Date: 8 Dec 2013; Venue: Intercontinental Grand Stanford, TST, Hong Kong
This is CCM Board accredited tutorial session
2013 Dec 1 - Intracerebral Hemorrhage and Delirium Symptoms. Length of Stay, Function, and Quality of Life in a 114-Patient Cohort
Andrew M. Naidech, Jennifer L. Beaumont, Neil F. Rosenberg, Matthew B. Maas, Adam R. Kosteva, Michael L. Ault, David Cella, and E. Wesley Ely Am. J. Resp. Crit. Care Med. Dec 1, 2013, vol. 188, no. 11: 1331-1337
Rationale: The prognostic significance of delirium symptoms in intensive care unit (ICU) patients with focal neurologic injury is unclear.
2013 Dec 1 - Prone Position in Acute Respiratory Distress Syndrome. Rationale, Indications, and Limits
Luciano Gattinoni, Paolo Taccone, Eleonora Carlesso, and John J. Marini Am. J. Resp. Crit. Care Med. Dec 1, 2013, vol. 188, no. 11: 1286-1293.
In the prone position, computed tomography scan densities redistribute from dorsal to ventral as the dorsal region tends to reexpand while the ventral zone tends to collapse. Although gravitational influence is similar in both positions, dorsal recruitment usually prevails over ventral derecruitment, because of the need for the lung and its confining chest wall to conform to the same volume. The final result of proning is that the overall lung inflation is more homogeneous from dorsal to ventral than in the supine position, with more homogeneously distributed stress and strain. As the distribution of perfusion remains nearly constant in both postures, proning usually improves oxygenation.
2013 Dec - Short- vs Long-Duration Antibiotic Regimens for Ventilator-Associated Pneumonia: A Systematic Review and Meta-analysis
George Dimopoulos, MD, PhD; Garyphallia Poulakou, MD, PhD; Ioannis A. Pneumatikos, MD, PhD; Apostolos Armaganidis, MD, PhD; Marin H. Kollef, MD, FCCP; Dimitrios K. Matthaiou, MD CHEST Dec, 2013; 144(6): 1759-1767
Background: We performed a systematic review and meta-analysis of short- vs long-duration antibiotic regimens for ventilator-associated pneumonia (VAP).
2013 Dec - Effect of Aerosolized Colistin as Adjunctive Treatment on the Outcomes of Microbiologically Documented Ventilator-Associated Pneumonia Caused by Colistin-Only Susceptible Gram-Negative Bacteria
Mario Tumbarello, MD; Gennaro De Pascale, MD; Enrico Maria Trecarichi, MD, PhD; Salvatore De Martino, MD; Giuseppe Bello, MD; Riccardo Maviglia, MD; Teresa Spanu, MD; Massimo Antonelli, MD CHEST Dec, 2013; 144(6): 1768-1775
Background: The increasing frequency of ventilator-associated pneumonia (VAP) caused by colistin-only susceptible (COS) gram-negative bacteria (GNB) is of great concern. Adjunctive aerosolized (AS) colistin can reportedly increase alveolar levels of the drug without increasing systemic toxicity. Good clinical results have been obtained in patients with cystic fibrosis, but conflicting data have been reported in patients with VAP.
2013 Nov - Optimal dosing of antibiotics in critically ill patients using continuous/extended infusions: a systematic review and meta-analysis
Clarence Chant, Ann Leung, Jan O Friedrich Critical Care 2013, 17:R279 (29 November 2013)
Introduction: The aim of this study was to determine whether using pharmacodynamic-based dosing of antimicrobials such as extended/continuous infusions in critically ill patients is associated with improved outcomes as compared to traditional dosing methods
Keene DD, Nordmann GR, Woolley T.: Curr Opin Crit Care. 2013 Dec;19(6):605-12.
Purpose of review: Haemorrhage from major trauma is a significant cause of death worldwide. The UK Defence Medical Service (UK-DMS) has had significant experience in managing severely injured and shocked trauma casualties over the last decade. This has led to the integration of rotational thromboelastometry (ROTEM) into damage control resuscitation delivered at Camp Bastion Field Hospital in Afghanistan. This review aims to describe the rationale for its use and how its use has evolved by UK-DMS.
2013 Dec - Salvage techniques in traumatic cardiac arrest: thoracotomy, extracorporeal life support, and therapeutic hypothermia
Tisherman SA.; Curr Opin Crit Care. 2013 Dec;19(6):594-8.
Purpose of review: Survival from traumatic cardiac arrest is associated with a very high mortality despite aggressive resuscitation including an Emergency Department thoracotomy (EDT). Novel salvage techniques are needed to improve these outcomes.
2013 Dec - Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients
D'Amours SK, Rastogi P, Ball CG.; Curr Opin Crit Care. 2013 Dec;19(6):587-93
Purpose of review: In recent years, combined interventional radiology and operative suites have been proposed and are now becoming operational in select trauma centres. Given the infancy of this technology, this review aims to review the rationale, benefits and challenges of hybrid suites in the management of seriously injured patients.
Holley AD, Reade MC.; Curr Opin Crit Care. 2013 Dec;19(6):578-86.
Purpose of review: Although early acute traumatic coagulopathy has received much recent attention, the procoagulopathy that often follows appears less appreciated. Thromboembolic disease following trauma is common and lethal, but very effective prophylactic strategies are available. These strategies are variably implemented because of the difficulty in quantifying the magnitude of procoagulopathy in individual patients.
2013 Dec - Measuring renal function in critically ill patients: tools and strategies for assessing glomerular filtration rate
Macedo E, Mehta RL.; Curr Opin Crit Care. 2013 Dec;19(6):560-6.
Purpose of review: Alterations in kidney function are common in critically ill patients and are generally assessed by changes in serum creatinine (sCr) or urine output, which are considered surrogates for glomerular filtration rate (GFR) but do not reflect the overall kidney function. There is a great need for more reliable measurements of glomerular filtration in order to guide diagnosis and therapy for acute kidney injury. In this review, we will focus on recent advances to measure GFR that could help to better evaluate kidney function and improve patient care.
Wilson JG, Butcher BW, Liu KD.; Curr Opin Crit Care. 2013 Dec;19(6):523-30
Purpose of review: This review highlights the principal advances in critical care over the past year, and discusses the impact of these advances on the diagnosis and management of acute kidney injury (AKI).
Karakala N, Raghunathan K, Shaw AD.; Curr Opin Crit Care. 2013 Dec;19(6):537-43
Purpose of review: Septic shock is one of the most common and life-threatening conditions afflicting critically ill patients. Intravenous volume resuscitation is considered an initial and very important step in management. The most suitable fluid for volume expansion during septic shock remains unclear. In this review, we focus on the benefits and adverse effects of the most commonly used intravenous fluids in critically ill septic patients.
Date: 17 Dec 2013; Time: 6pm-8pm; Venue: Seminar Room, G/F, Block A, QEH
Date: 16 - 21 May 2014; Venue: San Diego Convention Center