Critical Care Medicine (Highlights)

2012 Dec - Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest

Janz, David R.; Hollenbeck, Ryan D.; Pollock, Jeremy S.; McPherson, John A.; Rice, Todd W.; Critical Care Medicine. 40(12):3135-3139, December 2012.
Objective: To determine whether higher levels of PaO₂ are associated with in-hospital mortality and poor neurological status at hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest.

2012 Nov - Efficacy spectrum of antishivering medications: Meta-analysis of randomized controlled trials

Park, Sea Mi; Mangat, Halinder S.; Berger, Karen; Rosengart, Axel J.; Critical Care Medicine. 40(11):3070-3082, November 2012.
Objectives: Shivering after anesthesia or in the critical care setting is frequent, can be prolonged, and has the potential for serious adverse events and worsening outcomes. Furthermore, there are conflicting published data and clinical protocols on how to best treat shivering. In this study, we aimed to critically analyze the published evidence of antishivering medications.

2012 Nov - The Bereaved Parent Needs Assessment: A new instrument to assess the needs of parents whose children died in the pediatric intensive care unit

Meert, Kathleen L.; Templin, Thomas N.; Michelson, Kelly N.; Morrison, Wynne E.; Hackbarth, Richard; Custer, Joseph R.; Schim, Stephanie M.; Briller, Sherylyn H.; Thurston, Celia S.; Critical Care Medicine. 40(11):3050-3057, November 2012.
Objectives: To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents’ needs and need fulfillment around the time of their child’s death in the pediatric intensive care unit. We hypothesized that need fulfillment would be negatively related to complicated grief and positively related to quality of life during bereavement.

2012 Nov - Activated protein C and septic shock: A propensity-matched cohort study

Rimmer, Emily; Kumar, Anand; Doucette, Steve; Marshall, John; Dial, Sandra; Gurka, David; Dellinger, R. Phillip; Sharma, Satendra; Penner, Charles; Kramer, Andreas; Wood, Kenneth; Ronald, John; Kumar, Aseem; Turgeon, Alexis F.; Houston, Donald S.; Zarychanski, Ryan; The Co-operative Antimicrobial Therapy of Septic Shock (CATSS) Database Research Group; Critical Care Medicine. 40(11):2974-2981, November 2012.
Background: Septic shock is a highly inflammatory and procoagulant state associated with significant mortality. In a single randomized controlled trial, recombinant human activated protein C (drotrecogin alfa) reduced mortality in patients with severe sepsis at high risk of death. Further clinical trials, including a recently completed trial in patients with septic shock, failed to reproduce these results.

2012 Nov - A multicenter, phased, cluster-randomized controlled trial to reduce central line-associated bloodstream infections in intensive care units

Marsteller, Jill A.; Sexton, J. Bryan; Hsu, Yea-Jen; Hsiao, Chun-Ju; Holzmueller, Christine G.; Pronovost, Peter J.; Thompson, David A.; Critical Care Medicine. 40(11):2933-2939, November 2012.
Objectives: To determine the causal effects of an intervention proven effective in pre-post studies in reducing central line-associated bloodstream infections in the intensive care unit.

2012 Nov - Etomidate is associated with mortality and adrenal insufficiency in sepsis: A meta-analysis

Chan, Chee Man; Mitchell, Anthony L.; Shorr, Andrew F.; Critical Care Medicine. 40(11):2945-2953, November 2012
Objective: To evaluate the effects of single-dose etomidate on the adrenal axis and mortality in patients with severe sepsis and septic shock.

2012 Oct - Tracheostomy practice in adults with acute respiratory failure [Review]

Freeman, Bradley D.; Morris, Peter E.; Critical Care Medicine. 40(10):2890-2896, October 2012
Objective: Tracheostomy remains one of the most commonly performed surgical procedures in adults with acute respiratory failure and identifies a patient cohort which is among the most resource-intensive to provide care. The objective of this concise definitive review is the synthesis of current knowledge regarding tracheostomy practice in this context.

