2012 Oct - Endothelin-receptor antagonists for aneurysmal subarachnoid hemorrhage: an updated meta-analysis of randomized controlled trials
Introduction: Previous meta-analysis of the use of endothelin-receptor antagonists (ETRAs) to treat aneurysmal subarachnoid hemorrhage (SAH) has become outdated due to recently published Phase-3 clinical trials. An up-to-date meta-analysis is needed to provide the best available evidence of the efficacy of ETRAs for aneurysmal SAH.
2012 Oct - A comparison of RIFLE with and without urine output criteria for acute kidney injury in critically ills
Introduction: RIFLE is a consensus-based classification system for diagnosing acute kidney insufficiency (AKI), based on serum creatinine (SCr) and urine output criteria (RIFLESCr+UO). The urine output criteria, however, are frequently discarded and many studies in the literature applied only the SCr criteria (RIFLESCr). We diagnosed AKI using both RIFLE methods and compared the effects on time to AKI diagnosis, AKI incidence and AKI severity.
2012 Aug - Acute management and outcome of multiple trauma patients with pelvic disruptions
Introduction: Data on pre-hospital and trauma room fluid management of multiple trauma patients with pelvic disruptions are rarely reported. Present trauma algorithms recommend early haemorrhage control and massive fluid resuscitation. By matching the German Pelvic Injury Register (PIR) with the TraumaRegister DGU(R) (TR) for the first time, we attempt to assess the initial fluid management for different Tile/OTA types of pelvic ring fractures. Special attention was given to the patient's post traumatic course, particularly ICU data and patient outcome.
2012 Aug - Continuous venovenous hemodialysis with regional citrate anticoagulation in patients with liver failure: a prospective observational study
Introduction: Liver failure patients might be at risk for citrate accumulation during continuous venovenous hemodialysis (CVVHD) with regional citrate anticoagulation. The aim of this study was to investigate the predictive capability of baseline liver function parameters regarding citrate accumulation expressed as an increase in the calcium total/calcium ionized (Catot/Caion) ratio of [greater than or equal to]2.5 and to describe the feasibility of citrate CVVHD in liver failure patients.
2012 Aug - Epidemiology and outcome of severe pneumococcal pneumonia admitted to intensive care unit: a multicenter study
Introduction: Community-acquired pneumonia (CAP) account for a high proportion of ICU admissions, with Streptococcus pneumoniae being the main pathogen responsible for these infections. However, little is known on the clinical features and outcomes of ICU patients with pneumococcal pneumonia. The aims of this study were to provide epidemiological data and to determine risk factors of mortality in patients admitted to ICU for severe S. pneumoniae CAP.
2012 Aug - A perioperative infusion of sodium bicarbonate does not improve renal function in cardiac surgery patients: a prospective observational cohort study
Introduction: Cardiac-surgery-associated-acute-kidney-injury (CSA-AKI) is associated with increased morbidity and mortality. Recent data from patients undergoing on-pump coronary artery bypass grafting suggest that a perioperative infusion of sodium-bicarbonate may decrease the incidence of CSA-AKI. The present study aims to analyze the renoprotective effects of a 24h infusion of sodium-bicarbonate in a large, heterogeneous group of cardiac surgical patients
2012 Aug - Vasopressin and terlipressin in adult vasodilatory shock: a systematic review and meta-analysis of nine randomized controlled trials
Introduction: Catecholamines are the most used vasopressors in vasodilatory shock. However, the development of adrenergic hyposensitivity and the subsequent loss of catecholamine pressor activity necessitate the search for other options. Our aim was to evaluate the effects of vasopressin and its analogue terlipressin compared with cathecolamine infusion alone in vasodilatory shock.
2012 Aug - Improved neurologically intact survival with the use of an automated, load-distributing band chest compression device for cardiac arrest presenting to the emergency department
Introduction: It has been unclear if mechanical cardiopulmonary resuscitation (CPR) is a viable alternative to manual CPR. We aimed to compare resuscitation outcomes before and after switching from manual CPR to load-distributing band (LDB) CPR in a multi-center emergency department (ED) trial.
2012 Aug - Benefits and risks of manual hyperinflation in intubated and mechanically ventilated intensive care unit-patients: a systematic review
Introduction: Manual hyperinflation (MH), a frequently applied maneuver in critically ill intubated and mechanically ventilated patients, is suggested to mimic a cough so that airway secretions are mobilized towards the larger airways where they can easily be removed. As such, MH could prevent plugging of the airways.
