2010 Jul - Randomised controlled trial and parallel economic evaluation of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR).
OBJECTIVES: To determine the comparative effectiveness and cost-effectiveness of conventional ventilatory support versus extracorporeal membrane oxygenation (ECMO) for severe adult respiratory failure.
2010 Aug 17 - Narrative Review: Ventilator-Induced Respiratory Muscle Weakness
Clinicians have long been aware that substantial lung injury results when mechanical ventilation imposes too much stress on the pulmonary parenchyma. Evidence is accruing that substantial injury may also result when the ventilator imposes too little stress on the respiratory muscles.
2010 Aug 17 - Steroid Pretreatment of Organ Donors to Prevent Postischemic Renal Allograft Failure: A Randomized, Controlled Trial
Background: Posttransplantation acute renal failure (ARF) occurs in roughly 25% of recipients of organs from deceased donors. Inflammation in the donor organ is associated with risk for ARF.
2010 Jul - Vasoactive drugs for acute stroke [Review]
BACKGROUND: It is unclear whether blood pressure (BP) should be altered actively during the acute phase of stroke.
2010 Jul - Proton pump inhibitor treatment initiated prior to endoscopic diagnosis in upper gastrointestinal bleeding [Review]
BACKGROUND: There is conflicting evidence regarding the clinical efficacy of proton pump inhibitors (PPI) initiated before endoscopy for upper gastrointestinal bleeding.
2010 Jul - Tranexamic acid for preventing postpartum haemorrhage [Review]
BACKGROUND: Postpartum haemorrhage (PPH) is a common and occasionally life-threatening complication of labour. Several options for preventing PPH are available, but further advances in this field are important, especially the identification of safe, easy to use, and cost-effective regimes. Tranexamic acid, which is an antifibrinolytic that is used widely to prevent and treat haemorrhage, merits evaluation to assess whether it meets these criteria.
2010 Aug - Physical methods for preventing deep vein thrombosis in stroke [Review]
BACKGROUND: Deep vein thrombosis (DVT) and resulting pulmonary embolism (PE) are important complications of stroke. Physical methods to reduce the risk of DVT and PE, such as graduated compression stockings (GCS) or intermittent pneumatic compression (IPC) applied to the legs, do not appear to be associated with any bleeding risk and reduce the risk of DVT in some categories of surgical patients. We sought to assess their effects in stroke patients.
2010 Aug - Noninvasive positive pressure ventilation as a weaning strategy for intubated adults with respiratory failure. [Review]
BACKGROUND: Noninvasive positive pressure ventilation (NPPV) provides ventilatory support without the need for an invasive airway approach. Interest has emerged in using NPPV to facilitate earlier removal of an endotracheal tube and decrease complications associated with prolonged intubation.
2010 May- Venous thromboembolism and subsequent diagnosis of subarachnoid haemorrhage: a 20-year cohort study
Background: Venous thromboembolism is a predictor of subsequent risk of ischaemic stroke and intracerebral haemorrhage, but no data are available regarding its association with risk of subarachnoid haemorrhage.
2010 Jun - Medical thoracoscopy vs CT scan-guided Abrams pleural needle biopsy for diagnosis of patients with pleural effusions: a randomized, controlled trial
BACKGROUND: In cases of pleural effusion, tissue samples can be obtained through Abrams needle pleural biopsy (ANPB), thoracoscopy, or cutting-needle pleural biopsy under the guidance of CT scan (CT-CNPB) for histopathologic analysis. This study aimed to compare the diagnostic efficiency and reliability of ANPB under CT scan guidance (CT-ANPB) with that of medical thoracoscopy in patients with pleural effusion.
2010 Jul - Inhaled nitric oxide for acute respiratory distress syndrome (ARDS) and acute lung injury in children and adults
BACKGROUND: Acute hypoxaemic respiratory failure (AHRF), defined as acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), are critical conditions. AHRF results from a number of systemic conditions and is associated with high mortality and morbidity in all ages. Inhaled nitric oxide (INO) has been used to improve oxygenation but its role remains controversial.
2010 Jul - Elastic compression stockings for prevention of deep vein thrombosis
BACKGROUND: One of the settings where deep vein thrombosis (DVT) in the lower limb and pelvic veins occurs is in hospital with prolonged immobilisation of patients for various surgical and medical illnesses. Using graduated compression stockings (GCS) in these patients has been proposed to decrease the risk of DVT. This is an update of a Cochrane review first published in 2000 and updated in 2003.
2010 Aug 3 - One-Year Trajectories of Care and Resource Utilization for Recipients of Prolonged Mechanical Ventilation: A Cohort Study
Background: Growing numbers of critically ill patients receive prolonged mechanical ventilation. Little is known about the patterns of care as patients transition from acute care hospitals to postacute care facilities or about the associated resource utilization.
2010 Mar - Esophageal pressures in acute lung injury: do they represent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress?
Figure. An esophageal pressure catheter is being inserted for measurement of transpulmonary pressure in a patient with ARDS from human swine flu. An ECMO catheter is at right neck. (Photo courtesy of ICU, Pamela Youde Nethersole Eastern Hospital). This patient eventually survived.
Acute lung injury can be worsened by inappropriate mechanical ventilation, and numerous experimental studies suggest that ventilator-induced lung injury is increased by excessive lung inflation at end inspiration or inadequate lung inflation at end expiration. Lung inflation depends not only on airway pressures from the ventilator but, also, pleural pressure within the chest wall.
2010 Feb - The lessons of SARS in Hong Kong
Severe acute respiratory syndrome (SARS) is a novel coronavirus infection which broke out in Hong Kong in March 2003. Princess Margaret Hospital was designated to manage this new, mysterious and serious disease.
2010 May 18 - Letter: High-Dose N-Acetylcysteine Therapy for Novel H1N1 Influenza Pneumonia
Background: High-dose N-acetylcysteine synergizes with oseltamivir to protect mice from fatal influenza infection.
2010 May - Protocolized versus non-protocolized weaning for reducing the duration of mechanical ventilation in critically ill adult patients. [Review]
Blackwood B, Alderdice F, Burns KE, Cardwell CR, Lavery G, O'Halloran P.; Cochrane Database Syst Rev. 2010 May 12
BACKGROUND: Reducing weaning time is desirable in minimizing potential complications from mechanical ventilation. Standardized weaning protocols are purported to reduce time spent on mechanical ventilation. However, evidence supporting their use in clinical practice is inconsistent.
2010 Mar - Randomized, double-blind, placebo-controlled, pilot trial of high-dose methylprednisolone in aneurysmal subarachnoid hemorrhage
OBJECT: The object of this study was to determine the efficacy of methylprednisolone in reducing symptomatic vasospasm and poor outcomes after subarachnoid hemorrhage (SAH).
2010 May 4 - Review: Meta-analysis: Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema
Background: Noninvasive ventilation (NIV) is commonly used to treat patients with acute cardiogenic pulmonary edema (ACPE), but the findings of a recent large clinical trial suggest that NIV may be less effective for ACPE than previously thought.
2010 Apr - Heated humidification versus heat and moisture exchangers for ventilated adults and children
BACKGROUND: Humidification by artificial means must be provided when the upper airway is bypassed during mechanical ventilation. Heated humidification (HH) and heat and moisture exchangers (HME) are the most commonly used types of artificial humidification in this situation.