Goren O, Matot I.; Curr Opin Crit Care. 2016 Aug;22(4):370-8.
Purpose of review: In this review, we discuss the latest updates on perioperative acute kidney injury (AKI) and the specific considerations that are relevant to different surgeries and patient populations.
Wischmeyer PE, McDonald D, Knight R.; Curr Opin Crit Care. 2016 Aug;22(4):347-53.
Purpose of review: Loss of ‘health-promoting’ microbes and overgrowth of pathogenic bacteria (dysbiosis) in ICU is believed to contribute to nosocomial infections, sepsis, and organ failure (multiple organ dysfunction syndrome). This review discusses new understanding of ICU dysbiosis, new data for probiotics and fecal transplantation in ICU, and new data characterizing the ICU microbiome.
Manzanares W, Langlois PL, Hardy G.; Curr Opin Crit Care. 2016 Aug;22(4):308-15.
Purpose of review: Purpose of the review is to summarize recent research addressing the role of intravenous lipid emulsions (IVLEs) in the critically ill.
2016 Aug - Protein Requirements in the Critically Ill: A Randomized Controlled Trial Using Parenteral Nutrition
Ferrie S, Allman-Farinelli M, Daley M, Smith K.; JPEN J Parenter Enteral Nutr. 2016 Aug;40(6):795-805.
BACKGROUND: Current recommendations for higher protein/amino acid provision in the critically ill are based on weak evidence. This double-blinded randomized controlled trial aimed to compare standard amino acid intake with the higher level recommended as the minimum for critically ill patients.
Weijs PJ.; Curr Opin Crit Care. 2016 Aug;22(4):299-302.
Purpose of review: Protein delivery in the critically ill still is a highly debated issue. Here, we discuss only the most recent updates in the literature concerning protein nutrition of the critically ill.
Simpson F, Doig GS.; Curr Opin Crit Care. 2016 Aug;22(4):303-7.
Purpose of review: The purpose of this review is to highlight emerging techniques used to determine body composition early in ICU stay, their prediction of poor outcome, and what is required before they can be more widely used.
Faeq Husain-Syed, Arthur S. Slutsky, and Claudio Ronco Am. J. Resp. Crit. Care Med. Aug 15, 2016, vol. 194, no. 4: 402-414
Discoveries have emerged highlighting the complex nature of the interorgan cross-talk between the kidney and the lung. Vascular rigidity, neurohormonal activation, tissue hypoxia, and abnormal immune cell signaling have been identified as common pathways leading to the development and progression of chronic kidney disease. However, our understanding of the causal relationships between lung injury and kidney injury is not precise.
2015 Aug 15 - Necroptosis: A Novel Cell Death Modality and Its Potential Relevance for Critical Care Medicine
Gabriel Moreno-Gonzalez, Peter Vandenabeele, and Dmitri V. Krysko Am. J. Resp. Crit. Care Med. Aug 15, 2016, vol. 4, no. 4: 415-428
Cell death is intertwined with life in development, homeostasis, pathology, and aging. Until recently, apoptosis was the best known form of programmed cell death, whereas necrosis was for a long time considered accidental owing to physicochemical injury.
2016 Aug 15 - Urinary Glycosaminoglycans Predict Outcomes in Septic Shock and Acute Respiratory Distress Syndrome
Eric P. Schmidt, Katherine H. Overdier, Xiaojun Sun, Lei Lin, Xinyue Liu, Yimu Yang, Lee Anne Ammons, Terra D. Hiller, Matt A. Suflita, Yanlei Yu, Yin Chen, Fuming Zhang, Clay Cothren Burlew, Charles L. Edelstein, Ivor S. Douglas, and Robert J. Linhardt Am. J. Resp. Crit. Care Med. Aug 15, 2016, vol. 194, no. 4: 439-449
Rationale: Degradation of the endothelial glycocalyx, a glycosaminoglycan (GAG)-rich layer lining the vascular lumen, is associated with the onset of kidney injury in animal models of critical illness. It is unclear if similar pathogenic degradation occurs in critically ill patients.
Oshima T, Singer P, Pichard C.; Curr Opin Crit Care. 2016 Aug;22(4):292-8.
Purpose of review: The review focuses on the use of parenteral nutrition and enteral nutrition in critically ill patients to optimize the nutrition care throughout the ICU stay. The key message is: you have the choice!
2016 Aug - Are we creating survivors…or victims in critical care? Delivering targeted nutrition to improve outcomes
Wischmeyer PE.; Curr Opin Crit Care. 2016 Aug;22(4):279-84.
Over the last 10 years, we are proud of the fact we have finally begun to reduce in-hospital mortality following severe sepsis in some countries worldwide. Further, mortality from acute lung injury has fallen dramatically, as the control group mortality in a recent large Acute Respiratory Distress Syndrome Research Network (ARDSnet) trial was strikingly only 16%. But the fundamental question that must be asked is ‘are we winning many battles in our ICUs, but ultimately losing the war?’ ..
2016 Sep 26 - Evaluation and Management of the Seriously Ill Poisoned Patients - Joint Conference of Poison Control Centres
Date: 26/9/2016; Venue: Auditorium, Level 1, Main Clinical Block and Trauma Center, PWH
2016 Aug - When to start renal replacement therapy in critically ill patients with acute kidney injury: comment on AKIKI and ELAIN
Bagshaw SM, Lamontagne F, Joannidis M, Wald R.; Crit Care. 2016 Aug 6;20(1):245.
