The author replies
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

A Growing Problem of Critical Illness Due to Chimeric Antigen Receptor T-Cell Therapy
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Patient-Directed Music Therapy in the ICU
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Three Factors to Determine the Heat Generation During Targeted Temperature Management—Patient, Machine, and Surrounding
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Focusing on Risk Factors of Cardiac Arrest During Intubation in ICU Again
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Incidence and Prevalence of Pressure Injuries in Adult Intensive Care Patients: A Systematic Review and Meta-Analysis
Conclusions: Although well-designed studies are needed to ensure the scope of the problem of pressure injuries is better understood, it is clear prevention strategies are also required. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Review Article Source Type: research

Extracorporeal Membrane Oxygenation Can Successfully Support Patients With Severe Acute Respiratory Distress Syndrome in Lieu of Mechanical Ventilation
Conclusions: Our results suggest that venovenous extracorporeal membrane oxygenation can provide a safe and effective alternative to lung-protective mechanical ventilation in carefully selected patients. This approach facilitates participation in physical therapy and avoids complications associated with mechanical ventilation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Brief Report Source Type: research

Iodide Improves Outcome After Acute Myocardial Infarction in Rats and Pigs
Conclusions: Iodide administration improved the structure and function of the heart after acute myocardial infarction in rats and pigs. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Laboratory Investigation Source Type: research

Early Right Ventricular Systolic Dysfunction and Pulmonary Hypertension Are Associated With Worse Outcomes in Pediatric Acute Respiratory Distress Syndrome
Conclusions: Early ventricular dysfunction and pulmonary hypertension were detectable, prevalent, and independent of lung injury severity in children with pediatric acute respiratory distress syndrome. Right ventricular dysfunction was associated with PICU mortality, whereas right ventricular dysfunction and pulmonary hypertension were associated with lower probability of extubation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Postdischarge Major Adverse Cardiovascular Events of ICU Survivors Who Received Acute Renal Replacement Therapy
Objectives: Long-term risk of a major adverse cardiovascular events in ICU survivors who underwent acute renal replacement therapy requires further investigation. Design: Nationwide population-based study using the claims database of Korea. Setting: Index admission cases of ICU survivors in government-designated tertiary hospitals Patients: The study group consisted of ICU survivors who underwent acute renal replacement therapy, and the control group consisted of those without acute renal replacement therapy. Patients were excluded if they 1) were under age 20, 2) expired within 30 days after discharge, 3) recei...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Ultrasound Assessment of the Change in Carotid Corrected Flow Time in Fluid Responsiveness in Undifferentiated Shock
This study evaluates the accuracy of point-of-care Doppler ultrasound assessment of the change in carotid corrected flow time induced by a passive leg raise maneuver as a predictor of fluid responsiveness. Noninvasive cardiac output monitoring (NICOM, Cheetah Medical, Newton Center, MA) system based on a bioreactance method was used. Design: Prospective, noninterventional study. Setting: ICU at a large academic center. Patients: Patients with new, undifferentiated shock, and vasopressor requirements despite fluid resuscitation were included. Patients with significant cardiac disease and conditions that precluded a...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

The Association of Nutrition Status Expressed as Body Mass Index z Score With Outcomes in Children With Severe Sepsis: A Secondary Analysis From the Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study*
Conclusions: There is considerable variation in nutrition status for children with severe sepsis treated across this selected network of PICUs from different geographic regions. Severe undernutrition was independently associated with higher all-cause ICU mortality in children with severe sepsis. Severe overnutrition was independently associated with greater ICU length of stay in childhood survivors of severe sepsis. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Systemic High-Mobility Group Box-1: A Novel Predictive Biomarker for Cerebral Vasospasm in Aneurysmal Subarachnoid Hemorrhage*
Objectives: To investigate the release of proinflammatory damage-associated molecular pattern molecule “high-mobility group box-1” in the serum of patients after aneurysmal subarachnoid hemorrhage and its association with cerebral vasospasm. Design: Retrospective observational study. Setting: University hospital. Patients: Aneurysmal subarachnoid hemorrhage patients admitted within 24 hours of ictus. Interventions: Standard subarachnoid hemorrhage treatment after clipping or coiling of aneurysm. Measurements and Main Results: We enrolled 53 aneurysmal subarachnoid hemorrhage patients from which...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Nutritional Status and Outcomes in Pediatric Severe Sepsis—Size Matters*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Inflammation, Cerebral Vasospasm, and Brain Injury in Subarachnoid Hemorrhage—A Shifting Paradigm and a New Beginning*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

