IHME SEPSIS Study Results to be presented at CCR20
Welcome to the 417th 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 the VAPrapid2 randomised controlled trial investigating biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia; a systematic review and meta analysis investigating the effects of continuous epinephrine infusion on survival; and an observational studies assessing the association between supraphysiologic arterial oxygen levels and mortality. There is also a guideline on the transfer of the brain‐injured patient; narrative reviews on processed EEG monitoring for anesthesia and intensive care, ventricular assist device implantation in patients with a failing systemic right ventricle & monitoring of regional lung ventilation using electrical impedance tomography; and a commentary on producing and using trustworthy evidence.
The big news this week is the announcement the results of the landmark IHME Sepsis Study will be presented at the Critical Care Reviews Meeting 2020 next month. Dr Kristina Rudd from Pittsburgh, USA, will present the results, establishing the true global burden of sepsis for the very first time. The editorial will be delivered by Prof Kathryn Maitland, to be followed by a panel discussion from clinicians and scientists from North America, Africa, Europe, Asia and Australasia. For those who can't make it, we will be providing a free, worldwide live stream of these important data, starting at 16:35 local time in Belfast, Northern Ireland.
Continuing our focus on CCR20 presentations, this week's Topic of the Week is, based on the IHME Sepsis Study, sepsis epidemiology, starting with a paper on the global burden of sepsis: barriers and potential solutions in today's Paper of the Day.
If you only have time to read one review article this week, try this one on the management of severe acute pancreatitis.
- Full Text: Hellyer. Biomarker-guided antibiotic stewardship in suspected ventilator-associated pneumonia (VAPrapid2): a randomised controlled trial and process evaluation. Lancet Respir Med 2019;epublished December 3rd
- Full Text: Koeppen. Needle-free connectors catheter-related bloodstream infections: a prospective randomized controlled trial. Intensive Care Medicine Experimental 2019;7:63
- Full Text: Emadi. The Effect of High-Dose Vitamin C on Biochemical Markers of Myocardial Injury in Coronary Artery Bypass Surgery. Braz J Cardiovasc Surg 2019;34(5):517-524
- Full Text: Domizi. IgM-enriched immunoglobulins (Pentaglobin) may improve the microcirculation in sepsis: a pilot randomized trial. Annals of Intensive Care 2019,9:135
- Abstract: Belletti. Effect of Continuous Epinephrine Infusion on Survival in Critically Ill Patients. A Meta-Analysis of Randomized Trials. Crit Care Med 2019;epublished November 27th
- Full Text: Zhao. Effect of glucocorticoids on mortality in patients with acute respiratory distress syndrome: A meta-analysis. Exp Ther Med 2019;18(6):4913-4920
- Full Text: Sun. Effect of different doses and time-courses of corticosteroid treatment in patients with acute respiratory distress syndrome: A meta-analysis. Exp Ther Med 2019;18(6):4637-4644
- Abstract: Harrington. Circulating Mitochondrial DNA as Predictor of Mortality in Critically Ill Patients. A Systematic Review of Clinical Studies. Chest 2019;156(6):1120–1136
- Abstract: Palmer. The Association between Supraphysiologic Arterial Oxygen Levels and Mortality in Critically Ill Patients. A Multicenter Observational Cohort Study. Am J Respir Crit Care Med 2019;200(11):1373–1380
- Abstract: Hudson. Pharmacokinetic data support 6-hourly dosing of intravenous vitamin C to critically ill patients with septic shock. Crit Care Resusc 2019;21(4):236-242
- Full Text: Montravers. Epidemiology and prognosis of anti-infective therapy in the ICU setting during acute pancreatitis: a cohort study. Crit Care 2019;23(1):393
- Abstract: Hviid. Plasma Neurofilament Light Chain Is Associated with Poor Functional Outcome and Mortality Rate After Spontaneous Subarachnoid Hemorrhage. Transl Stroke Res 2019;epublished December 5th
- Abstract: Beaulieu. Association of High Mortality With Postoperative Myocardial Infarction After Major Vascular Surgery Despite Use of Evidence-Based Therapies. JAMA Surg 2019;epublished December 4th
- Abstract: You. The usefulness of neuron-specific enolase in cerebrospinal fluid to predict neurological prognosis in cardiac arrest survivors who underwent target temperature management: A prospective observational study. Resuscitation 2019;145:185–191
- Abstract: Kumar. Effects of Hospital-Acquired Pneumonia on Long-Term Recovery and Hospital Resource Utilization Following Moderate to Severe Traumatic Brain Injury. J Trauma Acute Care Surg 2019;epublished December 5th
- Abstract: Neumann. Myasthenic crisis demanding mechanical ventilation: A multicenter analysis of 250 cases. Neurology 2019;epublished December 4th
- Lindsell. Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial. Trials 2019;20:670
