A Retrospective, Pilot Study of De Novo Antidepressant Medication Initiation in Intensive Care Unit Patients and Post-ICU Depression.
Authors: Haines D, Hild J, He J, Stun L, Ballew A, Green JL, Satterwhite L, Flynn BC Abstract Post-ICU Syndromes (PICS) remain a devastating problem for intensive care unit (ICU) survivors. It is currently unknown if de novo initiation of an antidepressant medication during ICU stay decreases the prevalence of post-ICU depression. We performed a retrospective, pilot study evaluating patients who had not previously been on an antidepressant medication and who were started on an antidepressant while in the trauma surgical, cardiothoracic, or medical intensive care unit (ICU). The PHQ-2 depression scale was used to as...
Source: Critical Care Research and Practice - November 7, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Variability in Glycemic Control with Temperature Transitions during Therapeutic Hypothermia.
CONCLUSIONS: Glycemic excursions are common and occur more often in nonsurvivors. Excursions differ by phase but risk of hypoglycemia is increased during rewarming. PMID: 29075530 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 29, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Analysis of Adverse Events during Intrahospital Transportation of Critically Ill Patients.
Authors: Gimenez FMP, de Camargo WHB, Gomes ACB, Nihei TS, Andrade MWM, Valverde MLAFS, Campos LES, Grion DC, Festti J, Grion CMC Abstract PURPOSE: To describe adverse events occurring during intrahospital transportation of adult patients hospitalized in an Intensive Care Unit (ICU) and to evaluate the association with morbidity and mortality. METHOD: Prospective cohort study from July 2014 to July 2015. Data collection comprised clinical data, prognostic scores, length of stay, and outcome at hospital discharge. Data was collected on transport and adverse events. Adverse events were classified according to the...
Source: Critical Care Research and Practice - October 26, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

IVC Measurements in Critically Ill Patients with Acute Renal Failure.
CONCLUSION: In critically ill patients with AKI, concurrence of fluid therapy with IVC predicted fluid management, as assessed by bedside ultrasound, was associated with improved renal function at 48 hours. This trial is registered with ClinicalTrials.gov registration number: NCT02064244. PMID: 29057120 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 24, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Clinical Characteristics and Outcomes of Surgical Patients with Intensive Care Unit Lengths of Stay of 90 Days and Greater.
CONCLUSIONS: We found a high but in our opinion acceptable mortality rate in surgical patients with ICU LOS of 90 days and greater. We identified age and the need of renal replacement therapy as risk factors for mortality. PMID: 28828185 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 24, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Utilisation of Intermediate Care Units: A Systematic Review.
Authors: Plate JDJ, Leenen LPH, Houwert M, Hietbrink F Abstract Background. The diversity in formats of Intermediate Care Units (IMCUs) makes it difficult to compare data from different settings. The purpose of this article was to describe and quantify these different formations and utilisation. Methods. We performed a systematic review extracting geographic location, nomenclature used, admitting specialties, open (admitting specialist in charge) or closed (intensivist/generalist in charge) management format, location in hospital, number of beds, nursing workload, medical staff to patient ratios, and modalities-pos...
Source: Critical Care Research and Practice - August 5, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Resurgence of Polymyxin B for MDR/XDR Gram-Negative Infections: An Overview of Current Evidence.
Authors: Garg SK, Singh O, Juneja D, Tyagi N, Khurana AS, Qamra A, Motlekar S, Barkate H Abstract Polymyxin B has resurged in recent years as a last resort therapy for Gram-negative multidrug-resistant (MDR) and extremely drug resistant (XDR) infections. Understanding newer evidence on polymyxin B is necessary to guide clinical decision making. Here, we present a literature review of polymyxin B in Gram-negative infections with update on its pharmacology. PMID: 28761764 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 3, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Factors Associated with the Incidence and Severity of New-Onset Atrial Fibrillation in Adult Critically Ill Patients.