In the Middle of Difficulty Lies Opportunity.—Albert Einstein*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Inhaled Nitric Oxide for Pediatric Acute Respiratory Distress Syndrome: Another Brick in the Wall?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Using Intracranial Pressure Trajectories for Outcome Prediction in Traumatic Brain Injury: Are Summary Measures Still Valid in the Era of Precision-Based Medicine?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Adding to the Repertoire of Scoring Systems in Acute-on-Chronic Liver Failure: Will Simplicity Be Outdone by Complexity?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Where Did the Gas Go? Recruitment Versus Aeration*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Variation in Sepsis-Related Mortality; Implications for Performance Improvement*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Thiamine: An Essential Component of the Metabolic Resuscitation Protocol*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Monitoring the Adaptive Immune System in Septic Shock Patients: Ready for Prime Time?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Pediatric Acute Respiratory Distress Syndrome Survivors—What Happens After the PICU?*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Complex Legacy of the Target Temperature Management Trial*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Measuring the Results of the Handover*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Attending Intensivist Handoffs Are Far From Perfect*
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Editorials Source Type: research

Ethics of Outbreaks Position Statement. Part 2: Family-Centered Care
Objectives: Continue the dialogue presented in Ethics of Outbreaks Position Statement. Part 1, with a focus on strategies for provision of family-centered care in critical illness during Pubic Health Emergency of International Concern. Design: Development of a Society of Critical Care Medicine position statement using literature review, expert consensus from the Society of Critical Care Medicine Ethics Committee. A family member of a patient who was critically ill during a natural disaster served on the writing panel and provided validation from a family perspective to the recommendations. Setting: Provision of fam...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Special Articles Source Type: research

Ethics of Outbreaks Position Statement. Part 1: Therapies, Treatment Limitations, and Duty to Treat
Objectives: Outbreaks of disease, especially those that are declared a Public Health Emergency of International Concern, present substantial ethical challenges. Here we start a discourse (with a continuation of the dialogue in Ethics of Outbreaks Position Statement. Part 2: Family-Centered Care) concerning the ethics of the provision of medical care, research challenges and behaviors during a Public Health Emergency of International Concern with a focus on the proper conduct of clinical or epidemiologic research, clinical trial designs, unregistered medical interventions (including vaccine introduction, devices, pharmace...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Special Articles Source Type: research

Delirium Monitoring in Neurocritically Ill Patients: A Systematic Review*
Conclusions: These data from studies of neurocritically ill patients demonstrate that patients with primary neurologic diagnoses can meet diagnostic criteria for delirium and that delirious features may predict relevant untoward clinical outcomes. There is a need for ongoing investigations regarding delirium in these complicated neurocritically ill patients. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Review Article Source Type: research

Beyond Low Tidal Volume Ventilation: Treatment Adjuncts for Severe Respiratory Failure in Acute Respiratory Distress Syndrome
Conclusions: Severe respiratory failure in acute respiratory distress syndrome often necessitates the use of treatment adjuncts. Evidence-based application of these therapies in acute respiratory distress syndrome remains a significant challenge. However, a rational stepwise approach with frequent monitoring for improvement or harm can be achieved. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Concise Definitive Review Source Type: research

Epidemiology of Cause of Death in Pediatric Acute Respiratory Distress Syndrome
Conclusions: In pediatric acute respiratory distress syndrome, early deaths were due primarily to neurologic failure, whereas later deaths were more commonly due to multisystem organ failure. Deaths from neurologic causes accounted for a substantial portion of nonsurvivors. Refractory hypoxemia accounted for only a minority of deaths. Our study highlights limitations associated with using death as an endpoint in therapeutic pediatric acute respiratory distress syndrome trials. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

