2011 Oct - Routine management of volume status after aneurysmal subarachnoid hemorrhage
Wolf S; Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage.; Neurocrit Care. 2011 Sep;15(2):275-80.
Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarachnoid hemorrhage. Quality of selected studies was evaluated, using the standardized GRADE system. Eleven studies focused on prophylactic hypervolemic therapy after aneurysmal subarachnoid hemorrhage were identified, including four randomized controlled trials.
2011 Oct - Critical Care Management of Patients Following Aneurysmal Subarachnoid Hemorrhage: Recommendations from the Neurocritical Care Society’s Multidisciplinary Consensus Conference [Review]
Diringer MN, Bleck TP, Claude Hemphill J 3rd, Menon D, Shutter L, Vespa P, Bruder N, Connolly ES Jr, Citerio G, Gress D, Hänggi D, Hoh BL, Lanzino G, Le Roux P, Rabinstein A, Schmutzhard E, Stocchetti N, Suarez JI, Treggiari M, Tseng MY, Vergouwen MD, Wolf S, Zipfel G; Neurocritical Care Society.; Neurocrit Care. 2011 Sep;15(2):211-40.
Subarachnoid hemorrhage (SAH) is an acute cerebrovascular event which can have devastating effects on the central nervous system as well as a profound impact on several other organs. SAH patients are routinely admitted to an intensive care unit and are cared for by a multidisciplinary team. A lack of high quality data has led to numerous approaches to management and limited guidance on choosing among them. Existing guidelines emphasize risk factors, prevention, natural history, and prevention of rebleeding, but provide limited discussion of the complex critical care issues involved in the care of SAH patients. The Neurocritical Care Society organized an international, multidisciplinary consensus conference on the critical care management of SAH to address this need.
2011 Sep - Early administration of sivelestat, the neutrophil elastase inhibitor, in adults for acute lung injury following gastric aspiration
Hayashida K, Fujishima S, Sasao K, Orita T, Toyoda Y, Kitano M, Hori S.; Shock. 2011 Sep;36(3):223-7.
Gastric aspiration is the major cause of acute lung injury (ALI) and acute respiratory distress syndrome. Aspiration-induced ALI is believed to be, at least in part, facilitated by neutrophil-derived mediators and toxic molecules. We conducted a prospective cohort study based on the hypothesis that sivelestat, a specific neutrophil elastase inhibitor, is effective for treating ALI following gastric aspiration.
2011 Oct - Polymyxin B-immobilized fiber column hemoperfusion therapy for septic shock [Review]
Mitaka C, Tomita M.; Shock. 2011 Oct;36(4):332-8.
Endotoxin, an outer membrane component of gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin adsorption therapy by polymyxin B-immobilized fiber column hemoperfusion (PMX) has been used for the treatment of septic shock patients in Japan since 1994. The covalent binding of polymyxin B onto the surface of the polystyrene-based carrier fiber in PMX inactivates the endotoxin in the blood without exerting toxicity. This study was performed as a systematic review to evaluate the efficacy and mechanism of PMX treatment in patients with septic shock.
2011 Sep - Late Compliance With the Sepsis Resuscitation Bundle: Impact on Mortality
Castellanos-Ortega A, Suberviola B, Garcia-Astudillo LA, Ortiz F, Llorca J, Delgado-Rodriguez M. Shock. 2011 Sep 7. [Epub ahead of print]
PURPOSE: Early compliance with the sepsis resuscitation bundle has been suggested to reduce mortality. However, few data are available about the impact of late compliance with the bundle on outcomes. The aim of this study is to assess whether the completion of the resuscitation bundle within the first 6 hours after admission to the intensive care unit (ICU), but beyond the specific time limit of the various bundle interventions, is related to an improvement in survival.
2011 Sep - Insulin for glycaemic control in acute ischaemic stroke [Review]
Bellolio MF, Gilmore RM, Stead LG.; Cochrane Database Syst Rev. 2011 Sep 7;9:CD005346.
BACKGROUND: Patients with hyperglycaemia concomitant with an acute stroke have greater stroke severity and greater functional impairment when compared to those with normoglycaemia at stroke presentation.
2011 Sep 6 - Maintaining Connections: Some Thoughts on the Value of Intensive Care Unit Rounding for General Medicine Ward Teams
When established ward patients are unexpectedly transferred to an intensive care unit (ICU), the ward team should continue to follow them. Although there may be reasons not to do so, the advantages outweigh the obstacles.
