2012 May - Impact of intensive care unit admission during morning bedside rounds and mortality: a multi-center retrospective cohort study
de Souza IA, Karvellas CJ, Gibney RN, Bagshaw SM.; Crit Care. 2012 May 3;16(3):R72. [Epub ahead of print]
INTRODUCTION: Recent data has suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region.
2012 May - Higher vs. lower fluid volume for septic shock: clinical characteristics and outcome in unselected patients in a prospective, multicenter cohort
Smith SH, Perner A.; Crit Care. 2012 May 8;16(3):R76. [Epub ahead of print]
INTRODUCTION: Patients with septic shock require fluid, but the optimum amount is unknown. Therefore we assessed patient characteristics and outcome associated to fluid volume in unselected patients with septic shock including those with three days of shock.
2012 Apr - Nurse staffing levels and the incidence of mortality and morbidity in the adult intensive care unit: A literature review
McGahan M, Kucharski G, Coyer F.; Aust Crit Care. 2012 Apr 17. [Epub ahead of print]
BACKGROUND: Studies have shown that nurse staffing levels, among many other factors in the hospital setting, contribute to adverse patient outcomes. Concerns about patient safety and quality of care have resulted in numerous studies being conducted to examine the relationship between nurse staffing levels and the incidence of adverse patient events in both general wards and intensive care units.
2012 Apr - Effectiveness of extracorporeal membrane oxygenation when conventional ventilation fails: Valuable option or vague remedy?
Tiruvoipati R, Botha J, Peek G.; J Crit Care. 2012 Apr;27(2):192-8.
The mortality and morbidity of patients with severe acute respiratory distress syndrome (ARDS) remains high despite the advances in intensive care practice. The low-tidal-volume ventilation strategy (ARDS net protocol) has been shown to be effective in improving survival. Unfortunately, however, some patients have such severe ARDS that they cannot be managed with the ARDS net strategy. In these patients, rescue therapies such as high-frequency ventilation, prone ventilation, nitric oxide, and extracorporeal membrane oxygenation (ECMO) are considered...
2012 Apr - Relationship between the timing of administration of IgM and IgA enriched immunoglobulins in patients with severe sepsis and septic shock and the outcome: A retrospective analysis
Berlot G, Vassallo MC, Busetto N, Bianchi M, Zornada F, Rosato I, Tartamella F, Prisco L, Bigotto F, Bigolin T, Ferluga M, Batticci I, Michelone E, Borelli M, Viviani M, Tomasini A. J Crit Care. 2012 Apr;27(2):167-71.
PURPOSE: Because the use of IgM and IgA enriched polyclonal intravenous immunoglobulins (eIg) is a standard of care in critically ill patients admitted to our intensive care unit (ICU) with the diagnosis of severe sepsis or septic shock, we investigated if the delay from the onset of severe sepsis and septic shock and their administration could influence the outcome.
2012 Apr - Correlation between high blood interleukin-6 level, hyperglycemia and glucose control in septic patients
Nakamura M, Oda S, Sadahiro T, Watanabe E, Abe R, Nakada TA, Morita Y, Hirasawa H.; Crit Care. 2012 Apr 11;16(2):R58. [Epub ahead of print]
INTRODUCTION: To investigate the relationship between blood interleukin (IL)-6 level, blood glucose level and glucose control in septic patients.
2012 Apr - Stress hyperglycemia may not be harmful in critically ill patients with sepsis
Tiruvoipati R, Chiezey B, Lewis D, Ong K, Villanueva E, Haji K, Botha J.; J Crit Care. 2012 Apr;27(2):153-8.
BACKGROUND: Stress hyperglycemia (SH) is commonly seen in critically ill patients. It has been shown to be associated with adverse outcomes in some groups of patients. The effects of SH on critically ill patients with sepsis have not been well studied. We aimed to evaluate the effects of SH in critically ill patients with sepsis.
2012 Apr - Glucose variability negatively impacts long-term functional outcome in patients with traumatic brain injury
Matsushima K, Peng M, Velasco C, Schaefer E, Diaz-Arrastia R, Frankel H.; J Crit Care. 2012 Apr;27(2):125-31.
Purpose: Significant glycemic excursions (so-called glucose variability) affect the outcome of generic critically ill patients but has not been well studied in patients with traumatic brain injury (TBI). The purpose of this study was to evaluate the impact of glucose variability on long-term functional outcome of patients with TBI.
2012 Apr - Does patient volume affect clinical outcomes in adult intensive care units?
Kanhere MH, Kanhere HA, Cameron A, Maddern GJ.;Intensive Care Med. 2012 Apr 5. [Epub ahead of print]
PURPOSE: This systematic review assessed if outcomes in adult intensive care units (ICUs) are related to hospital and ICU patient volume.
2012 Apr - Diaphragm ultrasonography to estimate the work of breathing during non-invasive ventilation
Vivier E, Mekontso Dessap A, Dimassi S, Vargas F, Lyazidi A, Thille AW, Brochard L.;Intensive Care Med. 2012 Apr 5. [Epub ahead of print]
PURPOSE: Ultrasonography allows the direct observation of the diaphragm. Its thickness variation measured in the zone of apposition has been previously used to diagnose diaphragm paralysis. We assessed the feasibility and accuracy of this method to assess diaphragmatic function and its contribution to respiratory workload in critically ill patients under non-invasive ventilation.
