014 Jan - The effect of glutamine therapy on outcomes in critically ill patients: a meta-analysis of randomized controlled trials

Qi-Hong Chen, Yi Yang, Hong-Li He, Jian-Feng Xie, Shi-Xia Cai, Ai-Ran Liu, Hua-Ling Wang, Hai-Bo Qiu Critical Care 2014, 18:R8 (9 January 2014)

Introduction: Glutamine supplementation is supposed to reduce mortality, nosocomial infections and length of hospital stay in critically ill patients. However, the recently published reducing deaths due to oxidative stress (REDOX) trials did not provide evidence supporting this. This study investigated the impact of glutamine-supplemented nutrition on the outcomes of critically ill patients using a meta-analysis.

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2013 Dec - Hemodynamic variables and progression of acute kidney injury in critically ill patients with severe sepsis: data from the prospective observational FINNAKI study

Meri Poukkanen, Erika Wilkman, Suvi T Vaara, Ville Pettilä, Kirsi-Maija Kaukonen, Anna-Maija Korhonen, Ari Uusaro, Seppo Hovilehto, Outi Inkinen, Raili Laru-Sompa, Raku Hautamäki, Anne Kuitunen, Sari Karlsson, the FINNAKI Study Group Critical Care 2013, 17:R295 (13 December 2013)

Introduction: Knowledge of the association of hemodynamics with progression of septic acute kidney injury (AKI) is limited. However, some recent data suggest that mean arterial pressure (MAP) exceeding current guidelines (60-65 mmHg) may be needed to prevent AKI. We hypothesized that higher MAP during the first 24 hours in the intensive care unit (ICU), would be associated with a lower risk of progression of AKI in patients with severe sepsis.

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