2016 Jun - A Binational Multicenter Pilot Feasibility Randomized Controlled Trial of Early Goal-Directed Mobilization in the ICU
Hodgson CL, Bailey M, Bellomo R, Berney S, Buhr H, Denehy L, Gabbe B, Harrold M, Higgins A, Iwashyna TJ, Papworth R, Parke R, Patman S, Presneill J, Saxena M, Skinner E, Tipping C, Young P, Webb S; Trial of Early Activity and Mobilization Study Investigators.; Crit Care Med. 2016 Jun;44(6):1145-52.
Objectives: To determine if the early goal-directed mobilization intervention could be delivered to patients receiving mechanical ventilation with increased maximal levels of activity compared with standard care.
2016 Jun - Withdrawal of Life-Sustaining Therapy in Patients With Intracranial Hemorrhage: Self-Fulfilling Prophecy or Accurate Prediction of Outcome?
Weimer JM, Nowacki AS, Frontera JA.; Crit Care Med. 2016 Jun;44(6):1161-72.
Objectives: Withdrawal of life-sustaining therapy may lead to premature limitations of life-saving treatments among patients with intracranial hemorrhage, representing a self-fulfilling prophecy. We aimed to determine whether our algorithm for the withdrawal of life-sustaining therapy decision would accurately identify patients with a high probability of poor outcome, despite aggressive treatment.
2016 Jun - Iron Parameters Determine the Prognosis of Critically Ill Patients
Tacke F, Nuraldeen R, Koch A, Strathmann K, Hutschenreuter G, Trautwein C, Strnad P.; Crit Care Med. 2016 Jun;44(6):1049-58.
Objective: Because iron is both an essential and toxic micronutrient influencing the development of microbial infections, we evaluated the usefulness of iron parameters as outcome predictors in ICU patients.
2016 Jun - A Pilot Randomized Trial Comparing Weaning From Mechanical Ventilation on Pressure Support Versus Proportional Assist Ventilation
Bosma KJ, Read BA, Bahrgard Nikoo MJ, Jones PM, Priestap FA, Lewis JF.; Crit Care Med. 2016 Jun;44(6):1098-108
Objectives: Despite protocols incorporating spontaneous breathing trials, 31% of ICU patients experience difficult or prolonged weaning from mechanical ventilation. Nonfatiguing modes such as pressure support ventilation are recommended. Proportional assist ventilation provides assistance in proportion to patient effort, which may optimize weaning. However, it is not known how proportional assist ventilation performs relative to pressure support ventilation over a prolonged period in the complex ICU setting. The purpose of this study was to compare the physiologic and clinical performance (failure rate), safety, and feasibility of protocols using daily spontaneous breathing trial plus pressure support ventilation versus proportional assist ventilation until ventilation discontinuation.
2016 Jun - Glucocorticoid Sensitivity Is Highly Variable in Critically Ill Patients With Septic Shock and Is Associated With Disease Severity
Cohen J, Pretorius CJ, Ungerer JP, Cardinal J, Blumenthal A, Presneill J, Gatica-Andrades M, Jarrett P, Lassig-Smith M, Stuart J, Dunlop R, Starr T, Venkatesh B.; Crit Care Med. 2016 Jun;44(6):1034-41
Objectives: To measure tissue glucocorticoid sensitivity in patients with septic shock and determine its relationship to standard measurements of adrenal function and of outcome.
2016 May - Evaluating Physical Outcomes in Acute Respiratory Distress Syndrome Survivors: Validity, Responsiveness, and Minimal Important Difference of 4-Meter Gait Speed Test
Chan KS, Aronson Friedman L, Dinglas VD, Hough CL, Morris PE, Mendez-Tellez PA, Jackson JC, Ely EW, Hopkins RO, Needham DM.; Crit Care Med. 2016 May;44(5):859-68.
Objective: To examine the reliability, validity, responsiveness, and minimal important difference of the 4-m gait speed test in acute respiratory distress syndrome survivors.
2016 May - Epidemiology of RBC Transfusions in Patients With Severe Acute Kidney Injury: Analysis From the Randomized Evaluation of Normal Versus Augmented Level Study
Bellomo R, Mårtensson J, Kaukonen KM, Lo S, Gallagher M, Cass A, Myburgh J, Finfer S; Randomized Evaluation of Normal Versus Augmented Level of Replacement Therapy Study Investigators.; Crit Care Med. 2016 May;44(5):892-900.
