2011 Feb - Mucins Carrying Selectin Ligands as Predictive Biomarkers of Disseminated Intravascular Coagulation Complication in ARDS
Background: ARDS patients present with intrapulmonary and systemic coagulation abnormalities. We previously demonstrated that circulating KL-6/MUC1 could predict complications of disseminated intravascular coagulation (DIC) in ARDS. Recent studies indicate that circulating mucin can induce intravascular coagulation via interactions with selectin. We, therefore, investigated whether circulating mucins carrying selectin ligands are associated with DIC in ARDS.
2011 Feb - Prehospitalization Antiplatelet Therapy Is Associated With a Reduced Incidence of Acute Lung Injury - A Population-Based Cohort Study
Background: Acute lung injury (ALI) is a potentially fatal lung disease with few treatment options. Platelet activation is a key component of ALI pathophysiology and may provide an opportunity for prevention strategies. We examined the association of prehospitalization antiplatelet therapy with development of ALI in critically ill patients.
2011 Feb - Staff Acceptance of Tele-ICU Coverage: A Systematic Review
Background: Remote coverage of ICUs is increasing, but staff acceptance of this new technology is incompletely characterized. We conducted a systematic review to summarize existing research on acceptance of tele-ICU coverage among ICU staff.
2011 Feb - The Frequency and Clinical Significance of Thrombocytopenia Complicating Critical Illness: A Systematic Review
Background: The epidemiology of thrombocytopenia in critically ill patients has not been well characterized. The objective of this study was to systematically review the prevalence, incidence, and consequences of, and risk factors for, thrombocytopenia among critically ill patients.
2011 Jan - Use of Intensive Care in Patients With Nonresectable Lung Cancer
Background: Admission of patients with lung cancer to the ICU has been criticized. We evaluated whether ICU admission improved 3-month survival in patients with nonresectable lung cancer. Factors associated with survival were identified.
2011 Jan - Ultrasound Accurately Reflects the Jugular Venous Examination but Underestimates Central Venous Pressure
Background: Bedside ultrasound examination could be used to assess jugular venous pressure (JVP), and thus central venous pressure (CVP), more reliably than clinical examination.
2011 Jan - Only Severely Limited, Premorbid Functional Status Is Associated With Short- and Long-term Mortality in Patients With Pneumonia Who Are Critically Ill: A Prospective Observational Study
Background: Severe pneumonia requiring ICU admission has not been well characterized with respect to long-term outcomes or predictors thereof. We examined the association between premorbid functional status and mortality in patients with severe pneumonia.
2011 Jan - Performance of Medical Residents in Sterile Techniques During Central Vein Catheterization: Randomized Trial of Efficacy of Simulation-Based Training
Background: Catheter-related bloodstream infection (CRBSI) is a preventable cause of a potentially lethal ICU infection. The optimal method to teach health-care providers correct sterile techniques during central vein catheterization (CVC) remains unclear.
2010 Dec - Effectiveness Trial of an Intensive Communication Structure for Families of Long-Stay ICU Patients
Abstract
Background: Formal family meetings have been recommended as a useful approach to assist in goal setting, facilitate decision making, and reduce use of ineffective resources in the ICU. We examined patient outcomes before and after implementation of an intensive communication system (ICS) to test the effect of regular, structured formal family meetings on patient outcomes among long-stay ICU patients.
2010 Dec - Steady-State Pharmacokinetics and BAL Concentration of Colistin in Critically Ill Patients After IV Colistin Methanesulfonate Administration
Background: Infections caused by multidrug-resistant gram-negative bacteria have caused a resurgence of interest in colistin. To date, information about pharmacokinetics of colistin is very limited in critically ill patients, and no attempts have been made to evaluate its concentration in BAL.
2010 Dec - Outcomes of Etomidate in Severe Sepsis and Septic Shock
Dayton Dmello, MD, Stephen Taylor, MD, Jacklyn O’Brien, RN and George M. Matuschak, MD, FCCP. Published online before print July 22, 2010, doi: 10.1378/chest.10-0790. CHEST December 2010 vol. 138 no. 6 1327-1332
Abstract
Background: The use of single-dose etomidate to facilitate intubation in critically ill patients has recently been debated given its suppression of steroidogenesis with possible resultant adverse outcomes. Our objective was to assess the effects of single-dose etomidate used during rapid-sequence intubation (RSI) on various measures of outcome, such as mortality, vasopressor use, corticosteroid use, ICU length of stay (ICU-LOS), and number of ventilator days.