- Conradi. Solar-powered oxygen delivery for the treatment of children with hypoxemia: protocol for a cluster-randomized stepped-wedge controlled trial in Uganda. Trials 2019;20:679
- Romagnoli. Processed EEG monitoring for anesthesia and intensive care practice. Minerva Anestesiologica 2019;85(11):1219-30
- Pourkashanian. The Erector Spinae Plane Block: A Review of Current Evidence. Anaestesia Tutorial of the Week 2019;epublished December 3rd
- Vieira. Peripheral nerve block and rebound pain: literature review. Brazilian Journal of Anesthesiology 2019;epublished December 1st
- Zandstra. Ventricular assist device implantation in patients with a failing systemic right ventricle: a call to expand current practice. Netherlands Heart Journal 2019;27(12):590–593
- Myatchin. Bio-electrical impedance analysis in critically ill patients: are we ready for prime time? J Clin Monit Comput 2019;epublished December 5th
- Vasques. Monitoring of regional lung ventilation using electrical impedance tomography. Minerva Anestesiologica 2019;85(11):1231-41
- Robba. Mechanical ventilation in patients with acute ischaemic stroke: from pathophysiology to clinical practice. Critical Care 2019;23:388
- Fuentes. VpALI—Vaping-related Acute Lung Injury: A New Killer Around the Block. Mayo Clin Proc 2019;94(12):2534–2545
- Endeman. The use of high flow oxygen therapy (Optiflow®) in critically ill patients: a pragmatic review. Neth J Crit Care November 2019;27(6):225-8
- Gavrilovic. Adjunct corticosteroid treatment in patients with pneumonia: A precision medicine approach. Bosn J Basic Med Sci 2019;19(4):315–320
- Creamer. Procalcitonin in respiratory disease: use as a biomarker for diagnosis and guiding antibiotic therapy. Breathe 2019;15:296-304
- Quinn. Clinical course and management of idiopathic pulmonary fibrosis. Multidisciplinary Respiratory Medicine 2019;14:35
- Hines. Management of severe acute pancreatitis. BMJ 2019;367:l6227
- Mao. Intensive management of severe acute pancreatitis. Ann Transl Med 2019;7(22):687
- Hunter. Hyperkalemia: pathophysiology, risk factors and consequences. Nephrology Dialysis Transplantation 2019;34(Suppl 3):iii2–iii11
- Ostermann. Report of the first AKI Round Table meeting: an initiative of the ESICM AKI Section. Intensive Care Medicine Experimental 2019;7:69
- Huang. The Pathogenesis of Sepsis and Potential Therapeutic Targets. Int J Mol Sci 2019;20(21):5376
- Greer. Sepsis: Precision-Based Medicine for Pregnancy and the Puerperium. Int J Mol Sci 2019;20(21):5388
- Kang. Fluid management in perioperative and critically ill patients. Acute Crit Care 2019;34(4):235-245
- Pelaccia. Deconstructing the diagnostic reasoning of human versus artificial intelligence. CMAJ 2019;epublished December 2nd
- Konert. The Use of Drones in Emergency Medicine: Practical and Legal Aspects. Emergency Medicine International 2019;3589792
- Yepuri. Sparstolonin B. A Unique Anti-Inflammatory Agent. Shock 2019;52(6):568–576
- Lambden. Bench to bedside review: therapeutic modulation of nitric oxide in sepsis—an update. Intensive Care Medicine Experimental 2019;7:64
- Poles. Methane and Inflammation - A Review (Fight Fire with Fire). Intensive Care Medicine Experimental 2019;7:68
- Rendon-Ramirez. Tracheal amylase: a cheap way to predict ventilator associated pneumonia in patients with traumatic brain injury. Minerva Anestesiologica 2019;85(11):1249-50
- Toledo. Ultrasound Evaluation of Respiratory Mechanics and Diaphragm Function. Chest 2019;156(6):1268
- Bendib. Understanding the Role of Neutrophil Extracellular Traps in Patients With Severe Pneumonia and ARDS. Chest 2019;156(6):1278–1280
- Magoon. Norepinephrine in Sepsis. Looking beyond Vasoconstriction! IJCCM 2019;23(11):544
- Pidcock. A 65-Year-Old Man with Pulmonary Opacities and Worsening Cough. Chest 2019;156(6):e117–120
- Sonnick. A Man in His 20s With Cough, Unilateral Pleural Effusion, and Nodular Pleural Thickening. Chest 2019;156(6):e121–e126
- O’Brien. An 80-Year-Old Man With a 24-Hour History of Epigastric Pain. Chest 2019;156(6):e127–e131
- Matayeva. A 38-Year-Old Man With An Ataxic Gait, Night Sweats, and Weight Loss. Chest 2019;156(6):e133–e136
- Tan, A 60-Year-Old Man With Right Lung Mass Presents With Cough. Chest 2019;156(6):e137–e143
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, as well as a panel discission on the proposed MEGA-ROX trial, potentially a game changer for critical care trials. We are delighted to have the opportunity to conduct a one-on-one interview with the editor-in-chief of JAMA, Prof Howard Bauchner, in discussion with Prof Marion Campbell. As usual, we eound off the formal programme with 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.
For CCR20, we are hosting 3 major trial results presentations, PEPTIC, 65 & VITAMINS, one major sepsis epidemiological study - IHME Sepsis - as well as discussing 9 of the best trials from 2019 - COACT, TRACT, ICU-ROX, SPICE III, BiRDS, ROSE, CITRIS-ALI, SEPSIS-ACT & HYPERION.
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.
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Until next week
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