Objective: To assess the epidemiology and outcomes associated with RBC transfusion in patients with severe acute kidney injury requiring continuous renal replacement therapy.
2016 Mar - Adjuvant Corticosteroid Treatment in Adults With Influenza A (H7N9) Viral Pneumonia
Cao B, Gao H, Zhou B, Deng X, Hu C, Deng C, Lu H, Li Y, Gan J, Liu J, Li H, Zhang Y, Yang Y, Fang Q, Shen Y, Gu Q, Zhou X, Zhao W, Pu Z, Chen L, Sun B, Liu X, Hamilton CD, Li L.; Crit Care Med. 2016 Mar 1. [Epub ahead of print]
Objective: To determine the impact of adjuvant corticosteroids administered to patients hospitalized with influenza A (H7N9) viral pneumonia.
2016 Mar - Remote Ischemic Preconditioning and Protection of the Kidney—A Novel Therapeutic Option
Zarbock A, Kellum JA.; Crit Care Med. 2016 Mar;44(3):607-16.
Objective: Acute kidney injury is a common complication in critically ill patients and is associated with increased morbidity and mortality. Sepsis, major surgery, and nephrotoxic drugs are the most common causes of acute kidney injury. There is currently no effective strategy available to prevent or treat acute kidney injury. Therefore, novel treatment regimens are required to decrease acute kidney injury prevalence and to improve clinical outcomes. Remote ischemic preconditioning, triggered by brief episodes of ischemia and reperfusion applied in distant tissues or organs before the injury of the target organ, attempts to invoke adaptive responses that protect against acute kidney injury. We sought to evaluate the clinical evidence for remote ischemic preconditioning as a potential strategy to protect the kidney and to review the underlying mechanisms in light of recent studies.
2016 Mar - Long-Term Outcome Following Tracheostomy in Critical Care: A Systematic Review
Dempsey GA, Morton B, Hammell C, Williams LT, Tudur Smith C, Jones T.; Crit Care Med. 2016 Mar;44(3):617-28.
Objectives: The prevalence and impact of longer-term outcomes following percutaneous tracheostomy, particularly tracheal stenosis, are unclear. Previous meta-analyses addressing this problem have been confounded by the low prevalence of tracheal stenosis and a limited number of studies.
2016 Mar - Association Between Index Hospitalization and Hospital Readmission in Sepsis Survivors
Sun A, Netzer G, Small DS, Hanish A, Fuchs BD, Gaieski DF, Mikkelsen ME.; Crit Care Med. 2016 Mar;44(3):478-87.
Objectives: Hospital readmission is common after sepsis, yet the relationship between the index admission and readmission remains poorly understood. We sought to examine the relationship between infection during the index acute care hospitalization and readmission and to identify potentially modifiable factors during the index sepsis hospitalization associated with readmission.
2016 Mar - Comparison Between Neurally Adjusted Ventilatory Assist and Pressure Support Ventilation Levels in Terms of Respiratory Effort
Carteaux G, Córdoba-Izquierdo A, Lyazidi A, Heunks L, Thille AW, Brochard L.; Crit Care Med. 2016 Mar;44(3):503-11.
Objectives: To understand the potential equivalence between neurally adjusted ventilatory assist and pressure support ventilation levels in terms of respiratory muscle unloading. To compare the respiratory pattern, variability, synchronization, and neuromuscular coupling within comparable ranges of assistance.
2016 Mar - Preventing ICU Subsyndromal Delirium Conversion to Delirium With Low-Dose IV Haloperidol: A Double-Blind, Placebo-Controlled Pilot Study
Al-Qadheeb NS, Skrobik Y, Schumaker G, Pacheco MN, Roberts RJ, Ruthazer RR, Devlin JW.; Crit Care Med. 2016 Mar;44(3):583-91.
Objective: To compare the efficacy and safety of scheduled low-dose haloperidol versus placebo for the prevention of delirium (Intensive Care Delirium Screening Checklist ≥ 4) administered to critically ill adults with subsyndromal delirium (Intensive Care Delirium Screening Checklist = 1–3).
2016 Mar - Evaluation Following Staggered Implementation of the "Rethinking Critical Care" ICU Care Bundle in a Multicenter Community Setting
Liu V, Herbert D, Foss-Durant A, Marelich GP, Patel A, Whippy A, Turk BJ, Ragins AI, Kipnis P, Escobar GJ.; Crit Care Med. 2016 Mar;44(3):460-7.
