2016 Jul 15 - Long-Term Mortality and Major Adverse Cardiovascular Events in Sepsis Survivors. A Nationwide Population-based Study
Shuo-Ming Ou, Hsi Chu, Pei-Wen Chao, Yi-Jung Lee, Shu-Chen Kuo, Tzeng-Ji Chen, Ching-Min Tseng, Chia-Jen Shih, and Yung-Tai Chen Am. J. Resp. Crit. Care Med. Jul 15. 2016, vol. 194, no. 2: 209-217
Rationale: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis.
Nazir I. Lone, Michael A. Gillies, Catriona Haddow, Richard Dobbie, Kathryn M. Rowan, Sarah H. Wild, Gordon D. Murray, and Timothy S. Walsh Am. J. Resp. Crit. Care Med. Jul 15, 2016, vol. 194, no. 2: 198-208
Rationale: Survivors of critical illness experience significant morbidity, but the impact of surviving the intensive care unit (ICU) has not been quantified comprehensively at a population level.
Barletta JF, Bruno JJ, Buckley MS, Cook DJ.; Crit Care Med. 2016 Jul;44(7):1395-405.
Objectives: Stress ulcer prophylaxis is commonly administered to critically ill patients for the prevention of clinically important stress-related mucosal bleeding from the upper gastrointestinal tract. Despite widespread incorporation of stress ulcer prophylaxis into practice around the world, questions are emerging about its indications and impact. This clinically focused article will review current controversies related to stress ulcer prophylaxis for critically ill adult patients, including bleeding frequency, risk factors, comparative efficacy, adverse effect profile, and overall cost-effectiveness of the available stress ulcer prophylaxis regimens.
2016 Jul - Admission Hyperglycemia in Critically Ill Sepsis Patients: Association With Outcome and Host Response
van Vught LA, Wiewel MA, Klein Klouwenberg PM, Hoogendijk AJ, Scicluna BP, Ong DS, Cremer OL, Horn J, Bonten MM, Schultz MJ, van der Poll T; Molecular Diagnosis and Risk Stratification of Sepsis Consortium.; Crit Care Med. 2016 Jul;44(7):1338-46.
Objectives: To investigate whether admission hyperglycemia is associated with the presentation and/or outcome of sepsis, what the influence of hyperglycemia is on key host responses to sepsis, and whether hyperglycemia differentially affects patients with diabetes mellitus.
Date: 19/7/2016; Time: 6:30-8:30pm, Venue: Lecture Theatre, G/F, M Block, QEH
2016 Jul - Dexmedetomidine for the Treatment of Hyperactive Delirium Refractory to Haloperidol in Nonintubated ICU Patients: A Nonrandomized Controlled Trial
Carrasco G, Baeza N, Cabré L, Portillo E, Gimeno G, Manzanedo D, Calizaya M.; Crit Care Med. 2016 Jul;44(7):1295-306.
Objectives: To evaluate the clinical effectiveness, safety, and cost of dexmedetomidine for the treatment of agitated delirium refractory to haloperidol in nonintubated critically ill patients.
2016 Jul - Derivation of Novel Risk Prediction Scores for Community-Acquired Sepsis and Severe Sepsis
Wang HE, Donnelly JP, Griffin R, Levitan EB, Shapiro NI, Howard G, Safford MM.; Crit Care Med. 2016 Jul;44(7):1285-94.
Objective: We sought to derive and internally validate a Sepsis Risk Score and a Severe Sepsis Risk Score predicting future sepsis and severe sepsis events among community-dwelling adults.
Krysta S. Wolfe, MD; John P. Kress, MD, FCCP CHEST Jul 2016; 150(1): 237-246
Patients who are critically ill and hospitalized often require invasive procedures as a part of their medical care. Each procedure carries a unique set of risks and associated complications, but common to all of them is the risk of hemorrhage.
Matthew W. Semler, MD; Annis M. Marney, MD; Todd W. Rice, MD; Hui Nian, MS; Chang Yu, PhD; Arthur P. Wheeler, MD; Nancy J. Brown, MD CHEST Jul 2016; 150(1): 102-111
Background: Conservative fluid management increases ventilator-free days without influencing overall mortality in acute respiratory distress syndrome. Plasma concentrations of B-type natriuretic peptide (a marker of ventricular filling) or aldosterone (a marker of effective circulating volume) may identify patients for whom fluid management impacts survival.
Lima A.; Curr Opin Crit Care. 2016 Jun;22(3):274-8
Purpose of review: Tissue monitoring is one of the main strategies at the bedside to guide resuscitation of shock. Advances in tissue monitoring technologies have established noninvasive optical methods and transcutaneous oximetry as modalities of considerable value in the critical care setting for tissue monitoring in shock. The purpose of this article is to highlight the latest developments into the clinical applications of near-infrared spectroscopy, direct visualization of sublingual microcirculation, and transcutaneous oxygen measurements (PtcO2).
Chiumello D, Brioni M.; Crit Care. 2016 Jun 3;20(1):132.
