2013 Dec - Procalcitonin-guided therapy in intensive care unit patients with severe sepsis and septic shock - a systematic review and meta-analysis

Anna Prkno, Christina Wacker, Frank M Brunkhorst, Peter Schlattmann Critical Care 2013, 17:R291 (11 December 2013)

Introduction: Procalcitonin (PCT) algorithms for antibiotic treatment decisions have been studied in adult patients from primary care, emergency department, and intensive care unit (ICU) settings, suggesting that procalcitonin-guided therapy may reduce antibiotic exposure without increasing the mortality rate. However, information on the efficacy and safety of this approach in the most vulnerable population of critically ill patients with severe sepsis and septic shock is missing.

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2013 Dec - A randomized, controlled, multicenter trial of the effects of antithrombin on disseminated intravascular coagulation in patients with sepsis

Satoshi Gando, Daizoh Saitoh, Hiroyasu Ishikura, Masashi Ueyama, Yasuhiro Otomo, Shigeto Oda, Shigeki Kushimoto, Katsuhisa Tanjoh, Toshihiko Mayumi, Toshiaki Ikeda, Toshiaki Iba, Yutaka Eguchi, Kohji Okamoto, Hiroshi Ogura, Kazuhide Koseki, Yuichiro Sakamoto, Yasuhiro Takayama, Kunihiro Shirai, Osamu Takasu, Yoshiaki Inoue, Kunihiro Mashiko, Takaya Tsubota, Shigeatsu Endo Critical Care 2013, 17:R297 (16 December 2013)

Introduction: To test the hypothesis that the administration of antithrombin concentrate improves disseminated intravascular coagulation (DIC), resulting in recovery from DIC and better outcomes in patients with sepsis, we conducted a prospective, randomized controlled multicenter trial at 13 critical care centers in tertiary care hospitals.

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2013 Dec - Combining central venous-to-arterial partial pressure of carbon dioxide difference and central venous oxygen saturation to guide resuscitation in septic shock

Du W, Liu DW, Wang XT, Long Y, Chai WZ, Zhou X, Rui X.; J Crit Care. 2013 Dec;28(6):1110.e1-5.

PURPOSE: Central venous oxygen saturation (Scvo2) is a useful therapeutic target when treating septic shock. We hypothesized that combining Scvo2 and central venous-to-arterial partial pressure of carbon dioxide difference (△Pco2) may provide additional information about survival.

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2013 Oct - Fluid resuscitation with hydroxyethyl starches in patients with sepsis is associated with an increased incidence of acute kidney injury and use of renal replacement therapy: A systematic review and meta-analysis of the literature

Serpa Neto A, Veelo DP, Peireira VG, de Assunção MS, Manetta JA, Espósito DC, Schultz MJ.; J Crit Care. 2013 Oct 22. [Epub ahead of print]

PURPOSE: Fluid resuscitation is a key intervention in sepsis, but the type of fluids used varies widely. The aim of this meta-analysis is to determine whether resuscitation with hydroxyethyl starches (HES) compared with crystalloids affects outcomes in patients with sepsis.

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2013 Oct - Co-administration of furosemide with albumin for overcoming diuretic resistance in patients with hypoalbuminemia: A meta-analysis

Kitsios GD, Mascari P, Ettunsi R, Gray AW.; J Crit Care. 2013 Oct 22. [Epub ahead of print]

PURPOSE: To systematically review clinical studies of co-administration of albumin and loop diuretics in hypoalbuminemic patients as a strategy to overcome diuretic resistance.

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2013 Nov - Hypernatremia in patients with severe traumatic brain injury: a systematic review

Kolmodin L, Sekhon MS, Henderson WR, Turgeon AF and Griesdale DEG Annals of Intensive Care 2013, 3:35 (6 November 2013)

Background: Hypernatremia is common following traumatic brain injury (TBI) and occurs from a variety of mechanisms, including hyperosmotic fluids, limitation of free water, or diabetes insipidus. The purpose of this systematic review was to assess the relationship between hypernatremia and mortality in patients with TBI.

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2013 nov - Obituary: pulmonary artery catheter 1970 to 2013

Marik PE Annals of Intensive Care 2013, 3:38 (28 November 2013)

The birth of the intermittent injectate-based conventional pulmonary artery catheter (fondly nicknamed PAC) was proudly announced in the New England Journal of Medicine in 1970 by his parents HJ Swan and William Ganz. PAC grew rapidly, reaching manhood in 1986 where, in the US, he was shown to influence the management of over 40% of all ICU patients...