2012 Apr - Hemoglobin levels and transfusions in neurocritically ill patients: a systematic review of comparative studies
Desjardins P, Turgeon AF, Tremblay MH, Lauzier F, Zarychanski R, Boutin A, Moore L, McIntyre L, English SW, Rigamonti A, Lacroix J, Fergusson DA.;Crit Care. 2012 Apr 2;16(2):R54.
Introduction: Accumulating evidence suggests that, in critically ill patients, a lower hemoglobin transfusion threshold is safe. However, the optimal hemoglobin level and associated transfusion threshold remain unknown in neurocritically ill patients.
2012 Mar - Intra-arrest hypothermia during cardiac arrest: a systematic review
Scolletta S, Taccone FS, Nordberg P, Donadello K, Vincent JL, Castren M.; Crit Care. 2012 Mar 7;16(2):R41.
INTRODUCTION: Therapeutic hypothermia is largely used to protect the brain following return of spontaneous circulation (ROSC) after cardiac arrest (CA), but it is unclear whether we should start therapeutic hypothermia earlier, i.e., before ROSC.
2012 Mar - Impact of non-neurological complications in severe traumatic brain injury outcome
Corral L, Javierre CF, Ventura JL, Marcos P, Herrero JI, Manez R.; Crit Care. 2012 Mar 12;16(2):R44.
INTRODUCTION: Non-neurological complications in patients with severe traumatic brain injury (TBI) are frequent, worsening the prognosis, but the pathophysiology of systemic complications after TBI is unclear. The purpose of this study was to analyze non-neurological complications in patients with severe TBI admitted to the Intensive Care Unit (ICU), the impact of these complications on mortality, and their possible correlation with TBI severity.
2012 Feb - Efficacy and cardiovascular tolerability of continuous veno-venous hemodiafiltration in acute decompensated heart failure: A randomized comparative study
Badawy SS, Fahmy A.; J Crit Care. 2012 Feb;27(1):106.e7-106.e13. Epub 2011 Jul 6.
BACKGROUND AND OBJECTIVES: Recently, continuous veno-venous hemodiafiltration (CVVHDF) has received increased attention in the treatment of congestive heart failure (CHF). The aim of this study is to assess the safety and efficacy of CVVHDF compared with intravenous furosemide in patients with CHF.
2012 Feb - Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy
Greenberg JA, Lennox JL, Martin GS.; J Crit Care. 2012 Feb;27(1):51-7. Epub 2011 Oct 26.
Rationale: With the advent of highly active antiretroviral therapy (HAART), sepsis has become a more frequent ICU diagnosis for patients with HIV infections. Yet, little is known about the etiologies of acute infections in critically ill patients with HIV and the factors that affect in-hospital mortality.
2012 Feb - Hepatorenal syndrome: the 8th international consensus conference of the Acute Dialysis Quality Initiative (ADQI) group
Introduction: Renal dysfunction is a common complication in patients with end-stage cirrhosis. Since the original publication of the definition and diagnostic criteria for the hepatorenal syndrome (HRS), there have been major advances in our understanding of its pathogenesis. The prognosis of patients with cirrhosis who develop HRS remains poor, with a median survival without liver transplantation of less than 6 months. However, a number of pharmacological and other therapeutic strategies have now become available which offer the ability to more effectively prevent or treat renal dysfunction in this setting. Accordingly, we sought to review the available evidence, make recommendations and delineate key questions for future studies.
2012 Feb - Inter-hospital transport of critically ill patients; expect surprises
Introduction: Inter-hospital transport of critically ill patients is increasing. When performed by specialized retrieval teams there are less adverse events compared to transport by ambulance. These transports are performed with technical equipment also used in an Intensive Care Unit (ICU). As a consequence technical problems may arise and have to be dealt with on the road. In this study, all technical problems encountered while transporting patients with our mobile intensive care unit service (MICU) were evaluated.
2012 Feb - Early use of imipenem/cilastatin and vancomycin followed by de-escalation versus conventional antimicrobials without de-escalation for patients with hospital-acquired pneumonia in a medical ICU: a randomized clinical trial
Introduction: Although early use of broad spectrum antimicrobials in critically ill patients may increase antimicrobial adequacy, uncontrolled use of these agents may select for more resistant organisms. This study investigated the effects of early use of broad spectrum antimicrobials in critically ill patients with hospital-acquired pneumonia.
2012 Feb - A prospective randomized open-label crossover trial of regional citrate anticoagulation vs. anticoagulation free liver dialysis by the Molecular Adsorbents Recirculating System
Introduction: The Molecular Adsorbent Recycling System (MARS) is used to treat patients with liver failure. Observational data suggest that citrate anticoagulation during MARS is feasible. Comparative studies on the optimal anticoagulation regimen during MARS are lacking. The aim of the current study was to evaluate two heparin-free anticoagulation regimens.
2012 Feb - Costs and benefits of rapid screening of methicillin-resistant Staphylococcus aureus carriage in intensive care units: a prospective multicenter study
Introduction: Pre-emptive isolation of suspected methicillin-resistant Staphylococcus aureus (MRSA) carriers is a cornerstone of successful MRSA control policies. Implementation of such strategies is hampered when using conventional cultures with diagnostic delays of 3 to 5 days, as many non-carriers remain unnecessarily isolated. Rapid diagnostic testing (RDT) reduces the amount of unnecessary isolation days, but costs and benefits have not been accurately determined in intensive care units (ICUs).