2012 Oct - The sounds of cardiac arrest: Innovating to obtain an accurate record during in-hospital cardiac arrest
Duran N, Riera J, Nuvials X, Ruiz-Rodriguez JC, Serra J, Rello J; CRIPS/SODIR researchers.; Resuscitation. 2012 Oct;83(10):1219-22.
BACKGROUND: To obtain an accurate audit during in-hospital cardiac arrest, following recommendations of the Utstein style and measuring time intervals between the different interventions, is difficult.
OBJECTIVE: To assess whether the use of an audio recording system during in-hospital cardiac arrest resuscitation allows the register of more items during cardiopulmonary resuscitation.
2012 Sep - Endotracheal intubation versus supraglottic airway insertion in out-of-hospital cardiac arrest
Wang HE, Szydlo D, Stouffer JA, Lin S, Carlson JN, Vaillancourt C, Sears G, Verbeek RP, Fowler R, Idris AH, Koenig K, Christenson J, Minokadeh A, Brandt J, Rea T; The ROC Investigators.; Resuscitation. 2012 Sep;83(9):1061-1066.
OBJECTIVE: To simplify airway management and minimize cardiopulmonary resuscitation (CPR) chest compression interruptions, some emergency medical services (EMS) practitioners utilize supraglottic airway (SGA) devices instead of endotracheal intubation (ETI) as the primary airway adjunct in out-of-hospital cardiac arrest (OHCA). We compared the outcomes of patients receiving ETI with those receiving SGA following OHCA.
2012 Oct - Cardiovascular management of septic shock in 2012
Guillamet MC, Rhee C, Patterson AJ.; Curr Infect Dis Rep. 2012 Oct;14(5):493-502.
Septic shock is a major cause of morbidity and mortality throughout the world. Source control, antimicrobial therapy, early goal-directed fluid resuscitation, and infusion of vasoactive pharmaceuticals remain the cornerstones of treatment. However, the cardiovascular management of septic shock is evolving...
2012 Aug - Mortality after fluid bolus in children with shock due to sepsis or severe infection: a systematic review and meta-analysis
Ford N, Hargreaves S, Shanks L.; PLoS One. 2012;7(8):e43953. Epub 2012 Aug 30.
INTRODUCTION: Sepsis is one of the leading causes of childhood mortality, yet controversy surrounds the current treatment approach. We conducted a systematic review to assess the evidence base for fluid resuscitation in the treatment of children with shock due to sepsis or severe infection.
2012 Oct - The effect of a family support intervention on physician, nurse, and family perceptions of care in the surgical, neurological, and medical intensive care units
Moore CD, Bernardini GL, Hinerman R, Sigond K, Dowling J, Wang DB, Shelton W.; Crit Care Nurs Q. 2012 Oct;35(4):378-87.
Many patients in the intensive care unit (ICU) have predictable medical and discharge outcomes, but some trajectories are marked with medical uncertainty. Stressed family-surrogates receive multiple medical updates from a variety of personnel. These circumstances can lead to confusion, which may result in conflicts and dissatisfaction with care. This study examined the effects of adding a family support coordinator to the surgical, neurological, and medical ICUs on family, physician, and nurse satisfaction with communication and care..
2012 Aug - U-Curve Association between Timing of Renal Replacement Therapy Initiation and In-Hospital Mortality in Postoperative Acute Kidney Injury
Shiao CC, Ko WJ, Wu VC, Huang TM, Lai CF, Lin YF, Chao CT, Chu TS, Tsai HB, Wu PC, Young GH, Kao TW, Huang JW, Chen YM, Lin SL, Wu MS, Tsai PR, Wu KD, Wang MJ. PLoS One. 2012;7(8):e42952. Epub 2012 Aug 28.
BACKGROUND: Postoperative acute kidney injury (AKI) is associated with poor outcomes in surgical patients. This study aims to evaluate whether the timing of renal replacement therapy (RRT) initiation affects the in-hospital mortality of patients with postoperative AKI.
