Boulos S. Nassar, MD; Gregory A. Schmidt, MD, FCCP CHEST Feb 2016, 149(2): 576-585
Capnography has made steady inroads in the ICU and is increasingly used for all patients who are mechanically ventilated. There is growing recognition that capnography is rich in information about lung and circulatory physiology and provides insight into many diseases and treatments.
2016 Mar - Terlipressin versus noradrenaline in the treatment of hepatorenal syndrome: systematic review with meta-analysis and full economic evaluation
de Mattos ÂZ, de Mattos AA, Ribeiro RA.; Eur J Gastroenterol Hepatol. 2016 Mar;28(3):345-51.
Objective: The aim of this study was to compare the efficacy and costs of terlipressin and noradrenaline for the treatment of hepatorenal syndrome from the perspective of the Brazilian public health system and that of a major private health insurance.
Date: 23/2/2016; Time: 6-8pm; Venue: Seminar Room, G/F, Block A, QEH
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 1 - Using Technology to Create a More Humanistic Approach to Integrating Palliative Care into the Intensive Care Unit
Christopher E. Cox and J. Randall Curtis Am. J. Resp. Crit. Care Med. Feb 1, 2016, vol. 193, no. 3: 242-250
A decade ago, the major obstacles to integration of palliative care into the intensive care unit (ICU) were the limited number of providers trained in palliative care, an immature evidence base, and a lack of appreciation for the importance of palliative care in the ICU.
Course Fee: (included: handout, lunch on April 21, 2016 & light refreshment)
HK $2,100 (Full course: lecture and workshop) (HK$ 1,800 For Early Bird Registration)
HK $1,400 (Lecture only) (HK$ 1,200 For Early Bird Registration)
HKSCCM members may apply for the CCMF Subsidy to attend this course.
2015 Dec - Terlipressin given by continuous i.v. infusion versus i.v. boluses in the treatment of hepatorenal syndrome: A randomized controlled study
Cavallin M, Piano S, Romano A, Fasolato S, Chiara Frigo A, Benetti G, Gola E, Morando F, Stanco M, Rosi S, Sticca A, Cillo U, Angeli P.; Hepatology. 2015 Dec 13.
BACKGROUND: In patients with cirrhosis and hepatorenal syndrome (HRS), terlipressin has been used either as continuous i.v. infusion or as i.v. boluses. Up to now these two schedules have never been compared.
Salerno F, Navickis RJ, Wilkes MM.; BMC Gastroenterol. 2015 Nov 25;15(1):167.
BACKGROUND: Recommended treatment for type 1 hepatorenal syndrome consists of albumin and vasoconstrictor. The optimal albumin dose remains poorly characterized. This meta-analysis aimed to determine the impact of albumin dose on treatment outcomes.
2016 Feb - Pharmacist involvement in a multidisciplinary initiative to reduce sepsis-related mortality
Beardsley JR, Jones CM, Williamson J, Chou J, Currie-Coyoy M, Jackson T.; Am J Health Syst Pharm. 2016 Feb 1;73(3):143-9
PURPOSE: Pharmacy department contributions to a medical center's broad initiative to improve sepsis care outcomes are described.
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.
Airton de Oliveira Manoel, Alberto Goffi, Tom Marotta, Tom Schweizer, Simon Abrahamson, R. Macdonald Critical Care 2016, 20:21 (23 January 2016)
Aneurysmal subarachnoid haemorrhage is a neurological syndrome with complex systemic complications. The rupture of an intracranial aneurysm leads to the acute extravasation of arterial blood under high pressure into the subarachnoid space and often into the brain parenchyma and ventricles.
2016 Jan - Electrical impedance tomography (EIT) for quantification of pulmonary edema in acute lung injury
Constantin Trepte, Charles Phillips, Josep Solà, Andy Adler, Sebastian Haas, Michael Rapin, Stephan Böhm, Daniel Reuter Critical Care 2016, 20:18 (22 January 2016)
Background: Assessment of pulmonary edema is a key factor in monitoring and guidance of therapy in critically ill patients. To date, methods available at the bedside for estimating the physiologic correlate of pulmonary edema, extravascular lung water, often are unreliable or require invasive measurements. The aim of the present study was to develop a novel approach to reliably assess extravascular lung water by making use of the functional imaging capabilities of electrical impedance tomography.
2016 Jan 15 - Randomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-Life Care
J. Randall Curtis, Patsy D. Treece, Elizabeth L. Nielsen, Julia Gold, Paul S. Ciechanowski, Sarah E. Shannon, Nita Khandelwal, Jessica P. Young, and Ruth A. Engelberg Am. J. Resp. Crit. Care Med. Jan 15, 2016, vol. 193, no. 2: 154-162
Rationale: Communication with family of critically ill patients is often poor and associated with family distress.
2016 Jan 15 - Rising Billing for Intermediate Intensive Care among Hospitalized Medicare Beneficiaries between 1996 and 2010
Michael W. Sjoding, Thomas S. Valley, Hallie C. Prescott, Hannah Wunsch, Theodore J. Iwashyna, and Colin R. Cooke Am. J. Resp. Crit. Care Med. Jan 15, 2016, vol. 193, no. 2: 163-170
Rationale: Intermediate care (i.e., step-down or progressive care) is an alternative to the intensive care unit (ICU) for patients with moderate severity of illness. The adoption and current use of intermediate care is unknown.