Newsletter 100 / November 3rd 2013
Welcome
Hello
Welcome to the 100th Critical Care Reviews Newsletter, bringing you the best critical care research published in the past week, plus a wide range of free full text review articles and guidelines from over 300 clinical and scientific journals. It's a mixed newsletter, with no major research published this week, but still contains 46 review articles, 6 guidelines, 4 editorials and 7 commentaries, as well as links to 16 articles from the major critical care journals which have now been made open access. In addition, the latest CPD quiz, on minimally invasive cardiac output monitors is now available. Read the article, complete the MCQ, and print your personalised certificate for revalidation/CPD purposes. Registration is required to take the quiz, as your name is needed for the certificate.
This week's guidelines address airway management, faecal incontinence, alcoholic liver disease, anti-platelet therapy, cardiac resynchronization and cath lab radiation exposure. Editorials focus on acute heart failure, open access publication and tranexamic acid. Commentaries look at conflict-of-interest, clinical errors, septic shock and contrst-induced nephropathy.
Amongst the clinical review articles are papers on sedation in the neurological ICU, cardiopulmonary resuscitation, catheter-related bloodstream infection, airway clearance, fulminant clostridium difficile colitis, hepatopulmonary syndrome, nutrition in trauma, diabetes insipidus, C-reactive protein and traumatic colonic injuries. Non-clinical review articles include a paper on managing an emergency department.
The topic for This Week's Papers is extracorporeal therapies, starting with a paper on liver support in tomorrow's Paper of the Day.
There are three meetings coming up that might be of interest to you:
Critical Care Reviews Meeting January 24th, 2014 - Belfast, Northern Ireland
- If you are in Ireland or Great Britain (or a short flight away), Critical Care Reviews will be hosting it's second meeting outside Belfast, Northern Ireland. It's an all-day event with a fantastic programme consisting of local intensivists, local non-critical care specialists, and outstanding international guest speakers. The programme has been finalised and approved for 5 CPD points by the Royal College of Anaesthetists. Registration is now open.
Intensive Care Society State-of-the-Art Meeting, December 16th - 18th, London
- The ICS will be holding their annual State-of-the-Art meeting in London this December. It's the largest meeting of its kind in the UK and attracts a host of big names from the world of critical care.
SMACC GOLD March 19-21st, 2014 Gold Coast, Queensland, Australia
- This major international conference, also in it's second year, is a must for those active in the online critical care community. Webmasters of the most prominent critical care websites and blogs will descend on the beautiful Gold Coast for an amazing get together of like-minded people in a totally different style of conference. Registration is currently open.
Research
Interventional Trials
Critical Care: Acute Kidney Injury
Kim and colleagues completed a single-centre, randomized, case-controlled, double-blind study comparing erythropoietin (300 IU/kg post anesthetic induction, n=49) with control (n=49) on the incidence of postoperative acute kidney injury (defined as increase in serum creatinine >0.3 mg/dl or >50% from baseline) in the setting of complex cardiac surgery, and found:
- no difference in
- group baseline values
- incidence of postoperative AKI (control 32.7% vs eyrthropoietin 34.7%; P = 0.831)
- levels of renal injury biomarkers, including cystatin C and neutrophil gelatinase-associated lipocalin
- postoperative increase in interleukin-6 or myeloperoxidase
- erythropoietin was not associated with any complications, including thromboembolic events
Journal of the American Medical Association: Anti-Platelet Therapy
