The latest trial added to the CCR20 programme is SEPSIS-ACT
Welcome to the 409th Critical Care Reviews Newsletter, bringing you the best critical care research and open access articles from across the medical literature over the past seven days.
The highlights of this week's edition are randomised controlled trials on melatonin for prevention of post-operative delirium & an ultrasound-driven diagnostic protocol in ICU; systematic reviews and meta analyses on systemic corticosteroids and the incidence of gastrointestinal bleeding in critically ill adults & extracorporeal liver support in patients with liver failure; and observational studies on invasive pulmonary aspergillosis in critically ill patients with hematological malignancies & national trends in timing of death among patients with septic shock. There is also a French guideline on severe asthma exacerbation; narrative reviews on central pontine myelinosis and osmotic demyelination syndrome, intraoperative fraction of inspired oxygen & stepped wedge trials; commentaies on oxygen toxicity in major emergency surgery & alveolar recruitment in ARDS; as well as correspondence on venous and arterial base excess difference & ‘the pause’.
This week's Topic of the Week is the ICU-ROX trial (see below), starting with a paper on oxygen treatment in intensive care and emergency medicine in today's Paper of the Day.
If you only have time to read one review article this week, try this one on the role of speech and language therapists in the intensive care unit.
Critical Care Reviews Meeting 2020
The latest trial to be added to the CCR20 programme is SEPSIS-ACT, the largest randomised controlled yet of a vasopressin analogue in septic shock. This will be presented by Prof Anders Perner from Copenhagen. Also, tonight (or tomorrow, depending on where you are), Dr Paul Young will present the results of the much anticipated ICU-ROX trial, comparing a conservative oxygenation strategy with standard care in 1,000 mechanically ventilated patients, at the World Congress Meeting in Melbourne. This presentation is timed with a simultaneous major journal publication. I previously chatted with Paul about ICU-ROX in an early CCR podcast, which is worth checking out in anticipation of the results presentation. The results of CRASH-3, investigating tranexamic acid in traumatic brain injury, are due out in the same session.
- Abstract: Ford. The Healthy Heart-Mind Trial: Randomized Controlled Trial of Melatonin for Prevention of Delirium. J Am Geriatr Soc 2019;epublished October 8th
- Full Text: Pontet. Impact of an ultrasound-driven diagnostic protocol at early intensive-care stay: a randomized-controlled trial. The Ultrasound Journal 2019;11:24
- Abstract: Kuramatsu. Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. JAMA 2019;322(14):1392-1403
- Full Text: Butler. The effect of systemic corticosteroids on the incidence of gastrointestinal bleeding in critically ill adults: a systematic review with meta-analysis. Intensive Care Med 2019;epublished September 9th
- Abstract: Alshamsi. Extracorporeal liver support in patients with liver failure: a systematic review and meta-analysis of randomized trials. Intensive Care Med 2019;epublished October 7th
- Abstract: Geense. Nonpharmacologic Interventions to Prevent or Mitigate Adverse Long-Term Outcomes Among ICU Survivors: A Systematic Review and Meta-Analysis. Crit Care Med 47(11):1607-1618
- Full Text: Huang. Diagnostic performance of FDG PET/CT in critically ill patients with suspected infection: A systematic review and meta-analysis. J Formosan Medical Assoc 2019;epublished October 8th 2019;epublished October 8th
- Full Text: Li. Carbapenems vs β-Lactam Monotherapy or Combination Therapy for the Treatment of Complicated Intra-abdominal Infections: Systematic Review and Meta-analysis of Randomized Controlled Trials. Open Forum Infectious Diseases 2019;6(10):ofz394
- Abstract: Pardo. Invasive pulmonary aspergillosis in critically ill patients with hematological malignancies. Intensive Care Med 2019;epublished October 10th
