Date: 27 Aug 2014; Venue: HA TFCM Meeting; Speaker: Dr KY Lai (COS, ICU, QEH)
2014 Aug - Insulin treatment guided by subcutaneous continuous glucose monitoring compared to frequent point-of-care measurement in critically ill patients: a randomized controlled trial
Daphne T Boom, Marjolein K Sechterberger, Saskia Rijkenberg, Susanne Kreder, Rob J Bosman, Jos PJ Wester, Ilse van Stijn, J Hans DeVries, Peter HJ van der Voort Critical Care 2014, 18:453 (20 August 2014)
Introduction: Glucose measurement in intensive care medicine is performed intermittently with the risk of undetected hypoglycemia. The workload for the ICU nursing staff is substantial. Subcutaneous continuous glucose monitoring (CGM) systems are available and may be able to solve some of these issues in critically ill patients.
2014 Aug - Citrate anticoagulation versus systemic heparinisation in continuous venovenous hemofiltration in critically ill patients with acute kidney injury: a multi-center randomized clinical trial
Louise Schilder, S Nurmohamed, Frank H Bosch, Ilse M Purmer, Sylvia S den Boer, Cynthia G Kleppe, Marc G Vervloet, Albertus Beishuizen, Armand Girbes, Pieter M ter Wee, AB Groeneveld Critical Care 2014, 18:472 (16 August 2014)
Introduction: Because of ongoing controversy, renal and vital outcomes are compared between systemically administered unfractionated heparin and regional anticoagulation with citrate-buffered replacement solution in predilution mode, during continuous venovenous hemofiltration (CVVH) in critically ill patients with acute kidney injury (AKI).
2014 May - Extracorporeal life support for patients with acute respiratory distress syndrome: report of a Consensus Conference
Annals of Intensive Care 2014, 4:15 (24 May 2014)
The influenza H1N1 epidemics in 2009 led a substantial number of people to develop severe acute respiratory distress syndrome and refractory hypoxemia. In these patients, extracorporeal membrane oxygenation was used as rescue oxygenation therapy. Several randomized clinical trials and observational studies suggested that extracorporeal membrane oxygenation associated with protective mechanical ventilation could improve outcome, but its efficacy remains uncertain...
Joynt GM, Tat WW.; Intensive Care Med. 2014 Aug;40(8):1144-6.
The Hong Kong Hospital Authority provides a high standard of intensive care for residents at nominal cost. The territory-wide mean predicted risk of hospital death by APACHE III-j score is 26 %, with a risk-adjusted hospital mortality of 0.8, and hospital median and mean length of stay 2.1 and 4.2 days . While excellence in diagnosis and supportive care remain the cornerstone of ICU management internationally, practice in Hong Kong presents some special challenges.
Date: 29-30 Jan 2015; Venue: Lecture Theatre, Block J, Alice Ho Miu Ling Nethersole Hospital, 11 Chuen On Road, Tai Po, New Territories, Hong Kong
2014 Aug - Duration of hemodynamic effects of crystalloids in patients with circulatory shock after initial resuscitation
Annals of Intensive Care 2014, 4:25 (1 August 2014)
Background: In the later stages of circulatory shock, monitoring should help to avoid fluid overload. In this setting, volume expansion is ideally indicated only for patients in whom the cardiac index (CI) is expected to increase. Crystalloids are usually the choice for fluid replacement. As previous studies evaluating the hemodynamic effect of crystalloids have not distinguished responders from non-responders, the present study was designed to evaluate the duration of the hemodynamic effects of crystalloids according to the fluid responsiveness status.
2014 Jul - Principles and Operational Parameters to Optimize Poison Removal with Extracorporeal Treatments
Bouchard J, Roberts DM, Roy L, Ouellet G, Decker BS, Mueller BA, Desmeules S, Ghannoum M.: Semin Dial. 2014 Jul;27(4):371-80.
A role for nephrologists in the management of a poisoned patient involves evaluating the indications for, and methods of, enhancing the elimination of a poison. Nephrologists are familiar with the various extracorporeal treatments (ECTRs) used in the management of impaired kidney function, and their respective advantages and disadvantages. However, these same skills and knowledge may not always be considered, or applicable, when prescribing ECTR for the treatment of a poisoned patient. Maximizing solute elimination is a key aim of such treatments, perhaps more so than in the treatment of uremia, because ECTR has the potential to reverse clinical toxicity and shorten the duration of poisoning. This manuscript reviews the various principles that govern poison elimination by ECTR (diffusion, convection, adsorption, and centrifugation) and how components of the ECTR can be adjusted to maximize clearance. Data supporting these recommendations will be presented, whenever available.
Ghannoum M, Roberts DM, Hoffman RS, Ouellet G, Roy L, Decker BS, Bouchard J.; Semin Dial. 2014 Jul;27(4):362-70.
