2015 Nov - A randomized controlled trial of daily sedation interruption in critically ill children

Vet NJ, de Wildt SN, Verlaat CW, Knibbe CA, Mooij MG, van Woensel JB, van Rosmalen J, Tibboel D, de Hoog M. Intensive Care Med. 2015 Nov 24. [Epub ahead of print]

PURPOSE: To compare daily sedation interruption plus protocolized sedation (DSI + PS) to protocolized sedation only (PS) in critically ill children.

Read more ...

2016 Jan - The reliability of the Glasgow Coma Scale: a systematic review

Reith FC, Van den Brande R, Synnot A, Gruen R, Maas AI.; Intensive Care Med. 2016 Jan;42(1):3-15.

INTRODUCTION: The Glasgow Coma Scale (GCS) provides a structured method for assessment of the level of consciousness. Its derived sum score is applied in research and adopted in intensive care unit scoring systems. Controversy exists on the reliability of the GCS. The aim of this systematic review was to summarize evidence on the reliability of the GCS.

Read more ...

2016 Jan - Cholestatic liver (dys)function during sepsis and other critical illnesses

Jenniskens M, Langouche L, Vanwijngaerden YM, Mesotten D, Van den Berghe G.; Intensive Care Med. 2016 Jan;42(1):16-27.

OBJECTIVE: In ICU patients, abnormal liver tests are common. Markers of cholestasis are associated with adverse outcome. Research has focused on the possibility that mild hyperbilirubinemia, instead of indicating inadvertent cholestasis, may be adaptive and beneficial. These new insights are reviewed and integrated in the state-of-the-art knowledge on hepatobiliary alterations during sepsis and other critical illnesses.

Read more ...

2015 Aug - ICU-acquired candidemia within selective digestive decontamination studies: a meta-analysis

Hurley JC.; Intensive Care Med. 2015 Nov;41(11):1877-85.

PURPOSE: To estimate the direct and indirect (contextual) effects of the factorized constituents of selective digestive decontamination and selective oropharyngeal decontamination (SDD/SOD), being topical antibiotic (TA) and protocolized antifungal prophylaxis (PAFP), on ICU-acquired candidemia.

Read more ...

2015 Aug - Physical activity, muscle strength, and exercise capacity 3 months after severe sepsis and septic shock

Borges RC, Carvalho CR, Colombo AS, da Silva Borges MP, Soriano FG.; Intensive Care Med. 2015 Aug;41(8):1433-44. doi: 10.1007/s00134-015-3914-y. Epub 2015 Jun 25.

PURPOSE: To quantify the physical activity in daily life (PADL), muscle strength, and exercise capacity in the short and medium term in survivors of severe sepsis and septic shock.

Read more ...

2015 Aug - β-d-Glucan and Candida albicans germ tube antibody in ICU patients with invasive candidiasis

Martín-Mazuelos E, Loza A, Castro C, Macías D, Zakariya I, Saavedra P, Ruiz-Santana S, Marín E, León C.; Intensive Care Med. 2015 Aug;41(8):1424-32. doi: 10.1007/s00134-015-3922-y. Epub 2015 Jul 2.

PURPOSE: To assess the performance of (1→3)-β-D-glucan (BDG) and Candida albicans germ tube antibody (CAGTA) for the diagnosis of invasive candidiasis (IC) in a prospective cohort of 107 unselected, non-neutropenic ICU patients.

Read more ...

2015 Aug - Endogenous IgG hypogammaglobulinaemia in critically ill adults with sepsis: systematic review and meta-analysis

Shankar-Hari M, Culshaw N, Post B, Tamayo E, Andaluz-Ojeda D, Bermejo-Martín JF, Dietz S, Werdan K, Beale R, Spencer J, Singer M.: Intensive Care Med. 2015 Aug;41(8):1393-401. doi: 10.1007/s00134-015-3845-7. Epub 2015 May 14

PURPOSE: Plasma immunoglobulin concentrations are acutely altered in critically ill patients with sepsis. However, the association between immunoglobulin levels on the day of sepsis diagnosis and subsequent mortality is inconsistent.

Read more ...

