2016 May - Effect of Early vs Delayed Initiation of Renal Replacement Therapy on Mortality in Critically Ill Patients With Acute Kidney Injury: The ELAIN Randomized Clinical Trial
Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstädt H, Boanta A, Gerß J, Meersch M.; JAMA. 2016 May 24-31;315(20):2190-9.
IMPORTANCE: Optimal timing of initiation of renal replacement therapy (RRT) for severe acute kidney injury (AKI) but without life-threatening indications is still unknown.
OBJECTIVE: To determine whether early initiation of RRT in patients who are critically ill with AKI reduces 90-day all-cause mortality.
Date: 15 Jul 2016; Venue: Fe, MDSSC, QEH
2016 May - Role of Dexmedetomidine for Sedation in Neurocritical Care Patients: A Qualitative Systematic Review and Meta-analysis of Current Evidence
Tsaousi GG, Lamperti M, Bilotta F.; Clin Neuropharmacol. 2016 May-Jun;39(3):144-51.
INTRODUCTION: This systematic review appraises the clinical evidence on efficacy and safety of dexmedetomidine (DEX), as a sole sedative or as sedative adjunct in adult neurocritical care (NCC) patients.
Richards JR, Garber D, Laurin EG, Albertson TE, Derlet RW, Amsterdam EA, Olson KR, Ramoska EA, Lange RA.; Clin Toxicol (Phila). 2016 Jun;54(5):345-64
INTRODUCTION: Cocaine abuse is a major worldwide health problem. Patients with acute cocaine toxicity presenting to the emergency department may require urgent treatment for tachycardia, dysrhythmia, hypertension, and coronary vasospasm, leading to pathological sequelae such as acute coronary syndrome, stroke, and death.
Date: 24/5/2016; Time: 6:30-7:30pm; Venue: Lecture Theatre, G/F, M Block, QMH
Speaker: Dr Lawrence Lau (ICU, CMC)
Date: 28/6/016; Time: 19:00-22:00; Venue: Eaton Hong Kong
Oddo M, Crippa IA, Mehta S, Menon D, Payen JF, Taccone FS, Citerio G.; Crit Care. 2016 May 5;20(1):128.
Daily interruption of sedative therapy and limitation of deep sedation have been shown in several randomized trials to reduce the duration of mechanical ventilation and hospital length of stay, and to improve the outcome of critically ill patients. However, patients with severe acute brain injury (ABI; including subjects with coma after traumatic brain injury, ischaemic/haemorrhagic stroke, cardiac arrest, status epilepticus) were excluded from these studies.
Pesenti A, Musch G, Lichtenstein D, Mojoli F, Amato MB, Cinnella G, Gattinoni L, Quintel M.; Intensive Care Med. 2016 May;42(5):686-98.
PURPOSE: Imaging has become increasingly important across medical specialties for diagnostic, monitoring, and investigative purposes in acute respiratory distress syndrome (ARDS).
2016 May - The impact of “early” versus “late” initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis
Wierstra BT, Kadri S, Alomar S, Burbano X, Barrisford GW, Kao RL.; Crit Care. 2016 May 6;20(1):122.
BACKGROUND: The optimal timing of initiating renal replacement therapy (RRT) in critical illness complicated by acute kidney injury (AKI) is not clearly established. Trials completed on this topic have been marked by contradictory findings as well as quality and heterogeneity issues. Our goal was to perform a synthesis of the evidence regarding the impact of "early" versus "late" RRT in critically ill patients with AKI, focusing on the highest-quality research on this topic.
2016 Jun - Preoperative hydration with 0.9% normal saline to prevent acute kidney injury after major elective open abdominal surgery: A randomised controlled trial
Serrano AB, Candela-Toha AM, Zamora J, Vera J, Muriel A, Del Rey JM, Liaño F.; Eur J Anaesthesiol. 2016 Jun;33(6):436-43
BACKGROUND: Postoperative acute kidney injury (AKI) is the second leading cause of hospital-acquired AKI. Although many preventive strategies have been tested, none of them has been totally effective.
Dear CCM Trainer and Trainee
Landmark studies upto 2014 can be download here
Source: CCM Board
Christian A. Schaer, Jeremy W. Deuel, Daniela Schildknecht, Leila Mahmoudi, Ines Garcia-Rubio, Catherine Owczarek, Stefan Schauer, Reinhard Kissner, Uddyalok Banerjee, Andre F. Palmer, Donat R. Spahn, David C. Irwin, Florence Vallelian, Paul W. Buehler, and Dominik J. Schaer Am. J. Resp. Crit. Care Med. May 15, 2016, vol. 193, no. 10: 1111-1122
Rationale: Hemolysis occurs not only in conditions such as sickle cell disease and malaria but also during transfusion of stored blood, extracorporeal circulation, and sepsis. Cell-free Hb depletes nitric oxide (NO) in the vasculature, causing vasoconstriction and eventually cardiovascular complications. We hypothesize that Hb-binding proteins may preserve vascular NO signaling during hemolysis.
2016 May 15 - A Randomized Trial of an Intensive Physical Therapy Program for Patients with Acute Respiratory Failure
Marc Moss, Amy Nordon-Craft, Dan Malone, David Van Pelt, Stephen K. Frankel, Mary Laird Warner, Wendy Kriekels, Monica McNulty, Diane L. Fairclough, and Margaret Schenkman Am. J. Resp. Crit. Care Med. May 15, 2016, vol. 193, no. 10: 1101-1110
Rationale: Early physical therapy (PT) interventions may benefit patients with acute respiratory failure by preventing or attenuating neuromuscular weakness. However, the optimal dosage of these interventions is currently unknown.
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.
Stéphane Gaudry, David Hajage, Fréderique Schortgen et al for the AKIKI Study Group. NEJM May 15, 2016
BACKGROUND: The timing of renal-replacement therapy in critically ill patients who have acute kidney injury but no potentially life-threatening complication directly related to renal failure is a subject of debate.
Vijay Krishnamoorthy, MD, MPH; G. Burkhard Mackensen, MD, PhD; Edward F. Gibbons, MD; Monica S. Vavilala, MD CHEST May 2016; 149(5): 1325-133
Recent literature has implicated severe neurologic injuries, such as aneurysmal subarachnoid hemorrhage, as a cause of cardiac dysfunction, impaired hemodynamic function, and poor outcomes.
2016 May - The Presence of Diffuse Alveolar Damage on Open Lung Biopsy Is Associated With Mortality in Patients With Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Pablo Cardinal-Fernández, MD, PhD; Ednan K. Bajwa, MD; Andrea Dominguez-Calvo, MD; Justo M. Menéndez, MD, PhD; Laurent Papazian, MD; B. Taylor Thompson, MD CHEST May 2016; 149(5): 1155-1164
Objective: Diffuse alveolar damage (DAD) is considered the histologic hallmark of ARDS although DAD is absent in approximately half of patients with ARDS. The clinical implications of having the syndrome of ARDS with DAD vs other histologic patterns is unknown. To address this question, we conducted a meta-analysis of lung biopsy series for patients with ARDS.