June 9th 2013
Welcome to the 79th Critical Care Reviews Newsletter, bringing you the best critical care research published in the past week, plus a wide range of free full text review articles and guidelines from over 300 clinical and scientific journals. It's a huge newsletter this week, containing 103 articles.
This week's research studies include investigations into high volume haemofiltration in sepsis, early surgery for intracerebral haemorrhage, blood pressure control post stroke, pneumatic compression devices in immoblie stroke patients, the worldwide incidence of acute kidney injury and the burden of central venous catheter-associated bloodstream infections in the USA. There are numerous Cochrane reviews, including meta analyses on PEEP, impregnated central lines, wound infection in burns, bacterial meningitis and cardiogenic pulmonary oedema.
This week's guidelines address abdominal compartment syndrome, heart failure and stroke. There is one editiorial on guidelines and commentaries on starches, kidney diseases and fructose.
Amongst the clinical review articles are papers on right ventricular infarction, lung protective ventilation, the difficult airway, chest radiograph interpretation, acute pancreatitis, interpretation of liver function tests, cirrhosis, traumatic coagulopathy, carnitine in sepsis and cadmium toxicity. The latest review articles from the major journal that are now open access are also included.
Intensive Care Medicine: Renal Replacement Therapy
Joannes-Boyau and colleagues undertook a multicentre randomized controlled trial in 140 (137 analyzed) crtically ill patients with septic shock comparing high-volume haemofiltration (HVHF, n=66) at 70 mL/kg/h with standard-volume haemofiltration (SVHF, n=71) at 35 mL/kg/h, for a 96-h period. The trial was stopped early due to slow patient accrual and resource limitations. There was no difference in the primary end-point of 28-day mortality (HVHF 37.9 % vs. SVHF 40.8 %, p = 0.94) or in secondary endpoints.
Abstract: Joannes-Boyau. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med 2013;epublished June 6th
Intensive Care Medicine: Dobutamine in Sepsis
Hernandez et al performed a randomized, controlled, double-blind, crossover study to evaluate the effects of dobutamine on hemodynamic, metabolic, peripheral, hepatosplanchnic and microcirculatory perfusion parameters during early septic shock resuscitation. 20 septic shock patients with cardiac index ≥2.5 l/min/m2and hyperlactatemia received dobutamine (5 mcg/kg/min fixed-dose) or placebo. Although dobutamine increased cardiac index, heart rate and left ventricular ejection fraction, it did not improve tissue perfusion or function in the investigated regional circulations.
Abstract: Hernandez. Effects of dobutamine on systemic, regional and microcirculatory perfusion parameters in septic shock: a randomized, placebo-controlled, double-blind, crossover study. Intensve Care Med 2013;epublished June 6th
Clinical Journal of the American Society of Nephrology: Acute Kidney Injury
Susantitaphong and colleagues completed a systematic review (2004–2012) of large cohort studies from 2004 to 2012 to estimate the world incidence of AKI and its stages of severity and associated mortality. In 154 studies (n=3,585,911) using a KDIGO-equivalent AKI definition, the pooled incidence rates of AKI were 21.6% in adults (95% CI 19.3 to 24.1) and 33.7% in children (95% CI 26.9 to 41.3). The pooled AKI-associated mortality rates were 23.9% in adults (95% CI 22.1 to 25.7) and 13.8% in children (95% CI 8.8 to 21.0). The AKI-associated mortality rate declined over time, and was inversely related to income of countries and percentage of gross domestic product spent on total health expenditure.
Lancet: Intracerebral Haemorrhage
Mendelow et al completed an international, multi-centre, parallel-group trial comparing early surgery (n=307) with conservative therapy (n=294) in conscious patients with superficial lobar intracerebral haemorrhage of 10—100 mL and no intraventricular haemorrhage. There was no difference in the primary outcome of rates of unfavourable outcome at 6 months (surgery 59% versus 62%; odds ratio 0·86, 0·62 to 1·20; p=0·367). There was no difference in 6 mortality (surgery 18% versus conservative therapy 24%; OR 0·71, 95% CI 0·48 to 1·06; p=0·095).
