2016 Apr - Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial

Donnino MW, Andersen LW, Berg KM, Chase M, Sherwin R, Smithline H, Carney E, Ngo L, Patel PV, Liu X, Cutlip D, Zimetbaum P, Cocchi MN; collaborating authors from the Beth Israel Deaconess Medical Center’s Center for Resuscitation Science Research Group.; Crit Care. 2016 Apr 3;20(1):82.

BACKGROUND: The purpose of this study was to determine whether the provision of corticosteroids improves time to shock reversal and outcomes in patients with post-cardiac arrest shock.

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2016 Apr - Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill

Mitrić G, Udy A, Bandeshe H, Clement P, Boots R.; Crit Care. 2016 Apr 2;20(1):90.

BACKGROUND: Atrial fibrillation is a common rhythm disturbance in the general medical-surgical intensive care unit. Amiodarone is a popular drug in this setting but evidence to inform clinical practice remains scarce. We aimed to identify whether variation in the clinical use of amiodarone was associated with recurrent atrial fibrillation.

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2016 Mar - The influence of corticosteroid treatment on the outcome of influenza A(H1N1pdm09)-related critical illness

Delaney JW, Pinto R, Long J, Lamontagne F, Adhikari NK, Kumar A, Marshall JC, Cook DJ, Jouvet P, Ferguson ND, Griesdale D, Burry LD, Burns KE, Hutchison J, Mehta S, Menon K, Fowler RA; Canadian Critical Care Trials Group H1N1 Collaborative.; Crit Care. 2016 Mar 30;20(1):75.

BACKGROUND: Patients with 2009 pandemic influenza A(H1N1pdm09)-related critical illness were frequently treated with systemic corticosteroids. While observational studies have reported significant corticosteroid-associated mortality after adjusting for baseline differences in patients treated with corticosteroids or not, corticosteroids have remained a common treatment in subsequent influenza outbreaks, including avian influenza A(H7N9). Our objective was to describe the use of corticosteroids in these patients and investigate predictors of steroid prescription and clinical outcomes, adjusting for both baseline and time-dependent factors.

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2016 Jan - A randomized controlled trial of 2 protocols for weaning cardiac surgical patients receiving adaptive support ventilation

Tam MK, Wong WT, Gomersall CD, Tian Q, Ng SK, Leung CC, Underwood MJ.; J Crit Care. 2016 Jan 27. pii: S0883-9441(16)00019-8.

PURPOSE: This study aims to compare the effectiveness of weaning with adaptive support ventilation (ASV) incorporating progressively reduced or constant target minute ventilation in the protocol in postoperative care after cardiac surgery.

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2016 Feb - Prevention of stress-related ulcer bleeding at the intensive care unit: Risks and benefits of stress ulcer prophylaxis

Buendgens L, Koch A, Tacke F.; World J Crit Care Med. 2016 Feb 4;5(1):57-64.

Stress-related mucosal disease is a typical complication of critically ill patients in the intensive care unit (ICU). It poses a risk of clinically relevant upper gastrointestinal (GI) bleeding. Therefore, stress ulcer prophylaxis (SUP) is recommended in high-risk patients, especially those mechanically ventilated > 48 h and those with a manifest coagulopathy. Proton pump inhibitors (PPI) and, less effectively, histamine 2 receptor antagonists (H2RA) prevent GI bleeding in critically ill patients in the ICU...

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2016 Apr - The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition

Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, Filipescu D, Hunt BJ, Komadina R, Nardi G, Neugebauer EA, Ozier Y, Riddez L, Schultz A, Vincent JL, Spahn DR.; Crit Care. 2016 Apr 12;20(1):100.

BACKGROUND: Severe trauma continues to represent a global public health issue and mortality and morbidity in trauma patients remains substantial. A number of initiatives have aimed to provide guidance on the management of trauma patients. This document focuses on the management of major bleeding and coagulopathy following trauma and encourages adaptation of the guiding principles to each local situation and implementation within each institution.

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2016 Mar - Recent advances in the management of pulmonary embolism: focus on the critically ill patients

Meyer G, Vieillard-Baron A, Planquette B.; Ann Intensive Care. 2016 Dec;6(1):19.

The aim of this narrative review is to summarize for intensivists or any physicians managing "severe" pulmonary embolism (PE) the main recent advances or recommendations in the care of patients including risk stratification, diagnostic algorithm, hemodynamic management in the intensive care unit (ICU), recent data regarding the use of thrombolytic treatment and retrievable vena cava filters and finally results of direct oral anticoagulants.

