2015 Jan 15 - The Impact of the Organization of High-Dependency Care on Acute Hospital Mortality and Patient Flow for Critically Ill Patients
Hannah Wunsch, David A. Harrison, Andrew Jones, and Kathryn Rowan Am. J. Resp. Crit. Care Med. Jan 15, 2015, vol. 191, No. 2: 186-193
Rationale: Little is known about the utility of provision of high-dependency care (HDC) that is in a geographically separate location from a primary intensive care unit (ICU).
2015 Jan 15 - Timing of Low Tidal Volume Ventilation and Intensive Care Unit Mortality in Acute Respiratory Distress Syndrome. A Prospective Cohort Study
Dale M. Needham, Ting Yang, Victor D. Dinglas, Pedro A. Mendez-Tellez, Carl Shanholtz, Jonathan E. Sevransky, Roy G. Brower, Peter J. Pronovost, and Elizabeth Colantuoni Am. J. Resp. Crit. Care Med. Jan 15, 2015, vol. 191, no. 2: 177-185
Rationale: Reducing tidal volume decreases mortality in acute respiratory distress syndrome (ARDS). However, the effect of the timing of low tidal volume ventilation is not well understood.
Date: 23/1/2015, Time: 7-7:30pm, Venue: Lecture theatre, G/F, Block P, UCH
Event: ECMO case discussion; Speaker: Dr CW Lau, AC, ICU, PYNEH
2015 Hong Kong College of Anaesthesiologists (Intensive Care) Centrally Organised Tutorial Programme
The updated version of 2015 ICM tutorial program
2015 Jan - Male-Predominant Plasma Transfusion Strategy for Preventing Transfusion-Related Acute Lung Injury: A Systematic Review
Schmickl CN, Mastrobuoni S, Filippidis FT, Shah S, Radic J, Murad MH, Toy P, Gajic O. ;Crit Care Med. 2015 Jan;43(1):205-25.
Objectives: To assess 1) the effectiveness of male-predominant plasma transfusion strategy for preventing transfusion-related acute lung injury and related mortality; and 2) whether this effect varies across different patient subgroups.
2015 Jan - The Role of Simulation in Continuing Medical Education for Acute Care Physicians: A Systematic Review
Khanduja PK, Bould MD, Naik VN, Hladkowicz E, Boet S.; Crit Care Med. 2015 Jan;43(1):186-93.
Objectives: We systematically reviewed the effectiveness of simulation-based education, targeting independently practicing qualified physicians in acute care specialties. We also describe how simulation is used for performance assessment in this population.
Thiele RH, Bartels K, Gan TJ. ;Crit Care Med. 2015 Jan;43(1):177-85.
Objective: An increasing number of minimally or noninvasive devices are available to measure cardiac output in the critical care setting. This article reviews the underlying physical principles of these devices in addition to examining both animal and human comparative studies in an effort to allow clinicians to make informed decisions when selecting a device to measure cardiac output.
2015 Jan - Electroencephalogram Predicts Outcome in Patients With Postanoxic Coma During Mild Therapeutic Hypothermia
Tjepkema-Cloostermans MC, Hofmeijer J, Trof RJ, Blans MJ, Beishuizen A, van Putten MJ.; Crit Care Med. 2015 Jan;43(1):159-67.
Objective: To assess the value of electroencephalogram for prediction of outcome of comatose patients after cardiac arrest treated with mild therapeutic hypothermia.
2015 Jan - Extracorporeal Co2 Removal in Hypercapnic Patients At Risk of Noninvasive Ventilation Failure: A Matched Cohort Study With Historical Control
Del Sorbo L, Pisani L, Filippini C, Fanelli V, Fasano L, Terragni P, Dell'Amore A, Urbino R, Mascia L, Evangelista A, Antro C, D'Amato R, Sucre MJ, Simonetti U, Persico P, Nava S, Ranieri VM.; Crit Care Med. 2015 Jan;43(1):120-7
Objectives: To assess efficacy and safety of noninvasive ventilation-plus-extracorporeal Co2 removal in comparison to noninvasive ventilation-only to prevent endotracheal intubation patients with acute hypercapnic respiratory failure at risk of failing noninvasive ventilation.
Arthur CW Lau, HM So, SL Tang, Alwin Yeung, SM Lam, WW Yan; for the Hong Kong East Cluster Task Force on Prevention of Ventilator-associated Pneumonia in Critical Care Areas; Hong Kong Med J 2015;21:Epub 16 Jan 2015
Ventilator-associated pneumonia is the commonest, yet mostly preventable, infection in mechanically ventilated patients. Successful control of ventilator-associated pneumonia can save hospitalisation cost, and is possible by using a multidisciplinary clinical and administrative approach. The ventilator-associated pneumonia rate should be expressed as the number of ventilator-associated pneumonia days per 1000 ventilator days to take into account the device-utilisation duration for meaningful comparison. Various strategies address the issue, including general infection control measures, body positioning, intubation and mechanical ventilation, oral and gastro-intestinal tract, endotracheal tube, airway pressure, cuff pressure, selective digestive and/or oropharyngeal decontamination, and probiotic or early antibiotic treatment, as well as overall administration at a policy level..
2015 Jan - Influence of n-3 Polyunsaturated Fatty Acids Enriched Lipid Emulsions on Nosocomial Infections and Clinical Outcomes in Critically Ill Patients: ICU Lipids Study
Grau-Carmona T, Bonet-Saris A, García-de-Lorenzo A, Sánchez-Alvarez C, Rodríguez-Pozo A, Acosta-Escribano J, Miñambres E, Herrero-Meseguer JI, Mesejo A.; Crit Care Med. 2015 Jan;43(1):31-9.