Full Text: Mendelow. Early surgery versus initial conservative treatment in patients with spontaneous supratentorial lobar intracerebral haematomas (STICH II): a randomised trial. Lancet 2013;epublished May 29th (free registration required)
- Editorial: Gautschi. Surgery or conservative therapy for cerebral haemorrhage? Lancet 2013;epublished May 29th(free registration required)
The SPS3 study investigators completed a two-by-two multifactorial, randomised open-label trial examining the effects of different blood-pressure targets on the rate of recurrent stroke in 3020 patients with recent lacunar stroke. 1519 patients were randomized to a higher blood pressure target group (130—149 mm Hg) and 1501 to a lower-target group (<130 mm Hg), with a mean follow up of 3·7 years. After 1 year, mean systolic blood pressure was 138 mm Hg (95% CI 137—139) in the higher-target group and 127 mm Hg (95% CI 126—128) in the lower-target group. The lower blood pressure target was associated with a reduced rate of intracerebral haemorrhage (0·37, 0·15—0·95, p=0·03), a trend for reduced total stroke (hazard ratio 0·81, 95% CI 0·64—1·03, p=0·08), but no difference in disabling or fatal stroke (0·81, 0·53—1·23, p=0·32), and the composite outcome of myocardial infarction or vascular death (0·84, 0·68—1·04, p=0·32). Treatment-related serious adverse events were infrequent.
Lancet Respiratory Medicine: Magnesium for Asthma
Powell et al undertook a randomised placebo-controlled, multi-centre, parallel trial to assess the effect of 250 mmol nebulized MgSO4 in 508 children aged 2-16 with acute severe acute asthma not responding to standard inhaled therapy. The primary endpoint of mean Yung Asthma Severity Score at 60 min was lower in the MgSO4 group (4·72 [SD 1·37] versus 4·95 [SD 1·40]; adjusted difference −0·25, 95% CI −0·48 to −0·02; p=0·03), an effect which was clinically insignificant. The clinical effect was larger in children with more severe asthma exacerbation (p=0·03) and those with symptoms present for less than 6 h (p=0·049). There was no difference in adverse events between groups.
British Medical Journal: Influenza
In a double blind randomized trial in 326 patients with severe influenza (75.5% children aged <15), comparing oral oseltamivir at double dose (150 mg twice a day/paediatric equivalent, n=165) with standard dose (75 mg twice a day/paediatric equivalent, n=161), double dose therapy was not associated with improvements in mortality (double dose: 7.3% versus standard dose: 5.6%), days of supplemental oxygen, duration of mechanical ventilation (DD: 2.5 days (1-16) versus SD: 8 days (1-16)) or duration of intensive care admission (DD: 4.5 days (3-6) versus SD: 5 days (2-11). Tolerability of doses were similar.
Full Text: South East Asia Infectious Disease Clinical Research Network. Effect of double dose oseltamivir on clinical and virological outcomes in children and adults admitted to hospital with severe influenza: double blind randomised controlled trial. BMJ 2013; 346: f3039
Infection Control and Hospital Epidemiology: Central Venous Catheter-Associated Bacteraemia
Using Monte Carlo simulation based on data from nearly all US hospitals, Wise and colleagues estimated that there were between 462,000 and 636,000 central line-associated blood stream infections (CLABSIs) in nonneonatal critical care patients in the United States during 1990–2010. CLABSI rate reductions led to between 104,000 and 198,000 fewer CLABSIs than would have occurred if rates had remained unchanged since 1990. There were 15,000 hospital-onset CLABSIs in nonneonatal critical care patients in 2010; 70% occurred in medium and large teaching hospitals.
Cochrane Review: PEEP
Santa Cruz performed a systematic review and meta analysis to assess the benefits and harms of high versus low levels of PEEP in patients with ARDS and acute lung injury. Seven studies (n=2565) were included, although not all studies met eligibility criteria for each analyses. In three studies assessing in-hospital mortality, and comparing high versus low PEEP with the same tidal volume, there was no difference in mortality, risk of barotrauma (RR 0.97, 95% CI 0.66 to 1.42), or number of ventilator-free days. High-PEEP was associated with improved oxygenation, and possibly decreased mortality in the ARDS subgroup, although study designs limit this conclusion.