2010 Nov - Determinants of ICU Care in the Last Month of Life for Taiwanese Cancer Decedents, 2001 to 2006
Shiao-Chi Wu, PhD, Jen-Shi Chen, MD, Hung-Ming Wang, MD, Yen-Ni Hung, PhD, Tsang-Wu Liu, MD and Siew Tzuh Tang, DNSc. Published online before print April 2, 2010, doi: 10.1378/chest.09-2662. CHEST November 2010 vol. 138 no. 5 1071-1077
Background: Use of the hospital ICU is rising rapidly for end-of-life care. The purpose of this population-based study was to determine the prevalence of ICU care in the last month of life of patients with cancer and the associations between ICU care and patient demographics, disease characteristics, physician specialty, hospital characteristics, and availability of health-care resources at the hospital and regional levels in Taiwan. 2010 Nov - Cutaneous Ear Lobe Pco2 at 37°C To Evaluate Microperfusion in Patients With Septic Shock
Fabrice Vallée, MD, Joaquim Mateo, MD, Guillaume Dubreuil, MD, Thomas Poussant, MD, Guillaume Tachon, MD, Ingrid Ouanounou, MD and Didier Payen, MD, PhD. Published online before print May 14, 2010, doi: 10.1378/chest.09-2690
CHEST November 2010 vol. 138 no. 5 1062-1070
Background: Tissue hypercarbia is related to hypoperfusion and microcirculatory disturbances in patients with septic shock. Transcutaneous Pco2 devices using a heated sensor to arterialize the tissue have been used as an alternative method for estimation of Paco2. This study investigates whether a cutaneous sensor attached to an ear lobe and regulated to 37°C could be used to measure cutaneous Pco2 (Pcco2) and evaluate microperfusion in patients with septic shock. 2010 Nov - An Alternative Method of Acute Lung Injury Classification for Use in Observational Studies
Background: In observational studies using acute lung injury (ALI) as an outcome, a spectrum of lung injury and difficult-to-interpret chest radiographs (CXRs) may hamper efforts to uncover risk factor associations. We assessed the impact of excluding patients with difficult-to-classify or equivocal ALI diagnosis on clinical and genetic risk factor associations for ALI after trauma.
2010 Nov - Patient-Controlled Sedation: A Novel Approach to Patients Who Are Mechanically Ventilated in the ICU
Background: Patient self-administration of medications for analgesia and procedural sedation is common. However, it is not known whether mechanically ventilated ICU patients can self-administer their own sedation to manage symptoms.
2010 Oct - In Vitro Evaluation of Endotracheal Tubes With Intrinsic Suction
Background: Endotracheal tube (ETT) intubation impairs mucus clearance, which can lead to respiratory compromise. We compared three ETTs that have intrinsic capacity to aspirate secretions pooling above the cuff.
2010 Oct - C-Reactive Protein Levels and Post-ICU Mortality in Nonsurgical Intensive Care Patients
Background: There are no data on the association between acute inflammation during critical illness and long-term mortality in ICU patients.
2010 Oct - Ventricular Dilation Is Associated With Improved Cardiovascular Performance and Survival in Sepsis
Objectives: Myocardial dysfunction in sepsis may be associated with changes in left ventricular (LV) size. The goal of this study was to evaluate the impact of myocardial dysfunction and changes in LV diameter on hemodynamics and survival in a murine model of sepsis.
2010 Sep End-of-Life Treatment and Bacterial Antibiotic Resistance: A Potential Association
Background: Great variability exists in the occurrence of antibiotic-resistant bacteria in ICUs around the world. The contribution of specific ICU care variables to these geographic variations is unknown.
2010 Sep - Physiologic Response to Changing Positive End-Expiratory Pressure During Neurally Adjusted Ventilatory Assist in Sedated, Critically Ill Adults
Figure. A patient being put on the Neurally Adjusted Ventilatory Assist (NAVA) catheter (Photo courtesy: ICU, Pamela Youde Nethersole Eastern Hospital)
Background: Neurally adjusted ventilatory assist (NAVA) delivers airway pressure (Paw) in proportion to neural inspiratory drive as reflected by electrical activity of the diaphragm (EAdi). Changing positive end-expiratory pressure (PEEP) impacts respiratory muscle load and function and, hence, EAdi. We aimed to evaluate how PEEP affects the breathing pattern and neuroventilatory efficiency during NAVA.