2012 Aug - Hemofiltration compared to hemodialysis for acute kidney injury: systematic review and meta-analysis
Introduction: The objective of this systematic review and meta-analysis was to determine the effect of renal replacement therapy (RRT), delivered as hemofiltration vs. hemodialysis, on clinical outcomes in patients with acute kidney injury (AKI).
2012 Jul - Associations Between the Use of Critical Care Procedures and Change in Functional Status at Discharge
Kuwabara K, Matsuda S, Fushimi K, Ishikawa KB, Horiguchi H, Fujimori K.; J Intensive Care Med. 2012 Jul 8. [Epub ahead of print]
Quality improvement initiatives in intensive care units (ICUs) have increased survival rates. Changes in functional status following ICU care have been studied, but results are inconclusive because of insufficient consideration of the combinations of critical care procedures used.
2012 Jun - Number needed to treat and cost-effectiveness in the prevention of ventilator-associated pneumonia
While clinicians continue to redefine ventilator-associated pneumonia (VAP), numerous innovations that claim to reduce pulmonary microaspiration and its consequences - that is, novel endotracheal cuff shapes and cuff materials, subglottic drainage...
2012 Jun - Impact of whole-body computed tomography on mortality and surgical management of severe blunt trauma
Introduction: The mortality benefit of whole-body computed tomography (CT) in early trauma management remains controversial and poorly understood. The objective of this study was to assess the impact of whole-body CT compared with selective CT on mortality and management of patients with severe blunt trauma.
2012 Jun - Endotracheal intubation using the C-MAC(R) video laryngoscope or the Macintosh laryngoscope: a prospective, comparative study in the ICU
Introduction: Endotracheal intubation in the intensive care unit (ICU) is a challenging procedure and is frequently associated with life threatening complications. The aim of this study was to investigate the effect of the C-MAC video laryngoscope on laryngeal view and intubation success compared to direct laryngoscopy.
2012 Jun - Should lower respiratory tract secretions from intensive care patients be systematically screened for influenza virus during the influenza season?
Introduction: Influenza is easily overlooked in intensive care units (ICU), particularly in patients with alternative causes of respiratory failure or in those who acquire influenza during their ICU stay.
2012 Jun - Lung-protective mechanical ventilation does not protect against acute kidney injury in patients without lung injury at onset of mechanical ventilation
Cortjens B, Royakkers AA, Determann RM, van Suijlen JD, Kamphuis SS, Foppen J, de Boer A, Wieland CW, Spronk PE, Schultz MJ, Bouman CS. J Crit Care 2012 Jun;27(3):261-7.
INTRODUCTION: Preclinical and clinical studies suggest that mechanical ventilation contributes to the development of acute kidney injury (AKI), particularly in the setting of lung-injurious ventilator strategies.
2012 May - Total to ionized calcium ratio predicts mortality in continuous renal replacement therapy with citrate anticoagulation in critically ill patients
Introduction: Regional citrate anticoagulation is safe, feasible and increasingly used in critically ill patients on continuous renal replacement therapy (CRRT). However, in patients with hepatic or multi-organ dysfunction, citrate accumulation may lead to an imbalance of calcium homeostasis. The study aimed at evaluating the incidence and prognostic relevance of an increased total to ionized calcium ratio (T/I-Ca-ratio) and its association to hepatic dysfunction.
2012 Jun - Electrocardiographic changes in therapeutic hypothermia
Introduction: During therapeutic hypothermia (TH) ECG abnormalities such as Osborn waves and/or ST segment elevation have been described. However, the incidence and prognostic value of these ECG changes are uncertain given the small-scale studies that have been carried out to date. The aim of this study is to further evaluate the electrocardiographic changes during therapeutic hypothermia.
2012 Apr - Antioxidant micronutrients in the critically ill: a systematic review and meta-analysis
Manzanares W, Dhaliwal R, Jiang X, Murch L, Heyland DK.; Crit Care. 2012 Apr 25;16(2):R66. [Epub ahead of print]
Introduction: Critical illness is characterized by oxidative stress which is a major promoter of systemic inflammation and organ failure due to excessive free radicals production, depletion of antioxidant defenses, or both. We hypothesized that exogenous supplementation of trace elements and vitamins could restore antioxidant status improving clinical outcomes.
2012 May - The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients
Van Rompaey B, Elseviers MM, Van Drom W, Fromont V, Jorens PG.; Crit Care. 2012 May 4;16(3):R73. [Epub ahead of print]
INTRODUCTION: This study hypothesised that a sound reduction during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, does the use of earplugs during the night improve the quality of sleep in the ICU?