2012 Oct- Continuous electroencephalography monitoring for early prediction of neurological outcome in postanoxic patients after cardiac arrest: A prospective cohort study

Cloostermans, Marleen C.; van Meulen, Fokke B.; Eertman, Carin J.; Hom, Harold W.; van Putten, Michel J. A. M.; Critical Care Medicine. 40(10):2867-2875, October 2012.
Objective: To evaluate the value of continuous electroencephalography in early prognostication in patients treated with hypothermia after cardiac arrest.

2012 Oct -Initial resuscitation guided by the Surviving Sepsis Campaign recommendations and early echocardiographic assessment of hemodynamics in intensive care unit septic patients: A pilot study

Bouferrache, Koceila; Amiel, Jean-Bernard; Chimot, Loïc; Caille, Vincent; Charron, Cyril; Vignon, Philippe; Vieillard-Baron, Antoine; Critical Care Medicine. 40(10):2821-2827, October 2012
Objective: To compare therapeutic interventions during initial resuscitation derived from echocardiographic assessment of hemodynamics and from the Surviving Sepsis Campaign guidelines in intensive care unit septic patients.

2012 Oct - Diurnal sedative changes during intensive care: Impact on liberation from mechanical ventilation and delirium

Seymour, Christopher W.; Pandharipande, Pratik P.; Koestner, Tyler; Hudson, Leonard D.; Thompson, Jennifer L.; Shintani, Ayumi K.; Ely, E. Wesley; Girard, Timothy D.; Critical Care Medicine. 40(10):2788-2796, October 2012
Objective: To determine whether benzodiazepine and propofol doses are increased at night and whether daytime and nighttime sedative doses are associated with delirium, coma, and delayed liberation from mechanical ventilation.

2012 Oct - Longitudinal changes in procalcitonin in a heterogeneous group of critically ill patients

Reynolds, Steven C.; Shorr, Andrew F.; Muscedere, John; Jiang, Xuran; Heyland, Daren K.; Critical Care Medicine. 40(10):2781-2787, October 2012
Objective: The utility of procalcitonin for the diagnosis of infection in the critical care setting has been extensively investigated with conflicting results. Herein, we report procalcitonin values relative to baseline patient characteristics, presence of shock, intensive care unit time course, infectious status, and Gram stain of infecting organism.

2012 Oct - Previous prescription of β-blockers is associated with reduced mortality among patients hospitalized in intensive care units for sepsis

Macchia, Alejandro; Romero, Marilena; Comignani, Pablo Dino; Mariani, Javier; D’Ettorre, Antonio; Prini, Nadia; Santopinto, Mariano; Tognoni, Gianni; Critical Care Medicine. 40(10):2768-2772, October 2012.
Objectives: Results from basic science and narrative reviews suggest a potential role of β-blockers in patients with sepsis. Although the hypothesis is physiologically appealing, it could be seen as clinically counterintuitive. We sought to assess whether patients previously prescribed chronic β-blocker therapy had a different mortality rate than those who did not receive treatment.

2012 Sep - Treatment of four psychiatric emergencies in the intensive care unit [Review]

Sevransky, Jonathan E.; Bienvenu, O. Joseph; Neufeld, Karin J.; Needham, Dale M.; Critical Care Medicine. 40(9):2662-2670, September 2012
Objectives: To review the diagnosis and management of four selected psychiatric emergencies in the intensive care unit: agitated delirium, neuroleptic malignant syndrome, serotonin syndrome, and psychiatric medication overdose.

2012 Sep - Precision of noninvasive hemoglobin-level measurement by pulse co-oximetry in patients admitted to intensive care units for severe gastrointestinal bleeds

Coquin, Julien; Dewitte, Antoine; Manach, Yannick Le; Caujolle, Marie; Joannes-Boyau, Olivier; Fleureau, Catherine; Janvier, Gérard; Ouattara, Alexandre; Critical Care Medicine. 40(9):2576-2582, September 2012
Objectives: Measurement of total hemoglobin, based on pulse co-oximetry, is a continuous and noninvasive method that has been principally evaluated in healthy volunteers subjected to hemodilution. We tested the hypothesis that its accuracy could adversely affect patients presenting with severe hemorrhage, which is traditionally associated with increased microvascular tone.

