Aronis KN, Hylek EM.; J Thromb Thrombolysis. 2016 Feb;41(2):253-72.
Non-vitamin K oral anticoagulants (NOACs) have been a major addition to our therapeutic armamentarium. They are at least as effective as warfarin in the thromboprophylaxis of non-valvular atrial fibrillation and management of thromboembolic disease, with a more favorable safety profile. Their predictable pharmacokinetics and pharmacodynamics allow for a fixed oral dosing without the need for anticoagulation monitoring. A major concern regarding NOACs is the lack of a readily available antidote to reverse their anticoagulation effect in case of life-threatening bleeding or need for emergent surgery.
2016 Apr - Efficacy of prothrombin complex concentrates for the emergency reversal of dabigatran-induced anticoagulation
Grottke O, Aisenberg J, Bernstein R, Goldstein P, Huisman MV, Jamieson DG, Levy JH, Pollack CV Jr, Spyropoulos AC, Steiner T, Del Zoppo GJ, Eikelboom J.; Crit Care. 2016 Apr 28;20(1):115.
Dabigatran is effective in decreasing the risk of ischaemic stroke in patients with atrial fibrillation. However, like all anticoagulants, it is associated with a risk of bleeding. In cases of trauma or emergency surgery, emergency reversal of dabigatran-induced anticoagulation may be required. A specific reversal agent for dabigatran, idarucizumab, has been approved by the US Food and Drug Administration. Alternative reversal agents are available, such as prothrombin complex concentrates (PCCs) and activated PCCs (aPCCs).
2016 Apr - Pulmonary and extrapulmonary complications of human rhinovirus infection in critically ill patients
To KK, Lau SK, Chan KH, Mok KY, Luk HK, Yip CC, Ma YK, Sinn LH, Lam SH, Ngai CW, Hung IF, Chan KH, Yuen KY.; J Clin Virol. 2016 Apr;77:85-91.
BACKGROUND: Human rhinovirus (HRV) is frequently detected in patients with respiratory tract infection. However, the full clinical spectrum of HRV infection in critically ill patients is not well characterized.
2016 Apr - Active surveillance of carbapenem-resistant Enterobacteriaceae in intensive care units: Is it cost-effective in a nonendemic region?
Ho KW, Ng WT, Ip M, You JH.; Am J Infect Control. 2016 Apr 1;44(4):394-9.
OBJECTIVE: Carbapenem-resistant Enterobacteriaceae (CRE) cause significant morbidity and mortality in intensive care unit (ICU) settings. We examined potential cost-effectiveness of active CRE surveillance at ICUs in a nonendemic region from the perspective of a Hong Kong health care provider.
Stout JE, Koh WJ, Yew WW.; Int J Infect Dis. 2016 Mar 11;45:123-134
Non-tuberculous mycobacteria (NTM) are emerging worldwide as significant causes of chronic pulmonary infection, posing a number of challenges for both clinicians and researchers. While a number of studies worldwide have described an increasing prevalence of NTM pulmonary disease over time, population-based data are relatively sparse and subject to ascertainment bias. Furthermore, the disease is geographically heterogeneous. While some species are commonly implicated worldwide (Mycobacterium avium complex, Mycobacterium abscessus), others (e.g., Mycobacterium malmoense, Mycobacterium xenopi) are regionally important.
Pollesello P, Parissis J, Kivikko M, Harjola VP.; Int J Cardiol. 2016 Apr 15;209:77-83.
BACKGROUND: Levosimendan is an inodilator developed for treatment of acute heart failure and other cardiac conditions where the use of an inodilator is considered appropriate. Levosimendan has been studied in different therapeutic settings including acutely decompensated chronic heart failure, advanced heart failure, right ventricular failure, cardiogenic shock, septic shock, and cardiac and non-cardiac surgery. This variety of data has been re-analysed in 25 meta-analyses from 15 different international research groups, based on different rationales to select the studies included.
Date: 22/3/2016; Time: 6:30-7:30pm; Venue: Lecture Theatre, G/F, M blk, QEH
Speaker: Dr CK Leung, Resident, ICU, AHNH
2016 Apr - Withholding and withdrawal of life-sustaining treatments in low-middle-income versus high-income Asian countries and regions
Phua J, Joynt GM, Nishimura M, Deng Y, Myatra SN, Chan YH, Binh NG, Tan CC, Faruq MO, Arabi YM, Wahjuprajitno B, Liu SF, Hashemian SM, Kashif W, Staworn D, Palo JE, Koh Y.; Intensive Care Med. 2016 Apr 12. [Epub ahead of print]
PURPOSE: To compare the attitudes of physicians towards withholding and withdrawing life-sustaining treatments in intensive care units (ICUs) in low-middle-income Asian countries and regions with those in high-income ones, and to explore differences in the role of families and surrogates, legal risks, and financial considerations between these countries and regions.
Chan CK, Lam HC, Chiu SW, Tse ML, Lau FL.; Hong Kong Med J. 2016 Apr;22(2):124-30.