The Association Between Inhaled Nitric Oxide Treatment and ICU Mortality and 28-Day Ventilator-Free Days in Pediatric Acute Respiratory Distress Syndrome*
Objectives: To investigate the association between inhaled nitric oxide treatment and ICU mortality and 28-day ventilator-free days in pediatric acute respiratory distress syndrome. Design: Retrospective cohort study. A propensity score for inhaled nitric oxide treatment was developed and used in the analysis. Setting: Two quaternary care PICUs. Patients: Children with pediatric acute respiratory distress syndrome. Interventions: None. Measurements and Main Results: There were 499 children enrolled in this study with 143 (28.7%) receiving inhaled nitric oxide treatment. Children treated with inhaled nitric...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Intracranial Pressure Trajectories: A Novel Approach to Informing Severe Traumatic Brain Injury Phenotypes*
Objectives: Intracranial pressure in traumatic brain injury is dynamic and influenced by factors like injury patterns, treatments, and genetics. Existing studies use time invariant summary intracranial pressure measures thus potentially losing critical information about temporal trends. We identified longitudinal intracranial pressure trajectories in severe traumatic brain injury and evaluated whether they predicted outcome. We further interrogated the model to explore whether ABCC8 polymorphisms (a known cerebraledema regulator) differed across trajectory groups. Design: Prospective observational cohort. Setting: ...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Dynamic Prognostication in Critically Ill Cirrhotic Patients With Multiorgan Failure in ICUs in Europe and North America: A Multicenter Analysis*
Objectives: To evaluate the Chronic Liver Failure-Consortium Acute on Chronic Liver Failure score in acute on chronic liver failure patients admitted to ICUs from different global regions and compare discrimination ability with previously published scores. Design: Retrospective pooled analysis. Setting: Academic ICUs in Canada (Edmonton, Vancouver) and Europe (Paris, Barcelona, Chronic liver failure/Acute-on-Chronic Liver Failure in Cirrhosis [CANONIC] study). Patients: Sample of analysis of 867 cirrhotic patients with acute on chronic liver failure admitted to ICU. Cumulative incidence functions of death were e...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Case Fatality and Adverse Outcomes Are Reduced in Pregnant Women With Severe Sepsis or Septic Shock Compared With Age-Matched Comorbid-Matched Nonpregnant Women
Conclusions: Case fatality and adverse outcomes are reduced in women with pregnancy-associated severe sepsis or septic shock compared with nonpregnant women with severe sepsis or septic shock, and this is not explained by differences in age or chronic comorbidities alone. A less severe presentation of sepsis or protective effect of pregnancy may account for the difference observed with pregnancy-associated severe sepsis or septic shock. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Shoulder Impairment Following Critical Illness: A Prospective Cohort Study
Conclusions: Shoulder impairment is a highly prevalent potential source of disability in ICU survivors. This persists at 6 months after discharge with a significant impact on upper limb function. More research is needed into potential mechanisms underlying shoulder impairment and potential targeted interventions to reduce the prevalence. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Assessment of Lung Aeration and Recruitment by CT Scan and Ultrasound in Acute Respiratory Distress Syndrome Patients*
Objectives: Lung ultrasound is commonly used to evaluate lung morphology in patients with acute respiratory distress syndrome. Aim of this study was to determine lung ultrasound reliability in assessing lung aeration and positive end-expiratory pressure–induced recruitment compared with CT. Design: Randomized crossover study. Setting: University hospital ICU. Patients: Twenty sedated paralyzed acute respiratory distress syndrome patients: age 56 years (43–72 yr), body mass index 25 kg/m2 (22–27 kg/m2), and PaO2/FIO2 160 (113–218). Interventions: Lung CT and lung ultrasoun...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Assessing Variability in Hospital-Level Mortality Among U.S. Medicare Beneficiaries With Hospitalizations for Severe Sepsis and Septic Shock*
Objectives: To assess the variability in short-term sepsis mortality by hospital among Centers for Medicare and Medicaid Services beneficiaries in the United States during 2013–2014. Design: A retrospective cohort design. Setting: Hospitalizations from 3,068 acute care hospitals that participated in the Centers for Medicare and Medicaid Services inpatient prospective payment system in 2013 and 2014. Patients: Medicare fee-for-service beneficiaries greater than or equal to 65 years old who had an inpatient hospitalization coded with present at admission severe sepsis or septic shock. Interventions: None....
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock*
Conclusions: Thiamine administration within 24 hours of admission in patients presenting with septic shock was associated with improved lactate clearance and a reduction in 28-day mortality compared with matched controls. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Low Interleukin-7 Receptor Messenger RNA Expression Is Independently Associated With Day 28 Mortality in Septic Shock Patients*
Conclusions: Interleukin-7 receptor transcripts appear as biomarkers of impaired adaptive immune response in septic shock patients and as a promising tool for patient stratification in clinical trials evaluating immunoadjuvant therapies. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

New Morbidity and Discharge Disposition of Pediatric Acute Respiratory Distress Syndrome Survivors*
Conclusions: New morbidity was common after pediatric acute respiratory distress syndrome and appears to be intermediate phenotype between survival without morbidity and death, making it a useful metric in future interventional and outcome studies in pediatric acute respiratory distress syndrome. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Changes in Temperature Management of Cardiac Arrest Patients Following Publication of the Target Temperature Management Trial*
Conclusions: The average lowest temperature of postcardiac arrest patients in the first 24 hours in ICU rose after publication of the target temperature management trial. This change was associated with an increased frequency of fever not seen in the target temperature management trial. (Source: Critical Care Medicine)
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Handovers Among Staff Intensivists: A Study of Information Loss and Clinical Accuracy to Anticipate Events*
Objectives: Handovers are associated with medical errors, and our primary objective is to identify missed diagnosis and goals immediately after a shift handover. Our secondary objective is to assess clinicians’ diagnostic accuracy in anticipating clinical events during the night shift. Design: Single-center prospective observational cohort study. Setting: Thirty-bed tertiary ICU in Sao Paulo, Brazil. Patients: Three-hundred fifty-two patient encounters over 44 day-to-night handovers. Interventions: None. Measurements and Main Results: We used a multimethods approach to measure transmission of informa...
Source: Critical Care Medicine - October 13, 2018 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Challenges to Interprofessional Care in the ICU Environment
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - September 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - September 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Boarding Rather Than Boring, How Do We Best Juggle Our ICU Outliers?
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - September 15, 2018 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research