2011 Aug - Renal Insufficiency After Contrast Media Administration Trial II (REMEDIAL II): RenalGuard System in High-Risk Patients for Contrast-Induced Acute Kidney Injury
Briguori C, Visconti G, Focaccio A, Airoldi F, Valgimigli M, Sangiorgi GM, Golia B, Ricciardelli B, Condorelli G; for the REMEDIAL II Investigators.; Circulation. 2011 Aug 15. [Epub ahead of print]
Background- The RenalGuard System, which creates high urine output and fluid balancing, may be beneficial in preventing contrast-induced acute kidney injury.
2011 Aug - Acetylcysteine for Prevention of Renal Outcomes in Patients Undergoing Coronary and Peripheral Vascular Angiography: Main Results From the Randomized Acetylcysteine for Contrast-Induced Nephropathy Trial (ACT)
ACT Investigators.; Circulation. 2011 Aug 22. [Epub ahead of print]
Background- It remains uncertain whether acetylcysteine prevents contrast-induced acute kidney injury.
2011 Sep - Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial
Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL.; Resuscitation. 2011 Sep;82(9):1138-43. Epub 2011 Jul 2.
Background: There is little evidence from clinical trials that the use of adrenaline (epinephrine) in treating cardiac arrest improves survival, despite adrenaline being considered standard of care for many decades. The aim of our study was to determine the effect of adrenaline on patient survival to hospital discharge in out of hospital cardiac arrest.
2011 Sep - Advanced life support versus basic life support in the pre-hospital setting: A meta-analysis [Review]
Bakalos G, Mamali M, Komninos C, Koukou E, Tsantilas A, Tzima S, Rosenberg T. ; Resuscitation. 2011 Sep;82(9):1130-7. Epub 2011 Apr 17.
Background: The scientific evidence of a beneficial effect of ALS in pre-hospital treatment in trauma patients or patients with any acute illness is scarce. The objective of this systematic review of controlled studies was to examine whether ALS, as opposed to BLS, increases patient survival in pre-hospital treatment and if so, to identify the patient groups that gain benefit.
2011 Aug - Intraventricular Fibrinolysis for Intracerebral Hemorrhage with Severe Ventricular Involvement [Review]
Staykov D, Bardutzky J, Huttner HB, Schwab S.; Neurocrit Care. 2011 Aug;15(1):194-209.
Intraventricular hemorrhage (IVH) has been associated with poor prognosis in patients with spontaneous intracerebral hemorrhage. Several factors contribute to the deleterious effects of IVH, including direct mass effects of the ventricular blood clot on ependymal and subependymal brain structures, mechanical and inflammatory impairment of the Pacchioni granulations by blood and its breakdown products, and disturbance of physiological cerebrospinal fluid (CSF) circulation. Acute obstructive hydrocephalus represents a major life-threatening complication of IVH and is usually treated with an external ventricular drainage (EVD). However, treatment with EVD alone is frequently not sufficiently effective due to obstruction of the catheter by blood.....
2011 Aug - Impact of Percutaneous Transluminal Angioplasty for Treatment of Cerebral Vasospasm on Subarachnoid Hemorrhage Patient Outcomes
Khatri R, Memon MZ, Zacharatos H, Taqui AM, Qureshi MH, Vazquez G, Suri MF, Rodriguez GJ, Tummala RP, Ezzeddine MA, Qureshi AI.; Neurocrit Care. 2011 Aug;15(1):28-33.
Background: Percutaneous transluminal angioplasty (PTA) has been introduced for treatment of symptomatic cerebral vasospasm in patients with subarachnoid hemorrhage (SAH). While angiographic improvement is consistently reported, clinical improvement following the procedure varies, and limited data is available regarding overall impact on outcome.
2011 Jul - Critical Care Guidelines on the Endovascular Management of Cerebral Vasospasm [Review]
Kimball MM, Velat GJ, Hoh BL; The Participants in the International Multi-disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage.; Neurocrit Care. 2011 Jul 15. [Epub ahead of print]
Cerebral vasospasm and delayed cerebral ischemia account for significant morbidity and mortality after aneurysmal subarachnoid hemorrhage. While most patients are managed with triple-H therapy, endovascular treatments have been used when triple-H treatment cannot be used or is ineffective. An electronic literature search was conducted to identify English language articles published through October 2010 that addressed endovascular management of vasospasm...