2012 Sep - Association between systemic corticosteroids and outcomes of intensive care unit–acquired pneumonia

Ranzani, Otavio Tavares; Ferrer, Miquel; Esperatti, Mariano; Giunta, Valeria; Li Bassi, Gianluigi; Carvalho, Carlos Roberto Ribeiro; Torres, Antoni; Critical Care Medicine. 40(9):2552-2561, September 2012
Objective: The use of corticosteroids is frequent in critically-ill patients. However, little information is available on their effects in patients with intensive care unit–acquired pneumonia. We assessed patients’ characteristics, microbial etiology, inflammatory response, and outcomes of previous corticosteroid use in patients with intensive care unit–acquired pneumonia.

2012 Sep - Effects of fluid resuscitation with synthetic colloids or crystalloids alone on shock reversal, fluid balance, and patient outcomes in patients with severe sepsis: A prospective sequential analysis

Bayer, Ole; Reinhart, Konrad; Kohl, Matthias; Kabisch, Björn; Marshall, John; Sakr, Yasser; Bauer, Michael; Hartog, Christiane; Schwarzkopf, Daniel; Riedemann, Niels; Critical Care Medicine. 40(9):2543-2551, September 2012
Objective: To assess shock reversal and required fluid volumes in patients with septic shock.

Design: Prospective before and after study comparing three different treatment periods.

2012 Aug - The risk of catheter-related bloodstream infection with femoral venous catheters as compared to subclavian and internal jugular venous catheters: A systematic review of the literature and meta-analysis

Marik, Paul E.; Flemmer, Mark; Harrison, Wendy; Critical Care Medicine. 40(8):2479-2485, August 2012.
Background: Catheter-related bloodstream infections are an important cause of morbidity and mortality in hospitalized patients. Current guidelines recommend that femoral venous access should be avoided to reduce this complication (1A recommendation). However, the risk of catheter-related bloodstream infections from femoral as compared to subclavian and internal jugular venous catheterization has not been systematically reviewed.

2012 Aug - The incomplete infrastructure for interhospital patient transfer

Iwashyna, Theodore J.; Critical Care Medicine. 40(8):2470-2478, August 2012.
Objective: Interhospital transfer of critically ill patients is a common part of their care. This article sought to review the data on the current patterns of use of interhospital transfer and identify systematic barriers to optimal integration of transfer as a mechanism for improving patient outcomes and value of care.

2012 Aug - Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury

Aries, Marcel J. H.; Czosnyka, Marek; Budohoski, Karol P.; Steiner, Luzius A.; Lavinio, Andrea; Kolias, Angelos G.; Hutchinson, Peter J.; Brady, Ken M.; Menon, David K.; Pickard, John D.; Smielewski, Peter; Critical Care Medicine. 40(8):2456-2463, August 2012.
Objectives: We have sought to develop an automated methodology for the continuous updating of optimal cerebral perfusion pressure (CPP_opt) for patients after severe traumatic head injury, using continuous monitoring of cerebrovascular pressure reactivity. We then validated the CPP_opt algorithm by determining the association between outcome and the deviation of actual CPP from CPP_opt.

2012 Aug - Acute respiratory distress syndrome after trauma: Development and validation of a predictive model

Watkins, Timothy R.; Nathens, Avery B.; Cooke, Colin R.; Psaty, Bruce M.; Maier, Ronald V.; Cuschieri, Joseph; Rubenfeld, Gordon D.; Critical Care Medicine. 40(8):2295-2303, August 2012.
Objective: To determine early clinical predictors of acute respiratory distress syndrome after major traumatic injury and characterize the performance of this acute respiratory distress syndrome prediction model, and two previously published acute respiratory distress syndrome prediction models, in an independent cohort of severely injured patients.

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