2009 Dec - Post-extubation laryngeal edema and extubation failure in critically ill adult patients. [Review]
Wittekamp BH, van Mook WN, Tjan DH, Zwaveling JH, Bergmans DC.; Crit Care. 2009 Dec 1;13(6):233.
ABSTRACT: Laryngeal edema is a frequent complication of intubation. It often presents shortly after extubation as post-extubation stridor and results from damage to the mucosa of the larynx. Mucosal damage is caused by pressure and ischemia resulting in an inflammatory response. Laryngeal edema may compromise the airway necessitating reintubation. Several studies show that a positive cuff leak test combined with the presence of risk factors can identify patients with increased risk for laryngeal edema.
2009 Dec 29 - Intensivists' base specialty of training is associated with variations in mortality and practice patterns
Introduction
Current evidence regarding whether the staffing of intensive care units (ICUs) with a trained Intensivist benefits patient outcomes is discordant. We sought to determine whether, amongst certified Intensivists, base specialty of training could contribute to variation in practice patterns and patient outcomes in ICUs.
2009 Sep 18 - Dilutional acidosis: where do the protons come from?
PURPOSE: To investigate the mechanism of acidosis developing after saline infusion (dilutional acidosis or hyperchloremic acidosis). METHODS: We simulated normal extracellular fluid dilution by infusing distilled water, normal saline and lactated Ringer's solution. Simulations were performed either in a closed system or in a system open to alveolar gases using software based on the standard laws of mass action and mass conservation. In vitro experiments diluting human plasma were performed to validate the model.
2009 Dec - The incidence of sub-optimal sedation in the ICU: a systematic review
INTRODUCTION: Patients in intensive care units (ICUs) are generally sedated for prolonged periods. Over-sedation and under-sedation both have negative effects on patient safety and resource use. We conducted a systematic review of the literature in order to establish the incidence of sub-optimal sedation (both over- and under-sedation) in ICUs.
2009 Dec 17 - A new miniaturized system for extracorporeal membrane oxygenation in adult respiratory failure
Abstract (provisional)
Introduction
Mortality of severe acute respiratory distress syndrome in adults is still unacceptably high. Extracorporeal membrane oxygenation (ECMO) could represent an important treatment option, if complications were reduced by new technical developments.
2009 Oct - Late initiation of renal replacement therapy is associated with worse outcomes in acute kidney injury after major abdominal surgery.
Shiao CC, Wu VC, Li WY, Lin YF, Hu FC, Young GH, Kuo CC, Kao TW, Huang DM, Chen YM, Tsai PR, Lin SL, Chou NK, Lin TH, Yeh YC, Wang CH, Chou A, Ko WJ, Wu KD; National Taiwan University Surgical Intensive Care Unit-Associated Renal Failure Study Group.; Crit Care. 2009;13(5):R171. Epub 2009 Oct 30.
INTRODUCTION: Abdominal surgery is probably associated with more likelihood to cause acute kidney injury (AKI). The aim of this study was to evaluate whether early or late start of renal replacement therapy (RRT) defined by simplified RIFLE (sRIFLE) classification in AKI patients after major abdominal surgery will affect outcome.
2009 Nov - Correlation between parameters at initiation of renal replacement therapy and outcome in patients with acute kidney injury.
Ostermann M, Chang RW.; Crit Care. 2009 Nov 4;13(6):R175.
INTRODUCTION: Renal replacement therapy (RRT) is a fully established treatment for critically ill patients with acute kidney injury (AKI) but there are no scientifically established criteria when to initiate it. Our objectives were to describe the epidemiology of critically ill patients with AKI receiving RRT and to evaluate the relationship between biochemical, physiological and comorbid factors at time of RRT and ICU mortality.
2010 Jan - Diagnosis and management of infectious complications in critically ill patients with cancer.
Thirumala R, Ramaswamy M, Chawla S.; Crit Care Clin. 2010 Jan;26(1):59-91.
Cancer and its treatments lead to profound suppression of innate and acquired immune function. In this population, bacterial infections are common and may rapidly lead to overwhelming sepsis and death. Furthermore, infections caused by viral and fungal pathogens should be considered in patients who have specific immune defects.
2010 Jan - Critical care issues in oncological surgery patients.
Ahmed S, Oropello JM.; Crit Care Clin. 2010 Jan;26(1):93-106.
As life expectancy increases and advances in cancer treatment more often convert deadly conditions into more chronic diseases, the surgical intensivist can expect to be faced with greater numbers of oncology patients undergoing aggressive surgical treatments for curative intent, prolonging survival, or primarily palliation by alleviating obstruction, infection, bleeding, or pain.
2009 Oct - Ventilator-associated pneumonia and mortality: a systematic review of observational studies.
OBJECTIVE: To determine the attributable mortality of ventilator-associated pneumonia in a systematic review and meta-analysis of observational studies. Ventilator-associated pneumonia is generally believed to increase the mortality of patients. This notion is predominantly based on the results of observational studies.
2009 Oct - Ineffective triggering predicts increased duration of mechanical ventilation.
OBJECTIVES: To determine whether high rates of ineffective triggering within the first 24 hrs of mechanical ventilation (MV) are associated with longer MV duration and shorter ventilator-free survival (VFS). DESIGN: Prospective cohort study. SETTING: Medical intensive care unit (ICU) at an academic medical center.
2009 Sep 11 - Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain
See related commentary by Opal, http://ccforum.com/content/13/5/196
Introduction
Patients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain.
2009 Nov - Multidisciplinary care for tracheostomy patients: a systematic review.
Garrubba M, Turner T, Grieveson C.; Crit Care. 2009 Nov 6;13(6):R177.
INTRODUCTION: Appropriate care for patients with tracheostomies in hospital settings is an important issue. Each year more than 7000 patients receive tracheostomies in Australia and New Zealand alone. Many of these tracheostomy patients commence their care in the intensive care unit (ICU) and once stabilised are then transferred to a general ward. Insufficient skills and experience of staff caring for tracheostomy patients may lead to sub-optimal care and increased morbidity. The purpose of this review was to identify whether multidisciplinary tracheostomy outreach teams enable the reduction in time to decannulation and length of stay in acute and sub-acute settings, improve quality of care or decrease adverse events for patients with a tracheostomy.
2009 Nov - Management of severe crush injury in a front-line tent ICU after the 2008 Wenchuan earthquake in China: an experience with 32 cases.
Li W, Qian J, Liu X, Zhang Q, Wang L, Chen D, Lin Z.; Crit Care. 2009 Nov 6;13(6):R178.
INTRODUCTION: The experience on management of crush injury after a devastating earthquake is lacking, and there are even less reports on the front-line critical care of these patients. A front-line intensive care unit (ICU) was set up in a tent after the disastrous Wenchuan earthquake (May, 12, 2008, China), where 32 patients suffering from crush injury were treated from May 12 to May 26. This study summarized our experience on management of 32 crush injury patients in a front-line tent ICU.
2009 Jun - Anemia and red blood cell transfusion in neurocritical care.
Kramer AH, Zygun DA.; Crit Care. 2009;13(3):R89. Epub 2009 Jun 11.
INTRODUCTION: Anemia is one of the most common medical complications to be encountered in critically ill patients. Based on the results of clinical trials, transfusion practices across the world have generally become more restrictive. However, because reduced oxygen delivery contributes to 'secondary' cerebral injury, anemia may not be as well tolerated among neurocritical care patients.