Date: 2-3 Jul 2015, Venue: QEH
2015 Apr - Nighttime Intensivist Staffing, Mortality, and Limits on Life Support: A Retrospective Cohort Study
Meeta Prasad Kerlin, MD, MSCE; Michael O. Harhay, MPH; Jeremy M. Kahn, MD; Scott D. Halpern, MD, PhD CHEST Apr 2015; 147(4): 951-958
BACKGROUND: Evidence regarding nighttime physician staffing of ICUs is suboptimal. We aimed to determine how nighttime physician staffing models influence patient outcomes.
2015 Feb - Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial
Goldstein JN, Refaai MA, Milling TJ Jr, Lewis B, Goldberg-Alberts R, Hug BA, Sarode R.; Lancet. 2015 Feb 26. pii: S0140-6736(14)61685-8
BACKGROUND: Rapid reversal of vitamin K antagonist (VKA)-induced anticoagulation is often necessary for patients needing urgent surgical or invasive procedures. The optimum means of VKA reversal has not been established in comparative clinical trials. We compared the efficacy and safety of four-factor prothrombin complex concentrate (4F-PCC) with that of plasma in VKA-treated patients needing urgent surgical or invasive procedures.
2015 Mar - HMG CoA reductase inhibitors (statins) for preventing acute kidney injury after surgical procedures requiring cardiac bypass
Lewicki M, Ng I, Schneider AG.; Cochrane Database Syst Rev. 2015 Mar 11;3:CD010480.
BACKGROUND: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery among whom it is associated with poor outcomes, prolonged hospital stays and increased mortality. Statin drugs can produce more than one effect independent of their lipid lowering effect, and may improve kidney injury through inhibition of postoperative inflammatory responses.
2015 Apr - Prolonged Mild Therapeutic Hypothermia versus Fever Control with Tight Hemodynamic Monitoring and Slow Rewarming in Patients with Severe Traumatic Brain Injury: A Randomized Controlled Trial.
Maekawa T, Yamashita S, Nagao S, Hayashi N, Ohashi Y.; J Neurotrauma. 2015 Apr 1;32(7):422-9.
Although mild therapeutic hypothermia is an effective neuroprotective strategy for cardiac arrest/resuscitated patients, and asphyxic newborns, recent randomized controlled trials (RCTs) have equally shown good neurological outcome between targeted temperature management at 33°C versus 36°C, and have not shown consistent benefits in patients with traumatic brain injury (TBI)..
Poropat G, Giljaca V, Hauser G, Štimac D.; Cochrane Database Syst Rev. 2015 Mar 23;3:CD010605. [Epub ahead of print]
BACKGROUND: Acute pancreatitis is a common and potentially lethal disease with increasing incidence. Severe cases are characterised by high mortality, and despite improvements in intensive care management, no specific treatment relevantly improves clinical outcomes of the disease. Meta-analyses suggest that enteral nutrition is more effective than conventional treatment consisting of discontinuation of oral intake with use of total parenteral nutrition. However, no systematic review has compared different enteral nutrition formulations for the treatment of patients with acute pancreatitis.
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.
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.
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.
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.
2015 Apr - The Role of Neuromuscular Blockade in Patients with Traumatic Brain Injury: A Systematic Review
Sanfilippo F, Santonocito C, Veenith T, Astuto M, Maybauer MO.; Neurocrit Care. 2015 Apr;22(2):325-34.
Management offocuses on controlling intracranial pressure (ICP), while other treatments, such as the use of neuromuscular blocking agents (NMBAs), need scientific evidence. We conducted a systematic review to investigate the usefulness of NMBAs in the context of TBI and/or increased ICP...
2015 Apr - Rapid Unexpected Brain Herniation in Association with Renal Replacement Therapy in Acute Brain Injury: Caution in the Neurocritical Care Unit
Osgood M, Compton R, Carandang R, Hall W, Kershaw G, Muehlschlegel S.; Neurocrit Care. 2015 Apr;22(2):176-83.
Introduction: We aim to raise awareness for the potential for rapid brain edema and herniation in acutely brain-injured patients undergoing renal replacement therapy (RRT), including one case undergoing continuous veno-venous hemofiltration. Dialysis disequilibrium syndrome (DDS) may have been a possible cause for the brain edema.
