2015 May - A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators
Angus DC, Barnato AE, Bell D, Bellomo R, Chong CR, Coats TJ, Davies A, Delaney A, Harrison DA, Holdgate A, Howe B, Huang DT, Iwashyna T, Kellum JA, Peake SL, Pike F, Reade MC, Rowan KM, Singer M, Webb SA, Weissfeld LA, Yealy DM, Young JD.; Intensive Care Med. 2015 May 8. [Epub ahead of print]
PURPOSE: To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock.
David S. Hui, MD, FCCP; Benny K. Chow, PhD; Thomas Lo, MSc; Susanna S. Ng, MBChB; Fanny W. Ko, MD, FCCP; Tony Gin, MD; Matthew T. V. Chan, MD CHEST May 2015; 147(5): 1336-1343
BACKGROUND: Noninvasive ventilation (NIV) via helmet or total facemask is an option for managing patients with respiratory infections in respiratory failure. However, the risk of nosocomial infection is unknown.
2015 May - Endotracheal Tubes for Critically Ill Patients: An In Vivo Analysis of Associated Tracheal Injury, Mucociliary Clearance, and Sealing Efficacy
Gianluigi Li Bassi, MD, PhD; Nestor Luque, MD; Joan Daniel Martí, PhD, RPT; Eli Aguilera Xiol, MSc; Marta Di Pasquale, MD; Valeria Giunta, MD; Talitha Comaru, PhD, RPT; Montserrat Rigol, DVM, PhD; Silvia Terraneo, MD; Francesca De Rosa, MD; Mariano Rinaudo, MD; Ernesto Crisafulli, MD, PhD, FCCP; Rogelio Cesar Peralta Lepe, MD; Carles Agusti, MD, PhD; Carmen Lucena, MD; Miguel Ferrer, MD, PhD; Laia Fernández, PhD; Antoni Torres, MD, PhD, FCCP CHEST May 2015; 147(5): 1327-1335
BACKGROUND: Improvements in the design of the endotracheal tube (ETT) have been achieved in recent years. We evaluated tracheal injury associated with ETTs with novel high-volume low-pressure (HVLP) cuffs and subglottic secretions aspiration (SSA) and the effects on mucociliary clearance (MCC).
Lenz K, Buder R, Kapun L, Voglmayr M.; Therap Adv Gastroenterol. 2015 Mar;8(2):83-100
Ascites and renal dysfunction are frequent complications experienced by patients with cirrhosis of the liver. Ascites is the pathologic accumulation of fluid in the peritoneal cavity, and is one of the cardinal signs of portal hypertension. The diagnostic evaluation of ascites involves assessment of its granulocyte count and protein concentration to exclude complications such as infection or malignoma and to allow risk stratification for the development of spontaneous peritonitis.
Singanayagam A, Bernal W.; Curr Opin Crit Care. 2015 Apr;21(2):134-41.
Purpose of review: Although advances in critical care management and liver transplantation have improved survival in acute liver failure (ALF), mortality remains significant. An evidence base to support management has been lacking, due to the condition's rarity, severity and heterogeneity. The purpose of this review is to critically appraise the latest evidence, updating clinicians on the current understanding of the best management.
Zha AM, Sari M, Torbey MT.; Curr Opin Crit Care. 2015 Apr;21(2):91-8.
Purpose of review: Large hemispheric infarction is a devastating disease that continues to be associated with significant mortality and morbidity. Most often these patients are admitted to the ICU requiring significant physician and nursing resources. This review will address some of the ICU management issues and review the evidence supporting medical and surgical management of malignant cerebral edema.
2015 Feb - Evidence-based guidelines for the management of large hemispheric infarction : a statement for health care professionals from the neurocritical care society and the german society for neuro-intensive care and emergency medicine
Torbey MT, Bösel J, Rhoney DH, Rincon F, Staykov D, Amar AP, Varelas PN, Jüttler E, Olson D, Huttner HB, Zweckberger K, Sheth KN, Dohmen C, Brambrink AM, Mayer SA, Zaidat OO, Hacke W, Schwab S.: Neurocrit Care. 2015 Feb;22(1):146-64.
Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the critical care management of LHI.
Liotta EM, Levasseur-Franklin KE, Naidech AM.; Curr Opin Crit Care. 2015 Apr;21(2):127-33
Purpose of review: We summarize the available data related to reversing the anticoagulant effect of the oral direct thrombin and factor Xa inhibitors and provide our opinion on treating patients presenting with severe and life-threatening hemorrhage related to these agents.
Jordan JD, Morbitzer KA, Rhoney DH.; Neurol Clin. 2015 May;33(2):361-380.
Blood pressure elevation in the setting of acute ischemic stroke and intracerebral hemorrhage is common. Controversy exists as to the optimal management of elevated blood pressure in this patient population. This article reviews the available clinical data that guides acute blood pressure management and how this may affect clinical outcomes.