2011 Aug - A clinical description of extubation failure in patients with primary brain injury
Karanjia N, Nordquist D, Stevens R, Nyquist P.; Neurocrit Care. 2011 Aug;15(1):4-12.
Background: Patients with acute brain injury but normal lung function are often intubated for airway protection, but extubation often fails. Currently, no clinical data exist that describe the events leading to extubation failure in this population. We examined the extubation failure rate, reintubation rate, and clinical characteristics of patients whose reason for intubation was a primary neurological injury. We then identified the clinical characteristics of those patients with primary brain injury who were reintubated.
2011 Apr - Use of end-tidal carbon dioxide detection to determine correct placement of nasogastric tube: a meta-analysis
Chau JP, Lo SH, Thompson DR, Fernandez R, Griffiths R.; Int J Nurs Stud. 2011 Apr;48(4):513-21. Epub 2011 Jan 7. Review.
Objective: To review the diagnostic accuracy of end-tidal carbon dioxide detection in detecting inadvertent airway intubation and verifying correct placement of nasogastric tubes.
2011 Mar 3 - Inhaled nitric oxide for acute respiratory distress syndrome and acute lung injury in adults and children: a systematic review with meta-analysis and trial sequential analysis
BACKGROUND: Acute hypoxemic respiratory failure, defined as acute lung injury and acute respiratory distress syndrome, are critical conditions associated with frequent mortality and morbidity in all ages. Inhaled nitric oxide (iNO) has been used to improve oxygenation, but its role remains controversial. We performed a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials (RCTs). We searched CENTRAL, Medline, Embase, International Web of Science, LILACS, the Chinese Biomedical Literature Database, and CINHAL (up to January 31, 2010). Additionally, we hand-searched reference lists, contacted authors and experts, and searched registers of ongoing trials. Two reviewers independently selected all parallel group RCTs comparing iNO with placebo or no intervention and extracted data related to study methods, interventions, outcomes, bias risk, and adverse events. All trials, irrespective of blinding or language status were included. Retrieved trials were evaluated with Cochrane methodology. Disagreements were resolved by discussion. Our primary outcome measure was all-cause mortality. We performed subgroup and sensitivity analyses to assess the effect of iNO in adults and children and on various clinical and physiological outcomes. We assessed the risk of bias through assessment of trial methodological components. We assessed the risk of random error by applying trial sequential analysis.
2011 Jul - Clinical and cardiac features of patients with subarachnoid haemorrhage presenting with out-of-hospital cardiac arrest
Mitsuma W, Ito M, Kodama M, Takano H, Tomita M, Saito N, Oya H, Sato N, Ohashi S, Kinoshita H, Kazama JJ, Honda T, Endoh H, Aizawa Y. Resuscitation. 2011 Jul 19. [Epub ahead of print]
BACKGROUND: Subarachnoid haemorrhage (SAH) is known as one of the aetiologies of out-of-hospital cardiac arrest (OHCA). However, the mechanisms of circulatory collapse in these patients have remained unclear.
2011 Jul - Severity of intraventricular extension correlates with level of admission glucose after intracerebral hemorrhage
Appelboom G, Piazza MA, Hwang BY, Carpenter A, Bruce SS, Mayer S, Connolly ES Jr.; Stroke. 2011 Jul;42(7):1883-8. Epub 2011 Jun 2.
BACKGROUND AND PURPOSE: Hyperglycemia after spontaneous intracerebral hemorrhage (ICH) is associated with poor outcome, but the pathophysiology of ICH-induced glucose dysregulation remains unclear. We sought to identify clinical and radiographic parameters of ICH that are associated with admission hyperglycemia.
2011 Jul - Does treatment of ruptured intracranial aneurysms within 24 hours improve clinical outcome?
Phillips TJ, Dowling RJ, Yan B, Laidlaw JD, Mitchell PJ.; Stroke. 2011 Jul;42(7):1936-45. Epub 2011 Jun 16.
BACKGROUND AND PURPOSE: The purpose of this study was to analyze whether treating ruptured intracranial aneurysms within 24 hours of subarachnoid hemorrhage improves clinical outcome.