2011 Mar - Relationship between time to target temperature and outcome in patients treated with therapeutic hypothermia after cardiac arrest
Haugk M, Testori C, Sterz F, Uranitsch M, Holzer M, Behringer W, Herkner H, Time To Target Temperature Study Group T. ;Crit Care. 2011 Mar 25;15(2):R101.
INTRODUCTION: To study whether the time to target temperature correlates with neurologic outcome in patients after cardiac arrest with restoration of spontaneous circulation treated with therapeutic mild hypothermia in an academic emergency department.
2011 March - Procalcitonin in ICU patients with pneumonia requiring mechanical ventilation
Introduction
The intent of this study was to determine whether serum procalcitonin (PCT) levels are associated with prognosis, measured as organ dysfunctions and 28-day mortality, in patients with severe pneumonia...
2011 Mar - Audit of safety and quality of the use of enoxaparin for anticoagulation in continuous renal replacement therapy
Tsang DJ, Tuckfield A, Macisaac CM.; Crit Care Resusc. 2011 Mar;13(1):24-7.
OBJECTIVE: To evaluate the safety and efficacy of enoxaparin for anticoagulation during continuous renal replacement therapy (CRRT).
2010 Dec 8 - Clinical review: The ABC of weaning failure - a structured approach
About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing a treatment strategy require a dedicated clinician with in-depth knowledge of the pathophysiology of weaning failure.
2011 Feb 21 - A simple functional marker to predict the need for prolonged mechanical ventilation in patients with Guillain-Barre syndrome
Abstract (provisional)
Introduction
Patients suffering from Guillain-Barre syndrome (GBS) may frequently develop an acute respiratory failure and need ventilatory support. Immune therapy using plasma exchange or immunoglobulins has modified the natural course of the disease and by decreasing the length of the plateau phase, may induce a rapid improvement in ventilatory function. However a substantial proportion of patients still require prolonged mechanical ventilation (MV) and tracheotomy. The present study was designed to search for simple functional markers that could predict the need for prolonged MV just after completion of immune therapy.
2011 - Metformin-induced lactic acidosis: no one left behind
Sarah Vecchio1 and Alessandro Protti2*. Critical Care 2011, 15:107
Abstract (provisional)
Metformin is a safe drug when correctly used in properly selected patients. However, in real life, associated lactic acidosis has been repeatedly, although rarely, reported. The term metformin-induced lactic acidosis refers to cases that cannot be explained by any other major risk factor other than drug accumulation, usually due to renal failure. Treatment consists of vital function support and drug removal, mainly achieved by renal replacement therapy.
2010 Dec - Treatment strategies for refractory status epilepticus [Review]
Holtkamp M.; Curr Opin Crit Care. 2010 Dec 21.
PURPOSE OF REVIEW: Status epilepticus is one of the most common emergencies in neurology, and every third patient does not respond to adequate first-line treatment. Refractory status epilepticus may be associated with increased morbidity and mortality, and new treatment options are urgently required. This review critically discusses recently published data regarding the role of 'new' antiepileptic drugs, the efficacy and safety of anesthetic agents, and the overall clinical outcome that is an integral part of treatment decisions.
2011 Jan 19 - Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure: an experimental study
Abstract (provisional)
Introduction
The aim of the study was to evaluate dynamic indices of fluid responsiveness in a model of intra-abdominal hypertension.
2011 Jan 18 - Impact of delayed admission to intensive care units on mortality of critically ill patients: a cohort study
Introduction
When the number of patients who require intensive care is greater than the number of beds available, intensive care unit (ICU) entry flow is obstructed. This phenomenon has been associated with higher mortality rates in patients that are not admitted despite their need, and in patients that are admitted but are waiting for a bed. The purpose of this study is to evaluate if a delay in ICU admission affects mortality for critically ill patients.
2011 Jan 18 - Extracorporeal life support following out-of-hospital refractory cardiac arrest
Introduction
Extracorporeal life support (ECLS) has recently shown encouraging results in resuscitation of in-hospital (IH) refractory cardiac arrest. We assessed the use of ECLS following out-hospital (OH) refractory cardiac arrest.
2011 Jan - Antibiotics or probiotics as preventive measures against ventilator-associated pneumonia: a literature review
Schultz MJ, Haas L.; Crit Care. 2011 Jan 13;15(1):R18.
INTRODUCTION: Mechanically ventilated critically ill patients frequently develop ventilator-associated pneumonia (VAP), a life-threatening complication. Proposed preventive measures against VAP include, but are not restricted to selective decontamination of the digestive tract (SDD), selective oropharyngeal decontamination (SOD) and the use of probiotics. Probiotics are live bacteria that could have beneficial effects on the host by altering gastrointestinal flora. Similar to SDD and SOD, prescription of probiotics aims at the prevention of secondary colonization of upper and/or lower digestive tract.
