2010 Feb - Accuracy of clinical signs, SEP, and EEG in predicting outcome of hypoxic coma: A meta-analysis
Objective: Accurate prediction of neurologic outcome after hypoxic coma is important. Previous systematic reviews have not used summary statistics to summarize and formally compare the accuracy of different prognostic tests. We therefore used summary receiver operating characteristic curve (SROC) and cluster regression methods to compare motor and pupillary responses with sensory evoked potential (SEP) and EEG in predicting outcome after hypoxic coma.
2010 Apr 21 - Update in Pulmonary and Critical Care Medicine
This article summarizes studies published in 2009 that have important implications for the practice of pulmonary and critical care medicine.
2010 Mar - Primary Angioplasty Versus Fibrinolysis in Acute Myocardial Infarction. Long-Term Follow-Up in the Danish Acute Myocardial Infarction 2 Trial
BACKGROUND: -The Danish Acute Myocardial Infarction 2 (DANAMI-2) study found that primary angioplasty (primary percutaneous coronary intervention [pPCI]) compared with fibrinolysis reduced 30-day adverse events in patients with ST-segment elevation myocardial infarction. The present study investigated whether the benefit of pPCI was maintained at a long-term follow-up.
2010 Mar - Clinically-indicated replacement versus routine replacement of peripheral venous catheters
BACKGROUND: Centers for Disease Control Guidelines recommend replacement of peripheral intravenous (IV) catheters every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bacteraemia.
2009 Oct - Heparin flushing and other interventions to maintain patency ofcentral venous catheters: a systematic review
Abstract Title. Heparin flushing and other interventions to maintain patency of central venous catheters: a systematic review. Aim. This paper is a report of a review to assess clinical studies comparing the effectiveness of different means of maintaining central venous catheter patency.
2010 Apr 6 - Gadolinium-Enhanced Magnetic Resonance Angiography for Pulmonary Embolism - A Multicenter Prospective Study (PIOPED III)
Background: The accuracy of gadolinium-enhanced magnetic resonance pulmonary angiography and magnetic resonance venography for diagnosing pulmonary embolism has not been determined conclusively.
2010 Apr 6 - Association of Community-Acquired Pneumonia With Antipsychotic Drug Use in Elderly Patients. A Nested Case–Control Study
Background: According to safety alerts from the U.S. Food and Drug Administration, pneumonia is one of the most frequently reported causes of death in elderly patients with dementia who are treated with antipsychotic drugs. However, epidemiologic evidence of the association between antipsychotic drug use and pneumonia is limited.
2010 Jan - Percutaneous coronary intervention or coronary artery bypass surgery for cardiogenic shock and multivessel coronary artery disease? [Review]
Mehta RH, Lopes RD, Ballotta A, Frigiola A, Sketch MH Jr, Bossone E, Bates ER.; Am Heart J. 2010 Jan;159(1):141-7.
BACKGROUND: Despite advances in treatment of cardiogenic shock (CS), the incidence of this serious complication of acute ST-elevation myocardial infarction (STEMI) has stayed relatively constant, and rates of mortality, although somewhat improved in recent decades, remain dauntingly high. Although both percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are used in patients with CS with multivessel coronary disease, the optimal revascularization strategy in this setting remains unknown.
2010 Feb 17 - Chest physiotherapy for pneumonia in adults
Background
Despite conflicting evidence, chest physiotherapy has been widely used as an adjunctive treatment for adults with pneumonia.
2010 Mar 18 - Critical illness due to 2009 A/H1N1 influenza in pregnant and postpartum women: population based cohort study
Objective To describe the epidemiology of 2009 A/H1N1 influenza in critically ill pregnant women.
Design: Population based cohort study.
2010 Jan - Risk of fatal and nonfatal lactic acidosis with metformin use in type 2 diabetes mellitus
BACKGROUND: Metformin is an oral anti-hyperglycemic agent that has been shown to reduce total mortality compared to other anti-hyperglycemic agents, in the treatment of type 2 diabetes mellitus. Metformin, however, is thought to increase the risk of lactic acidosis, and has been considered to be contraindicated in many chronic hypoxemic conditions that may be associated with lactic acidosis, such as cardiovascular, renal, hepatic and pulmonary disease, and advancing age.
2010 Mar - Gastric perforation after cardiopulmonary resuscitation: review of the literature
Spoormans I, Van Hoorenbeeck K, Balliu L, Jorens PG.; Resuscitation. 2010 Mar;81(3):272-80.
The risk of complications of cardiopulmonary resuscitation (CPR) does not outweigh the benefit of a successful restoration of a spontaneous circulation. Despite the frequent occurrence of gastric distension (caused by air entering the stomach because of too forceful and/or too quick rescue breathing), there are few reports of massive gastric distension causing gastric rupture and pneumoperitoneum after CPR.
2010 Jan 20 - Enteral versus parenteral nutrition for acute pancreatitis
Background
Acute pancreatitis creates a catabolic stress state promoting a systemic inflammatory response and nutritional deterioration. Adequate supply of nutrients plays an important role in recovery. Total parenteral nutrition (TPN) has been standard practice for providing exogenous nutrients to patients with severe acute pancreatitis. However, recent data suggest that enteral nutrition (EN) is not only feasible, but safer and more effective.Therefore, we sought to update our systematic review to re-evaluate the level of evidence.
2010 Feb - Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study.
OBJECTIVES: To evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections. Design Collaborative cohort study to implement and evaluate interventions to improve patients' safety.
2010 Feb - Comparison of BISAP, Ranson's, APACHE-II, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis
OBJECTIVES: Identification of patients at risk for severe disease early in the course of acute pancreatitis (AP) is an important step to guiding management and improving outcomes.
2009 Nov - Systematic review and meta-analysis of enteral nutrition formulations in acute pancreatitis.
BACKGROUND: Although the benefits of enteral nutrition in acute pancreatitis are well established, the optimal composition of enteral feeding is largely unknown. The aim of the study was to compare the tolerance and safety of enteral nutrition formulations in patients with acute pancreatitis.
2010 Mar - Haemodilution-induced profibrinolytic state is mitigated by fresh-frozen plasma: implications for early haemostatic intervention in massive haemorrhage.
BACKGROUND: Fibrinolysis contributes to coagulopathy after major trauma and surgery. We hypothesized that progressive haemodilution is responsible, at least in part, for increased fibrinolytic tendency of blood clot.
2009 Dec - Severe sepsis in cirrhosis [Review]
Gustot T, Durand F, Lebrec D, Vincent JL, Moreau R.; Hepatology. 2009 Dec;50(6):2022-33.
Sepsis is physiologically viewed as a proinflammatory and procoagulant response to invading pathogens. There are three recognized stages in the inflammatory response with progressively increased risk of end-organ failure and death: sepsis, severe sepsis, and septic shock. Patients with cirrhosis are prone to develop sepsis, sepsis-induced organ failure, and death. There is evidence that in cirrhosis, sepsis is accompanied by a markedly imbalanced cytokine response ("cytokine storm"), which converts responses that are normally beneficial for fighting infections into excessive, damaging inflammation.
2010 Jan - Sepsis and the heart [Review]
Hunter JD, Doddi M. ;Br J Anaesth. 2010 Jan;104(1):3-11
Septic shock, the most severe complication of sepsis, accounts for approximately 10% of all admissions to intensive care. Our understanding of its complex pathophysiology remains incomplete but clearly involves stimulation of the immune system with subsequent inflammation and microvascular dysfunction.