2014 Mar 15 - Statin Use and Risk of Delirium in the Critically Ill

Valerie J. Page, Daniel Davis, Xiao B. Zhao, Samuel Norton, Annalisa Casarin, Thomas Brown, E. Wesley Ely, and Daniel F. McAuley  Am. J. Resp. Crit. Care Med. Mar 15, 2014, vol. 189, no. 6: 666-673

Rationale: Delirium is common in intensive care unit (ICU) patients and is a predictor of worse outcomes and neuroinflammation is a possible mechanism. The antiinflammatory actions of statins may reduce delirium.

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2014 Mar 15 - Rapidly Reversible, Sedation-related Delirium versus Persistent Delirium in the Intensive Care Unit

Shruti B. Patel, Jason T. Poston, Anne Pohlman, Jesse B. Hall, and John P. Kress  Am. J. Resp. Crit. Care Med. Mar 15, 2014, vol. 189, no. 6: 658-665

Rationale: Intensive care unit (ICU) delirium is associated with ventilator, ICU, and hospital days; discharge functional status; and mortality. Whether rapidly reversible, sedation-related delirium (delirium that abates shortly after sedative interruption) occurs with the same frequency and portends the same prognosis as persistent delirium (delirium that persists despite a short period of sedative interruption) is unknown.

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2014 Mar 1 - Hospital Case Volume and Outcomes among Patients Hospitalized with Severe Sepsis

Allan J. Walkey and Renda Soylemez Wiener  Am. J. Resp. Crit. Care Med. Mar 1, 2014, vol. 189, no. 5: 548-555

Rationale: Processes of care are potential determinants of outcomes in patients with severe sepsis. Whether hospitals with more experience caring for patients with severe sepsis also have improved outcomes is unclear.

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2014 Feb 15 - Estimates of the Need for Palliative Care Consultation across United States Intensive Care Units Using a Trigger-based Model

May S. Hua, Guohua Li, Craig D. Blinderman, and Hannah Wunsch  Am. J. Resp. Crit. Care Med. Feb 15, 2014, vol. 189, no. 4: 428-436

Abstract

Rationale: Use of triggers for palliative care consultation has been advocated in intensive care units (ICUs) to ensure appropriate specialist involvement for patients at high risk of unmet palliative care needs. The volume of patients meeting these triggers, and thus the potential workload for providers, is unknown.

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2014 Feb 1 - Simultaneous Targeting of IL-1 and IL-18 Is Required for Protection against Inflammatory and Septic Shock

Tom Vanden Berghe, Dieter Demon, Pieter Bogaert, Benjamin Vandendriessche, Alain Goethals, Bart Depuydt, Marnik Vuylsteke, Ria Roelandt, Elien Van Wonterghem, Jill Vandenbroecke, Sze Men Choi, Evelyn Meyer, Stefan Krautwald, Wim Declercq, Nozomi Takahashi, Anje Cauwels, and Peter Vandenabeele  Am. J. Resp. Crit. Care Med. Feb 1, 2014, vol. 189, no. 3: 282-291

Abstract

Rationale: Sepsis is one of the leading causes of death around the world. The failure of clinical trials to treat sepsis demonstrates that the molecular mechanisms are multiple and are still insufficiently understood.

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2014 Jan 15 - Lung Inhomogeneity in Patients with Acute Respiratory Distress Syndrome

Massimo Cressoni, Paolo Cadringher, Chiara Chiurazzi, Martina Amini, Elisabetta Gallazzi, Antonella Marino, Matteo Brioni, Eleonora Carlesso, Davide Chiumello, Michael Quintel, Guillermo Bugedo, and Luciano Gattinoni  Am. J. Resp. Crit. Care Med. Jan 15, 2014, vol. 189, no. 2: 149-158

Abstract

Rationale: Pressures and volumes needed to induce ventilator-induced lung injury in healthy lungs are far greater than those applied in diseased lungs. A possible explanation may be the presence of local inhomogeneities acting as pressure multipliers (stress raisers).

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2014 Jan 1 - Determinants of Procedural Pain Intensity in the Intensive Care Unit. The Europain® Study

Kathleen A. Puntillo, Adeline Max, Jean-Francois Timsit, Lucile Vignoud, Gerald Chanques, Gemma Robleda, Ferran Roche-Campo, Jordi Mancebo, Jigeeshu V. Divatia, Marcio Soares, Daniela C. Ionescu, Ioana M. Grintescu, Irena L. Vasiliu, Salvatore Maurizio Maggiore, Katerina Rusinova, Radoslaw Owczuk, Ingrid Egerod, Elizabeth D. E. Papathanassoglou, Maria Kyranou, Gavin M. Joynt, Gastón Burghi, Ross C. Freebairn, Kwok M. Ho, Anne Kaarlola, Rik T. Gerritsen, Jozef Kesecioglu, Miroslav M. S. Sulaj, Michelle Norrenberg, Dominique D. Benoit, Myriam S. G. Seha, Akram Hennein, Fernando J. Periera, Julie S. Benbenishty, Fekri Abroug, Andrew Aquilina, Júlia R. C. Monte, Youzhong An, and Elie Azoulay  Am. J. Resp. Crit. Care Med. Jan 1, 2014, vol. 189, no. 1: 39-47

Abstract

Rationale: Intensive care unit (ICU) patients undergo several diagnostic and therapeutic procedures every day. The prevalence, intensity, and risk factors of pain related to these procedures are not well known.