2015 Apr - Blood pressure management in acute intracerebral hemorrhage: current evidence and ongoing controversies
Gioia LC, Kate M, Dowlatshahi D, Hill MD, Butcher K.; Curr Opin Crit Care. 2015 Apr;21(2):99-106
Purpose of review: Spontaneous intracerebral hemorrhage (ICH) is associated with high rates of morbidity and mortality. Although treatment options are limited, a potential acute medical intervention is blood pressure (BP) reduction. The review will summarize the current evidence and remaining knowledge gaps with respect to acute BP management in acute ICH.
Navalesi P, Longhini F. Curr Opin Crit Care. 2015 Feb;21(1):58-64.
Purpose of review: Compared with the conventional forms of partial support, neurally adjusted ventilatory assist was repeatedly shown to improve patient–ventilator synchrony and reduce the risk of overassistance, while guaranteeing adequate inspiratory effort and gas exchange. A few animal studies also suggested the potential of neurally adjusted ventilatory assist in averting the risk of ventilator-induced lung injury. Recent work adds new information on the physiological effects of neurally adjusted ventilatory assist.
Peñuelas Ó, Thille AW, Esteban A. Curr Opin Crit Care. 2015 Feb;21(1):74-81.
Purpose of review: Weaning from mechanical ventilation implies two separate but closely related aspects of care, the discontinuation of mechanical ventilation and removal of artificial airway, which implies routine clinical dilemmas. Extubation delay and extubation failure are associated with poor clinical outcomes. We sought to summarize recent evidence on weaning.
Terragni P, Ranieri VM, Brazzi L. Curr Opin Crit Care. 2015 Feb;21(1):20-5
Purpose of review: To discuss the mechanisms of ventilator-induced lung injury and the pro and cons of the different approaches proposed by literature to minimize its impact in patients with acute respiratory distress syndrome.
2015 May 1 - The Timing of Discharge from the Intensive Care Unit and Subsequent Mortality. A Prospective, Multicenter Study
John D. Santamaria, Graeme J. Duke, David V. Pilcher, D. James Cooper, John Moran, and Rinaldo Bellomo Am. J. Resp. Crit. Care Med. May 1, 2015, vol. 191, no. 9: 1033-1039
Rationale: Previous studies suggested an association between after-hours intensive care unit (ICU) discharge and increased hospital mortality. Their retrospective design and lack of correction for patient factors present at the time of discharge make this association problematic.
2015 May 1 - Ethanol Lock and Risk of Hemodialysis Catheter Infection in Critically Ill Patients. A Randomized Controlled Trial
Bertrand Souweine, Alexandre Lautrette, Didier Gruson, Emmanuel Canet, Kada Klouche, Laurent Argaud, Julien Bohe, Maïté Garrouste-Orgeas, Christophe Mariat, François Vincent, Sophie Cayot, Olivier Cointault, Alain Lepape, Dominique Guelon, Michael Darmon, Aurélien Vesin, Nicolas Caillot, Carole Schwebel, Alexandre Boyer, Elie Azoulay, Lila Bouadma, and Jean-François Timsit Am. J. Resp. Crit. Care Med. May 1, 2015, vol. 191, no. 9: 1024-1032
Rationale: Ethanol rapidly eradicated experimental biofilm. Clinical studies of ethanol lock to prevent catheter-related infections (CRIs) suggest preventive efficacy. No such studies have been done in intensive care units (ICU).
2015 May - Construct Validity and Minimal Important Difference of 6-Minute Walk Distance in Survivors of Acute Respiratory Failure
Kitty S. Chan, PhD; Elizabeth R. Pfoh, PhD; Linda Denehy, PhD; Doug Elliott, PhD; Anne E. Holland, PhD; Victor D. Dinglas, MPH; Dale M. Needham, MD, PhD CHEST May 2015; 147(5): 1316-1326
OBJECTIVE: The 6-min walk distance (6MWD), a widely used test of functional capacity, has limited evidence of construct validity among patients surviving acute respiratory failure (ARF) and ARDS. The objective of this study was to examine construct validity and responsiveness and estimate minimal important difference (MID) for the 6MWD in patients surviving ARF/ARDS.
Date: 19/5/2015; Time: 6:30-8:30pm, Venue: Lecture Theatre, G/F, M Block, QEH
Date: 20/1/2015, Speaker: Dr CH Ng, AC, KWH
Date: 5/6/2015; Time: 18:00-19:30
Venue: Lecture Theatre, 10/F, TWGHs Yu Chun Keung Memorial Medical Centre, KWH
Leligdowicz A, Fan E. Curr Opin Crit Care. 2015 Feb;21(1):13-9
Purpose of review: To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications.