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.
2015 Feb - Automated versus non-automated weaning for reducing the duration of mechanical ventilation for critically ill adults and children: a cochrane systematic review and meta-analysis
Louise Rose, Marcus J Schultz, Chris R Cardwell, Philippe Jouvet, Danny F McAuley, Bronagh Blackwood Critical Care 2015, 19:48 (24 February 2015)
Introduction: Automated weaning systems may improve adaptation of mechanical support for a patient’s ventilatory needs and facilitate systematic and early recognition of their ability to breathe spontaneously and the potential for discontinuation of ventilation. Our objective was to compare mechanical ventilator weaning duration for critically ill adults and children when managed with automated systems versus non-automated strategies. Secondary objectives were to determine differences in duration of ventilation, intensive care unit (ICU) and hospital length of stay (LOS), mortality, and adverse events.
Yi Zhang, Wenjie Sun, Erik R Svendsen, Song Tang, Raina C MacIntyre, Peng Yang, Daitao Zhang, Quanyi Wang Critical Care 2015, 19:46 (20 February 2015)
Introduction: Corticosteroids are used empirically in influenza A (H1N1) treatment despite lack of clear evidence for effective treatment. This study aims to assess the efficacy of corticosteroids treatment for H1N1 infection.
2015 Feb - Effect of corticosteroids on treatment failure among hospitalized patients with severe community-acquired pneumonia and high inflammatory response: a randomized clinical trial
Torres A, Sibila O, Ferrer M, Polverino E, Menendez R, Mensa J, Gabarrús A, Sellarés J, Restrepo MI, Anzueto A, Niederman MS, Agustí C.; JAMA. 2015 Feb 17;313(7):677-86.
IMPORTANCE: In patients with severe community-acquired pneumonia, treatment failure is associated with excessive inflammatory response and worse outcomes. Corticosteroids may modulate cytokine release in these patients, but the benefit of this adjunctive therapy remains controversial.
OBJECTIVE: To assess the effect of corticosteroids in patients with severe community-acquired pneumonia and high associated inflammatory response.
2015 Feb - Metoclopramide or domperidone improves post-pyloric placement of spiral nasojejunal tubes in critically ill patients: a prospective, multicenter, open-label, randomized, controlled clinical trial
Bei Hu, Heng Ye, Cheng Sun, Yichen Zhang, Zhigang Lao, Fanghong Wu, Zhaohui Liu, Linxi Huang, Changchun Qu, Lewu Xian, Hao Wu, Yingjie Jiao, Junling Liu, Juyu Cai, Weiying Chen, Zhiqiang Nie, Zaiyi Liu, Chunbo Chen Critical Care 2015, 19:61 (13 February 2015)
Introduction: The use of prokinetic agents on post-pyloric placement of spiral nasojejunal tubes is controversial. The aim of the present study was to examine if metoclopramide or domperidone can increase the success rate of post-pyloric placement of spiral nasojejunal tubes.
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.
2015 Jan - Terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of hepatorenal syndrome: A randomized trial
Cavallin M, Kamath PS, Merli M, Fasolato S, Toniutto P, Salerno F, Bernardi M, Romanelli RG, Colletta C, Salinas F, Di Giacomo A, Ridola L, Fornasiere E, Caraceni P, Morando F, Piano S, Gatta A, Angeli P; for the Italian Association for the Study of Liver (AISF) study group on HRS.; Hepatology. 2015 Jan 16.
Background: Hepatorenal syndrome (HRS), a serious complication of cirrhosis, is associated with high mortality without treatment. Terlipressin with albumin is effective in the reversal of HRS. Where terlipressin is not available as in the United States, midodrine and octreotide with albumin is used as an alternative treatment of HRS. The aim was to compare the effectiveness of terlipressin plus albumin versus midodrine and octreotide plus albumin in the treatment of HRS in a randomized controlled trial.
2015 Feb 15 - Critical Care Bed Growth in the United States. A Comparison of Regional and National Trends
David J. Wallace, Derek C. Angus, Christopher W. Seymour, Amber E. Barnato, and Jeremy M. Kahn Am. J. Resp. Crit. Care Med. Feb 15, 2015, vol. 191, no. 4: 410-416
Rationale: Although the number of intensive care unit (ICU) beds in the United States is increasing, it is unknown whether this trend is consistent across all regions.