Feres and colleagues performed an open-label, active-controlled, 1:1 randomized, noninferiority study assessing the clinical noninferiority of 3 months (n = 1,563) vs 12 months (n = 1,556) of dual antiplatelet therapy (aspirin 100-200 mg daily and clopidogrel 75 mg daily) in patients with stable coronary artery disease or history of low-risk acute coronary syndrome undergoing percutaneous coronary intervention with zotarolimus-eluting stents, and found:
- no difference in (short term versus long term)
- the primary outcome, a composite of all-cause death, myocardial infarction, stroke, or major bleeding
- 93 [6.0%] versus 90 patients [5.8%]; risk difference 0.17 (95% CI −1.52 to 1.860); P = 0.002 for noninferiority
- Kaplan-Meier estimates of a composite of all-cause death, myocardial infarction, emergent coronary artery bypass graft surgery, or target lesion revascularization rates at 1 year of
- 128 [8.3%] versus 114 [7.4%]; HR 1.12 (95% CI 0.87-1.45)
- between 91 and 360 days
- a composite of all-cause death, myocardial infarction, stroke, or major bleeding
- 39 [2.6%] vs 38 [2.6%], HR 1.03 (95% CI 0.66-1.60)
- a composite of all-cause death, myocardial infarction, emergent coronary artery bypass graft surgery, or target lesion revascularization
- 78 [5.3%] vs 64 [4.3%]; HR 1.22 (95% CI 0.88-1.70)
- stent thrombosis
- 4 [0.3%] vs 1 [0.1%]; HR 3.97 (95% CI 0.44-35.49)
- a composite of all-cause death, myocardial infarction, stroke, or major bleeding
- the primary outcome, a composite of all-cause death, myocardial infarction, stroke, or major bleeding
Clinical Infectious Disease: Influenza
Lee and colleagues completed a dual site, prospective, interventional study, comparing 150 mg (n=41) with 75 mg (n=114) oseltamivir twice daily for 5 days, commenced within 96 hours of presentation, with allocated by site, which switched after 2 influenza seasons, in 165 adults with laboratory-confirmed influenza (85 A/H3N2, 34 A/H1N1pdm09, 36 B), and found:
- higher trough oseltamivir carboxylate levels in the 150-mg group (501.0 ± 237.0 vs 342.6 ± 192.7 ng/mL)
- no significant differences in
- day 5 viral RNA (44.7% vs 40.2%)
- culture negativity (100.0% vs 98.1%)
- RNA decline rate
- durations of fever, oxygen supplementation, and hospitalization
- subanalysis of influenza B patients showed faster
- RNA decline rate (analysis of variance, F = 4.14; P = 0.05) and clearance (day 5, 80.0% vs 57.1%) with higher-dose treatment.
- there was no oseltamivir resistance
- treatments were generally well tolerated
Meta Analysis
Critical Care: Percutaneous Tracheostomy
Simon and colleagues analyzed cases of lethal outcome due to complications from percutaneous dilatational tracheostomy, including 68 published cases (1985 - 2013) and 3 of their own patients, and found:
- lethal complications occurred in 0.17%
- of the fatal complications
- 31.0% occurred during the procedure
- 49.3% within seven days of the procedure
- main causes of death were
- hemorrhage (38.0%)
- airway complications (29.6%)
- tracheal perforation (15.5%)
- pneumothorax (5.6%)
- specific risk factors for complications in 73.2% of patients, with 25.4% of patients having more than one risk factor
- bronchoscopic guidance was used in only 46.5% of cases
Observational Studies
Medicina Intensiva: Ventilatory Modes
Critical Care: Noisy Pressure Support
Journal of Critical Care: Vasopressor Therapy
Neurocritical Care: Subarachnoid Haemorrhage
Critical Care Medicine: Hyperoxia
Liver International: Coagulation in Acute Liver Injury
British Journal of Anaesthesia: Fluids
Critical Care: Respiratory Failure
Guideline
Canadian Journal of Anaesthesia: Difficult Airway
- Law. The difficult airway with recommendations for management – Part 1 – Difficult tracheal intubation encountered in an unconscious/induced patient. Can J Anesth 2013;60:1089-1118
- Law. The difficult airway with recommendations for management – Part 2 – The anticipated difficult airway. Can J Anesth 2013;60:1119-1138
Journal of the Intensive Care Society: Faecal Incontinence