BACKGROUND: Acute respiratory distress syndrome (ARDS) is characterized by a noncardiogenic pulmonary edema with bilateral chest X-ray opacities and reduction in lung compliance, and the hallmark of the syndrome is hypoxemia refractory to oxygen therapy. Severe hypoxemia (PaO2/FiO2 < 100 mmHg), which defines severe ARDS, can be found in 20-30 % of the patients and is associated with the highest mortality rate. Although the standard supportive treatment remains mechanical ventilation (noninvasive and invasive), possible adjuvant therapies can be considered. We performed an up-to-date clinical review of the possible available strategies for ARDS patients with severe hypoxemia.
Douflé G, Ferguson ND.; Curr Opin Crit Care. 2016 Jun;22(3):230-8.
Purpose of review: An increasing number of patients are placed on extracorporeal membrane oxygenation (ECMO) for respiratory or cardiac failure. Sound understanding of physiology and configuration of ECMO is essential for proper management. This review covers different monitoring parameters and tools for patients supported with different types of ECMO.
Message from CCM Specialty Board
Dear All: The BPT guidelines has been approved by HKCP
Please note the changes: Training experience in ICU/CCM in a unit (either within Department of Medicine or independent department) may be accredited for up to twelve months, provided that six months’ training takes place in ICUs with at least two accredited CCM Trainers. (P. 6, Training guidelines (II) Structure point 6)
Effective from 1 Jul 2016
Download BPT guidelines here
2016 Jul 1 - Inflammation and Organ Failure Severely Affect Midazolam Clearance in Critically Ill Children
Nienke J. Vet, Janneke M. Brussee, Matthijs de Hoog, Miriam G. Mooij, Carin W. M. Verlaat, Isabel S. Jerchel, Ron H. N. van Schaik, Birgit C. P. Koch, Dick Tibboel, Catherijne A. J. Knibbe, and Saskia N. de Wildt Am. J. Resp. Crit. Care Med. Jul 1, 2016, vol. 194, no. 1: 58-66
Rationale: Various in vitro, animal, and limited human adult studies suggest a profound inhibitory effect of inflammation and disease on cytochrome P-450 3A (CYP3A)-mediated drug metabolism. Studies showing this relationship in critically ill patients are lacking, whereas clearance of many CYP3A drug substrates may be decreased, potentially leading to toxicity.
2016 Jun 15 - Incidence and Risk Factors for Intensive Care Unit–related Post-traumatic Stress Disorder in Veterans and Civilians
Mayur B. Patel, James C. Jackson, Alessandro Morandi, Timothy D. Girard, Christopher G. Hughes, Jennifer L. Thompson, Amy L. Kiehl, Mark R. Elstad, Mitzi L. Wasserstein, Richard B. Goodman, Jean C. Beckham, Rameela Chandrasekhar, Robert S. Dittus, E. Wesley Ely, and Pratik P. Pandharipande Am. J. Resp. Crit. Care Med. Jun 15, 2016, vol. 193, no. 12: 1373-1381
Rationale: The incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort.
2016 Jun - Near-infrared spectroscopy during cardiopulmonary resuscitation and after restoration of spontaneous circulation: a valid technology?
Wik L.; Curr Opin Crit Care. 2016 Jun;22(3):191-8.
Purpose of review: This article explores the status of using near-infrared spectroscopy and reporting cerebral oximetry (rSO2) for cardiac arrest patients.
Rubertsson S.; Curr Opin Crit Care. 2016 Jun;22(3):225-9.
Purpose of review: The aim of this review is to update and discuss the use of mechanical chest compression devices in treatment of cardiac arrest.
Dear HKSCCM Members and ICU colleagues,
Hong Kong Society of Critical Care Medicine (HKSCCM) would like to inform you that on September 8th and 9th, 2016, the Global Sepsis Alliance will host the 1 st World Sepsis Congress – which is a great opportunity for you to connect and learn with leading sepsis experts from around the globe – right from your home or office.
We are endorsing this innovative online-only congress and hereby encourage you to participate, which is completely free of charge and can be done from wherever you have an internet connection. To register now or to find out more on program, speakers, time zones, and much more please go to www.worldsepsiscongress.org.
In 13 distinctive sessions, over 70 speakers from over 20 countries will give 10-minute keynotes and presentations on the number one preventable cause of death worldwide: sepsis. From prevention to acute management, long-term sequela, and epidemiology of sepsis, all topics regarding sepsis will be covered. There will even be a panel discussion with sepsis survivors and their families. After each talk, the speakers will answer live questions from the audience.
Highlights include the Opening Session, titled "Sepsis - A Global Health Threat", with German Minister Helge Braun, Marie-Paule Kieny, Assistant Director-General of the WHO, Achim Steiner, former Under-Secretary General UN and Director of UNEP, and Joe Kiani, Founder & CEO of the Patient Safety Movement Foundation.
Date: 21-24 Mar 2017; Venue: Square, Brussels