2015 Feb - Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial
Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, del Junco DJ, Brasel KJ, Bulger EM, Callcut RA, Cohen MJ, Cotton BA, Fabian TC, Inaba K, Kerby JD, Muskat P, O'Keeffe T, Rizoli S, Robinson BR, Scalea TM, Schreiber MA, Stein DM, Weinberg JA, Callum JL, Hess JR, Matijevic N, Miller CN, Pittet JF, Hoyt DB, Pearson GD, Leroux B, van Belle G; PROPPR Study Group.; JAMA. 2015 Feb 3;313(5):471-82.
IMPORTANCE: Severely injured patients experiencing hemorrhagic shock often require massive transfusion. Earlier transfusion with higher blood product ratios (plasma, platelets, and red blood cells), defined as damage control resuscitation, has been associated with improved outcomes; however, there have been no large multicenter clinical trials.
OBJECTIVE: To determine the effectiveness and safety of transfusing patients with severe trauma and major bleeding using plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio.
Date: Apr - Dec 2015, Veneu: Lecture & Case presentation sessions at F1 Conference Room, Block F (or Room 2A, Block K), United Christian Hospital
On behalf of the Hospital Authority Hong Kong Poison Information Centre (HKPIC) and the Hong Kong College of Emergency Medicine (HKCEM), it is my great pleasure to invite you to attend the 2015 Certificate Program in Clinical Toxicology.
The program is a nine months training program include systemic lecture, case discussion, training activities of the HKPIC & HKCEM accredited toxicology training units, and a MCQ assessment. It was organized successfully for more than 10 years and nearly 200 doctors and other health care professionals had completed the program. The intended participants this year are doctors who take care of acute poisoned patients.
Please refer to the attached PDF for further information. For those who are interested, please complete the attached registration form and return to us on or before 20th March 2015
For queries, please contact Ms Bejyork Wong at 39495094
Thank you very much for your attention
Dr Yiu-cheung CHAN
On behalf of Dr Fei-lung LAU
Chairman, Toxicology Subcommittee, HKCEM
2015 Jan - Pharmacologic agents for the prevention and treatment of delirium in patients undergoing cardiac surgery: systematic review and metaanalysis
Mu JL, Lee A, Joynt GM.; Crit Care Med. 2015 Jan;43(1):194-204.
OBJECTIVES: Postcardiac surgery delirium is associated with increased risks of morbidity, cognitive decline, poor health-related quality of life and mortality, and higher healthcare costs. We performed a systematic review of randomized controlled trials to examine the effect of pharmacologic agents for the prevention and the treatment of delirium after cardiac surgery.
2015 Feb - Blood conservation in extracorporeal membrane oxygenation for acute respiratory distress syndrome
Agerstrand CL, Burkart KM, Abrams DC, Bacchetta MD, Brodie D.; Ann Thorac Surg. 2015 Feb;99(2):590-5.
BACKGROUND: Extracorporeal membrane oxygenation support (ECMO) typically requires multiple blood transfusions and is associated with frequent bleeding complications. Blood transfusions are known to increase morbidity and mortality in critically ill patients, which may extend to patients receiving ECMO. Aiming to reduce transfusion requirements, we implemented a blood conservation protocol in adults with severe acute respiratory distress syndrome (ARDS) receiving ECMO.
Tramm R, Ilic D, Davies AR, Pellegrino VA, Romero L, Hodgson C.; Cochrane Database Syst Rev. 2015 Jan 22;1:CD010381
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is a form of life support that targets the heart and lungs. Extracorporeal membrane oxygenation for severe respiratory failure accesses and returns blood from the venous system and provides non-pulmonary gas exchange. Extracorporeal membrane oxygenation for severe cardiac failure or for refractory cardiac arrest (extracorporeal cardiopulmonary resuscitation (ECPR)) provides gas exchange and systemic circulation. The configuration of ECMO is variable, and several pump-driven and pump-free systems are in use. Use of ECMO is associated with several risks. Patient-related adverse events include haemorrhage or extremity ischaemia; circuit-related adverse effects may include pump failure, oxygenator failure and thrombus formation. Use of ECMO in newborns and infants is well established, yet its clinical effectiveness in adults remains uncertain.