Clinical & Molecular Hepatology: Alcoholic Liver Disease
Canadian Journal of Cardiology: Antiplatelet Therapy
Canadian Journal of Cardiology: Cardiac Resynchronization Therapy
Canadian Journal of Cardiology: Radiation Exposure
Editorial
American Heart Journal: Acute Decompensated Heart Failure
Medical Journal of Australia: Tranexamic Acid
PLoS Biology: Open Access Publishing
- Ganley. A Lot Can Happen in a Decade. PLoS Biol 2013;11(10):e1001689
- Roberts. Collection Overview: Ten Years of Wonderful Open Access Science. PLoS Biol 2013;11(10):e1001688
Commentary
Annals of Emergency Medicine: Social Media
Nature: PubMed
The Scientist: Conflict of Interest
New England Journal of Medicine: Patient Safety
New England Journal of Medicine: Clinical Errors
Annals of Emergency Medicine: Septic Shock
Emergency Medicine News: Contrast Nephropathy
Review - Clinical
Neurological
- Godoy. The myasthenic patient in crisis: an update of the management in Neurointensive Care Unit. Arq Neuropsiquiatr 2013;71(9A):627-39
- Dionello. Indications for Interventional Radiology in the Management of Patients with Spinal Cord Injuries. Top Spinal Cord Inj Rehabil 2013;19(3):211–221
- Miranda. Brain abscess: Current management. J Neurosci Rural Pract 2013;4(Suppl 1):S67–S81
- Fine. The Endocannabinoid System, Cannabinoids, and Pain. Rambam Maimonides Med J 2013;4(4):e0022
- Diener. Failures, Mistakes and Shortcomings of My Stroke Trials. Cerebrovasc Dis 2013;36:250-256
- Hacke. Good Times - Bad Times: My Story regarding Acute Stroke Treatment. Cerebrovasc Dis 2013;36:257-265
- Birinder. Sedation in neurological intensive care unit. Ann Indian Acad Neurol 2013;16(2): 194–202
Circulatory
- Shah. Intravascular Catheter-Related Bloodstream Infection. Neurohospitalist 2013;3(3):144–151
- Hwang. Cardiopulmonary resuscitation—From the past into the future. Journal of Acute Medicine 2013;3(3):67-72
- Krum. Management of heart failure. Med J Aust 2013;199(5):334-339
- Verheugt. Antithrombotic Therapy During and After Percutaneous Coronary Intervention in Patients With Atrial Fibrillation. Circulation 2013;128:2058-2061
- Bartel. Why is intracardiac echocardiography helpful? Benefits, costs, and how to learn. Eur Heart J 2013;epublished October 21st
Respiratory
- Kahn. Major advances in managing community-acquired pneumonia. F1000Prime Rep 2013;5:43
- Makhabah. Airway Clearance In The Intensive Care Unit. EMJ Respir 2013;1:135-139
- Moodley. Stem cells: A recapitulation of development. Respirology 2013;18:1167–1176
- Kurai. Virus-induced exacerbations in asthma and COPD. Front Microbiol 2013;4:293
- Koutsokera. Pulmonary biomarkers in COPD exacerbations: a systematic review. Respiratory Research 2013;14:111
- Zarogoulidis. Intensive care unit and lung cancer: when should we intubate? J Thorac Dis 2013;5(Suppl 4): S407–S412
- Spagnolo. Pharmacological Treatment Of Idiopathic Pulmonary Fibrosis - An Update. EMJ Respir 2013;1:108-121
- Bhatti. Approach to acute exacerbation of idiopathic pulmonary fibrosis. Ann Thorac Med 2013;8(2):71–77
Gastrointestinal
- Klobuka. Current status of surgical treatment for fulminant clostridium difficile colitis. World J Gastrointest Surg 2013;5(6):167–172
- Contini. Caustic injury of the upper gastrointestinal tract: A comprehensive review. World J Gastroenterol 2013;19(25):3918–3930
Nutrition
Hepatobiliary
- Hepatopulmonary syndrome: the anaesthetic considerations. European Journal of Anaesthesiology 2013;30(12):721-730
- Mishra. Efficient Hepatic Delivery of Drugs: Novel Strategies and Their Significance. BioMed Research International 2013;2013:382184
- Northup. Coagulation in Liver Disease: A Guide for the Clinician. Clinical Gastroenterology and Hepatology 2013;11(9):1064-1074
- Parker. Diagnosis and treatment of alcoholic hepatitis. Frontline Gastroenterol 2013;epublished November 1st
Renal
- Mao. Cardiac Surgery-Associated Acute Kidney Injury. Cardiorenal Med 2013;3:178-199