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2016 Mar - Concepts from paediatric extracorporeal membrane oxygenation for adult intensivists

Butt W, MacLaren G.; Ann Intensive Care. 2016 Dec;6(1):20.

Over the last 5 years, there has been a dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) in adult patients with severe respiratory or cardiac failure. This contrasts to the use of the technology in neonatal and paediatric intensive care units, where it has been regarded as a standard of care for a number of conditions for over 25 years..

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2016 Mar - Algorithm-guided goal-directed haemodynamic therapy does not improve renal function after major abdominal surgery compared to good standard clinical care: a prospective randomised trial

Schmid S, Kapfer B, Heim M, Bogdanski R, Anetsberger A, Blobner M, Jungwirth B.; Crit Care. 2016 Mar 8;20(1):50.

BACKGROUND: Acute kidney injury is a common complication after major surgery. In this study, we investigated whether an algorithm-guided goal-directed haemodynamic therapy (GDT) can improve renal outcome compared to good standard clinical care.

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2016 Mar - Moderate hyperoxic versus near-physiological oxygen targets during and after coronary artery bypass surgery: a randomised controlled trial

Smit B, Smulders YM, de Waard MC, Boer C, Vonk AB, Veerhoek D, Kamminga S, de Grooth HS, García-Vallejo JJ, Musters RJ, Girbes AR, Oudemans-van Straaten HM, Spoelstra-de Man AM.; Crit Care. 2016 Mar 10;20(1):55.

BACKGROUND: The safety of perioperative hyperoxia is currently unclear. Previous studies in patients undergoing coronary artery bypass surgery suggest reduced myocardial damage when avoiding extreme perioperative hyperoxia (>400 mmHg). In this study we investigated whether an oxygenation strategy from moderate hyperoxia to a near-physiological oxygen tension reduces myocardial damage and improves haemodynamics, organ dysfunction and oxidative stress.

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2016 Mar - Applying the termination of resuscitation rules to out-of-hospital cardiac arrests of both cardiac and non-cardiac etiologies: a prospective cohort study

Kashiura M, Hamabe Y, Akashi A, Sakurai A, Tahara Y, Yonemoto N, Nagao K, Yaguchi A, Morimura N; SOS-KANTO 2012 Study Group.; Crit Care. 2016 Mar 1;20(1):49.

BACKGROUND: The 2015 American Heart Association Guidelines for Cardiopulmonary Resuscitation recommend Basic Life Support (BLS) and Advanced Life Support (ALS) rules for termination of resuscitation (TOR). However, it is unclear whether the TOR rules are valid for out-of-hospital cardiac arrests (OHCAs) of both cardiac and non-cardiac etiologies. In this study, we validated the TOR rules for OHCA resulting from both etiologies.

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2016 Feb - Urinary chitinase 3-like protein 1 for early diagnosis of acute kidney injury: a prospective cohort study in adult critically ill patients

De Loor J, Decruyenaere J, Demeyere K, Nuytinck L, Hoste EA, Meyer E.; Crit Care. 2016 Feb 11;20(1):38.

BACKGROUND: Acute kidney injury (AKI) occurs frequently and adversely affects patient and kidney outcomes, especially when its severity increases from stage 1 to stages 2 or 3. Early interventions may counteract such deterioration, but this requires early detection. Our aim was to evaluate whether the novel renal damage biomarker urinary chitinase 3-like protein 1 (UCHI3L1) can detect AKI stage ≥2 more early than serum creatinine and urine output, using the respective Kidney Disease | Improving Global Outcomes (KDIGO) criteria for definition and classification of AKI, and compare this to urinary neutrophil gelatinase-associated lipocalin (UNGAL).

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2016 Feb - Feasibility and safety of low-flow extracorporeal carbon dioxide removal to facilitate ultra-protective ventilation in patients with moderate acute respiratory distress sindrome

Fanelli V, Ranieri MV, Mancebo J, Moerer O, Quintel M, Morley S, Moran I, Parrilla F, Costamagna A, Gaudiosi M, Combes A.; Crit Care. 2016 Feb 10;20(1):36.

BACKGROUND: Mechanical ventilation with a tidal volume (VT) of 6 mL/kg/predicted body weight (PBW), to maintain plateau pressure (Pplat) lower than 30 cmH2O, does not completely avoid the risk of ventilator induced lung injury (VILI). The aim of this study was to evaluate safety and feasibility of a ventilation strategy consisting of very low VT combined with extracorporeal carbon dioxide removal (ECCO2R).