OBJECTIVES: The primary objective of this systematic review was to determine whether use of veno-venous (VV) or venous-arterial (VA) ECMO in adults is more effective in improving survival compared with conventional respiratory and cardiac support.
2015 Jan - Gastric tonometry guided therapy in critical care patients: a systematic review and meta-analysis
Zhang X, Xuan W, Yin P, Wang L, Wu X, Wu Q.; Crit Care. 2015 Jan 27;19(1):22. [Epub ahead of print]
Introduction: The value of gastric intramucosal pH (pHi) can be calculated from the tonometrically measured partial pressure of carbon dioxide ( PCO2 ) in the stomach and the arterial bicarbonate content. Low pHi and increase of the difference between gastric mucosal and arterial PCO2 ( PCO2 gap) reflect splanchnic hypoperfusion and are good indicators of poor prognosis. Some randomized controlled trials (RCTs) were performed based on the theory that normalizing the low pHi or PCO2 gap could improve the outcomes of critical care patients. However, the conclusions of these RCTs were divergent. Therefore, we performed a systematic review and meta-analysis to assess the effects of this goal directed therapy on patient outcome in Intensive Care Units (ICUs).
Date: 17/2/2015; Time: 6-8pm, Venue: Seminar Rm, G/F, Block A, QEH
Speaker: Dr YS Poon, SMO, ICU, UCH
Conference: The 35th International Symposium on Intensive Care and Emergency Medicine (ISICEM 2015), Brussels, Belgium Date of event: 17th to 20th March 2015
Quota of sponsorship: Two
Deadline to submit application: 27th February, 2015
Dear HKSCCM members
I am delighted to announce that there is sponsorship to be granted to TWO HKSCCM members to attend the above symposium. Interested members are advised to follow the procedure of application in the Membership & Sponsorship section in the HKSCCM website.
Please be reminded that the deadline of application is 27th February 2015, and no late application will be entertained. If there are more than two applications, selection of successful candidates will be carried out by a committee based on the pre-defined scoring system. One has to submit a cheque of HK$500 to HKSCCM as handling fee at the same time of submitting application via the Secretary in order to ensure eligibility of application.
Dr CW Lau
2015 Jan - Milrinone for the Treatment of Acute Heart Failure After Acute Myocardial Infarction: A Systematic Review and Meta-analysis
Tang X, Liu P, Li R, Jing Q, Lv J, Liu L, Liu Y. ;Basic Clin Pharmacol Toxicol. 2015 Jan 27. doi: 10.1111/bcpt.12385. [Epub ahead of print]
Despite advancements in modern medicine, the treatment of acute heart failure (AHF) after acute myocardial infarction (AMI) remains challenging. Milrinone is effective in the treatment of chronic congestive heart failure, but its safety and efficacy in patients with AHF after AMI have not been systematically evaluated. This meta-analysis was performed to assess the safety and efficacy of milrinone in patients with AHF after AMI.
Dear HKSCCM Members,
Re: Critical Care Respiratory Medicine Handbook
In the Hong Kong Society of Critical Care Medicine (HKSCCM) Council Meeting on 20th January 2015, publication of a Critical Care Respiratory Medicine Handbook is to be planned under the auspices of the HKSCCM.
Dr Grace Lam (AC, ICU, PYNEH) and I would like to make this proposal to publish a book because we feel that there is a true demand of such knowledge in a concise way, especially of contents related to the local scene. Resident doctors, nurses, specialist trainees and young specialists need some handy reference for their daily work, and for more experienced doctors, they also need updated and practical reference to facilitate teaching.
We plan that this handbook might include the following content:
1. Respiratory Equipment
3. Respiratory Care procedures
4. Respiratory imaging
5. Respiratory physiology, equations and blood gas interpretation as related to critical care
6. Microbiology and infection control
7. Common scenarios (case-based approach)
8. ICU-related administrative issues and ethics
9. References of landmark papers on critical care respiratory medicine
In view of the breadth of the areas to be covered, the eventual publication of this book would require the joint effort and expertise of many people, including you. If you are interested in joining us to contribute to this book, please kindly let us know before 28th February, 2015.