Full Text: Santa Cruz. High versus low positive end-expiratory pressure (PEEP) levels for mechanically ventilated adult patients with acute lung injury and acute respiratory distress syndrome. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD009098
Cochrane Review: Central Venous Catheter Impregnation
Lai evaluated the effects of antimicrobial CVCs in reducing clinically diagnosed sepsis, established catheter-related bloodstream infection (CRBSI) and mortality. 56 studies with 16,512 catheters and 11 types of antimicrobial impregnations were analysed. Catheter impregnation significantly reduced CRBSI, with an absolute risk reduction of 2% (95% CI 3% to 1%), risk ratio of 0.61 (95% CI 0.51 to 0.73) and number needed to treat of 50. Catheter impregnation also reduced catheter colonization, with an absolute risk reduction of 10% (95% CI 13% to 7%), RR of 0.66 (95% CI 0.58 to 0.75) and NNT of 10. However, catheter impregnation made no significant difference to the rates of clinically diagnosed sepsis (RR 1.0, 95% CI 0.88 to 1.13) and all-cause mortality (RR 0.88, 95% CI 0.75 to 1.05). Catheter impregnation conferred significant benefit in studies conducted in intensive care units (RR 0.68, 95% CI 0.59 to 0.78) but not in studies conducted in haematological and oncological units or studies that assessed predominantly patients who required CVCs for long-term total parenteral nutrition. There were no differences between the impregnated and non-impregnated groups in the rates of adverse effects.
Cochrane Review: Burns
Barajas-Nava performed a systematic review and meta analysis, identifying 36 randomized controlled trials (n=2117), to examine the effects of antibiotic prophylaxis on rates of burn wound infection. In 11 trials (n=645) topical prophylaxis with silver sulfadiazine, compared with dressings/skin substitute, was associated with both an increase in burn wound infection (OR = 1.87; 95% CI: 1.09 to 3.19, I2 = 0%) and longer hospital stay (mean difference 2.11 days; 95% CI 1.93 to 2.28). Systemic antibiotic prophylaxis had no effect on burn wound infection in non-surgical patients (3 trials, n=119). Perioperative antibiotics also appeared ineffective. While selective digestive decontamination with non-absorbable antibiotics had no effect on rates of all types of infection (2 trials, n=140), there was an increase in rates of MRSA associated with use of non-absorbable antibiotics plus cefotaxime compared with placebo (RR = 2.22; 95% CI: 1.21 to 4.07). The evidence reviewed was limited, consisting of small studies at unclear or high risk of bias for each comparison.
Cochrane Review: Cardiac Surgery
Svircevic et al completed a systematic review and meta analysis (31 studies, n=3047) to evaluate the effect of perioperative epidural analgesia in cardiac surgery on perioperative mortality and cardiac, pulmonary or neurological morbidity. Compared with GA alone, GA with thoracic epidural analgesia had no effect on mortality (odds ratio 0.84, 95% CI 0.33 to 2.13, 31 studies), myocardial infarction (OR 0.76, 95% CI 0.49 to 1.19, 17 studies) or stroke (0.50, 95% CI 0.21 to 1.18, 10 studies). The risk of respiratory complications and supraventricular arrhythmias were both reduced with thoracic epidural analgesia (risk ratio 0.68, 95% CI 0.54 to 0.86, 14 studies and risk ratio 0.65, 95% CI 0.50 to 0.86, 15 studies, respectively).
Cochrane Review: Alcohol Withdrawal
Sarai and colleagues completed a systematic review and meta analysis evaluating the effects of magnesium for the prevention or treatment of alcohol withdrawal syndrome in hospitalised adults. In 4 trials (n=317), all at high risk of bias, there was insufficient evidence to determine whether magnesium is beneficial or harmful for the treatment or prevention of alcohol withdrawal syndrome.