2015 Jul - Glucocorticosteroids for sepsis: systematic review with meta-analysis and trial sequential analysis

Volbeda M, Wetterslev J, Gluud C, Zijlstra JG, van der Horst IC, Keus F.; Intensive Care Med. 2015 Jul;41(7):1220-34

INTRODUCTION: Glucocorticosteroids (steroids) are widely used for sepsis patients. However, the potential benefits and harms of both high and low dose steroids remain unclear. A systematic review of randomised clinical trials with meta-analysis and trial sequential analysis (TSA) might shed light on this clinically important question.

Read more ...

2015 May - Early temperature and mortality in critically ill patients with acute neurological diseases: trauma and stroke differ from infection

Saxena M, Young P, Pilcher D, Bailey M, Harrison D, Bellomo R, Finfer S, Beasley R, Hyam J, Menon D, Rowan K, Myburgh J.; Intensive Care Med. 2015 May;41(5):823-32.

BACKGROUND: Fever suppression may be beneficial for patients with traumatic brain injury (TBI) and stroke, but for patients with meningitis or encephalitis [central nervous system (CNS) infection], the febrile response may be advantageous.

Read more ...

2015 May - Early physical rehabilitation in intensive care patients with sepsis syndromes: a pilot randomised controlled trial

Kayambu G, Boots R, Paratz J.; Intensive Care Med. 2015 May;41(5):865-74.

RATIONALE: Survivors of sepsis syndromes have poor outcomes for physical and cognitive function. No investigations of early physical rehabilitation in the intensive care unit have specifically targeted patients with sepsis syndromes.

OBJECTIVE: To determine whether early physical rehabilitation improves physical function and associated outcomes in patients with sepsis syndromes.

Read more ...

2015 May - Preventive and therapeutic strategies in critically ill patients with highly resistant bacteria

Bassetti M, De Waele JJ, Eggimann P, Garnacho-Montero J, Kahlmeter G, Menichetti F, Nicolau DP, Paiva JA, Tumbarello M, Welte T, Wilcox M, Zahar JR, Poulakou G.; Intensive Care Med. 2015 May;41(5):776-95.

The antibiotic pipeline continues to diminish and the majority of the public remains unaware of this critical situation. The cause of the decline of antibiotic development is multifactorial and currently most ICUs are confronted with the challenge of multidrug-resistant organisms. Antimicrobial multidrug resistance is expanding all over the world, with extreme and pandrug resistance being increasingly encountered, especially in healthcare-associated infections in large highly specialized hospitals.

Read more ...

2015 May - A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators

Angus DC, Barnato AE, Bell D, Bellomo R, Chong CR, Coats TJ, Davies A, Delaney A, Harrison DA, Holdgate A, Howe B, Huang DT, Iwashyna T, Kellum JA, Peake SL, Pike F, Reade MC, Rowan KM, Singer M, Webb SA, Weissfeld LA, Yealy DM, Young JD.; Intensive Care Med. 2015 May 8. [Epub ahead of print]

PURPOSE: To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock.

Read more ...

2015 Apr - Early use of polymyxin B hemoperfusion in patients with septic shock due to peritonitis: a multicenter randomized control trial

Payen DM, Guilhot J, Launey Y, Lukaszewicz AC, Kaaki M, Veber B, Pottecher J, Joannes-Boyau O, Martin-Lefevre L, Jabaudon M, Mimoz O, Coudroy R, Ferrandière M, Kipnis E, Vela C, Chevallier S, Mallat J, Robert R; ABDOMIX Group. Intensive Care Med. 2015 Apr 11. [Epub ahead of print]

PURPOSE: To test whether the polymyxin B hemoperfusion (PMX HP) fiber column reduces mortality and organ failure in peritonitis-induced septic shock (SS) from abdominal infections.

Read more ...

2015 Mar - Protocolized fluid therapy in brain-dead donors: the multicenter randomized MOnIToR trial

Al-Khafaji A, Elder M, Lebovitz DJ, Murugan R, Souter M, Stuart S, Wahed AS, Keebler B, Dils D, Mitchell S, Shutterly K, Wilkerson D, Pearse R, Kellum JA.; Intensive Care Med. 2015 Mar;41(3):418-26.