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2013 Nov 22 - Study of tracheostomized patients in Intensive Care Unit

Chang LL, Lau CW, Lam SM, Shum HP, Chan KC, Yan WW; Crit Care & Shock (2013) 16:113-124

Objectives: To describe the short-term and long-term outcomes of tracheostomized Intensive Care Unit (ICU) patients and to identify any predictors of complications during and after the tracheostomy procedure.

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2013 Nov - A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores

Ruijun Ji, Haipeng Shen, Yuesong Pan, Penglian Wang, Gaifen Liu, Yilong Wang, Hao Li, Xingquan Zhao, Yongjun Wang Critical Care 2013, 17:R275 (29 November 2013)

Introduction: Spontaneous intracerebral hemorrhage (ICH) is one of leading causes of mortality and morbidity worldwide. Several predictive models have been developed for ICH; however, none of them have been consistently used in routine clinical practice or clinical research. In the study, we aimed to develop and validate a risk score for predicting 1-year functional outcome after ICH (ICH Functional Outcome Score, ICH-FOS). Furthermore, we compared discrimination of the ICH-FOS and 8 existing ICH scores with regard to 30-day, 3-month, 6-month, and 1-year functional outcome and mortality after ICH.

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2013 Nov - Optimal dosing of antibiotics in critically ill patients using continuous/extended infusions: a systematic review and meta-analysis

Clarence Chant, Ann Leung, Jan O Friedrich Critical Care 2013, 17:R279 (29 November 2013)

Introduction: The aim of this study was to determine whether using pharmacodynamic-based dosing of antimicrobials such as extended/continuous infusions in critically ill patients is associated with improved outcomes as compared to traditional dosing methods

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2013 Nov - Non-invasive ventilation for acute hypoxemic respiratory failure: intubation rate and risk factors

Arnaud W Thille, Damien Contou, Chiara Fragnoli, Ana Córdoba-Izquierdo, Florence Boissier, Christian Brun-Buisson Critical Care 2013, 17:R269 (11 November 2013)

Introduction: To assess rates and predictive factors of non-invasive ventilation (NIV) failure in patients admitted to the intensive care unit (ICU) for non-hypercapnic acute hypoxemic respiratory failure (AHRF).

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2013 Nov - The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis

Shigeki Kushimoto, Satoshi Gando, Daizoh Saitoh, Toshihiko Mayumi, Hiroshi Ogura, Seitaro Fujishima, Tsunetoshi Araki, Hiroto Ikeda, Joji Kotani, Yasuo Miki, Shin-ichiro Shiraishi, Koichiro Suzuki, Yasushi Suzuki, Naoshi Takeyama, Kiyotsugu Takuma, Ryosuke Tsuruta, Yoshihiro Yamaguchi, Norio Yamashita, Naoki Aikawa Critical Care 2013, 17:R271 (13 November 2013)

Introduction: Abnormal body temperatures (Tb) are frequently seen in patients with severe sepsis. However, the relationship between Tb abnormalities and the severity of disease is not clear. This study investigated the impact of Tb on disease severity and outcomes in patients with severe sepsis.

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2013 Nov - Lung imaging in acute respiratory distress syndrome patients - an update

Davide Chiumello, Sara Froio, Belaïd Bouhemad, Luigi Camporota, Silvia Coppola Critical Care 2013, 17:243 (18 November 2013)

Over the past 30 years lung imaging has greatly contributed to the current understanding of the pathophysiology and the management of acute respiratory distress syndrome (ARDS). In the past few years, in addition to chest X-ray and lung computed tomography, newer functional lung imaging techniques, such as lung ultrasound, positron emission tomography, electrical impedance tomography and magnetic resonance, have been gaining a role as diagnostic tools to optimize lung assessment and ventilator management in ARDS patients...

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2013 Nov - Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest

Yoshikazu Goto, Tetsuo Maeda, Yumiko Nakatsu-Goto Critical Care 2013, 17:R274 (20 November 2013)

Introduction: As emergency medical services (EMS) personnel in Japan are not allowed to perform termination of resuscitation in the field, most patients experiencing an out-of-hospital cardiac arrest (OHCA) are transported to hospitals without a prehospital return of spontaneous circulation (ROSC). As the crucial prehospital factors for outcomes are not clear in patients who had an OHCA without a prehospital ROSC, we aimed to determine the prehospital factors associated with 1-month favorable neurological outcomes (Cerebral Performance Category scale 1 or 2 (CPC 1--2)).