Objectives: To evaluate process metrics and outcomes after implementation of the “Rethinking Critical Care” ICU care bundle in a community setting.
2016 Feb - Bradycardia During Targeted Temperature Management: An Early Marker of Lower Mortality and Favorable Neurologic Outcome in Comatose Out-of-Hospital Cardiac Arrest Patients
Thomsen JH, Nielsen N, Hassager C, Wanscher M, Pehrson S, Køber L, Bro-Jeppesen J, Søholm H, Winther-Jensen M, Pellis T, Kuiper M, Erlinge D, Friberg H, Kjaergaard J.; Crit Care Med. 2016 Feb;44(2):308-18.
Objectives: Bradycardia is common during targeted temperature management, likely being a physiologic response to lower body temperature, and has recently been associated with favorable outcome following out-of-hospital cardiac arrest in smaller observational studies. The present study sought to confirm this finding in a large multicenter cohort of patients treated with targeted temperature management at 33°C and explore the response to targeted temperature management targeting 36°C.
2016 Feb - Recruitment Maneuvers and Positive End-Expiratory Pressure Titration in Morbidly Obese ICU Patients
Pirrone M, Fisher D, Chipman D, Imber DA, Corona J, Mietto C, Kacmarek RM, Berra L.; Crit Care Med. 2016 Feb;44(2):300-7.
Objective: The approach to applying positive end-expiratory pressure in morbidly obese patients is not well defined. These patients frequently require prolonged mechanical ventilation, increasing the risk for failed liberation from ventilatory support. We hypothesized that lung recruitment maneuvers and titration of positive end-expiratory pressure were both necessary to improve lung volumes and the elastic properties of the lungs, leading to improved gas exchange.
2016 Feb - Interleukin-1 Receptor Blockade Is Associated With Reduced Mortality in Sepsis Patients With Features of Macrophage Activation Syndrome: Reanalysis of a Prior Phase III Trial
Shakoory B, Carcillo JA, Chatham WW, Amdur RL, Zhao H, Dinarello CA, Cron RQ, Opal SM.; Crit Care Med. 2016 Feb;44(2):275-81.
OBJECTIVE: To determine the efficacy of anakinra (recombinant interleukin-1 receptor antagonist) in improving 28-day survival in sepsis patients with features of macrophage activation syndrome. Despite equivocal results in sepsis trials, anakinra is effective in treating macrophage activation syndrome, a similar entity with fever, disseminated intravascular coagulation, hepatobiliary dysfunction, cytopenias, and hyperferritinemia. Hence, sepsis patients with macrophage activation syndrome features may benefit from interleukin-1 receptor blockade.
2016 Feb - Randomized, Double-Blind, Placebo-Controlled Trial of Thiamine as a Metabolic Resuscitator in Septic Shock: A Pilot Study
Donnino MW, Andersen LW, Chase M, Berg KM, Tidswell M, Giberson T, Wolfe R, Moskowitz A, Smithline H, Ngo L, Cocchi MN; Center for Resuscitation Science Research Group.; Crit Care Med. 2016 Feb;44(2):360-7.
Objective: To determine if intravenous thiamine would reduce lactate in patients with septic shock.
2015 Dec - Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit
Sakr Y, Alhussami I, Nanchal R, Wunderink RG, Pellis T, Wittebole X, Martin-Loeches I, François B, Leone M, Vincent JL; Intensive Care Over Nations Investigators.; Crit Care Med. 2015 Dec;43(12):2623-32.
Objective: To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection.
2015 Dec - Long-Term β-Blocker Therapy Decreases Blood Lactate Concentration in Severely Septic Patients
Contenti J, Occelli C, Corraze H, Lemoël F, Levraut J.; Crit Care Med. 2015 Dec;43(12):2616-22.
Objectives: Measurement of blood lactate concentration in the early management of sepsis is an important step in severity assessment. High blood lactate levels in the early phase of sepsis have classically been thought to be related to tissue hypoxia, but other factors could intervene. We hypothesized that the activation of glycolysis through β-adrenergic stimulation by endogenous catecholamines plays an important role in lactate production and that long-term β-blocker therapy could affect the lactate concentration in patients with severe sepsis and septic shock.