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2013 Dec 15 - Beneficial Hemodynamic Effects of Prone Positioning in Patients with Acute Respiratory Distress Syndrome

Mathieu Jozwiak, Jean-Louis Teboul, Nadia Anguel, Romain Persichini, Serena Silva, Denis Chemla, Christian Richard, and Xavier Monnet  Am. J. Resp. Crit. Care Med. 15 Dec, 2013, vol. 188, no. 12: 1428-1433

Rationale: The effects of prone positioning during acute respiratory distress syndrome on all the components of cardiac function have not been investigated under protective ventilation and maximal alveolar recruitment.

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2013 Dec 15 - Spontaneous Effort Causes Occult Pendelluft during Mechanical Ventilation

Takeshi Yoshida, Vinicius Torsani, Susimeire Gomes, Roberta R. De Santis, Marcelo A. Beraldo, Eduardo L. V. Costa, Mauro R. Tucci, Walter A. Zin, Brian P. Kavanagh, and Marcelo B. P. Amato  Am. J. Resp. Crit. Care Med. 15 Dec, 2013, vol. 188, no. 12: 1420-1427

Rationale: In normal lungs, local changes in pleural pressure (Ppl) are generalized over the whole pleural surface. However, in a patient with injured lungs, we observed (using electrical impedance tomography) a pendelluft phenomenon (movement of air within the lung from nondependent to dependent regions without change in tidal volume) that was caused by spontaneous breathing during mechanical ventilation.

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2013 Dec 1 - Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort

Andrew M. Naidech, Jennifer L. Beaumont, Neil F. Rosenberg, Matthew B. Maas, Adam R. Kosteva, Michael L. Ault, David Cella, and E. Wesley Ely  Am. J. Resp. Crit. Care Med. Dec 1, 2013, vol. 188, no. 11: 1331-1337

Rationale: The prognostic significance of delirium symptoms in intensive care unit (ICU) patients with focal neurologic injury is unclear.

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2013 Dec 1 - Prone Position in Acute Respiratory Distress Syndrome. Rationale, Indications, and Limits

Luciano Gattinoni, Paolo Taccone, Eleonora Carlesso, and John J. Marini  Am. J. Resp. Crit. Care Med. Dec 1, 2013, vol. 188, no. 11: 1286-1293.

In the prone position, computed tomography scan densities redistribute from dorsal to ventral as the dorsal region tends to reexpand while the ventral zone tends to collapse. Although gravitational influence is similar in both positions, dorsal recruitment usually prevails over ventral derecruitment, because of the need for the lung and its confining chest wall to conform to the same volume. The final result of proning is that the overall lung inflation is more homogeneous from dorsal to ventral than in the supine position, with more homogeneously distributed stress and strain. As the distribution of perfusion remains nearly constant in both postures, proning usually improves oxygenation. 

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2013 Nov 15 - Jugular versus Femoral Short-Term Catheterization and Risk of Infection in Intensive Care Unit Patients. Causal Analysis of Two Randomized Trials

Jean-François Timsit, Lila Bouadma, Olivier Mimoz, Jean-Jacques Parienti, Maïté Garrouste-Orgeas, Serge Alfandari, Gaétan Plantefeve, Régis Bronchard, Gilles Troche, Remy Gauzit, Marion Antona, Emmanuel Canet, Julien Bohe, Marie-Christine Herrault, Carole Schwebel, Stéphane Ruckly, Bertrand Souweine, and Jean-Christophe Lucet  Am. J. Resp. Crit. Care Med. Nov 15, 2013, vol. 188, no. 10: 1232-1239

Rationale: When subclavian access is not possible, controversy exists between the internal jugular and femoral sites for the choice of central-venous access in intensive care unit patients.

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2013 Nov 1 - β-Glucan Antigenemia Anticipates Diagnosis of Blood Culture–Negative Intraabdominal Candidiasis

Frederic Tissot, Frederic Lamoth, Philippe M. Hauser, Christina Orasch, Ursula Flückiger, Martin Siegemund, Stefan Zimmerli, Thierry Calandra, Jacques Bille, Philippe Eggimann, and Oscar Marchetti  Am. J. Resp. Crit. Care Med. Nov 1, 2013, vol. 188, no. 9: 1100-1109

Abstract

Rationale: Life-threatening intraabdominal candidiasis (IAC) occurs in 30 to 40% of high-risk surgical intensive care unit (ICU) patients. Although early IAC diagnosis is crucial, blood cultures are negative, and the role of Candida score/colonization indexes is not established.