Objective: n-3 polyunsaturated fatty acids (contained in fish oil) have been shown to beneficially influence infection rate and clinical outcomes in surgical patients probably due to their immunomodulatory action. In contrast, study results of fish oil administration in critically ill patients are controversial. The aim of this study was to investigate the effects of n-3 polyunsaturated fatty acids on the prevalence of nosocomial infections and clinical outcomes in medical and surgical critically ill patients.
2014 Oct - Ventilator-associated conditions versus ventilator-associated pneumonia: different by design
Klompas M.; Curr Infect Dis Rep. 2014 Oct;16(10):430.
The Centers for Disease Control and Prevention (CDC) released a new surveillance concept called ventilator-associated conditions (VACs) in early 2013. VAC was created to overcome some of the limitations of traditional ventilator-associated pneumonia (VAP) definitions, including their complexity, subjectivity, and insensitivity to complications other than pneumonia. VAC is defined by sustained increases in ventilator support after ≥2 days of stable or decreasing settings. The VAC definition was designed to be objective, reproducible, and amenable to automated analysis...
2015 Jan - Would Triage Predictors Perform Better Than First-Come, First-Served in Pandemic Ventilator Allocation?
Robert K. Kanter, MD CHEST Jan 2015; 147(1): 102-108
BACKGROUND: In a pandemic, needs for ventilators might overwhelm the limited supply. Outcome predictors have been proposed to guide ventilator triage allocation decisions. However, pandemic triage predictors have not been validated. This quantitative simulation study evaluated outcomes resulting from allocation strategies varying in their performance for selecting short-stay survivors as favorable candidates for ventilators.
Arendina W. van der Kooi, PhD; Irene J. Zaal, MD; Francina A. Klijn, MD; Huiberdina L. Koek, MD, PhD; Ronald C. Meijer, MD; Frans S. Leijten, MD, PhD; Arjen J. Slooter, MD, PhD CHEST Jan 2015; 147(1): 94-101
BACKGROUND: Despite its frequency and impact, delirium is poorly recognized in postoperative and critically ill patients. EEG is highly sensitive to delirium but, as currently used, it is not diagnostic. To develop an EEG-based tool for delirium detection with a limited number of electrodes, we determined the optimal electrode derivation and EEG characteristic to discriminate delirium from nondelirium.
2015 Jan - Factors Associated With Family Satisfaction With End-of-Life Care in the ICU: A Systematic Review
Laura J. Hinkle, MD; Gabriel T. Bosslet, MD, FCCP; Alexia M. Torke, MD CHEST Jan 2015; 147(1): 82-93
BACKGROUND: Family satisfaction with end-of-life care in the ICU has not previously been systematically reviewed. Our objective was to perform a review, synthesizing published data identifying factors associated with family satisfaction with end-of-life care in critically ill adult populations.
2015 Jan - A Prospective Evaluation of Ventilator-Associated Conditions and Infection-Related Ventilator-Associated Conditions
Anthony F. Boyer, MD; Noah Schoenberg, MD; Hilary Babcock, MD, MPH; Kathleen M. McMullen, MPH; Scott T. Micek, PharmD; Marin H. Kollef, MD, FCCP CHEST Jan 2015; 147(1): 68-81
BACKGROUND: The Centers for Disease Control and Prevention has shifted policy away from using ventilator-associated pneumonia (VAP) and toward using ventilator-associated conditions (VACs) as a marker of ICU quality. To date, limited prospective data regarding the incidence of VAC among medical and surgical ICU patients, the ability of VAC criteria to capture patients with VAP, and the potential clinical preventability of VACs are available.
2015 Jan 1 - The Association between Acute Respiratory Distress Syndrome, Delirium, and In-Hospital Mortality in Intensive Care Unit Patients
S. Jean Hsieh, Graciela J. Soto, Aluko A. Hope, Ana Ponea, and Michelle N. Gong Am. J. Resp. Crit. Care Med. Jan 1, 2015, vol. 191, no. 1: 71-78.
Rationale: Both acute respiratory distress syndrome (ARDS) and intensive care unit (ICU) delirium are associated with significant morbidity and mortality. However, the risk of delirium and its impact on mortality in ARDS patients is unknown.
The 9th Critical Care Nephrology Course will be held on April 22 & 23, 2015, at the Pamela Youde Nethersole Eastern Hospital. Download programme here
Course Fee: (included: handout, lunch on April 22, 2015 & light refreshment)
HK $2,100 (Full course: lecture and workshop) (HK$ 1,800 For Early Bird Registration)
HK $1,400 (Lecture only) (HK$ 1,200 For Early Bird Registration)
HKSCCM members may apply for the CCMF Subsidy to attend this course.
2015 Jan - Mild induced hypothermia: Effects on sepsis-related coagulopathy -results from a randomized controlled trial
Johansen ME, Jensen JU, Bestle MH, Ostrowski SR, Thormar K, Christensen H, Pedersen HP, Poulsen L, Mohr T, Kjær J, Cozzi-Lepri A, Møller K, Tønnesen E, Lundgren JD, Johansson PI.; Thromb Res. 2015 Jan;135(1):175-82. doi: 10.1016/j.thromres.2014.10.028. Epub 2014 Nov 5.
INTRODUCTION: Coagulopathy associates with poor outcome in sepsis. Mild induced hypothermia has been proposed as treatment in sepsis but it is not known whether this intervention worsens functional coagulopathy.