BACKGROUND: Critical shortages of organs for transplantation jeopardize many lives. Observational data suggest that better fluid management for deceased organ donors could increase organ recovery. We conducted the first large multicenter randomized trial in brain-dead donors to determine whether protocolized fluid therapy increases the number of organs transplanted.

Read more ...

2015 Mar - Effectiveness of treatment based on PiCCO parameters in critically ill patients with septic shock and/or acute respiratory distress syndrome: a randomized controlled trial

Zhang Z, Ni H, Qian Z.; Intensive Care Med. 2015 Mar;41(3):444-51.

PURPOSE: To compare treatment based on either PiCCO-derived physiological values or central venous pressure (CVP) monitoring, we performed a prospective randomized controlled trial with group sequential analysis.

Read more ...

2015 Mar - Diastolic dysfunction and mortality in septic patients: a systematic review and meta-analysis

Sanfilippo F, Corredor C, Fletcher N, Landesberg G, Benedetto U, Foex P, Cecconi M.; Intensive Care Med. 2015 Mar 24. [Epub ahead of print]

BACKGROUND: Myocardial dysfunction may contribute to the haemodynamic instability which accompanies sepsis, and may result in circulatory failure. There is no association between systolic dysfunction (SD) and mortality in septic patients and there is conflicting evidence regarding the effects of diastolic dysfunction (DD) on mortality in septic patients.

Read more ...

2015 Mar - Impact of closed versus open tracheal suctioning systems for mechanically ventilated adults: a systematic review and meta-analysis

Kuriyama A, Umakoshi N, Fujinaga J, Takada T.; Intensive Care Med. 2015 Mar;41(3):402-11.

PURPOSE: Whether closed tracheal suctioning systems (CTSS) reduce the incidence of ventilator-associated pneumonia (VAP) compared with open tracheal suctioning systems (OTSS) is inconclusive. We conducted a systematic review and meta-analysis of randomized controlled trials that compared CTSS and OTSS.

Read more ...

2015 Mar - Mechanical ventilation during extracorporeal life support (ECLS): a systematic review

Marhong JD, Munshi L, Detsky M, Telesnicki T, Fan E. Intensive Care Med. 2015 Mar 10. [Epub ahead of print]

PURPOSE: In patients with acute respiratory distress syndrome (ARDS), extracorporeal life support (ECLS) has been utilized to support gas exchange and mitigate ventilator-induced lung injury (VILI). The optimal ventilation settings while on ECLS are unknown. The purpose of this systematic review is to describe the ventilation practices in patients with ARDS who require ECLS.

Read more ...

2015 Feb - Preemptive enteral nutrition enriched with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in severe multiple trauma: a prospective, randomized, double-blind study

Kagan I, Cohen J, Stein M, Bendavid I, Pinsker D, Silva V, Theilla M, Anbar R, Lev S, Grinev M, Singer P.; Intensive Care Med. 2015 Feb 12. [Epub ahead of print

BACKGROUND:: Severe injury triggers a complex systemic immune response which may result in significant respiratory compromise, including the development of acute respiratory distress syndrome (ARDS). No randomized clinical trial has assessed the role of nutritional interventions to limit respiratory complications.

Read more ...

2015 Feb - Effects of levosimendan for low cardiac output syndrome in critically ill patients: systematic review with meta-analysis and trial sequential analysis

Koster G, Wetterslev J, Gluud C, Zijlstra JG, Scheeren TW, van der Horst IC, Keus F.; Intensive Care Med. 2015 Feb;41(2):203-21.

PURPOSE: To assess the benefits and harms of levosimendan for low cardiac output syndrome in critically ill patients.

METHODS: We conducted a systematic review with meta-analyses and trial sequential analyses (TSA) of randomised clinical trials comparing levosimendan with any type of control. Two reviewers independently assessed studies for inclusion. The Cochrane Collaboration methodology was used. Random-effects risk ratios (RR) and 95 % confidence intervals (CI) were derived for the principal primary outcome mortality at maximal follow-up.

Read more ...