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Critical Care Reviews Newsletter

May 22nd 2012



Welcome to the 24th Critical Care Reviews Newsletter. Every week over two 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 Journal Watch 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.

I'm at the ATS conference this week, so hopefully normal service will be resumed next week. I've added a new section called Hot Articles, focusing on newly published influential articles that you probably should be aware of. This will grow as soon as I get the chance to add to it.



JAMA:     Severe Sepsis

In a randomized, open-label, parallel-group trial of 600 patients with severe sepsis or septic shock, therapy with meropenam (1 g 8 hourly) plus moxifloxacin (400 mg daily) was not superior to meropenam alone for either severity of organ failure or mortality at 28 or 90 days.

Full Text: Brunkhorst. Effect of Empirical Treatment With Moxifloxacin and Meropenem vs Meropenem on Sepsis-Related Organ Dysfunction in Patients With Severe Sepsis. A Randomized Trial. JAMA 2012;epublished ahead of print


JAMA:     Berlin Definition of ARDS

The recently produced Berlin Definition of ARDS was empirically evaluated with data from 4188 patients with ARDS from 4 multicenter clinical data sets and 269 patients with ARDS from 3 single-center data sets. Using the Berlin Definition, stages of mild (PaO2/FiO2 > 200 mmHg), moderate (PaO2/FiO2 > 100 mmHg), and severe (PaO2/FiO2 < 100 mmHg) ARDS were associated with increased mortality (mild: 27%; 95% CI, 24%-30%), (moderate: 32%; 95% CI, 29%-34%), (severe: 45%; 95% CI, 42%-48%) respectively, P < .001. Also the new definition demonstrated increased median duration of mechanical ventilation in survivors (mild: 5 days; IQR, 2-11) (moderate: 7 days; IQR, 4-14), (severe: 9 days; IQR, 5-17) respectively, P < .001. Although both were poor predictors of mortality, the final Berlin Definition had better predictive validity for mortality than the American-European Consensus Conference Criteria, with an area under the receiver operating curve of 0.577 (95% CI, 0.561-0.593) vs 0.536 (95% CI, 0.520-0.553), P < .001.

Full Text: The ARDS Definition Task Force. Acute Respiratory Distress Syndrome. The Berlin Definition. JAMA 2012;():1-8


New England Journal of Medicine:     Coffee Consumption

It's not really critical care, but I don't know many intensivists who don't drink coffee! Freedman et al investigated te effects of coffee consumption on total and cause-specific mortality among 229,119 men and 173,141 women aged 50 to 71 years of age. Between 1995 and 2008, over a followup of 5,148,760 person-years, a total of 33,731 men and 18,784 women died. The good news for coffee lovers is that coffee consumption was inversely associated with total and cause-specific mortality, although whether this was a causal or associational finding could not be determined from the observational nature of the study.

Abstract: Freedman. Association of Coffee Drinking with Total and Cause-Specific Mortality. N Eng J Med 2012;366:1891-1904


Cochrane Library:   

Abstract: Tse. Early routine endoscopic retrograde cholangiopancreatography strategy versus early conservative management strategy in acute gallstone pancreatitis. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD009779

Abstract: Sajid. Knee length versus thigh length graduated compression stockings for prevention of deep vein thrombosis in postoperative surgical patients. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD007162

Abstract: Watts. Leukotriene receptor antagonists in addition to usual care for acute asthma in adults and children. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD006100


Intensive Care Medicine:     Chlorhexidine Body Wash

Full Text: Lennie. Chlorhexidine body wash to control antimicrobial-resistant bacteria in intensive care units: a systematic review. Intensive Care Med 2012;38(6):931-939


Intensive Care Medicine:     Procalcitonin

Abstract: Matthaiou. An ESICM systematic review and meta-analysis of procalcitonin-guided antibiotic therapy algorithms in adult critically ill patients. Intensive Care Med 2012;38(6):940-949


Lancet:     Oesophagectomy

Abstract: Biere. Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 2012;379(9829):1887-1892



Journal of Critical Care:     Sepsis


Respirology:     Lung Transplantation


Clinical Pharmacology & Therapeutics:     Personalized Therapy


Clinical Pharmacology & Therapeutics:     Database Mining


Current Opinion in Pulmonary Medicine:     Pneumonia


Seminars in Respiratory and Critical Care Medicine:     Portopulmonary Hypertension



Stroke:     Subarachnoid Haemorrhage


Mayo Clinic Proceedings:     Pharmaceutical Sponsored Research



I hope you find these links and brief summaries useful.

Until next week