Cochrane Review: Inhalers versus Nebulizers
Holland et al undertook a a systematic review and meta analysis comparing the effectiveness of nebulizers and meter dose inhalers (MDI) for bronchodilator delivery in critically ill adults receiving invasive mechanical ventilation. Just 5 trials (n=64) were identified, leaving the authors unable to adequately address this evaluation.
Full Text: Holland. Metered dose inhalers versus nebulizers for aerosol bronchodilator delivery for adult patients receiving mechanical ventilation in critical care units. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD008863
Cochrane Review: Bacterial Meningitis
In an updated Cochrane Review, Brouwer and colleagues identified 25 studies (n=4121) investigating the efficacy of corticosteroids for bacterial meningitis in both children and adults. Corticosteroids were associated with a trend for reduced mortality in both analyses involving all patients (17.8% versus 19.9%; risk ratio 0.90, 95% CI 0.80 to 1.01, P = 0.07) and just adults (RR 0.74, 95% CI 0.53 to 1.05, P = 0.09). Corticosteroids were also associated with lower rates of severe hearing loss (RR 0.67, 95% CI 0.51 to 0.88), any hearing loss (RR 0.74, 95% CI 0.63 to 0.87) and neurological sequelae (RR 0.83, 95% CI 0.69 to 1.00). Subgroup analyses for causative organisms showed that corticosteroids reduced mortality in Streptococcus pneumoniae (S. pneumoniae) meningitis (RR 0.84, 95% CI 0.72 to 0.98), but not in Haemophilus influenzae (H. influenzae) or Neisseria meningitidis (N. meningitidis) meningitis. Corticosteroids reduced severe hearing loss in children with H. influenzae meningitis (RR 0.34, 95% CI 0.20 to 0.59) but not in children with meningitis due to non-Haemophilus species. In high-income countries, corticosteroids reduced severe hearing loss (RR 0.51, 95% CI 0.35 to 0.73), any hearing loss (RR 0.58, 95% CI 0.45 to 0.73) and short-term neurological sequelae (RR 0.64, 95% CI 0.48 to 0.85). There was no beneficial effect of corticosteroid therapy in low-income countries. Subgroup analysis for study quality showed no effect of corticosteroids on severe hearing loss in high-quality studies. Corticosteroid treatment was associated with an increase in recurrent fever (RR 1.27, 95% CI 1.09 to 1.47), but not with other adverse events.
Cochrane Review: Myocardial Infarction
Moazzami completed a systematic review and meta analysis (7 studies, n=354) to assess the effects of stem cell mobilization following granulocyte colony stimulating factor therapy (subcutaneous administration of G-CSF through a daily dose of 2.5, 5 or 10 microgram/kg for four to six days or placebo) in patients with acute myocardial infarction. G-CSF had no effect on mortality (risk ratio 0.64, 95% CI 0.15 to 2.80, P = 0.55) or any beneficial effects on left ventricular function parameters, including left ventricular ejection fraction (RR 3.41, 95% CI -0.61 to 7.44, P = 0.1), end systolic volume (RR -1.35, 95% CI -4.68 to 1.99, P = 0.43) and end diastolic volume (RR -4.08, 95% CI -8.28 to 0.12, P = 0.06). There was insufficient evidence to assess the safety of G-CSF therapy. The review was limited by the short follow up of subjects.
Cochrane Review: Clostridium Difficile
Goldenberg assess the efficacy and safety of probiotics for preventing Clostridium difficile-associated diarrhea (CDAD) or C. difficile infection in adults and children. In 23 moderate-quality studies (n=4213) probiotics were associated with a reduced risk of CDAD (probiotics: 2.0% versus placebo: 5.5%; RR 0.36; 95% CI 0.26 to 0.51).
