2012 Nov - Antipyretic therapy in febrile critically ill adults: A systematic review and meta-analysis

Niven DJ, Stelfox HT, Laupland KB. J Crit Care. 2012 Nov 14. [Epub ahead of print]
PURPOSE: To determine whether fever control with antipyretic therapy effects the mortality of febrile critically ill adults.

Read more ...

2012 Nov - Prophylactic magnesium for improving neurologic outcome after aneurysmal subarachnoid hemorrhage: Systematic review and meta-analysis

Golan E, Vasquez DN, Ferguson ND, Adhikari NK, Scales DC. J Crit Care. 2012 Nov 26.  [Epub ahead of print]
PURPOSE: Neurologic disability is common after aneurysmal subarachnoid hemorrhage (aSAH). Our objective was to systematically review the prophylactic use of magnesium to improve neurologic outcomes in these patients.

Read more ...

2012 Dec - Prognostic factors in critically ill patients with hematologic malignancies admitted to the intensive care unit

Yeo CD, Kim JW, Kim SC, Kim YK, Kim KH, Kim HJ, Lee S, Rhee CK. J Crit Care. 2012 Dec;27(6):739.e1-6.
OBJECTIVE: Despite an improvement in the prognosis of patients with hematologic malignancies, the mortality of such patients transferred to the intensive care unit (ICU) is high. This study determined the predictors of mortality in a cohort of critically ill patients with hematologic malignancies admitted to the ICU.

Read more ...

2012 Dec - Hypophosphatemia in critically ill patients

Suzuki S, Egi M, Schneider AG, Bellomo R, Hart GK, Hegarty C. J Crit Care. 2012 Dec 19. [Epub ahead of print]
PURPOSE: The aim of this study was to assess the association of phosphate concentration with key clinical outcomes in a heterogeneous cohort of critically ill patients.

Read more ...

2012 Dec - Randomized double-blind placebo-controlled trial of 40 mg/day of atorvastatin in reducing the severity of sepsis in ward patients (ASEPSIS Trial)

Jaimin M Patel, Catherine Snaith, David R Thickett, Lucie Linhartova, Teresa Melody, Peter Hawkey, Anthony H Barnett, Alan Jones, Tan Hong, Matthew W Cooke, Gavin D Perkins, Fang Gao Critical Care 2012, 16:R231 (11 December 2012)
Introduction: Several observational studies suggest that statins modulate the pathophysiology of sepsis and may prevent its progression. The aim of this study was to determine if the acute administration of atorvastatin reduces sepsis progression in statin naive patients hospitalized with sepsis.

Read more ...

2012 Dec - Lower short- and long-term mortality associated with overweight and obesity in a large cohort study of adult intensive care unit patients

Swapna Abhyankar, Kira Leishear, Fiona M Callaghan, Dina Demner-Fushman, Clement J McDonald Critical Care 2012, 16:R235 (18 December 2012)
Introduction: Two-thirds of U.S. adults are overweight or obese, which puts them at higher risk of developing chronic diseases and of death compared to normal weight individuals. However, recent studies have found that overweight and obesity by themselves may be protective in some contexts, such as hospitalization in an intensive care unit (ICU). Our objective was to determine the relationship between body mass index (BMI) and mortality 30 days and one year after ICU admission.

Read more ...

2012 Dec - Efficacy of renal replacement therapy in critically ill patients: a propensity analysis

Christophe Clec'h, Michael Darmon, Alexandre Lautrette, Frank Chemouni, Elie Azoulay, Carole Schwebel, Anne-Sylvie Dumenil, Maite Garrouste-Orgeas, Dany Goldgran-Toledano, Yves Cohen, Jean-Francois Timsit Critical Care 2012, 16:R236 (19 December 2012)
Introduction: Although renal replacement therapy (RRT) being a common procedure in critically ill patients with acute kidney injury (AKI), its efficacy remains uncertain. Patients who receive RRT usually have higher mortality rates than those who do not. However, many differences exist in severity patterns between patients with and those without RRT and available results are further confounded by treatment selection bias since no consensus on indications for RRT has been reached so far. Our aim was to account for these biases to accurately assess RRT efficacy, with special attention to RRT timing.

Read more ...