2015 Feb - Sleeping on a problem: the impact of sleep disturbance on intensive care patients - a clinical review
Annals of Intensive Care 2015, 5:3 (26 February 2015)
Sleep disturbance is commonly encountered amongst intensive care patients and has significant psychophysiological effects, which protract recovery and increases mortality. Bio-physiological monitoring of intensive care patients reveal alterations in sleep architecture, with reduced sleep quality and continuity...
2015 Apr - Fluid overload at start of continuous renal replacement therapy is associated with poorer clinical condition and outcome: a prospective observational study on the combined use of bioimpedance vector analysis and serum N-terminal pro-B-type natr
Haiyan Chen, Buyun Wu, Dehua Gong, Zhihong Liu Critical Care 2015, 19:135 (2 April 2015)
Introduction: It is unclear whether the fluid status, as determined by bioimpedance vector analysis (BIVA) combined with serum N-terminal pro-B-type natriuretic peptides (NT-pro-BNP) measurement, is associated with treatment outcome among patients receiving continuous renal replacement therapy (CRRT). Our objective was to answer it.
2015 Apr - Significant modification of traditional rapid sequence induction improves safety and effectiveness of pre-hospital trauma anaesthesia
Richard M Lyon, Zane B Perkins, Debamoy Chatterjee, David J Lockey, Malcolm Q Russell, on behalf of Kent, Surrey & Sussex Air Ambulance Trust Critical Care 2015, 19:134 (1 April 2015)
Introduction: Rapid Sequence Induction of anaesthesia (RSI) is the recommended method to facilitate emergency tracheal intubation in trauma patients. In emergency situations, a simple and standardised RSI protocol may improve the safety and effectiveness of the procedure. A crucial component of developing a standardised protocol is the selection of induction agents. The aim of this study is to compare the safety and effectiveness of a traditional RSI protocol using etomidate and suxamethonium with a modified RSI protocol using fentanyl, ketamine and rocuronium.
2015 Mar - Effects of earplugs and eye masks combined with relaxing music on sleep, melatonin and cortisol levels in ICU patients: a randomized control trial
Rong-Fang Hu, Xiao-Ying Jiang, Kathleen M Hegadoren, You-Hua Zhang Critical Care 2015, 19:115 (27 March 2015)
Introduction: Intensive care unit (ICU) environmental factors such as noise and light have been cited as important causes of sleep deprivation in critically ill patients. Previous studies indicated that using earplugs and eye masks can improve REM sleep in healthy subjects in simulated ICU environment, and improve sleep quality in ICU patients. This study aimed to determine the effects of using earplugs and eye masks with relaxing background music on sleep, melatonin and cortisol levels in ICU patients.
2015 Mar - Colistin and tobramycin resistance during long- term use of selective decontamination strategies in the intensive care unit: a post hoc analysis
Bastiaan Wittekamp, Evelien Oostdijk, Anne de Smet, Marc Bonten Critical Care 2015, 19:113 (25 March 2015)
Introduction: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) have been shown to improve intensive care unit (ICU) patients’ outcomes. The aim of this study was to determine the effects of long-term use of SDD and SOD on colistin and tobramycin resistance among gram-negative bacteria.
2015 Mar - Timing for deep vein thrombosis chemoprophylaxis in traumatic brain injury: an evidence-based review
Hiba Abdel-Aziz, C Dunham, Rema J Malik, Barbara M Hileman Critical Care 2015, 19:96 (24 March 2015)
Multiple studies have addressed deep vein thrombosis chemoprophylaxis timing in traumatic brain injuries. However, a precise time for safe and effective chemoprophylaxis is uncertain according to experts. A comprehensive literature review on brain injuries was performed to delineate temporal proportions for 1) spontaneous intracranial hemorrhage (ICH) progression, 2) post-chemoprophylaxis ICH expansion, and 3) post-chemoprophylaxis deep vein thrombosis...
2015 Mar - Aspirin therapy in patients with acute respiratory distress syndrome (ARDS) is associated with reduced intensive care unit mortality: a prospective analysis
Andrew J Boyle, Stefania Di Gangi, Umar I Hamid, Linda-Jayne Mottram, Lia McNamee, Griania White, LJ Cross, James J McNamee, Cecilia M O’Kane, Daniel F McAuley Critical Care 2015, 19:109 (23 March 2015)
Introduction: Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce the risk of developing ARDS, but the effect of aspirin on established ARDS is unknown.