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2016 Jan - Electrical impedance tomography (EIT) for quantification of pulmonary edema in acute lung injury

Constantin Trepte, Charles Phillips, Josep Solà, Andy Adler, Sebastian Haas, Michael Rapin, Stephan Böhm, Daniel Reuter Critical Care 2016, 20:18 (22 January 2016)

Background: Assessment of pulmonary edema is a key factor in monitoring and guidance of therapy in critically ill patients. To date, methods available at the bedside for estimating the physiologic correlate of pulmonary edema, extravascular lung water, often are unreliable or require invasive measurements. The aim of the present study was to develop a novel approach to reliably assess extravascular lung water by making use of the functional imaging capabilities of electrical impedance tomography.

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2016 Jan - The critical care management of poor-grade subarachnoid haemorrhage

Airton de Oliveira Manoel, Alberto Goffi, Tom Marotta, Tom Schweizer, Simon Abrahamson, R. Macdonald Critical Care 2016, 20:21 (23 January 2016)

Aneurysmal subarachnoid haemorrhage is a neurological syndrome with complex systemic complications. The rupture of an intracranial aneurysm leads to the acute extravasation of arterial blood under high pressure into the subarachnoid space and often into the brain parenchyma and ventricles.

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2016 Jan - Influence of EMS-physician presence on survival after out-of-hospital cardiopulmonary resuscitation: systematic review and meta-analysis

Bernd Böttiger, Michael Bernhard, Jürgen Knapp, Peter Nagele Critical Care 2016, 20:4 (9 January 2016)

Background: Evidence suggests that EMS-physician-guided cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OOHCA) may be associated with improved outcomes, yet randomized controlled trials are not available. The goal of this meta-analysis was to determine the association between EMS-physician- versus paramedic-guided CPR and survival after OOHCA.

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2016 Jan - Safety and efficacy of prothrombin complex concentrate as first-line treatment in bleeding after cardiac surgery

Giangiuseppe Cappabianca, Giovanni Mariscalco, Fausto Biancari, Daniele Maselli, Francesca Papesso, Marzia Cottini, Sandro Crosta, Simona Banescu, Aamer Ahmed, Cesare Beghi Critical Care 2016, 20:5 (6 January 2016)

Background: Bleeding after cardiac surgery requiring surgical reexploration and blood component transfusion is associated with increased morbidity and mortality. Although prothrombin complex concentrate (PCC) has been used satisfactorily in bleeding disorders, studies on its efficacy and safety after cardiopulmonary bypass are limited.

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2016 Jan - A commentary on the 2015 Canadian Clinical Practice Guidelines in glutamine supplementation to parenteral nutrition

Alberto Leguina-Ruzzi Critical Care 2016, 20:7 (8 January 2016)

Glutamine is one of the conditionally essential free amino acids with multiple biological functions. Its supplementation to parenteral nutrition has been widely used for the management of complications in intensive care. However, controversial clinical reports have generated reluctance in the use of this pharmaco-nutrient.

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2016 Jan - Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV

Rosa Di mussi, Savino Spadaro, Lucia Mirabella, Carlo Volta, Gabriella Serio, Francesco Staffieri, Michele Dambrosio, Gilda Cinnella, Francesco Bruno, Salvatore Grasso Critical Care 2016, 20:1 (5 January 2016)

Background: Prolonged controlled mechanical ventilation depresses diaphragmatic efficiency. Assisted modes of ventilation should improve it. We assessed the impact of pressure support ventilation versus neurally adjusted ventilator assist on diaphragmatic efficiency.

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2016 Jan - Molecular adsorbent recirculating system and single-pass albumin dialysis in liver failure – a prospective, randomised crossover study

Christoph Sponholz, Katja Matthes, Dina Rupp, Wolf Backaus, Sebastian Klammt, Diana Karailieva, Astrid Bauschke, Utz Settmacher, Matthias Kohl, Mark Clemens, Steffen Mitzner, Michael Bauer, Andreas Kortgen Critical Care 2016, 20:2 (4 January 2016)

Background: The aim of extracorporeal albumin dialysis (ECAD) is to reduce endogenous toxins accumulating in liver failure. To date, ECAD is conducted mainly with the Molecular Adsorbents Recirculating System (MARS). However, single-pass albumin dialysis (SPAD) has been proposed as an alternative. The aim of this study was to compare the two devices with a prospective, single-centre, non-inferiority crossover study design with particular focus on reduction of bilirubin levels (primary endpoint) and influence on paraclinical and clinical parameters (secondary endpoints) associated with liver failure.

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