2012 Dec - Timing of dialysis initiation in AKI in ICU: international survey

Charuhas V Thakar, James Rousseau, Anthony C Leonard Critical Care 2012, 16:R237 (19 December 2012)
Introduction: Initiating dialysis in acute kidney injury (AKI) in an intensive care unit (ICU) remains a subjective clinical decision. We examined factors and practice patterns that influence early initiation of dialysis in ICU patients with acute kidney injury.

Read more ...

2012 Dec - Ventilator Associated Pneumonia in Intensive Care Unit: Incidence, patient characteristics, outcome and validation of VAP-PIRO score in a local Chinese chort

Arthur Ming-Chit Kwan, King-Chung Chan, Arthur Chun-Wing Lau, Wing-Wa Yan
Department of Intensive Care (ICU), Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
Crit Care & Shock 2012;15:111-9

Abstract:

Objective
: Despite a systematic scoring system has been developed to assess the severity and to stratify the mortality risk of Ventilator-Associated Pneumonia (VAP), few clinical studies had published in validating this scoring system. We intend to study the incidence of VAP in a local Chinese cohort and to validate the VAP-PIRO (Predisposition, Insult, Response, Organ Dysfunction) score.

Read more ...

2012 Nov - Accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients: a systematic review and meta-analysis

Youping Wu, Fei Wang, Xiaohua Fan, Rui Bao, Lulong Bo, Jinbao Li, Xiaoming Deng Critical Care 2012, 16:R229 (29 November 2012)
Introduction: Early diagnosis of sepsis is vital to the clinical course and outcome of septic patients. Recently, soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) appears to be a potential marker of infection. The objective of this systematic review and meta-analysis was to evaluate the accuracy of plasma sTREM-1 for sepsis diagnosis in systemic inflammatory patients.

Read more ...

2012 Nov - Extracorporeal membrane oxygenation: a new mode of organ support in Hong Kong ICUs

WW Yan, Arthur CW Lau, SM Lam, Kenny KC Chan, on behalf of the PYNEH ICU ECMO Team, Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China; Intensetimes November 2012,17:2-10


 
Introduction
Extracorporeal membrane oxygenation (ECMO) is a form of extracorporeal life support (ECLS) whereby an artificial circuit carries venous blood to a gas exchange device (the oxygenator) for oxygen enrichment and carbon dioxide removal. (The phrase ‘extracorporeal gas exchange’ might be a better term to describe this form of life support but ECMO is the term that has entered the professional vocabulary and gripped the public imagination.)

2012 Nov - A randomized trial of 7-day doripenem versus 10-day imipenem-cilastatin for ventilator-associated pneumonia

Kollef MH, Chastre J, Clavel M, Restrepo MI, Michiels B, Kaniga K, Cirillo I, Kimko H, Redman R.; Crit Care. 2012 Nov 13;16(6):R218. [Epub ahead of print]
Introduction: To compare a 7-day course of doripenem to a 10-day course of imipenem-cilastatin for ventilator-associated pneumonia (VAP) due to Gram-negative bacteria.

Read more ...

2012 Nov - Antibiotic prescription patterns in the empirical therapy of severe sepsis: combination of antimicrobials with different mechanisms of action reduces mortality

Diaz-Martin A, Martinez-Gonzalez ML, Ferrer R, Ortiz-Leyba C, Piacentini E, Lopez-Pueyo MJ, Martin-Loeches I, Levy MM, Artigas A, Garnacho-Montero J, Study Group E.; Crit Care. 2012 Nov 18;16(6):R223. [Epub ahead of print]
Introduction: Although early institution of adequate antimicrobial therapy is life-saving in septic patients, optimal antimicrobial strategy has not been established. Moreover, the benefit of combination therapy over monotherapy remains to be determined. Our aims are to describe patterns of empirical antimicrobial therapy in severe sepsis, assessing the impact of combination therapy including antimicrobials with different mechanisms of action on mortality.

Read more ...

2012 Oct - Influence of prehospital volume replacement on outcome in polytraumatized children

Hussmann B, Lefering R, Kauther MD, Ruchholtz S, Moldzio P, Lendemans S, Dgu T.; Crit Care. 2012 Oct 18;16(5):R201. [Epub ahead of print]
Introduction: Severe bleeding after trauma frequently results in poor outcomes in children. Prehospital fluid replacement therapy is regarded as an important primary treatment option. Our study aimed, through a retrospective analysis of matched pairs, to assess the influence of prehospital fluid replacement therapy on the post-traumatic course of severely injured children.