- Abstract: Law. National Trends in Timing of Death Among Patients With Septic Shock, 1994–2014. Crit Care Med 2019;47(11):1493-1496
- Abstract: Scarpino. Neurophysiology and neuroimaging accurately predict poor neurological outcome within 24 hours after cardiac arrest: The ProNeCA prospective multicentre prognostication study. Resuscitation 2019;143:115–123
- Abstract: Abazi. Long-term survival in out-of-hospital cardiac arrest patients treated with targeted temperature control at 33 °C or 36 °C: A national registry study. Resuscitation 2019;143:142–147
- Kasapoğlu. The Role of Transcranial Doppler Ultrasonography in the Diagnosis of Brain Death. Turk J Anaesthesiol Reanim 2019; 47(5): 367-74
- Kohler. Cognitive Deficits Following Intensive Care. Dtsch Arztebl Int 2019;116:627-34
- Lambeck. Central Pontine Myelinosis and Osmotic Demyelination Syndrome. Dtsch Arztebl Int 2019;116:600-6
- Geil. Chronified Pain Following Operative Procedures. The place of locoregional and systemic local anesthetics. Dtsch Arztebl Int 2019;116:261-6
- Rubio-haro. Regional analgesia techniques for pain management in patients admitted to the intensive care unit. Minerva Anestesiologica 2019;85(10):1118-28
- Montandon. Solving the Opioid Crisis. Chest 2019;156(4):653–658
- Chow. Update on anesthesia management for explantation of veno-arterial extracorporeal membrane oxygenation in adult patients. Ann Card Anaesth 2019;22:422-9
- Azizi. Emerging Drug Classes and Their Potential Use in Hypertension. Hypertension 2019;74:1075–1083
- Annachhatre. Preconditioning in cardiac anesthesia…… where are we?. Ann Card Anaesth 2019;22:412-21
- Chowdhury. Consideration for thrombolysis for significant pulmonary embolism in haemodynamically stable patients—is it time for a rethink? J Emerg Crit Care Med 2019;3:53
- Rahaghi. Managing the Alpha-1 patient in the ICU: Adapting broad critical care strategies in AATD. J Crit Care 2019;54:212-219
- Balestra. Diving physiopathology: the end of certainties? Food for thought. Minerva Anestesiologica 2019;85(10):1129-37
- Sheerin. Haemolytic uremic syndrome: diagnosis and management. F1000Research 2019, 8(F1000 Faculty Rev):1690
- Should Broad-Spectrum Antibiotics Be Routinely Administered to All Patients With Sepsis as Soon as Possible? Chest 2019;156(4):645–652
- Mason. The pearls of pediatric sedation: polish the old and embrace the new. Minerva Anestesiologica 2019;85(10):1105-17
- de Keijzer. Which type of fluid to use perioperatively? J Emerg Crit Care Med 2019;3:51
- Mellado Artigas. Setting intraoperative fraction of inspired oxygen. J Emerg Crit Care Med 2019;3:52
- McRae. The role of speech and language therapists in the intensive care unit. JICS 2019;epublished September 30th
- Aggarwal. Study designs: Part 5 – interventional studies (II). Perspect Clin Res 2019;10:183-6
- Trkulja. Confidence intervals: what are they to us, medical doctors?. CMJ 2019;60:375-82
- Wellek. Planning and Analysis of Trials Using a Stepped Wedge Design: Part 26 of a Series on Evaluation of Scientific Publications. Part 26 of a serieson evaluation of scientific publications. Dtsch Arztebl Int 2019;116:453-8
- Horlocker. Practice advisory on the bleeding risks for peripheral nerve and interfascial blockade: going out on a limb. Can J Anesth 2019;66(11):1281-1285
- Ranganathan. The CONSORT statement and its impact on quality of reporting of trials. Perspect Clin Res 2019;10:145-7
- Anstey. “Hang on, I haven’t seen this patient yet...”: near simultaneous admissions to the ICU. Intensive Care Med 2019;epublished October 7th
- Weiss. My wife's turn in the ICU. Intensive Care Med 2019;epublished October 9th
- Hedenstierna. Oxygen toxicity in major emergency surgery-anything new? Intensive Care Med 2019;epublished October 10th
- Stelfox. De-implementing low value care in critically ill patients: a call for action—less is more. Intensive Care Med 2019;45:1443–1446
- Del Sorbo. Alveolar recruitment in acute respiratory distress syndrome: should we open the lung (no matter what) or may accept (part of) the lung closed? Lorenzo. Intensive Care Med 2019;45:1436–1439