CONCLUSIONS: In general ICU patients, incidence of new-onset AF was 11.2% with a high impact on morbidity and mortality, particularly associated with the presence of Acute Renal Failure. The use of vasoactive drugs (norepinephrine and dobutamine) could lead to a higher incidence of new-onset AF-associated morbidity and mortality. PMID: 28702263 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - July 15, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Melatonin Secretion Pattern in Critically Ill Patients: A Pilot Descriptive Study.
Authors: Boyko Y, Holst R, Jennum P, Oerding H, Nikolic M, Toft P Abstract Critically ill patients have abnormal circadian and sleep homeostasis. This may be associated with higher morbidity and mortality. The aims of this pilot study were (1) to describe melatonin secretion in conscious critically ill mechanically ventilated patients and (2) to describe whether melatonin secretion and sleep patterns differed in these patients with and without remifentanil infusion. Eight patients were included. Blood-melatonin was taken every 4th hour, and polysomnography was carried out continually during a 48-hour period. Americ...
Source: Critical Care Research and Practice - June 8, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Brain Multimodality Monitoring: A New Tool in Neurocritical Care of Comatose Patients.
Authors: Tasneem N, Samaniego EA, Pieper C, Leira EC, Adams HP, Hasan D, Ortega-Gutierrez S Abstract Neurocritical care patients are at risk of developing secondary brain injury from inflammation, ischemia, and edema that follows the primary insult. Recognizing clinical deterioration due to secondary injury is frequently challenging in comatose patients. Multimodality monitoring (MMM) encompasses various tools to monitor cerebral metabolism, perfusion, and oxygenation aimed at detecting these changes to help modify therapies before irreversible injury sets in. These tools include intracranial pressure (ICP) monitor...
Source: Critical Care Research and Practice - June 1, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance.
Authors: Agustin M, Price LL, Andoh-Duku A, LaCamera P Abstract Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS
Source: Critical Care Research and Practice - April 16, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Benefit of Neuromuscular Blockade in Patients with Postanoxic Myoclonus Otherwise Obscuring Continuous Electroencephalography (CEEG).
Conclusion. Short-acting neuromuscular blockade is useful in determining background cerebral activity on CEEG otherwise partially or completely obscured by muscle artifact in patients with postanoxic myoclonus. Fully understanding background cerebral activity is important in prognostication and treatment, particularly when there are underlying EEG seizures. PMID: 28265468 [PubMed - in process] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 9, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Severe Tuberculosis Requiring Intensive Care: A Descriptive Analysis.
This study aims to describe the characteristics of tuberculosis (TB) patients requiring intensive care and to determine the in-hospital mortality and the associated predictive factors. Methods. Retrospective cohort study of all TB patients admitted to the ICU of the Infectious Diseases Department of Centro Hospitalar de São João (Porto, Portugal) between January 2007 and July 2014. Comorbid diagnoses, clinical features, radiological and laboratory investigations, and outcomes were reviewed. Univariate analysis was performed to identify risk factors for death. Results. We included 39 patients: median age was 5...
Source: Critical Care Research and Practice - March 3, 2017 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Does Obesity Predispose Medical Intensive Care Unit Patients to Venous Thromboembolism despite Prophylaxis? A Retrospective Chart Review.
Authors: Peters BJ, Dierkhising RA, Mara KC Abstract Background. Obesity is a significant issue in the critically ill population. There is little evidence directing the dosing of venous thromboembolism (VTE) prophylaxis within this population. We aimed to determine whether obesity predisposes medical intensive care unit patients to venous thromboembolism despite standard chemoprophylaxis with 5000 international units of subcutaneous heparin three times daily. Results. We found a 60% increased risk of venous thromboembolism in the body mass index (BMI) ≥ 30 kg/m(2) group compared to the BMI
Source: Critical Care Research and Practice - December 22, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Impact of a Local Low-Cost Ward-Based Response System in a Canadian Tertiary Care Hospital.