2012 Aug - The spine-injured patient: initial assessment and emergency treatment
Schouten R, Albert T, Kwon BK.; J Am Acad Orthop Surg. 2012 Jun;20(6):336-46
Failure to recognize spinal column or spinal cord injuries, or improper treatment of them, can have catastrophic and often irreversible neurologic consequences. Although the initial assessment is often shared with emergency care personnel, an orthopaedic surgeon's perspective can elevate the priority of spinal care to the level that is warranted. An accurate early appraisal, including complete neurologic assessment, is critical...
2012 Jun - Intensive Versus Subcutaneous Insulin in Patients With Hyperacute Stroke: Results From the Randomized INSULINFARCT Trial.
BACKGROUND AND PURPOSE: Intensive insulin therapy (IIT) has not yet proven its efficacy on stroke prognosis or in the reduction of MRI infarct growth. The INSULINFARCT study aims at determining in patients with hyperacute stroke whether IIT, with a better control of poststroke hyperglycemia, would reduce subsequent MRI infarct growth than usual care with subcutaneous insulin.
2012 Jul - Emerging drugs for the treatment of sepsis
Kotsaki A, Giamarellos-Bourboulis EJ.; Expert Opin Emerg Drugs. 2012 Jul 11. [Epub ahead of print]
Introduction: Despite improvement in medical care, severe sepsis and septic shock remain an unmet medical need. Their incidence is steadily increasing and the worldwide mortality ranges between 30% and 50%. This generates the need for agents that modulate the immune function of the host.
2012 Jul - Intra-aortic balloon counterpulsation in patients with acute myocardial infarction without cardiogenic shock. A meta-analysis of randomized trials
Cassese S, de Waha A, Ndrepepa G, Ranftl S, King L, Schömig A, Kastrati A.; Am Heart J. 2012 Jul;164(1):58-65.e1.
BACKGROUND: Conflicting data on intra-aortic balloon counterpulsation (IABC) as adjunctive therapy in high-risk acute myocardial infarction (AMI) without cardiogenic shock (CS) have been published. We performed a meta-analysis of randomized trials evaluating the benefits of IABC in patients with AMI without CS.
2012 Jun - Statin therapy in critical illness: an international survey of intensive care physicians' opinions, attitudes and practice
Shankar Hari M, Kruger PS, Di Gangi S, Scales DC, Perkins GD, McAuley DF, Terblanche M.; BMC Clin Pharmacol. 2012 Jun 28;12(1):13. [Epub ahead of print]
BACKGROUND: Pleotropic effects of statins on inflammation are hypothesised to attenuate the severity of and possibly prevent the occurrence of the host inflammatory response to pathogen and infection-related acute organ failure. We conducted an international survey of intensive care physicians in Australia, New Zealand (ANZ) and United Kingdom (UK). The aims of the survey were to assess the current prescribing practice patterns, attitudes towards prescribing statin therapy in critically ill patients and opinions on the need for an interventional trial of statin therapy in critically ill patients.
2012 May - Mineralocorticoid deficiency in hemorrhagic shock
Tolstoy NS, Aized M, McMonagle MP, Holena DN, Pascual JL, Sonnad SS, Sims CA.; J Surg Res. 2012 May 25. [Epub ahead of print]
BACKGROUND: In the critically ill, mineralocorticoid deficiency (MD) is associated with greater disease severity, the development of acute renal insufficiency, and increased mortality. We hypothesized that severely injured trauma patients presenting with hemorrhagic shock would demonstrate a high degree of MD. We also hypothesized that MD in these patients would be associated with increased length of stay, hypotension, fluid requirements, and acute kidney injury (AKI).
2012 Jun - Clinical Spectrum, Frequency, and Significance of Myocardial Dysfunction in Severe Sepsis and Septic Shock
Pulido JN, Afessa B, Masaki M, Yuasa T, Gillespie S, Herasevich V, Brown DR, Oh JK.; Mayo Clin Proc. 2012 Jun 7. [Epub ahead of print]
Objective: To determine the frequency and spectrum of myocardial dysfunction in patients with severe sepsis and septic shock using transthoracic echocardiography and to evaluate the impact of the myocardial dysfunction types on mortality.
2012 Jun - High-volume Hemofiltration in the Intensive Care Unit: A Blood Purification Therapy
Rimmelé T, Kellum JA.; Anesthesiology. 2012 Jun;116(6):1377-87.