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2013 Nov - Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: impact on survival and bacterial resistance

Christophe Adrie, Carole Schwebel, Maïté Garrouste-Orgeas, Lucile Vignoud, Benjamin Planquette, Elie Azoulay, Hatem Kallel, Michael Darmon, Bertrand Souweine, Anh-Tuan Dinh-Xuan, Samir Jamali, Jean-Ralph Zahar, Jean-François Timsit Critical Care 2013, 17:R265 (7 November 2013)

Introduction: Several guidelines recommend initial empirical treatment with two antibiotics instead of one to decrease mortality in community-acquired pneumonia (CAP) requiring intensive-care-unit (ICU) admission. We compared the impact on 60-day mortality of using one or two antibiotics. We also compared the rates of nosocomial pneumonia and multidrug-resistant bacteria.

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2013 Nov - Cefepime neurotoxicity in the intensive care unit: a cause of severe, underappreciated encephalopathy

Jennifer E Fugate, Ejaaz A Kalimullah, Sara E Hocker, Sarah L Clark, Eelco FM Wijdicks, Alejandro A Rabinstein Critical Care 2013, 17:R264 (7 November 2013)

Introduction: Cefepime, a broad spectrum antibiotic, is commonly prescribed in intensive care units (ICU) and may be an overlooked cause of neurologic symptoms such as encephalopathy, myoclonus, seizures, and coma. We aimed to characterize cefepime neurotoxicity in the ICU.

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2013 Oct - A Cerebral Recovery Index (CRI) for early prognosis in patients after cardiac arrest

Marleen C Tjepkema-Cloostermans, Fokke B van Meulen, Gjerrit Meinsma, Michel JAM van Putten Critical Care 2013, 17:R252 (22 October 2013)

Introduction: Electroencephalogram (EEG) monitoring in patients treated with therapeutic hypothermia after cardiac arrest may assist in early outcome prediction. Quantitative EEG (qEEG) analysis can reduce the time needed to review long-term EEG, and makes the analysis more objective. In this study we evaluated the predictive value of qEEG analysis for neurological outcome in postanoxic patients.

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2013 Oct - Diagnostic value and prognostic evaluation of Presepsin for sepsis in an emergency department

Bo Liu, Yun-Xia Chen, Qin Yin, Yun-Zhou Zhao, Chun-Sheng Li Critical Care 2013, 17:R244 (20 October 2013)

Introduction: Presepsin levels are known to be increased in sepsis. The aim of this study was to evaluate the early diagnostic and prognostic value of Presepsin compared with procalcitonin (PCT), Mortality in Emergency Department Sepsis (MEDS) score and Acute Physiology and Chronic Health Evaluation II (APACHE II) score in septic patients in an emergency department (ED) and to investigate Presepsin as a new biomarker of sepsis.

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2013 Jul - Beyond intracranial pressure: optimization of cerebral blood flow, oxygen, and substrate delivery after traumatic brain injury [Review]

Pierre Bouzat, Nathalie Sala, Jean-François Payen, Mauro Oddo Annals of Intensive Care 2013, 3:23 (10 July 2013)

Monitoring and management of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) is a standard of care after traumatic brain injury (TBI). However, the pathophysiology of so-called secondary brain injury, i.e., the cascade of potentially deleterious events that occur in the early phase following initial cerebral insult—after TBI, is complex, involving a subtle interplay between cerebral blood flow (CBF), oxygen delivery and utilization, and supply of main cerebral energy substrates (glucose) to the injured brain...

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2013 Oct - Risk factors for intra-abdominal hypertension and abdominal compartment syndrome among adult intensive care unit patients: a systematic review and meta-analysis

Jessalyn K Holodinsky, Derek J Roberts, Chad G Ball, Annika Reintam Blaser, Joel Starkopf, David A Zygun, Henry Thomas Stelfox, Manu L Malbrain, Roman C Jaeschke, Andrew W Kirkpatrick Critical Care 2013, 17:R249 (21 October 2013)

Introduction: Although intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are associated with substantial morbidity and mortality among critically ill adults, it remains unknown if prevention or treatment of these conditions improves patient outcomes. We sought to identify evidence-based risk factors for IAH and ACS in order to guide identification of the source population for future IAH/ACS treatment trials and to stratify patients into risk groups based on prognosis.

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