Cochrane Review: Cardiogenic Pulmonary Oedema
In an updated Cochrane Review (32 studies, n=2916), Vital et al found that non-invasive positive pressure ventilation, compared with standard care, reduced hospital mortality (RR 0.66, 95% CI 0.48 to 0.89) and endotracheal intubation (RR 0.52, 95% CI 0.36 to 0.75 ) in adults with acute cardiogenic pulmonary oedema. There was no difference in hospital length of stay with NPPV; although intensive care unit stay was reduced by 1 day (weighted mean difference -0.89 days, 95% CI -1.33 to -0.45). NPPV was associated with no increase in the incidence of acute myocardial infarction during its application (RR 1.24, 95% CI 0.79 to 1.95) or after (RR 0.70, 95% CI 0.11 to 4.26), and also with fewer adverse events (progressive respiratory distress and coma)
Cochrane Review: Ischaemic Stroke
Wardlaw et al undertook a systematic review and meta analysis to examine the risks and benefits of different thrombolytic agents, doses and routes of administration for the treatment of acute ischaemic stroke. A total of 20 studies (n=2527) were evaluated, with smaller numbers contributing to each specific analysis. Higher doses, in comparison with lower doses of the same thrombolytic, were associated with an approximately three-fold increase in fatal intracranial haemorrhages (odds ratio 2.71, 95% CI 1.22 to 6.04), although there was no difference in the number of patients dead or dependent at the end of follow-up (OR 0.86, 95% CI 0.62 to 1.19). Higher versus lower doses of desmoteplase were associated with more deaths at the end of follow-up (OR 3.21, 95% CI 1.23 to 8.39). There was no evidence of any benefit for intra-arterial over intravenous treatment. The evidence was inadequate to determine whether one agent is better than another, or which route of administration is the best, for acute ischaemic stroke. The authors concluded by recommending intravenous rt-PA at 0.9mg/kg as probably representing best practice and other drugs, doses or routes of administration should only be used in randomised controlled trials.
Cochrane Review: Subarachnoid Haemorrhage
Marigold and colleagues assessed the effects of anti-epileptic drugs (AED) for the primary and secondary prevention of seizures after subarachnoid haemorrhage. There were no relevant studies to inform current practice.
Intensive Care Medicine: Abdominal Compartment Syndrome
- Kirkpatrick. Intra-abdominal hypertension and the abdominal compartment syndrome: updated consensus definitions and clinical practice guidelines from the World Society of the Abdominal Compartment Syndrome. Intensive Care Med 2013;epublished May
Circulation: Heart Failure
- 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;epublished June 5th
- 2013 ACCF/AHA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013;epublished May 5th
Cerebrovascular Disease: Ischaemic Stroke
- Kern. Comparison of the European and Japanese Guidelines for the Management of Ischemic Stroke. Cerebrovasc Dis 2013;35:402-418
Cerebrovascular Disease: Haemorrhagic Stroke
European Journal of Anaesthesiology: Guidelines
- Smith. Creating guidelines and treating patients when there are no trials or systematic reviews. Eur J Anaesthes 2013;30(7):383-385
American Journal of Kidney Disease: Kidney Diseases
Journal of the American Medical Association: Fructose
Review - Clinical
BMC Medicine: Cerebral Circulation
- Beggs. Venous hemodynamics in neurological disorders: an analytical review with hydrodynamic analysis. BMC Medicine 2013;11:142
European Heart Journal: Acute Cardiovascular Care: Right Ventricular Infarction
- Inohara. The challenges in the management of right ventricular infarction. European Heart Journal: Acute Cardiovascular Care 2013;epublished May 21st