2011 Jan - An updated study-level meta-analysis of randomised controlled trials on proning in ARDS and Acute Lung Injury
Introduction: In patients with acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS), recent randomised controlled trials (RCTs) showed a consistent trend of mortality reduction with prone ventilation. We updated a meta-analysis on this topic.
2011 Jan - Paradoxical ventilator associated pneumonia incidences among selective digestive decontamination studies versus other studies of mechanically ventilated patients: benchmarking the evidence base
Introduction: Selective digestive decontamination (SDD) appears to have a more compelling evidence base than non-antimicrobial methods for the prevention of ventilator associated pneumonia (VAP). However, the striking variability in ventilator associated pneumonia-incidence proportion (VAP-IP) among the SDD studies remains unexplained and a postulated contextual effect remains untested for.
2011 Jan - The dynamic pattern of end-tidal carbon dioxide during cardiopulmonary resuscitation - difference between asphyxial cardiac arrest and ventricular fibrillation/pulseless ventricular tachycardia cardiac arrest
Introduction: Partial pressure of end-tidal carbon dioxide (PetCO2) during cardiopulmonary resuscitation (CPR) correlates with cardiac output and consequently has a prognostic value in CPR. In our previous study we confirmed that initial PetCO2 value was significantly higher in asphyxial arrest than in ventricular fibrillation/pulseless ventricular tachycardia (VF/VT) cardiac arrest. In this study we sought to evaluate the pattern of PetCO2 changes in cardiac arrest caused by VF/VT and asphyxial cardiac arrest in patients who were resuscitated according to new 2005 Guidelines.
2010 Dec - Pre-hospital cooling of patients following cardiac arrest is effective using even low volumes of cold saline
Introduction: Pre-hospital induction of therapeutic mild hypothermia (TH) may reduce post-cardiac arrest brain injury in patients resuscitated from out-of-hospital cardiac arrest. Most often, it is induced by a rapid intravenous administration of as much as 30 ml/kg of cold crystalloids. We decided to assess the pre-hospital cooling effectivity of this approach; using a target dose of 15-20 ml/kg of 4degrees C cold normal saline in the setting of the physician staffed Emergency Medical Service. The safety and impact on the clinical outcome have also been analyzed.
2011 Jan - Antimicrobial pharmacokinetic and pharmacodynamic issues in the critically ill with severe sepsis and septic shock [Review]
Varghese JM, Roberts JA, Lipman J.; Crit Care Clin. 2011 Jan;27(1):19-34.
Antimicrobial pharmacokinetics (PK) and pharmacodynamics (PD) are important considerations, particularly in critically ill patients with severe sepsis and septic shock. The pathophysiologic changes that occur in these conditions can have a major effect on pharmacokinetic parameters, which in turn could result in failure to achieve pharmacodynamic targets for antimicrobials thus adversely affecting clinical outcome.
2011 Jan - Optimizing aminoglycoside use [Review]
Craig WA.; Crit Care Clin. 2011 Jan;27(1):107-21.
The appearance of new third- and fourth-generation cephalosporins, carbapenems, and fluoroquinolones have decreased the use of aminoglycosides as monotherapy for most gram-negative infections. Historically, aminoglycosides were used in combination with other antibiotics to enhance bacterial killing and improve overall efficacy. However, most studies have failed to demonstrate improved outcomes in patients treated with antibiotic combinations over those receiving monotherapy.
2010 Dec - Mean glucose during ICU admission is related to mortality by a U-shaped curve in surgical and medical patients: a retrospective cohort study
Siegelaar SE, Hermanides J, Oudemans-van Straaten HM, van der Voort PH, Bosman RJ, Zandstra DF, Devries JH.; Crit Care. 2010 Dec 10;14(6):R224.
INTRODUCTION: Lowering of hyperglycaemia in the intensive care unit (ICU) is widely practised. We investigated in which way glucose regulation, defined as mean glucose concentration during admission, is associated with ICU mortality in a medical and a surgical cohort.
2010 Dec - De-escalation after empirical meropenem treatment in the intensive care unit: fiction or reality?
De Waele JJ, Ravyts M, Depuydt P, Blot SI, Decruyenaere J, Vogelaers D.; J Crit Care. 2010 Dec;25(4):641-6.
INTRODUCTION: De-escalation of antimicrobial therapy is often advocated to reduce the use of broad-spectrum antibiotics in critically ill patients. However, little data are available on the application of this strategy in daily clinical practice.
2010 Nov - Cross-comparison of cardiac output trending accuracy of LiDCO, PiCCO, FloTrac and pulmonary artery catheters
INTRODUCTION: Arterial pulse pressure analysis techniques for estimating cardiac output (CO) though less invasive than pulmonary artery catheters (PAC) CO estimates have not been simultaneously compared to PAC bolus thermodilution CO (COtd) or continuous CO (CCO) devices.