Authors: Blotsky A, Mardini L, Jayaraman D Abstract Background. Medical emergency teams (METs) or rapid response teams (RRTs) facilitate early intervention for clinically deteriorating hospitalized patients. In healthcare systems where financial resources and intensivist availability are limited, the establishment of such teams can prove challenging. Objectives. A low-cost, ward-based response system was implemented on a medical clinical teaching unit in a Montreal tertiary care hospital. A prospective before/after study was undertaken to examine the system's impact on time to intervention, code blue rates, and ICU...
Source: Critical Care Research and Practice - November 12, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Correlation between Arterial Lactate and Central Venous Lactate in Children with Sepsis.
The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital. The lactate value obtained from an arterial blood sample and a central venous blood sample drawn simultaneously, and within 24 hours of admission to the unit, was recorded. Res...
Source: Critical Care Research and Practice - November 10, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Clinical Characteristics and Short-Term Outcomes of HIV Patients Admitted to an African Intensive Care Unit.
Authors: Kwizera A, Nabukenya M, Peter A, Semogerere L, Ayebale E, Katabira C, Kizito S, Nantume C, Clarke I, Nakibuuka J Abstract Purpose. In high-income countries, improved survival has been documented among intensive care unit (ICU) patients infected with human immune deficiency virus (HIV). There are no data from low-income country ICUs. We sought to identify clinical characteristics and survival outcomes among HIV patients in a low-income country ICU. Materials and Methods. A retrospective cohort study of HIV infected patients admitted to a university teaching hospital ICU in Uganda. Medical records were revie...
Source: Critical Care Research and Practice - November 3, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals.
Conclusions. Twenty-seven percent of adults dying in Mongolian secondary and tertiary level hospitals do so without prior ICU admission. One-third, mostly young patients suffering from acute reversible conditions, may have potentially been saved by intensive care medicine. PMID: 27795857 [PubMed - in process] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - November 2, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Abnormal Admission Chest X-Ray and MEWS as ICU Outcome Predictors in a Sub-Saharan Tertiary Hospital: A Prospective Observational Study.
Conclusion. Trauma (31%) caused most ICU admissions, having an abnormal admission chest X-rays positively associated with mortality and a high MEWS was also a good predictor of mortality. PMID: 27721991 [PubMed - in process] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 12, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Development of Intensive Care Unit Acquired Hypernatremia Is Not Explained by Sodium Overload or Water Deficit: A Retrospective Cohort Study on Water Balance and Sodium Handling.
Authors: van IJzendoorn MC, Buter H, Kingma WP, Navis GJ, Boerma EC Abstract Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion? Methods. Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients...
Source: Critical Care Research and Practice - October 11, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Can Transcutaneous CO2 Tension Be Used to Calculate Ventilatory Dead Space? A Pilot Study.
Authors: Lakshminarayana PH, Geeti AA, Darr UM, Kaufman DA Abstract Dead space fraction (V d/V t) measurement performed using volumetric capnography requires arterial blood gas (ABG) sampling to estimate the partial pressure of carbon dioxide (PaCO2). In recent years, transcutaneous capnography (PtcCO2) has emerged as a noninvasive method of estimating PaCO2. We hypothesized that PtcCO2 can be used as a substitute for PaCO2 in the calculation of V d/V t. In this prospective pilot comparison study, 30 consecutive postcardiac surgery mechanically ventilated patients had V d/V t calculated separately using volumetric ...
Source: Critical Care Research and Practice - October 2, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Comment on "Management of Atrial Fibrillation in Critically Ill Patients".
Comment on "Management of Atrial Fibrillation in Critically Ill Patients". Crit Care Res Pract. 2016;2016:8985161 Authors: Jelliffe R PMID: 27641992 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - September 20, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Response to: Comment on "Management of Atrial Fibrillation in Critically Ill Patients".
Response to: Comment on "Management of Atrial Fibrillation in Critically Ill Patients". Crit Care Res Pract. 2016;2016:9724504 Authors: Arrigo M, Bettex D, Rudiger A PMID: 27642081 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - September 20, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study.
Conclusion. This study demonstrated improved OBGYN resident knowledge, confidence, and competence in the management of third trimester maternal cardiac arrest. Several skills, however, will likely require more longitudinal curricular exposure and training to develop and maintain proficiency. PMID: 27555967 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 26, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units.
Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension. PMID: 27516901 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 17, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Determinants of Deescalation Failure in Critically Ill Patients with Sepsis: A Prospective Cohort Study.
Authors: Salahuddin N, Amer L, Joseph M, El Hazmi A, Hawa H, Maghrabi K Abstract Introduction. Deescalation refers to either discontinuation or a step-down of antimicrobials. Despite strong recommendations in the Surviving Sepsis Guidelines (2012) to deescalate, actual practices can vary. Our objective was to identify variables that are associated with deescalation failure. Methods. In this prospective study of patients with sepsis/septic shock, patients were categorized into 4 groups based on antibiotic administration: no change in antibiotics, deescalation, escalation (where antibiotics were changed to those with...
Source: Critical Care Research and Practice - August 7, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Antimicrobial Doses in Continuous Renal Replacement Therapy: A Comparison of Dosing Strategies.
Conclusion. Wide variability in dose recommendations for patients undergoing CRRT exists when these equations are used. Alternate, validated dosing methods need to be developed for this at-risk patient population. PMID: 27433357 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - July 21, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Accuracy of Transcutaneous Carbon Dioxide Measurement in Premature Infants.
Authors: Janaillac M, Labarinas S, Pfister RE, Karam O Abstract Background. In premature infants, maintaining blood partial pressure of carbon dioxide (pCO2) value within a narrow range is important to avoid cerebral lesions. The aim of this study was to assess the accuracy of a noninvasive transcutaneous method (TcpCO2), compared to blood partial pressure of carbon dioxide (pCO2). Methods. Retrospective observational study in a tertiary neonatal intensive care unit. We analyzed the correlation between blood pCO2 and transcutaneous values and the accuracy between the trends of blood pCO2 and TcpCO2 in all consecuti...
Source: Critical Care Research and Practice - July 6, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Immunocompromised Children with Severe Adenoviral Respiratory Infection.
Conclusions. There is substantial case fatality as well as short- and long-term morbidity associated with severe adenoviral respiratory infection in immunocompromised children. PMID: 27242924 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - June 2, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Neutropenic Sepsis in the ICU: Outcome Predictors in a Two-Phase Model and Microbiology Findings.
Conclusion. Patients with persistent organ dysfunction show an increased mortality in the further course of their ICU stay. Early antimicrobial treatment of Gram-positive cocci may improve the outcome of these patients. PMID: 27195148 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - May 21, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Additional Analgesia for Central Venous Catheter Insertion: A Placebo Controlled Randomized Trial of Dexmedetomidine and Fentanyl.
Authors: Samantaray A, Hanumantha Rao M, Sahu CR Abstract We aimed to show that a single preprocedural dose of either dexmedetomidine or fentanyl reduces procedural pain and discomfort and provides clinically acceptable sedation. In this prospective, double-blind study, sixty patients scheduled for elective surgery and requiring planned central venous catheter insertion were randomized to receive dexmedetomidine (1 μg/kg), fentanyl (1 μg/kg), or 0.9% normal saline intravenously over ten minutes followed by local anesthetic field infiltration before attempting central venous catheterization. The ...
Source: Critical Care Research and Practice - May 21, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Applicability of Pulse Pressure Variation during Unstable Hemodynamic Events in the Intensive Care Unit: A Five-Day Prospective Multicenter Study.
Authors: Delannoy B, Wallet F, Maucort-Boulch D, Page M, Kaaki M, Schoeffler M, Alexander B, Desebbe O Abstract Pulse pressure variation can predict fluid responsiveness in strict applicability conditions. The purpose of this study was to describe the clinical applicability of pulse pressure variation during episodes of patient hemodynamic instability in the intensive care unit. We conducted a five-day, seven-center prospective study that included patients presenting with an unstable hemodynamic event. The six predefined inclusion criteria for pulse pressure variation applicability were as follows: mechanical venti...