Ulster Medical Journal: Endovascular Aortic Aneurysm Repair
Swiss Medical Weekly: Paediatric LVADs
- Schweiger. Paediatric ventricular assist devices: current achievements. Swiss Med Wkly 2013;143:w13804
BMC Medicine: Cardiac Circulation
Cleveland Clinic Journal of Medicine: Premature Ventricular Complexes
- Cantillon. Evaluation and management of premature ventricular complexes. Cleve Clin J Med 2013;80:377-387
Journal of the American College of Cardiology: Thoracic Irradiation Cardiac Complications
Expert Reviews in Respiratory Medicine: Lung Protective Ventilation
- Turner. Lung protective ventilation: a summary of the current evidence from the 2012 American Association for Respiratory Care International Congress. Expert Rev Respir Med 2013;7(3):209-12
Anesthesia News: Difficult Airway
Cerebrovascular Disease: Stroke
Ulster Medical Journal: Chest Radiograph
Cleveland Clinic Journal of Medicine: Acute Pancreatitis
Gastroenterology Research and Practice: Small Intestine Imaging
- Dolezal. Radionuclide Small Intestine Imaging. Gastroenterology Research and Practice 2013;2013:861619
Gastroenterology Research and Practice: Acute Liver Failure
- Cui. Alterations of Blood-Brain Barrier and Associated Factors in Acute Liver Failure. Gastroenterology Research and Practice 2013;2013:841707
Ulster Medical Journal: Liver Function Tests
World Journal of Hepatology: Cirrhosis
- Moore. Cirrhotic ascites review: Pathophysiology, diagnosis and management. World J Hepatol 2013;5(5):251-263
Blood Purification: Artificial Kidney
International Journal of Nutrition, Pharmacology and Neurological Diseases: Thyroid Disorders
Swiss Medical Weekly: Peptidomics & Metabolomics
- Leichtle. Potentials and pitfalls of clinical peptidomics and metabolomics. Swiss Med Wkly 2013;143:w13801
Annals of Intensive Care: Plasma in Paediatrics
Journal of Pharmacy and Pharmaceutical Sciences: Carnitine in Sepsis
- Hatamkhani. Carnitine and Sepsis: A Review of an Old Clinical Dilemma. J Pharm Pharm Sci 2013;16(3):414-423
ISRN Critical Care
Ulster Medical Journal: Upper Limb Injury
- Savage. Interpretation Of Radiographs Performed For Investigation Of Upper Limb Injury. Ulster Med J 2013;82(1):26-30
The Scientific World Journal: Cadmium Toxicity
Ulster Medical Journal: Radiological Error
- Brady. Discrepancy and Error in Radiology: Concepts, Causes and Consequences. Ulster Med J 2012;81(1):3-9
Recently Made Open Access Articles from Major Journals
American Journal of Respiratory and Critical Care Medicine
- Miller. Pulmonary Complications of Sickle Cell Disease. Am J Respir Crit Care Med 2012;185:(11):1154-1165
- Hassoun. Update in Pulmonary Vascular Diseases 2011. Am J Respir Crit Care Med 2012;185:(11):1177-1182
- Smith. Introduction to Drug Pharmacokinetics in the Critically Ill Patient. Chest 2012;141(5):1327-1336
- Kerlin. Twenty-four-Hour Intensivist Staffing in Teaching Hospitals: Tensions Between Safety Today and Safety Tomorrow. Chest 2012;141(5):1315-1320
- Saiprakash. Sleep and Sleep Disorders in the Hospital. Chest 2012;141(5):1337-1345
- Baron. Point: Should Coagulopathy Be Repaired Prior to Central Venous Line Insertion? Yes: Why Take Chances? Chest 2012;141(5):1139-1142
- Goldhaber. Counterpoint: Should Coagulopathy Be Repaired Prior to Central Venous Line Insertion? No. Chest 2012;141(5):1142-1144
- Rebuttal From Dr Baron. Chest 2012;141(5):1144-1145
- Rebuttal From Dr Goldhaber. Chest 2012;141(5):1145-1146
- Dijkema. Preventable mortality evaluation in the ICU. Critical Care 2012;16:30
- Spasojević. Neonatal sepsis - redox processes in pathogenesis. Critical Care 2012;16:221
- Afshari. Rapid molecular diagnostics for bloodstream infection - a new frontier? Critical Care 2012;16:222
Anesthesia & Analgesia