The use of an extracorporeal treatment (ECTR) in a poisoned patient may be life-saving in a limited number of scenarios. The decision-processes surrounding the use of ECTR in poisoning is complex: most nephrologists are not trained to assess a poisoned patient while clinical toxicologists rarely prescribe ECTRs. Deciding on which ECTR is most appropriate for a poison requires a good understanding of the poison's physicochemical and pharmacokinetic properties. Further, a detailed understanding of the capabilities and limitations of the different ECTRs can be useful to select the most appropriate ECTR for a given clinical situation. This manuscript provides a stepwise approach to assess the usefulness of ECTRs in poisoning.
Ouellet G, Bouchard J, Ghannoum M, Decker BS.: Semin Dial. 2014 Jul;27(4):342-9.
Poisoning is a significant public health problem. In severe cases, extracorporeal treatments (ECTRs) may be required to prevent or reverse major toxicity. Available ECTRs include intermittent hemodialysis, sustained low-efficiency dialysis, intermittent hemofiltration and hemodiafiltration, continuous renal replacement therapy, hemoperfusion, therapeutic plasma exchange, exchange transfusion, peritoneal dialysis, albumin dialysis, cerebrospinal fluid exchange, and extracorporeal life support. The aim of this article was to provide an overview of the technical aspects, as well as the potential indications and limitations of the different ECTRs used for poisoned patients.
De Gasperi A, Feltracco P, Ceravola E, Mazza E.: Curr Opin Crit Care. 2014 Aug;20(4):411-9.
Purpose of review: Major improvements in perioperative care and immunobiology have not abated the risk for severe pulmonary complications after solid-organ transplantation. The aim of this study is to update information on infectious and noninfectious pulmonary complications after solid-organ transplantation, addressing epidemiology, risk factors, diagnostic workup, and management.
Carcillo JA.: Curr Opin Crit Care. 2014 Aug;20(4):396-401.
Purpose of review: To review the past year's literature, and selected prior literature relevant to these most recent findings, regarding intravenous fluid choices in the management of critically ill children.
Kozek-Langenecker SA.: Curr Opin Crit Care. 2014 Aug;20(4):460-6.
Purpose of review: Bleeding can be minimal, severe, life-threatening, or organ-threatening. Depending on the compensatory capacity of the patient, most bleeding events going beyond 20% blood volume may represent an emergency as well as a risk factor for anemia, transfusion, coagulopathy, and tissue hypoperfusion. All these factors are independent predictors for survival in postoperative critical care and are drivers for resource use and costs.
Guarracino F, Bertini P.: Curr Opin Crit Care. 2014 Aug;20(4):431-7.
Purpose of review: This review analyses the application of perioperative echocardiography as an important tool in the management of haemodynamic impairment.
Lee B, Michaels MG.: Curr Opin Crit Care. 2014 Aug;20(4):420-5.
Purpose of review: This review summarizes recent updates in the prevention of infections in solid organ transplant patients using antimicrobial prophylaxis that are pertinent for the intensive care physician.
Gantner D, Moore EM, Cooper DJ.: Curr Opin Crit Care. 2014 Aug;20(4):385-9.
Purpose of review: Intravenous fluid is a fundamental component of trauma care and fluid management influences patient outcomes. This narrative review appraises recent clinical studies of fluid therapy in patients with traumatic brain injury (TBI), with respect to its use in volume resuscitation and prevention of secondary injury.
2014 Aug 15 - Acute Outcomes and 1-Year Mortality of Intensive Care Unit–acquired Weakness. A Cohort Study and Propensity-matched Analysis
Greet Hermans, Helena Van Mechelen, Beatrix Clerckx, Tine Vanhullebusch, Dieter Mesotten, Alexander Wilmer, Michael P. Casaer, Philippe Meersseman, Yves Debaveye, Sophie Van Cromphaut, Pieter J. Wouters, Rik Gosselink, and Greet Van den Berghe Am. J. Resp. Crit. Care Med. Aug 15, 2014, vol. 190, no. 4: 410-420
Rationale: Intensive care unit (ICU)-acquired weakness is a frequent complication of critical illness. It is unclear whether it is a marker or mediator of poor outcomes.
Date: 12 Aug 2014; Time: 7-8pm; Venue: Lecture Theatre, G/F, M block, QEH
Speaker: Dr FL Chow, CON, ICU, CMC
Date: 30 Oct 2014 (for Doctors) and 31 Oct 2014 (for Nurses); Venue: H7 Conference Room, PMH
Date: 15 Nov 2014
Message from the organizer
We are pleased to advise you that the Health Research Symposium 2014 organised by the Food and Health Bureau, the Government of the Hong Kong Special Administrative Region, will be held on 15 November 2014 at the Hong Kong Academy of Medicine. The theme of the Symposium is Translating Health Research into Policy and Practice for Health of the Population. Please post the following event information on your website for the interest of your members: