2011 Mar - Severe pneumococcal pneumonia: impact of new quinolones on prognosis
Olive D, Georges H, Devos P, Boussekey N, Chiche A, Meybeck A, Alfandari S, Leroy O.; BMC Infect Dis. 2011 Mar 15;11(1):66. [Epub ahead of print]
BACKGROUND: Most guidelines have been proposing, for more than 15 years, a beta-lactam combined with either a quinolone or a macrolide as empirical, first-line therapy of severe community acquired pneumonia (CAP) requiring ICU admission. Our goal was to evaluate the outcome of patients with severe CAP, focusing on the impact of new rather than old fluoroquinolones combined with beta-lactam in the empirical antimicrobial treatments.
2011 Apr - Diagnostic and prognostic biomarkers of sepsis in critical care [Review]
Kibe S, Adams K, Barlow G.; J Antimicrob Chemother. 2011 Apr;66 Suppl 2:ii33-40.
Sepsis is a leading cause of mortality in critically ill patients. Delay in diagnosis and initiation of antibiotics have been shown to increase mortality in this cohort. However, differentiating sepsis from non-infectious triggers of the systemic inflammatory response syndrome (SIRS) is difficult, especially in critically ill patients who may have SIRS for other reasons. It is this conundrum that predominantly drives broad-spectrum antimicrobial use and the associated evolution of antibiotic resistance in critical care environments.
2011 Mar - Randomised trial of glutamine, selenium, or both, to supplement parenteral nutrition for critically ill patients
Andrews PJ, Avenell A, Noble DW, Campbell MK, Croal BL, Simpson WG, Vale LD, Battison CG, Jenkinson DJ, Cook JA; and the SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial) Trials Group.; BMJ. 2011 Mar 17;342:d1542.
OBJECTIVE: To determine whether inclusion of glutamine, selenium, or both in a standard isonitrogenous, isocaloric preparation of parenteral nutrition influenced new infections and mortality among critically ill patients.
2011 Mar - Acute and critically ill peripartum cardiomyopathy and 'bridge to' therapeutic options: a single center experience with intra-aortic balloon pump, extra corporeal membrane oxygenation and continuous-flow left ventricular assist devices
Peripartum cardiomyopathy (PPCM) patients refractory to medical therapy and intra-aortic balloon pump (IABP) counterpulsation or in whom weaning from these therapies is impossible, are candidates for a left ventricular assist device (LVAD) as a bridge to recovery or transplant. Continuous-flow LVADs are smaller, have a better long-term durability and are associated with better outcomes. Extra corporeal membrane oxygenation (ECMO) can be used as a temporary support in patients with refractory cardiogenic shock. The aim of this study was to evaluate the efficacy and safety of mechanical support in acute and critically ill PPCM patients.
2011 Feb - The risk of hypotension following co-prescription of macrolide antibiotics and calcium-channel blockers
Background: The macrolide antibiotics clarithromycin and erythromycin may potentiate calcium-channel blockers by inhibiting cytochrome P450 isoenzyme 3A4. However, this potential drug interaction is widely underappreciated and its clinical consequences have not been well characterized. We explored the risk of hypotension or shock requiring hospital admission following the simultaneous use of calcium-channel blockers and macrolide antibiotics.
2011 Mar - The Predictive Value of Preoperative Natriuretic Peptide Concentrations in Adults Undergoing Surgery: A Systematic Review and Meta-Analysis
Lurati Buse GA, Koller MT, Burkhart C, Seeberger MD, Filipovic M.; Anesth Analg. 2011 Mar 3. [Epub ahead of print]
Background: Several studies have evaluated preoperative B-type natriuretic peptides (NPs) for predicting mortality after surgery; however, the number of deaths in each study was small, limiting the power of these studies. We conducted a systematic review and meta-analysis of studies addressing preoperative NP levels to predict mortality after cardiac and noncardiac surgery.
2011 Mar- A Systematic Review of Third-Generation Hydroxyethyl Starch (HES 130/0.4) in Resuscitation: Safety Not Adequately Addressed
Hartog CS, Kohl M, Reinhart K.; Anesth Analg. 2011 Mar;112(3):635-45.
BACKGROUND: Hydroxyethyl starches (HES) are widely used for intravascular volume therapy in surgical, emergency, and intensive care patients. There are safety concerns with regard to coagulopathy, renal failure, pruritus, tissue storage, and mortality. Third-generation HES 130/0.4 is considered to have an improved risk profile. A common rationale for the use of HES is the belief that 3 to 4 times more crystalloid than colloid volume is needed to achieve similar hemodynamic end points. Our goal was to assess whether published studies on HES 130/0.4 resuscitation are sufficiently well designed to draw conclusions about the safety of this compound. In addition, we wanted to assess crystalloid-to-colloid fluid ratios in studies with goal-directed fluid regimen.
2011 Feb 14 - Use of Intensive Insulin Therapy for the Management of Glycemic Control in Hospitalized Patients: A Clinical Practice Guideline From the American College of Physicians
Description: The American College of Physicians (ACP) developed this guideline to present the evidence for the link between the use of intensive insulin therapy to achieve different glycemic targets and health outcomes in hospitalized patients with or without diabetes mellitus.
2011 Feb 1 - Effect of Routine Sterile Gloving on Contamination Rates in Blood Culture: A Cluster Randomized Trial
Background: Blood culture contamination leads to inappropriate or unnecessary antibiotic use. However, practical guidelines are inconsistent about the routine use of sterile gloving in collection of blood for culture.
2011 Jan - Airway Management in Critically Ill Patients [Review]
Griesdale DE, Henderson WR, Green RS.; Lung. 2011 Jan 28.
In critically ill patients, endotracheal intubation is associated with a high risk of complications, including severe hypoxemia and hypotension. The purpose of this review is to discuss the definitions, complications, airway assessment, and patient optimization with respect to these patients. In addition, we present different approaches and techniques to help secure the airway in critically ill patients. We also discuss strategies to help minimize the risk of a difficult or failed airway and to mitigate the severe life-threatening complications associated with this high-risk procedure.
2011 Jan - Surveillance and outbreak reports: Oseltamivir-resistant influenza viruses circulating during the first year of the influenza A(H1N1)2009 pandemic in the Asia-Pacific region, March 2009 to March 2010
During the first year of the influenza A(H1N1)2009 pandemic, unprecedented amounts of the neuraminidase inhibitors, predominantly oseltamivir, were used in economically developed countries for the treatment and prophylaxis of patients prior to the availability of a pandemic vaccine.
2011 Feb - A randomized trial for the treatment of refractory status epilepticus
Rossetti AO, Milligan TA, Vulliémoz S, Michaelides C, Bertschi M, Lee JW.; Neurocrit Care. 2011 Feb;14(1):4-10.
BACKGROUND: Refractory status epilepticus (RSE) has a mortality of 16-39%; coma induction is advocated for its management, but no comparative study has been performed. We aimed to assess the effectiveness (RSE control, adverse events) of the first course of propofol versus barbiturates in the treatment of RSE.
2011 Feb - Impact of Intraventricular Hemorrhage upon Intracerebral Hematoma Expansion
Moussouttas M, Malhotra R, Fernandez L, Maltenfort M, Holowecki M, Delgado J, Lawson N, Badjatia N.; Neurocrit Care. 2011 Feb;14(1):50-4.
BACKGROUND: The purpose of this study is to determine whether intraventricular hemorrhage (IVH) exerts a "decompressive" effect that limits intracerebral hemorrhage (ICH) enlargement.
2011 Feb - Current practices of triple-h prophylaxis and therapy in patients with subarachnoid hemorrhage
Meyer R, Deem S, David Yanez N, Souter M, Lam A, Treggiari MM.; Neurocrit Care. 2011 Feb;14(1):24-36.
BACKGROUND: Medical management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) includes hypertensive, hypervolemic, and hemodilution ("triple-H") therapy. However, there is little information regarding the indications and guidance used to initiate and adjust triple-H therapy.
2011 Jan - Surface Cooling after Cardiac Arrest: Effectiveness, Skin Safety, and Adverse Events in Routine Clinical Practice
Jarrah S, Dziodzio J, Lord C, Fraser GL, Lucas L, Riker RR, Seder DB.; Neurocrit Care. 2011 Jan 20.
BACKGROUND: Effectiveness of cooling and adverse events (AEs) involving skin have not been intensively evaluated in cardiac arrest survivors treated with therapeutic hypothermia (TH) when induced and maintained with a servomechanism-regulated surface cooling system.
2010 Jun - Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology
OBJECTIVE: To provide an update of the 1995 American Academy of Neurology guideline with regard to the following questions: Are there patients who fulfill the clinical criteria of brain death who recover neurologic function? What is an adequate observation period to ensure that cessation of neurologic function is permanent? Are complex motor movements that falsely suggest retained brain function sometimes observed in brain death? What is the comparative safety of techniques for determining apnea? Are there new ancillary tests that accurately identify patients with brain death? METHODS: A systematic literature search was conducted and included a review of MEDLINE and EMBASE from January 1996 to May 2009. Studies were limited to adults.
2010 Nov - Quantitative analysis of acid-base disorders in patients with chronic respiratory failure in stable or unstable respiratory condition
Guérin C, Nesme P, Leray V, Wallet F, Bourdin G, Bayle F, Germain M, Richard JC.; Respir Care. 2010 Nov;55(11):1453-63.
BACKGROUND: The Stewart approach theorizes that plasma pH depends on P(aCO₂), the strong ion difference, and the plasma total concentration of non-volatile weak acids (A(tot)). The conventional approach measures standardized base excess, bicarbonate (HCO₃⁻), and the anion gap.
2010 Nov - Comparative analysis of therapeutic options used for myasthenia gravis
Mandawat A, Kaminski HJ, Cutter G, Katirji B, Alshekhlee A.; Ann Neurol. 2010 Nov 8.
OBJECTIVE: To compare clinical and economic outcomes following plasma exchange (PLEX) and intravenous immunoglobulin (IVIG) in U.S. patients with primary diagnoses of myasthenia gravis (MG).
2010 Dec - Are patients brain-dead after successful resuscitation from cardiac arrest suitable as organ donors? A systematic review [Review]
Sandroni C, Adrie C, Cavallaro F, Marano C, Monchi M, Sanna T, Antonelli M.; Resuscitation. 2010 Dec;81(12):1609-14.
AIM: To compare the outcome of organs retrieved from patients brain dead due to cardiac arrest (CA) with that of organs retrieved from patients brain dead due to other causes (non-CA).
2010 Nov - A rapid, safe, and low-cost technique for the induction of mild therapeutic hypothermia in post-cardiac arrest patients
Kory P, Weiner J, Mathew JP, Fukunaga M, Palmero V, Singh B, Haimowitz S, Clark ET, Fischer A, Mayo PH.; Resuscitation. 2010 Nov 1. [Epub ahead of print]
AIM OF STUDY: The benefits of inducing mild therapeutic hypothermia (MTH) in cardiac arrest patients are well established. Timing and speed of induction have been related to improved outcomes in several animal trials and one human study. We report the results of an easily implemented, rapid, safe, and low-cost protocol for the induction of MTH.