- Mascha. Joint Hypothesis Testing and Gatekeeping Procedures for Studies with Multiple Endpoints. Anesth Analg 2012;114:1304-1317
- Brook. Ventilation of Neck Breathers Undergoing a Diagnostic Procedure or Surgery. Anesth Analg June 2012;114:1318-1321
Continuing Education in Anaesthesia, Critical Care and Pain
- Lloyd. Cognitive decline after anaesthesia and critical care. Contin Educ Anaesth Crit Care Pain 2012;12(3):105-109
- Berry. Abdominal compartment syndrome. Contin Educ Anaesth Crit Care Pain 2012;12(3):110-117
- Bishop. Anaesthesia and intensive care for major burns. Contin Educ Anaesth Crit Care Pain 2012;12(3):118-122
- Findley. Porphyrias: implications for anaesthesia, critical care, and pain medicine. Contin Educ Anaesth Crit Care Pain 2012;12(3):128-133
- Martinez. Infective endocarditis. Contin Educ Anaesth Crit Care Pain 2012;12(3):134-139
- Reddy. Anaesthesia for magnetic resonance imaging. Contin Educ Anaesth Crit Care Pain 2012;12(3):140-144
- Harris. Ventricular assist devices. Contin Educ Anaesth Crit Care Pain 2012;12(3):145-151
- Cullen. Paediatric trauma. Contin Educ Anaesth Crit Care Pain 2012;12(3):157-161
- Jenkins. New Standards for Critically Ill Children: towards a unified approach. Contin Educ Anaesth Crit Care Pain 2012;12(2):47-51
- Allan. Anaesthetic implications of chemotherapy. Contin Educ Anaesth Crit Care Pain 2012;12(2):52-56
- Martinez. Extracorporeal membrane oxygenation in adults. Contin Educ Anaesth Crit Care Pain 2012;12(2):57-61
- Appleton. Intensive care unit-acquired weakness. Contin Educ Anaesth Crit Care Pain 2012;12(2):62-66
- Gregory. Cardiovascular complications of brain injury. Contin Educ Anaesth Crit Care Pain 2012;12(2):67-71
- Fleming. Amyloidosis and anaesthesia. Contin Educ Anaesth Crit Care Pain 2012;12(2):72-77
- Marsh. Outreach: ‘the past, present, and future’. Contin Educ Anaesth Crit Care Pain 2012;12(2):78-81
- Shawkat. Mannitol: a review of its clinical uses. Contin Educ Anaesth Crit Care Pain 2012;12(2):82-85
- Rucklidge. Difficult and failed intubation in obstetrics. Contin Educ Anaesth Crit Care Pain 2012;12(2):86-91
- Drummond. Minimally invasive cardiac output monitors. Contin Educ Anaesth Crit Care Pain 2012;12(1):5-10
- Davies. Regional anaesthesia and antithrombotic drugs. Contin Educ Anaesth Crit Care Pain 2012;12(1):11-16
- White. Anaesthetic management of children with congenital heart disease for non-cardiac surgery. Contin Educ Anaesth Crit Care Pain 2012;12(1):17-22
- Peyton. Anaesthesia for correction of congenital heart disease (for the specialist or senior trainee). Contin Educ Anaesth Crit Care Pain 2012;12(1):23-27
- Kelleher. Adult congenital heart disease (grown-up congenital heart disease). Contin Educ Anaesth Crit Care Pain 2012;12(1):28-32
- McNeill. Clinical applications of non-invasive ventilation in critical care. Contin Educ Anaesth Crit Care Pain 2012;12(1):33-37
- Bhatia. Perioperative peripheral nerve injuries. Contin Educ Anaesth Crit Care Pain 2012;12(1):38-42
British Journal of Anaesthesia
American Journal of Respiratory and Critical Care Medicine
- dos Santos. The Role of the Inflammasome in Ventilator-induced Lung Injury. Am J Respir Crit Care Med 2012;185:(11):1141-1144
Anaesthesia: Anaesthetic Equipment
- AAGBI Working Party. Checking Anaesthetic Equipment. Anaesthesia 2012;67:660–668
- Diringer. Protocol-directed care in the ICU: making a future generation of intensivists less knowledgeable? Critical Care 2012;16:307
Review - Basic Science
Canadian Journal of Surgery: Statistics
Indian Journal of Dermatology, Venereology, and Leprology: Genetics
Review - Non-Clinical
Ulster Medical Journal: Metric-Based Simulation
I hope you find these brief summaries and links useful.
Until next week