Source: Critical Care Research and Practice - April 30, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Comment on "Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion".
Comment on "Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion". Crit Care Res Pract. 2016;2016:3834891 Authors: Veloso HH PMID: 27110396 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - April 27, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Achievement of Vancomycin Therapeutic Goals in Critically Ill Patients: Early Individualization May Be Beneficial.
Conclusions. With early individualized dosing regimen, significantly more patients achieved peak and trough steady state concentrations. In the context of pharmacokinetic/pharmacodynamic goal of area under the time concentration curve to minimum inhibitory concentration (AUC/MIC) ≥400 and also to obtain trough serum concentration of vancomycin of ≥15 mg/L, it is necessary to individualize doses of vancomycin in critically ill patients. PMID: 27073695 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - April 15, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Blood Lactate Is a Useful Indicator for the Medical Emergency Team.
Authors: Schollin-Borg M, Nordin P, Zetterström H, Johansson J Abstract Lactate has been thoroughly studied and found useful for stratification of patients with sepsis, in the Intensive Care Unit, and trauma care. However, little is known about lactate as a risk-stratification marker in the Medical Emergency Team- (MET-) call setting. We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. All MET-calls during the two-year s...
Source: Critical Care Research and Practice - April 6, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation.
In conclusion, in our center, ECPR has a poorer outcome than expected. Therefore, it might be important to identify, a priori, patients who might benefit from this treatment. PMID: 27006826 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 25, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Perceived versus Observed Patient Safety Measures in a Critical Care Unit from a Teaching Hospital in Southern Colombia.
Conclusion. Perception of PSM was higher than observed in the management of critically ill patients in a teaching hospital in southern Colombia. PMID: 26989508 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 19, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis.
Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high. PMID: 26966574 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - March 13, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Mechanical Ventilation Boot Camp: A Simulation-Based Pilot Study.
Authors: Yee J, Fuenning C, George R, Hejal R, Haines N, Dunn D, Gothard MD, Ahmed RA Abstract Objectives. Management of mechanically ventilated patients may pose a challenge to novice residents, many of which may not have received formal dedicated critical care instruction prior to starting their residency training. There is a paucity of data regarding simulation and mechanical ventilation training in the medical education literature. The purpose of this study was to develop a curriculum to educate first-year residents on addressing and troubleshooting ventilator alarms. Methods. Prospective evaluation was conduct...
Source: Critical Care Research and Practice - March 9, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Spectrum of Intracerebral Hemorrhage in Children: A Report from PICU of a Resource Limited Country.
We report our experience of ICH in children. Retrospective review of medical records of children (1 month-16 years) admitted in Pediatric Intensive Care Unit between January 2007 and December 2014 was done. Data collected included age, gender, presentation, examination findings, neuroimaging done (CT, MRI, and angiography) management (conservative/intervention), and outcome. Results are presented as frequency and percentages. Of the total 50 patients, 58% were male and 26% were
Source: Critical Care Research and Practice - February 19, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Review and Outcome of Prolonged Cardiopulmonary Resuscitation.
Conclusion. Patients undergoing prolonged CPR can survive with good outcome. Young age, myocardial infarction, and potentially reversible causes of cardiac arrest such as hypothermia and pulmonary emboli predict a favorable result, especially when the arrest is witnessed and followed by prompt and good resuscitative efforts. PMID: 26885387 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - February 19, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Clonal Relatedness among Imipenem-Resistant Pseudomonas aeruginosa Isolated from ICU-Hospitalized Patients.
Authors: Vaez H, Moghim S, Nasr Esfahani B, Ghasemian Safaei H Abstract Imipenem-resistant Pseudomonas aeruginosa (P. aeruginosa) has become an increasingly important problem in healthcare settings worldwide. The aim of the present study was to evaluate clonal spread among imipenem-resistant P. aeruginosa isolated from ICU-hospitalized patients. Totally, 150 wound specimens were analyzed. Antibiotic resistance profiles and clonal diversity were evaluated using Kirby-Bauer's disk diffusion method and Random Amplified Polymorphic DNA- (RAPD-) PCR, respectively. The isolates showed a high frequency of antibiotic resis...
