McClave SA, Martindale RG, Rice TW, Heyland DK.; Crit Care Med. 2014 Dec;42(12):2600-10
Objective: Critically ill patients are usually unable to maintain adequate volitional intake to meet their metabolic demands. As such, provision of nutrition is part of the medical care of these patients. This review provides detail and interpretation of current data on specialized nutrition therapy in critically ill patients, with focus on recently published studies.
2014 Dec- Transfusion Triggers for Guiding RBC Transfusion for Cardiovascular Surgery: A Systematic Review and Meta-Analysis
Curley GF, Shehata N, Mazer CD, Hare GM, Friedrich JO.; Crit Care Med. 2014 Dec;42(12):2611-24
Objective: Restrictive red cell transfusion is recommended to minimize risk associated with exposure to allogeneic blood. However, perioperative anemia is an independent risk factor for adverse outcomes after cardiovascular surgery. The purpose of this systematic review and meta-analysis is to determine whether perioperative restrictive transfusion thresholds are associated with inferior clinical outcomes in randomized trials of cardiovascular surgery patients.
Date: 16/12/2014, Time: 7-8pm, Venue: AG, QEH
Speaker: Dr HP Shum, AC, ICU, PYNEH
2014 Dec - Vancomycin-Associated Nephrotoxicity in the Critically Ill: A Retrospective Multivariate Regression Analysis
Hanrahan TP, Harlow G, Hutchinson J, Dulhunty JM, Lipman J, Whitehouse T, Roberts JA.; Crit Care Med. 2014 Dec;42(12):2527-36
Objectives: To evaluate the influence of vancomycin dose, serum trough concentration, and dosing strategy on the evolution of acute kidney injury in critically ill patients.
2014 Dec - Randomized Controlled Trial of Inhaled Nitric Oxide for the Treatment of Microcirculatory Dysfunction in Patients With Sepsis
Trzeciak S, Glaspey LJ, Dellinger RP, Durflinger P, Anderson K, Dezfulian C, Roberts BW, Chansky ME, Parrillo JE, Hollenberg SM.; Crit Care Med. 2014 Dec;42(12):2482-92.
Objectives: Sepsis treatment guidelines recommend macrocirculatory hemodynamic optimization; however, microcirculatory dysfunction is integral to sepsis pathogenesis. We aimed to test the hypothesis that following macrocirculatory optimization, inhaled nitric oxide would improve microcirculation in patients with sepsis and that improved microcirculation would improve lactate clearance and multiple organ dysfunction.
Nita Khandelwal, MD; Ruth A. Engelberg, PhD; David C. Benkeser, MPH; Norma B. Coe, PhD; J. Randall Curtis, MD, MPH CHEST Dec 2014; 146(6): 1594-1603
OBJECTIVE: Although end-of-life care in the ICU accounts for a large proportion of health-care costs, few studies have examined the association between costs and satisfaction with care. The objective of this study was to investigate the association of ICU costs with family- and nurse-assessed quality of dying and family satisfaction.
2014 Dec - Integrated Use of Bedside Lung Ultrasound and Echocardiography in Acute Respiratory Failure: A Prospective Observational Study in ICU
Benoit Bataille, MD; Beatrice Riu, MD; Fabrice Ferre, MD; Pierre Etienne Moussot, MD; Arnaud Mari, MD; Elodie Brunel, MD; Jean Ruiz, MD; Michel Mora, MD; Olivier Fourcade, MD, PhD; Michele Genestal, MD; Stein Silva, MD, PhD CHEST Dec 2014; 146(6): 1586-1593
BACKGROUND: It has been suggested that the complementary use of echocardiography could improve the diagnostic accuracy of lung ultrasonography (LUS) in patients with acute respiratory failure (ARF). Nevertheless, the additional diagnostic value of echocardiographic data when coupled with LUS is still debated in this setting. The aim of the current study was to compare the diagnostic accuracy of LUS and an integrative cardiopulmonary ultrasound approach (thoracic ultrasonography [TUS]) in patients with ARF.
2014 Dec - Diagnosis of Ventilator-Associated Pneumonia: A Pilot, Exploratory Analysis of a New Score Based on Procalcitonin and Chest Echography
Giovanni Zagli, MD, PhD; Morena Cozzolino, MD; Alessandro Terreni, BSc; Tiziana Biagioli, PhD; Anna Lucia Caldini, BSc; Adriano Peris, MD CHEST Dec 2014; 146(6): 1578-1585
BACKGROUND: To facilitate the clinical diagnosis of ventilator-associated pneumonia (VAP) in the ICU, the Clinical Pulmonary Infection Score (CPIS) has been proposed but has shown a low diagnostic performance in subsequent studies. We propose a new score based on procalcitonin level and chest echography with the aim of improving VAP diagnosis: the Chest Echography and Procalcitonin Pulmonary Infection Score (CEPPIS).
Date: 9-12 Jun 2015; Venue: Vicenza, Italy
2014 Dec - The Effect of Point-of-Care Ultrasonography on Imaging Studies in the Medical ICU: A Comparative Study
Margarita Oks, MD; Krystal L. Cleven, MD; Jose Cardenas-Garcia, MD; Jennifer Ann Schaub, MD; Seth Koenig, MD, FCCP; Rubin I. Cohen, MD, FCCP; Paul H. Mayo, MD, FCCP; Mangala Narasimhan, DO, FCCP CHEST Dec 2014; 146(6): 1574-1577
BACKGROUND: Point-of-care ultrasonography performed by frontline intensivists offers the possibility of reducing the use of traditional imaging in the medical ICU (MICU). We compared the use of traditional radiographic studies between two MICUs: one where point-of-care ultrasonography is used as a primary imaging modality, the other where it is used only for procedure guidance.