The dilemma of whether and when to start renal replacement therapy among critically ill patients with acute kidney injury in the absence of conventional indications has long been a vexing challenge for clinicians. The lack of high-quality evidence has undoubtedly contributed decisional uncertainty and unnecessary practice variation. Recently, two randomized trials (ELAIN and AKIKI) reported specifically on the issue of the timing of initiation of renal replacement therapy in critically ill patients with acute kidney injury. In this commentary, their fundamental differences in trial design, sample size, and widely discrepant findings are considered in context. While both trials are important contributions towards informing practice on this issue, additional evidence from large multicenter randomized trials is needed.
2016 Aug - Application of a simplified definition of diastolic function in severe sepsis and septic shock
Lanspa MJ, Gutsche AR, Wilson EL, Olsen TD, Hirshberg EL, Knox DB, Brown SM, Grissom CK.; Crit Care. 2016 Aug 4;20(1):243.
BACKGROUND: Left ventricular diastolic dysfunction is common in patients with severe sepsis or septic shock, but the best approach to categorization is unknown. We assessed the association of common measures of diastolic function with clinical outcomes and tested the utility of a simplified definition of diastolic dysfunction against the American Society of Echocardiography (ASE) 2009 definition.
Lameire N, Vanholder R, Van Biesen W, Benoit D.; Crit Care. 2016 Aug 2;20(1):209.
Patients with cancer represent a growing group among actual ICU admissions (up to 20 %). Due to their increased susceptibility to infectious and noninfectious complications related to the underlying cancer itself or its treatment, these patients frequently develop acute kidney injury (AKI). A wide variety of definitions for AKI are still used in the cancer literature, despite existing guidelines on definitions and staging of AKI. Alternative diagnostic investigations such as Cystatin C and urinary biomarkers are discussed briefly. This review summarizes the literature between 2010 and 2015 on epidemiology and prognosis of AKI in this population.
2016 Jul -Respiratory weakness after mechanical ventilation is associated with one-year mortality - a prospective study
Medrinal C, Prieur G, Frenoy É, Robledo Quesada A, Poncet A, Bonnevie T, Gravier FE, Lamia B, Contal O.; Crit Care. 2016 Jul 31;20(1):231
BACKGROUND: Diaphragm dysfunction in mechanically ventilated patients is associated with poor outcome. Maximal inspiratory pressure (MIP) can be used to evaluate inspiratory muscle function. However, it is unclear whether respiratory weakness is independently associated with long-term mortality. The aim of this study was to determine if low MIP is independently associated with one-year mortality.
2016 Aug - Guidewire exchange vs new site placement for temporary dialysis catheter insertion in ICU patients: is there a greater risk of colonization or dysfunction?
Coupez E, Timsit JF, Ruckly S, Schwebel C, Gruson D, Canet E, Klouche K, Argaud L, Bohe J, Garrouste-Orgeas M, Mariat C, Vincent F, Cayot S, Cointault O, Lepape A, Darmon M, Boyer A, Azoulay E, Bouadma L, Lautrette A, Souweine B. ;Crit Care. 2016 Jul 30;20(1):230.
BACKGROUND: Intensive care unit (ICU) patients require dialysis catheters (DCs) for renal replacement therapy (RRT). They carry a high risk of developing end-stage renal disease, and therefore their vascular access must be preserved. Guidewire exchange (GWE) is often used to avoid venipuncture insertion (VPI) at a new site. However, the impact of GWE on infection and dysfunction of DCs in the ICU is unknown. Our aim was to compare the effect of GWE and VPI on DC colonization and dysfunction in ICU patients.
2016 Jul - Benefit profile of anticoagulant therapy in sepsis: a nationwide multicentre registry in Japan
Yamakawa K, Umemura Y, Hayakawa M, Kudo D, Sanui M, Takahashi H, Yoshikawa Y, Hamasaki T, Fujimi S; Japan Septic Disseminated Intravascular Coagulation (J-Septic DIC) study group.; Crit Care. 2016 Jul 29;20(1):229
BACKGROUND: Little evidence supports anticoagulant therapy as effective adjuvant therapy to reduce mortality overall in sepsis. However, several studies suggest that anticoagulant therapy may reduce mortality in specific patients. This study aimed to identify a subset of patients with high benefit profiles for anticoagulant therapy against sepsis.
Vetter P, Fischer WA 2nd, Schibler M, Jacobs M, Bausch DG, Kaiser L.; J Infect Dis. 2016 Jul 20. pii: jiw254. [Epub ahead of print]
BACKGROUND: The magnitude of the 2013-2016 Ebola virus disease outbreak in West Africa was unprecedented, with >28 500 reported cases and >11 000 deaths. Understanding the key elements of Ebola virus transmission is necessary to implement adequate infection prevention and control measures to protect healthcare workers and halt transmission in the community.
Leligdowicz A, Fischer WA 2nd, Uyeki TM, Fletcher TE, Adhikari NK, Portella G, Lamontagne F, Clement C, Jacob ST, Rubinson L, Vanderschuren A, Hajek J, Murthy S, Ferri M, Crozier I, Ibrahima E, Lamah MC, Schieffelin JS, Brett-Major D, Bausch DG, Shindo N, Chan AK, O'Dempsey T, Mishra S, Jacobs M, Dickson S, Lyon GM 3rd, Fowler RA.; Crit Care. 2016 Jul 29;20(1):217.
As of 20 May 2016 there have been 28,646 cases and 11,323 deaths resulting from the West African Ebola virus disease (EVD) outbreak reported to the World Health Organization. There continue to be sporadic flare-ups of EVD cases in West Africa.EVD presentation is nonspecific and characterized initially by onset of fatigue, myalgias, arthralgias, headache, and fever; this is followed several days later by anorexia, nausea, vomiting, diarrhea, and abdominal pain. Anorexia and gastrointestinal losses lead to dehydration, electrolyte abnormalities, and metabolic acidosis, and, in some patients, acute kidney injury.