Source: Critical Care Research and Practice - January 24, 2016 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Anemia and Blood Transfusion in Patients with Isolated Traumatic Brain Injury.
This study evaluated the impact of anemia and blood transfusion on TBI outcomes. Methods. This was a retrospective cohort study of adult patients with isolated TBI at a tertiary-care intensive care unit from 1/1/2000 to 31/12/2011. Daily hemoglobin level and packed red blood cell (PRBC) transfusion were recorded. Patients with hemoglobin
Source: Critical Care Research and Practice - November 27, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Sedative and Analgesic Effects of Entonox Gas Compared with Midazolam and Fentanyl in Synchronized Cardioversion.
Authors: Masoumi K, Forouzan A, Saghari S, Feli M, Sattari AR, Asgari Darian A Abstract The purpose of this study was to determine if the Entonox gas could cause adequate analgesic and sedative effects in patients who need cardioversion. In this randomized not blinded clinical trial, the sedative and analgesic effects of midazolam and fentanyl were compared with Entonox. Eligible patients who need synchronized cardioversion because of dysrhythmia were randomly divided into two groups. The first group received intravenous midazolam and fentanyl; the second group received Entonox through a blower-dependent mask. Onse...
Source: Critical Care Research and Practice - November 19, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Impact of Intravenous Lidocaine on ICP in Neurological Illness: A Systematic Review.
Conclusions. We cannot make a strong definitive recommendation on the effectiveness of IV lidocaine on the attenuation of ICP spikes during stimulation. There currently exists both Oxford 2b and GRADE B literature to support and refute the attenuation of ICP spikes with IV lidocaine during stimulation. There currently exists Oxford 2b, GRADE B evidence to support ICP reduction with lidocaine when used as a therapeutic agent. PMID: 26448873 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - October 10, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Development of Delirium in the Intensive Care Unit in Patients after Endovascular Aortic Repair: A Retrospective Evaluation of the Prevalence and Risk Factors.
In this study, we retrospectively examined the rate of delirium development in the intensive care unit (ICU) after EVAR, as well as the associated preoperative risk factors and effects on the lengths of ICU and hospital stays. We examined the 81 consecutive patients who underwent elective EVAR between November 2013 and August 2014. The Intensive Care Delirium Screening Checklist was used to diagnose delirium. Twenty patients (24.7%) were diagnosed with delirium in this study. The ICU and hospital length of stays of patients with delirium were 3.3 ± 2.4 days and 14.5 ± 11.9 days, respectively, the latter of wh...
Source: Critical Care Research and Practice - October 2, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial.
This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery. Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode. Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system (P
Source: Critical Care Research and Practice - October 2, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Impact of a 2-Day Critical Care Ultrasound Course during Fellowship Training: A Pilot Study.
Conclusions. Implementation of a 2-day critical care ultrasound course covering general CCUS and basic critical care echocardiography using a combination of didactics, live models, and ultrasound simulators is effective in improving critical care fellows' proficiency and confidence with ultrasound use in both the short- and long-term settings. PMID: 26346694 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - September 10, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients.
This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients. Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC) curve demonstrated the optimal LIPS value to statistically predict development of ARDS. Results. 268 venti...
Source: Critical Care Research and Practice - August 25, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research

The Use of Sodium Bicarbonate in the Treatment of Acidosis in Sepsis: A Literature Update on a Long Term Debate.
Conclusions. Routine use of bicarbonate for treatment of severe acidemia and lactic acidosis due to sepsis is subject of controversy, and current opinion does not favor routine use of bicarbonates. However, available evidence is inconclusive, and more studies are required to determine the potential benefit, if any, of bicarbonate therapy in the sepsis patient with acidosis. PMID: 26294968 [PubMed] (Source: Critical Care Research and Practice)
Source: Critical Care Research and Practice - August 22, 2015 Category: Intensive Care Tags: Crit Care Res Pract Source Type: research