Deena Kelly Costa, PhD, RN; David J. Wallace, MD, MPH; Amber E. Barnato, MD, MPH; Jeremy M. Kahn, MD CHEST Dec 2014; 146(6): 1566-1573
BACKGROUND: ICUs are increasingly staffed with nurse practitioners/physician assistants (NPs/PAs), but it is unclear how NPs/PAs influence quality of care. We examined the association between NP/PA staffing and in-hospital mortality for patients in the ICU.
2014 Dec - Hospital-Level Variation in ICU Admission and Critical Care Procedures for Patients Hospitalized for Pulmonary Embolism
Andrew J. Admon, MD, MPH; Christopher W. Seymour, MD; Hayley B. Gershengorn, MD; Hannah Wunsch, MD; Colin R. Cooke, MD CHEST Dec 2014; 146(6): 1452-1461
BACKGROUND: Variation in the use of ICUs for low-risk conditions contributes to health system inefficiency. We sought to examine the relationship between ICU use for patients with pulmonary embolism (PE) and cost, mortality, readmission, and procedure use.
Shum HP, Yan WW, Chan TM.; Hong Kong Med J. 2014 Dec 5
Heparin, despite its significant side-effects, is the most commonly used anticoagulant for continuous renal replacement therapy in critical care setting. In recent years, citrate has gained much popularity by improving continuous renal replacement therapy circuit survival and decreasing blood transfusion requirements. However, its complex metabolic consequences warrant modification in the design of the citrate-based continuous renal replacement therapy protocol. With thorough understanding of the therapeutic mechanism of citrate, a simple and practicable protocol can be devised. Citrate-based continuous renal replacement therapy can be safely and widely used in the clinical setting with appropriate clinical staff training.
2014 Dec 1 - Patient-Centric Blood Pressure–targeted Cardiopulmonary Resuscitation Improves Survival from Cardiac Arrest
Robert M. Sutton, Stuart H. Friess, Maryam Y. Naim, Joshua W. Lampe, George Bratinov, Theodore R. Weiland III, Mia Garuccio, Vinay M. Nadkarni, Lance B. Becker, and Robert A. Berg Am. J. Resp. Crit. Care Med. Nov 15, 2014; vol. 190, no. 11: 1255-1262
Rationale: Although current resuscitation guidelines are rescuer focused, the opportunity exists to develop patient-centered resuscitation strategies that optimize the hemodynamic response of the individual in the hopes to improve survival.
2014 Dec 1 - Red Blood Cells Induce Necroptosis of Lung Endothelial Cells and Increase Susceptibility to Lung Inflammation
Danielle Y. Qing, David Conegliano, Michael G. S. Shashaty, Jeongyun Seo, John P. Reilly, G. Scott Worthen, Dongeun Huh, Nuala J. Meyer, and Nilam S. Mangalmurti Am. J. Resp. Crit. Care Med. Nov 15, 2014; vol. 190: no. 11: 1243-1254
Rationale: Red blood cell (RBC) transfusions are associated with increased risk of acute respiratory distress syndrome (ARDS) in the critically ill, yet the mechanisms for enhanced susceptibility to ARDS conferred by RBC transfusions remain unknown.
2014 Nov - The benefit of prothrombin complex concentrate in decreasing neurological deterioration in patients with warfarin-associated intracerebral haemorrhage
Fong WC, Lo WT, Ng YW, Cheung YF, Wong GC, Ho HF, Chan JH, Li PC.; Hong Kong Med J. 2014 Nov 7.
OBJECTIVE. To compare the outcomes of patients with warfarin-associated intracerebral haemorrhage given different treatments to reverse the effect of anticoagulation.
2014 Nov - Neurally adjusted non-invasive ventilation in patients with chronic obstructive pulmonary disease: does patient–ventilator synchrony matter?
Stefano Nava, Lara Pisani Critical Care 2014, 18:670 (28 November 2014)
Patient–ventilator interaction represents an important clinical challenge during non-invasive ventilation (NIV). Doorduin and colleagues’ study shows that non-invasive neurally adjusted ventilatory assist (NAVA) improves patient–ventilator interaction compared with pressure support ventilation in patients with chronic obstructive pulmonary disease. There is no doubt nowadays that NAVA is the most effective mode of improving the synchrony between patient and machine, but the key question for the clinicians is whether or not this will make a difference to the patient’s outcome...
2014 Nov - Pre-hospital identification of trauma patients with early acute coagulopathy and massive bleeding: results of a prospective non-interventional clinical trial evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS)
Martin L Tonglet, Jean Minon, Laurence Seidel, Jean Poplavsky, Michel Vergnion Critical Care 2014, 18:648 (26 November 2014)
Introduction: Identifying patients in need for Damage Control Resuscitation (DCR) early after trauma, is pivotal for adequate management of their critical condition. Several trauma-scoring systems have been developed to identify such patients but most of them are not simple enough to be used in the pre-hospital settings at the early post-traumatic phase. The Trauma Induced Coagulopathy Clinical Score (TICCS) is an easy-to-measure and strictly clinical trauma score developed to meet this medical need.
Date: 23 Jan 2015, Time: 18:00-19:30; Venue: Lecture theatre, G/F, Block P, UCH
2015 Aug - 12th Congress of the World Federation of Societies of Intensive and Critical Care Medicine
Date: 29 Aug - 1 Sep 2015; Venue: Convention and Exhibition Center (COEX), Seoul, Korea