INTRODUCTION: Mushroom poisoning is a cause of major mortality and morbidity all over the world. Although Hong Kong people consume a lot of mushrooms, there are only a few clinical studies and reviews of local mushroom poisoning. This study aimed to review the clinical characteristics, source, and outcome of mushroom poisoning incidences in Hong Kong.
2016 Mar - Septic acute kidney injury in critically ill patients - a single-center study on its incidence, clinical characteristics, and outcome predictors
Shum HP, Kong HH, Chan KC, Yan WW, Chan TM.; Ren Fail. 2016 Mar 16:1-11. [Epub ahead of print]
Purpose: The objective of this study is to examine the incidence, clinical characteristics, and outcome (90-day mortality) of critically ill Chinese patients with septic AKI.
2016 Apr - Plasma neutrophil gelatinase-associated lipocalin as an early predicting biomarker of acute kidney injury and clinical outcomes after recovery of spontaneous circulation in out-of-hospital cardiac arrest patients
Park SO, Ahn JY, Lee YH, Kim YJ, Min YH, Ahn HC, Sohn YD, Park SM, Oh YT, Shin DH.; Resuscitation. 2016 Apr;101:84-90.
AIMS: To determine whether the level of plasma neutrophil gelatinase-associated lipocalin (NGAL) can predict acute kidney injury (AKI) and clinical outcomes after recovery of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA).
2016 Apr - Prevention of contrast-induced nephropathy with single bolus erythropoietin in patients with diabetic kidney disease: A randomized controlled trial
Shema-Didi L, Kristal B, Eizenberg S, Marzuq N, Sussan M, Feldman-Idov Y, Ofir P, Atar S.; Nephrology (Carlton). 2016 Apr;21(4):295-300.
AIM: Contrast-induced-nephropathy (CIN) is associated with poor outcomes, thus prevention of CIN may be of clinical value. Erythropoietin (EPO) has been shown to elicit tissue-protective effects in experimental models and in clinical studies of acute kidney injury. We therefore evaluated its effectiveness for prevention of CIN after coronary angiography (CA) ± percutaneous coronary intervention (PCI) in diabetic patients with chronic kidney disease.
Date: 7-8 May 2016; Venue: Rm N101, 1/F (New Wing), HKCEC
2016 Apr - Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill
Mitrić G, Udy A, Bandeshe H, Clement P, Boots R.; Crit Care. 2016 Apr 2;20(1):90.
BACKGROUND: Atrial fibrillation is a common rhythm disturbance in the general medical-surgical intensive care unit. Amiodarone is a popular drug in this setting but evidence to inform clinical practice remains scarce. We aimed to identify whether variation in the clinical use of amiodarone was associated with recurrent atrial fibrillation.
2016 Apr - Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial
Donnino MW, Andersen LW, Berg KM, Chase M, Sherwin R, Smithline H, Carney E, Ngo L, Patel PV, Liu X, Cutlip D, Zimetbaum P, Cocchi MN; collaborating authors from the Beth Israel Deaconess Medical Center’s Center for Resuscitation Science Research Group.; Crit Care. 2016 Apr 3;20(1):82.
BACKGROUND: The purpose of this study was to determine whether the provision of corticosteroids improves time to shock reversal and outcomes in patients with post-cardiac arrest shock.
2016 Mar - Postoperative blood pressure deficit and acute kidney injury progression in vasopressor-dependent cardiovascular surgery patients
Saito S, Uchino S, Takinami M, Uezono S, Bellomo R.; Crit Care. 2016 Mar 24;20(1):74.
BACKGROUND: In vasopressor-dependent patients who had undergone cardiovascular surgery, we examined whether those with progression of acute kidney injury (AKI) had a greater difference (deficit) between premorbid and within-ICU hemodynamic pressure-related parameters compared to those without AKI progression.
Date: 28/6/016; Time: 19:00-22:00; Venue: Eaton Hong Kong
2016 Apr - The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition
Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, Filipescu D, Hunt BJ, Komadina R, Nardi G, Neugebauer EA, Ozier Y, Riddez L, Schultz A, Vincent JL, Spahn DR.; Crit Care. 2016 Apr 12;20(1):100.
BACKGROUND: Severe trauma continues to represent a global public health issue and mortality and morbidity in trauma patients remains substantial. A number of initiatives have aimed to provide guidance on the management of trauma patients. This document focuses on the management of major bleeding and coagulopathy following trauma and encourages adaptation of the guiding principles to each local situation and implementation within each institution.
Rodrigo C, Leonardi-Bee J, Nguyen-Van-Tam J, Lim WS.; Cochrane Database Syst Rev. 2016 Mar 7;3:CD010406.
BACKGROUND: Specific treatments for influenza are limited to neuraminidase inhibitors and adamantanes. Corticosteroids show evidence of benefit in sepsis and related conditions, most likely due to their anti-inflammatory and immunomodulatory properties. Although commonly prescribed for severe influenza, there is uncertainty over their potential benefit or harm.