High-volume hemofiltration is an extracorporeal therapy that has been available in the intensive care unit for more than 10 yr. Recent improvements in technology have made its clinical application easier and safer. However, the definition, indications, and management of this technique are still unclear, and considerable controversy and confusion remain. The aim of this review is to analyze the available data while taking into account the distinction between two very different clinical situations: acute kidney injury requiring renal support, and severe inflammatory states where blood purification has been suggested as an adjuvant therapy...
2012 May - Therapeutic hypothermia for severe traumatic brain injury: a critically appraised topic
Kramer C, Freeman WD, Larson JS, Hoffman-Snyder C, Wellik KE, Demaerschalk BM, Wingerchuk DM.; Neurologist. 2012 May;18(3):173-7.
Background: Traumatic brain injury (TBI) is common and confers a high rate of disability and mortality. Current treatments are primarily supportive. Therapeutic hypothermia has been proposed for severe TBI because of its ability to reduce intracranial pressure and putative neuroprotective effects.
2012 Jun - Cardiopulmonary resuscitation and management of cardiac arrest
Nolan JP, Soar J, Wenzel V, Paal P.; Nat Rev Cardiol. 2012 Jun 5. doi: 10.1038/nrcardio.2012.78. [Epub ahead of print]
The best chance of survival with a good neurological outcome after cardiac arrest is afforded by early recognition and high-quality cardiopulmonary resuscitation (CPR), early defibrillation of ventricular fibrillation (VF), and subsequent care in a specialist center. Compression-only CPR should be used by responders who are unable or unwilling to perform mouth-to-mouth ventilations. After the first defibrillator shock, further rhythm checks and defibrillation attempts should be performed after 2 min of CPR....
2012 Jun - Pulmonary Embolism Diagnosis and Mortality With Pulmonary CT Angiography Versus Ventilation-Perfusion Scintigraphy: Evidence of Overdiagnosis With CT?
Sheh SH, Bellin E, Freeman KD, Haramati LB.; AJR Am J Roentgenol. 2012 Jun;198(6):1340-5.
OBJECTIVE: The purposes of this study were to determine whether pulmonary emboli diagnosed with pulmonary CT angiography (CTA) represent a milder disease spectrum than those diagnosed with ventilation-perfusion (V/Q) scintigraphy, to determine the trends in incidence and mortality among patients with the diagnosis of pulmonary embolism from 2000 to 2007, and to correlate incidence and mortality trends with imaging modality trends.
2012 May - Chlorhexidine bathing to reduce central venous catheter-associated bloodstream infection: impact and sustainability
BACKGROUND: Chlorhexidine bathing has been associated with reductions in healthcare-associated bloodstream infection. To determine the impact and sustainability of the effect of chlorhexidine bathing on central venous catheter-associated bloodstream infection, we performed a prospective, 3-phase, multiple-hospital study.
2012 May - Systolic Blood Pressure Reduction and Risk of Acute Renal Injury in Patients with Intracerebral Hemorrhage
Qureshi AI, Palesch YY, Martin R, Novitzke J, Cruz Flores S, Ehtisham A, Goldstein JN, Kirmani JF, Hussein HM, Suri MF, Tariq N; Antihypertensive Treatment of Acute Cerebral Hemorrhage Investigators.; Am J Med. 2012 May 4. [Epub ahead of print]
BACKGROUND: Aggressive systolic blood pressure reduction may precipitate acute renal injury because of underlying hypertensive nephropathy in patients with intracerebral hemorrhage. The study's objective was to determine the rate and determinants of acute renal injury during acute hospitalization among subjects with intracerebral hemorrhage using a post hoc analysis of a multicenter prospective study.
2012 Apr - Effectiveness of physiotherapy and occupational therapy after traumatic brain injury in the intensive care unit
Hellweg S.; Crit Care Res Pract. 2012;2012:768456. Epub 2012 Apr 5.
Physiotherapy and occupational therapy are frequently administered in intensive care units (ICUs) after traumatic brain injury (TBI) to promote recovery. The increasing economic pressure and the growing need for evidence of therapeutic effectiveness are reasons for reviewing the currently available scientific data. The databases of OTseeker, PEDro, Medline, and Cochrane were searched for studies on frequently applied therapeutic procedures in the ICU following a TBI...