- Schiffl. Earlier diagnosis of acute kidney injury in critically ill patients by novel biomarkers: Moving from supportive care to targeted renoprotection? OA Critical Care 2013;1(1):5
- Aguado-Fraile. MicroRNAs in the kidney: Novel biomarkers of Acute Kidney Injury. Nefrologia 2013;epublished October 25th
- Viswanathan. Urine Bag as a Modern Day Matula. ISRN Nephrology 2013;2013:215690
- Dongol. Hymenoptera Stings and the Acute Kidney Injury. EMJ Neph 2013;1:68-75
Endocrine
- Saifan. Diabetes Insipidus: A Challenging Diagnosis with New Drug Therapies. ISRN Nephrology 2013;2013:797620
- Lai. The Pleiotropic Effect of Vitamin D. ISRN Nephrology 2013;2013:898125
Haematological
- Chandler. Emergency assessment of hemostasis in the bleeding patient. International Journal of Laboratory Hematology 2013;35:339–343
- Ramandeep. Argatroban in heparin-induced thrombocytopenia: rationale for use and place in therapy. Ther Adv Chronic Dis 2013;4(6):302–304
Sepsis
- Butler. Antibiotics in the clinical pipeline in 2013. J Antibiot 2013 66: 571-591
- Lelubre. Interpretation of C-Reactive Protein Concentrations in Critically Ill Patients. BioMed Research International. BioMed Research International 2013;213:124021
- Du Clos. Pentraxins: Structure, Function, and Role in Inflammation. ISRN Inflamm 2013;2013:379040
- Runyen-Janecky. Role and regulation of heme iron acquisition in gram-negative pathogens. Front Cell Infect Microbiol 2013;3:55
- Gaspar. From antimicrobial to anticancer peptides. A review. Front Microbiol 2013;4:294
- Esteban. Immunomodulation in Sepsis: The Role of Endotoxin Removal by Polymyxin B-Immobilized Cartridge. Mediators of Inflammation 2013;2013:507539
Trauma
- Jinescu. Colon Traumatic Injuries - Factors that Influence Surgical Management. Chirurgia (Bucur) 2013;108(5):652-8
- Legout. Periprosthetic Joint Infections: Clinical and Bench Research. The Scientific World Journal 2013;2013:549091
Recently Made Open Access Articles from Major Journals
Critical Care
Commentary
Review
- Nesseler. Clinical review: The liver in sepsis. Critical Care 2012;16:235
- Madger. Bench-to-bedside review: An approach to hemodynamic monitoring - Guyton at the bedside. Critical Care 2012;16:236
Study Critique
Anesthesia & Analgesia
Commentary
- Vignon. PRO: Physician-Performed Ultrasound: The Time Has Come for Routine Use in Acute Care Medicine. Anesthesia & Analgesia 2012;115(5):999–1003
- Oxorn. CON: Physician-Performed Ultrasound: The Time Has Come for Routine Use in Acute Care Medicine. Anesthesia & Analgesia 2012;115(5):1004–1006
Review
- Royse. Core Review: Physician-Performed Ultrasound: The Time Has Come for Routine Use in Acute Care Medicine. Anesthesia & Analgesia 2012;115(5):1007–1028
- Holm. Perioperative Use of Focus Assessed Transthoracic Echocardiography (FATE). Anesthesia & Analgesia 2012;115(5):1029–1032
- Dennis. The Use of Transthoracic Echocardiography in Postpartum Hypotension. Anesthesia & Analgesia 2012;115(5):1033–1037
- Oren-Grinberg. Hand-Held Echocardiography in the Management of Cardiac Arrest. Anesthesia & Analgesia 2012;115(5):1038–1041
- Vutskits. General Anesthesia: A Gateway to Modulate Synapse Formation and Neural Plasticity? Anesthesia & Analgesia 2012;115(5):1174–1182
British Journal of Anaesthesia
Editorial
- Thomson. Value of pilots and the need to choose the right comparator. Br J Anaesth 2012;109(4):485-486
- Skinner. Accreditation in transoesophageal echocardiography in the UK: the initial experience. Br J Anaesth 2012;109(4):487-490
- Fletcher. Critical care echocardiography: cleared for take up. Br J Anaesth 2012;109(4):490-492
- Fawcett. Enhanced recovery: more than just reducing length of stay? Br J Anaesth 2012;109(5):671-674
Review
Review - Basic Science
Cerebrovascular Diseases: Diagnostic Accuracy
Review - Non-Clinical
Journal of Acute Medicine: Managing an Emergency Department
I hope you find these brief summaries and links useful.
Until next week
Rob
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