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2013 Oct 15 - Endogenous α2-Antiplasmin Is Protective during Severe Gram-Negative Sepsis (Melioidosis)

Liesbeth M. Kager, Tassili A. Weehuizen, W. Joost Wiersinga, Joris J. T. H. Roelofs, Joost C. M. Meijers, Arjen M. Dondorp, Cornelis van ’t Veer, and Tom van der Poll  Am. J. Resp. Crit. Care Med. Oct 15, 2013, vol. 188(8): 967-975

Rationale: α2-Antiplasmin (A2AP) is a major inhibitor of fibrinolysis by virtue of its capacity to inhibit plasmin. Although the fibrinolytic system is strongly affected by infection, the functional role of A2AP in the host response to sepsis is unknown.

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2013 Oct 15 - Implementation of an Evidence-based Extubation Readiness Bundle in 499 Brain-injured Patients. A Before–After Evaluation of a Quality Improvement Project

Antoine Roquilly, Raphaël Cinotti, Samir Jaber, Mickael Vourc’h, Florence Pengam, Pierre Joachim Mahe, Karim Lakhal, Dominique Demeure Dit Latte, Nelly Rondeau, Olivier Loutrel, Jérôme Paulus, Bertrand Rozec, Yvonnick Blanloeil, Marie-Anne Vibet, Véronique Sebille, Fanny Feuillet, and Karim Asehnoune  Am. J. Resp. Crit. Care Med. Oct 15, 2013, vol. 188 (8): 958-966

Rationale: Mechanical ventilation is associated with morbidity in patients with brain injury.

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2013 Oct 1 - Mortality among Patients Admitted to Strained Intensive Care Units

Nicole B. Gabler, Sarah J. Ratcliffe, Jason Wagner, David A. Asch, Gordon D. Rubenfeld, Derek C. Angus, and Scott D. Halpern  Am. J. Resp. Crit. Care Med. Oct 1, 2013, vol. 188, no. 7: 800-806

Rationale: The aging population may strain intensive care unit (ICU) capacity and adversely affect patient outcomes. Existing fluctuations in demand for ICU care offer an opportunity to explore such relationships.

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2013 Sep 15 - Mechanical Ventilation Triggers Hippocampal Apoptosis by Vagal and Dopaminergic Pathways

Adrián González-López, Inés López-Alonso, Alina Aguirre, Laura Amado-Rodríguez, Estefanía Batalla-Solís, Aurora Astudillo, Cristina Tomás-Zapico, Antonio Fueyo, Claudia C. dos Santos, Konrad Talbot, and Guillermo M. Albaiceta  Am. J. Resp. Crit. Care Med. Sep 15, 2013, vol. 188, no. 6: 693-702

Abstract

Rationale: Critically ill patients frequently develop neuropsychological disturbances including acute delirium or memory impairment. The need for mechanical ventilation is a risk factor for these adverse events, but a mechanism that links lung stretch and brain injury has not been identified.

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2013 Sep 15 - Assessment of the Interplay between Blood and Skin Vascular Abnormalities in Adult Purpura Fulminans

Nicolas Lerolle, Agnes Carlotti, Keira Melican, Flore Aubey, Marc Pierrot, Jean-Luc Diehl, Vincent Caille, Guillaume Hékimian, Sophie Gandrille, Chantal Mandet, Patrick Bruneval, Guillaume Dumenil, and Delphine Borgel  Am. J. Resp. Crit. Care Med. Sep 15, 2013, vol. 188, no. 6: 684-692

Abstract

Rationale: Purpura fulminans in adults is a rare but devastating disease. Its pathophysiology is not well known.

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2013 Sep 1 - Innate Type 2 Immunity Is Associated with Eosinophilic Pleural Effusion in Primary Spontaneous Pneumothorax

Bo-In Kwon, Seokchan Hong, Kihyuk Shin, Eun-Hye Choi, Jung-Joo Hwang, and Seung-Hyo Lee  Am. J. Resp. Crit. Care Med. Sep 1, 2013, vol. 188, no. 5: 577-585

Rationale: Eosinophilic pleural effusion (EPE) is characterized by greater than 10% eosinophilia and is frequently associated with air and/or blood in the pleural cavity. Primary spontaneous pneumothorax (PSP), defined as the spontaneous presence of air in the pleural space, is one of the most common causes of EPE. Recent studies have shown that type 2 immune responses play important roles in eosinophilic airway inflammation resulting in pleural pathology.

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2013 Sep 1 - Physical and Cognitive Performance of Patients with Acute Lung Injury 1 Year after Initial Trophic versus Full Enteral Feeding. EDEN Trial Follow-up

Dale M. Needham, Victor D. Dinglas, Peter E. Morris, James C. Jackson, Catherine L. Hough, Pedro A. Mendez-Tellez, Amy W. Wozniak, Elizabeth Colantuoni, E. Wesley Ely, Todd W. Rice, and Ramona O. Hopkins  Am. J. Resp. Crit. Care Med. Sep 1, 2013, vol. 188, no. 5: 567-576

Rationale: We hypothesized that providing patients with acute lung injury two different protein/calorie nutritional strategies in the intensive care unit may affect longer-term physical and cognitive performance.

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