2009 Cuff-leak test for the diagnosis of upper airway obstruction in adults: a systematic review and meta-analysis
Intensive Care Med. 2009 Jul;35(7):1171-9. Epub 2009 Apr 28.
PURPOSE: To evaluate, in adults, the diagnostic accuracy of the cuff-leak test for the diagnosis of upper airway obstruction secondary to laryngeal edema and for reintubation secondary to upper airway obstruction.
METHODS: Systematic review without language restrictions based on electronic databases and manual review of the literature up to December 2008. When appropriate, a random-effects meta-analysis and meta-regression (Moses' method) were performed.
Presented by Dr TAM Oi Yan Jackie at the Daily Journal Club of ICU, PYNEH, Hong Kong
Iribarren-Diarasarri, Sebastián - Aizpuru-Barandiaran, Felipe - Muñoz-Martínez, et al. Intensive Care Med (2009) 35:833–839
Objective To evaluate whether health-related quality of life prior to admission into an intensive care unit (ICU) is a prognostic factor of hospital and 1 year mortality. Design Prospective cohort study. Setting Fourteen-bed medical–surgical ICU.
Patients A total of 377 patients admitted to the ICU for more than 24 h with 1-year follow-up after discharge from the hospital. Intervention A health-related quality of life (HRQoL) survey was conducted, using the questionnaire developed by the “Project for the Epidemiological Analysis of Critical Care Patients”, to assess patient’s quality of life 1 month before ICU hospitalization.
Gomersall CD, Joynt GM, Ho OM, Ip M, Yap F, Derrick JL, Leung P.
Department of Anaesthesia and Intensive Care, The Chinese University of Hong
OBJECTIVE: To describe the extent and temporal pattern of transmission of severe
acute respiratory syndrome (SARS) to intensive care unit staff. DESIGN:
Retrospective observational cohort study. SETTING: University hospital intensive
care unit, caring solely for patients with SARS or suspected to have SARS.
PARTICIPANTS: Thirty-five doctors and 152 nurses and healthcare assistants who
worked in the ICU during the SARS epidemic. Interventions: Infection control
measures designed to prevent transmission of disease to staff were implemented.
MEASUREMENTS AND RESULTS: Sixty-seven patients with SARS were admitted to the
intensive care unit. Four nurses and one healthcare assistant contracted SARS,
with three of these developing symptoms within 10 days of admission of the first
patient with SARS. Doctors were exposed to patients with SARS for a median (IQR)
of 284 (97-376) h, while nurses and healthcare assistants were exposed for a
median (IQR) of 119 (57-166) h. The ICU did not meet international standards for
physical space or ventilation. CONCLUSIONS: In an ICU in which infection control
procedures are rigorously applied, the risk to staff of contracting SARS from
patients is low, despite long staff exposure times and a sub-standard physical
2006 Expanding ICU facilities in an epidemic: recommendations based on experience from the SARS epidemic in Hong Kong and Singapore
Gomersall CD, Tai DY, Loo S, Derrick JL, Goh MS, Buckley TA, Chua C, Ho KM,
Raghavan GP, Ho OM, Lee LB, Joynt GM.
Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong,
Epidemics have the potential to severely strain intensive care resources and may
require an increase in intensive care capability. Few intensivists have direct
experience of rapidly expanding intensive care services in response to an
epidemic. This contribution presents the recommendations of an expert group from
Hong Kong and Singapore who had direct experience of expanding intensive care
services in response to the epidemic of severe acute respiratory syndrome. These
recommendations cover training, infection control, staffing, communication and
ethical issues. The issue of what equipment to purchase is not addressed. Early
preparations should include fit testing of negative pressure respirators,
training of reserve staff, sourcing of material for physical modifications to the
ICU, development of infection control policies and training programmes, and
discussion of triage and quarantine issues.