- Schetz. When more could be industry-driven: the case of the extracorporeal treatment of sepsis. Intensive Care Med 2019;epublished August 13th
- Ferrone. Proportional assist ventilation plus (PAVAV+) from weaning to assist control ventilation: insights for caution on issue. Minerva Anestesiologica 2019 October;85(10):1141-2
- Gattinoni. Venous and arterial base excess difference: methodological error or physiological reality? Intensive Care Med 2019;epublished July 24th
- Morgan. ‘The pause’: honouring the passing of a patient or a collective countertransference for healthcare providers? Intensive Care Med 2019;45(10):1493–1493
- Raut. Sudden, new-onset aortic regurgitation during off pump coronary bypass surgery. Ann Card Anaesth 2019;22:430-1
- Dinesh Kumar. “Left atrial myxoma - A tumor in transit”. Ann Card Anaesth 2019;22:432-4
- Tolia. Sudden-Onset Abdominal Pain in a 76-Year-Old Woman With Graft-vs-Host Disease. Chest 2019;156(4):e77–e79
- Schoonbeek. A 37-Year-Old Woman With Recurrent Hemoptysis. Chest 2019;156(4):e81–e84
- Scamporlino. Cannonball-Like Lung Nodules in a Patient With a Colorectal Tumor. Chest 2019;156(4):e85–e89
- Terayama. Carbon dioxide angiography for detecting minor hemorrhage. Intensive Care Med 2019;epublished October 7th
- Anile. Renal resistive index: a new reversible tool for the early diagnosis and evaluation of organ perfusion in critically ill patients: a case report. Ultrasound J 2019;10;11(1):23
Now in it's 8th year, the Critical Care Reviews Meeting brings the chief investigators for the best critical care trials of the previous year to Titanic, Belfast, to discuss their studies. We aim to decide whether these trials are sufficiently robust to support their findings and if we should consider changing practice on the basis of them. To help in this endeavour we invite world leading experts to provide independent editorial overviews and have panel discussions to delve deep into the specifics of each trial. In addition, we also have detailed discussions on research methodology, to encourage critical thinking about the scientific findings which form the basis of our clinical practice. It's not just about specific trials though; for 2020, we have a distinguished panel of trialists, methodologists, statisticians and clinicians provide insight into the mysteries of clinical trial interpretation. We also have the annual honorary John Hinds Lecture, to be delivered by Prof Kathryn Maitland, entitled "A Higher Calling: Two Decades of Emergency Research in Africa", and finish the meeting with the incredibly popular "Informal Chat", where the faculty and delegates congregate in the bar and an enormous, meandering discussion about all things critical care takes place.
Based on our feedback from last year, we've reverted to keeping everyone on the same floor during breaks. In addition, we will also provide a sleeping area for those post-call to rest for a few hours as needed. As before, we are offering free childcare and a baby feeding area, where the meeting will live streamed. All dietary requirements are catered for also. Please get in touch if you have any specific needs. We sold out last year, so please don't delay if you want to attend. As usual, CPD points will be applied for in due course.
Critical Care Horizons is a fresh new voice in the critical care literature, offering thought-provoking, cutting-edge commentary and opinion papers, plus state-of-the-art review articles. The journal is free to publish with and free to read, opening authorship opportunity to all. The energetic editorial board consists of a deliberate mix of clinicians active in social media and world renowned academics, all driven by a desire to improve the care we offer our patients, and operate without financial gain or incentive. If you have an idea for a paper, and can say it in an engaging manner, please get in touch. We also need peer reviewers.
COI - I am the editor-in-chief of this new journal, but work in a voluntary capacity, as do all the editors.
I hope you find these links useful.
Until next week
Supported by the Health Research Board