ccr logo 246x225 13121Critical Care Reviews Newsletter

December 18th 2011





Welcome to the Critical Care Reviews Newsletter. Every week some of the more important research publications in critical care are highlighted. These studies are added to the News section of the website on a daily basis, as publication occurs. If you do not wish to receive the newsletter please use the unsubscribe option below. If you would like this newsletter to contain other information please let me know.


Saturday December 17th 2011

There are a couple of interesting RCTs in January's issue of Critical Care Medicine.

Induction Agent

Payen and colleagues report a randomized controlled trial in 97 subjects comparing the effects of hydrocortisone supplementation versus placebo post single-induction dose of etomidate. Although the requirement for noradrenaline was reduced at 6 hours in the hydrocortisone group, no intergroup differences were found regarding the duration of mechanical ventilation, intensive care unit length of stay, or 28-day mortality.

Abstract. Payen. Corticosteroid after etomidate in critically ill patients: A randomized controlled trial. Crit Care Med 2012;40(1):29-35


Acute Lung Injury -Therapy

A double-blind, placebo-controlled randomized trial in 130 patients with acute lung injury of 3 days duration failed to demonstrate an effect from human recombinant granulocyte-macrophage colony stimulating factor on ventilator-free days, organ failure-free days or 28 day mortality.

Abstract. Paine. A randomized trial of recombinant human granulocyte-macrophage colony stimulating factor for patients with acute lung injury. Crit Care Med 2012;40(1):90-97


Thursday December 15th 2011

Red Cell Transfusion

Although not a critical care study, The FOCUS study, reported in this week's New England Journal of Medicine further informs the field of transfusion triggers. 2016 patients aged 50 years or older and post hip fracture surgery, with either a history of or risk factors for cardiovascular disease, were randomly assigned to a liberal transfusion strategy (a hemoglobin threshold of 10 g per deciliter) or restrictive transfusion strategy (symptoms of anemia or at physician discretion for a hemoglobin level of <8 g per deciliter). A median of 2 units of red cells were transfused in the liberal-strategy group and none in the restrictive-strategy group. No effect was seen on mortality, ability to walk across a room unassisted, the development of acute coronary syndromes or other complication.

Carson. Liberal or Restrictive Transfusion in High-Risk Patients after Hip Surgery. N Engl J Med 2011;10.1056/NEJMoa1012452

Editorial - Barr. Transfusion threshold in FOCUS. N Engl J Med 2011;10.1056/NEJMe1110087


I hope you find these brief summaries useful.

Until next week