Read more ...

2012 Oct - Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia

Hodgson CL, Hayes K, Everard T, Nichol A, Davies AR, Bailey MJ, Tuxen DV, Cooper DJ, Pellegrino V.; Crit Care. 2012 Oct 19;16(5):R202. [Epub ahead of print]
Introduction: The purpose of the study was to assess the long term outcome and quality of life of patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) for refractory hypoxemia.

Read more ...

2012 Oct - Optimal glycemic control in neurocritical care patients: a systematic review and meta-analysis

Kramer AH, Roberts DJ, Zygun DA.; Crit Care. 2012 Oct 22;16(5):R203. [Epub ahead of print]
Introduction: Hyper- and hypoglycemia are strongly associated with adverse outcomes in critical care. Neurologically injured patients are a unique subgroup, where optimal glycemic targets may differ, such that the findings of clinical trials involving heterogeneous critically ill patients may not apply.

Read more ...

2012 Oct - n-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis

Lorenzo Pradelli, Konstantin Mayer, Maurizio Muscaritoli, Axel R Heller Critical Care 2012, 16:R184 (4 October 2012)
Introduction: Previous studies and a meta-analysis in surgical patients indicate that supplementing parenteral nutrition regimens with n-3 polyunsaturated fatty acids (PUFAs), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with improved laboratory and clinical outcomes in the setting of hyper-inflammatory conditions. Refined or synthetic fish oils are commonly used as a source of EPA and DHA. The objective of the present meta-analysis was to evaluate n-3 PUFA-enriched parenteral nutrition regimens in elective surgical and intensive care unit (ICU) patients.

Read more ...

2012 Oct - Impact of oral care with versus without toothbrushing on the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials

Wan-Jie Gu, Yi-Zhen Gong, Lei Pan, Yu-Xia Ni, Jing-Chen Liu Critical Care 2012, 16:R190 (12 October 2012)
Introduction: Ventilator-associated pneumonia (VAP) remains a common hazardous complication in mechanically ventilated patients and is associated with increased morbidity and mortality. We undertook a systematic review and meta-analysis of randomized controlled trials to assess the effect of toothbrushing as a component of oral care on the prevention of VAP in adult critically ill patients.

Read more ...

2012 Oct - Sequestration of drugs in the circuit may lead to therapeutic failure during extracorporeal membrane oxygenation

Kiran Shekar, Jason A Roberts, Charles I McDonald, Stephanie Fisquet, Adrian G Barnett, Daniel V Mullany, Sussan Ghassabian, Steven C Wallis, Yoke L Fung, Maree T Smith, John F Fraser Critical Care 2012, 16:R194 (15 October 2012)
Introduction: Extracorporeal membrane oxygenation (ECMO) is a supportive therapy, with its success dependent on effective drug therapy that reverses the pathology and/or normalises physiology. However, the circuit that sustains life can also sequester life-saving drugs, thereby compromising the role of ECMO as a temporary support device. This ex vivo study was designed to determine the degree of sequestration of commonly used antibiotics, sedatives and analgesics in ECMO circuits.

Read more ...

2012 Oct - Fluid overload is associated with an increased risk for 90-day mortality in critically ill patients with renal replacement therapy: data from the prospective FINNAKI study

Suvi T Vaara, Anna-Maija Korhonen, Kirsi-Maija Kaukonen, Sara Nisula, Outi Inkinen, Sanna Hoppu, Jouko J Laurila, Leena Mildh, Matti Reinikainen, Vesa Lund, Ilkka Parviainen, Ville Pettila, Study group Finnaki Critical Care 2012, 16:R197 (17 October 2012)
Introduction: Positive fluid balance has been associated with an increased risk for mortality in critically ill patients with acute kidney injury with or without renal replacement therapy (RRT). Data on fluid accumulation prior to RRT initiation and mortality are limited. We aimed to study the association between fluid accumulation at RRT initiation and 90-day mortality.

Read more ...