July 9th 2012
Welcome to the 31st Critical Care Reviews Newsletter. Every week, now over three hundred clinical and scientific journals are monitored and the most important and interesting research publications in critical care are highlighted. These studies are added to the Current Articles section of the website on a daily basis, as publication occurs. A link to either the full text or abstract, depending on the publishers degree of open access, is attached. Also, links to other important papers, such as guidelines or consensus statements are included. Free review articles from across the medical literature are also highlighted.
It's a relatively quiet week for research this week, with no major studies being published, although colloids continue to suffer. However, there is a wide variety of new review articles linked to, including a great debate on PEEP in ARDS from Chest.
The topic for This Week's Papers is imaging, starting with a fascinating review on the biological hazards of ultrasound in today's Paper of the Day. It's an easy way to stay up-to-date with your reading.
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American Journal of Respiratory & Critical care Medicine: Sepsis
Gibot and colleagues sought to determine the usefulness of a serum biomarker score, consisting of measurements of soluble triggering receptor expressed on myeloid cells-1, procalcitonin, and the expression of the high-affinity immunoglobulin-Fc fragment receptor I (FcγRI) CD64 on neutrophils (polymorphonuclear [PMN] CD64 index), in diagnosing sepsis. Three hundred consecutive patients were enrolled to construct a biologic score that was then validated in an independent prospective cohort of 79 critically ill patients from another center. Serum concentrations of these 3 biomarkers were higher in patients with sepsis compared with all others (P < 0.001 for the three markers). Also, these biomarkers were all independent predictors of infection, with the best receiver-operating characteristic curve being obtained for the PMN CD64 index. The performance of the bioscore was superior to that of each individual biomarker.
Intensive Care Medicine: Religion
Bülow and colleagues performed an international, multi-centre survey of 304 physicians, 386 nurses, 248 patients and 330 family members to determine the effect of strength of religious belief on end-of-life decisions in the ICU. Patients and family members were more likely to want treatment than professionals. Those with stronger religious beliefs wanted more treatment, were more in favour of life prolongation and less in favour of euthanaisa than those of less religious belief.
Intensive Care Medicine: Gelatin Solutions
Thomas-Ruddel et al performed a systematic review of 40 randomized controlled trials (n=3725) in patients receiving gelatin for resuscitation in comparison to albumin or crystalloids. No study was adequately powered to investigate the frequency of patient-important outcomes. Risks were not statistically significantly different for mortality (RR 1.12, 95 % CIl, 0.87–1.44) and exposure to allogeneic transfusion (RR 1.28, 0.89–1.83). The authors conclude the safety and efficacy of gelatin solutions is undetermined in some settings.
Critical Care: Delirium
Gusmao-Flores et al performed a systematic review and meta analysis of the accuracy of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU; 9 studies totalling 969 patients) and the Intensive Care Delirium Screening Checklist (ICDSC; 4 studies totalling 361 patients) for the diagnosis of delirium in critically ill patients. For the CAM-ICU method, the pooled sensitivity, specificity, C-statistic and diagnostic odds ratio were 80.0% (95% CI: 77.1 - 82.6%), 95.9% (95% IC: 94.8 - 96.8%), 0.97 and 103.2 (95% IC: 39.6 - 268.8), respectively. For the ICDSC the pooled sensitivity, specificity, C-statistic and diagnostic odds ratio were 74% (95% IC: 65.3 - 81.5%), 81.9% (95% IC: 76.7 - 86.4%), 0.89 and 21.5 (95% IC: 8.51 - 54.4), respectively.
Full Text: Gusmao-Flores. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium: a systematic review and meta-analysis of clinical studies. Critical Care 2012; 16:R115
Chest: Positive End-Expiratory Pressure
- Should Positive End-Expiratory Pressure in Patients With ARDS Be Set on Oxygenation? Chest June 2012 141:6 1379-1388
Review - Clinical
Drug Design, Development & Therapy: Scorpion Sting
- Chippaux. Emerging options for the management of scorpion stings. Drug Design, Development and Therapy 2012:6 165–173
Perioperative Medicine: Acute Kidney Injury
Annals of Intensive Care: Acute Kidney Injury
- Honore. Biomarkers for early diagnosis of AKI in the ICU: ready for prime time use at the bedside? Annals of Intensive Care 2012;2:24
Gut: End-Stage Liver Disease
Journal of the American Medical Association: Delirium
- Marcantonio. Postoperative Delirium: A 76-Year-Old Woman With Delirium Following Surgery. JAMA 2012;308(1):73
Annals of Cardiac Anaesthesia: Cardiopulmonary Bypass
- Licker. Clinical Review: Management of weaning from cardiopulmonary bypass after cardiac surgery. Ann Card Anaesth 2012;15:206-23
Annals of Intensive Care: Antimicrobial Administration
- Van Herendael. Continuous infusion of antibiotics in the critically ill: The new holy grail for beta-lactams and vancomycin? Annals of Intensive Care 2012;2:22
Saudi Journal of Kidney Diseases & Transplantation: Transplantation
- Albar M. Organ transplantation: A Sunni Islamic perspective. Saudi J Kidney Dis Transpl 2012;23:817-22
Review - Basic Science
Cardiology: Beta-Adrenergic Receptors
- Wachter. Beta-Adrenergic Receptors, from Their Discovery and Characterization through Their Manipulation to Beneficial Clinical Application. Cardiology 2012;122:104-112
Review - Non-Clinical
Canadian Medical Association Journal: Professionalism
I hope you find these links and brief summaries useful.
Until next week