The persistent potential of extracorporeal therapies in liver failure
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 10, 2019 Category: Intensive Care Source Type: research

Lung –kidney interactions in critically ill patients: consensus report of the Acute Disease Quality Initiative (ADQI) 21 Workgroup
ConclusionThe ADQI 21  conference found significant knowledge gaps about organ crosstalk between lung and kidney and its relevance for critically ill patients. Lung protective ventilation, conservative fluid management and early recognition and treatment of pulmonary infections were the only clinical recommendations wit h higher quality of evidence. Recommendations for research were formulated, targeting lung–kidney interactions to improve care processes and outcomes in critical illness. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 9, 2019 Category: Intensive Care Source Type: research

Climate change, global warming, and intensive care
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 9, 2019 Category: Intensive Care Source Type: research

Is tranexamic acid going to CRASH the management of traumatic brain injury?
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 9, 2019 Category: Intensive Care Source Type: research

Selective decontamination of the digestive tract (SDD) in critically ill patients: a narrative review
AbstractSelective decontamination of the digestive tract (SDD) is an infection prevention measure for intensive care unit (ICU) patients that was proposed more than 30 years ago, and that is currently considered standard of care in the Netherlands, but only used sporadically in ICUs in other countries. In this narrative review, we first describe the rationale of the individual components of SDD and then review the evidence base for patient-centered outcomes, where we distinguish ICUs with low prevalence of antibiotic resistance from ICUs with moderate –high prevalence of resistance. In settings with low prevalence of...
Source: Intensive Care Medicine - December 9, 2019 Category: Intensive Care Source Type: research

The Janus faces of bicarbonate therapy in the ICU: not sure!
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 9, 2019 Category: Intensive Care Source Type: research

Massive hemoptysis due to a candida-related pulmonary artery pseudoaneurysm
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 4, 2019 Category: Intensive Care Source Type: research

Shaping critical care through sound-driven innovation: introduction, outline, and research agenda
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 3, 2019 Category: Intensive Care Source Type: research

Understanding resistance in enterococcal infections
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - December 2, 2019 Category: Intensive Care Source Type: research

Liquefactive necrosis of the brain
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 18, 2019 Category: Intensive Care Source Type: research

A microbiologist consultant should attend daily ICU rounds
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 14, 2019 Category: Intensive Care Source Type: research

The Janus faces of bicarbonate therapy in the ICU: con
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 14, 2019 Category: Intensive Care Source Type: research

Leptospirosis: different presentation and mortality in tropical and non-tropical areas
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 12, 2019 Category: Intensive Care Source Type: research

Pneumorrhachis: an imaging hint of Clostridium septicum infection
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 12, 2019 Category: Intensive Care Source Type: research

Dynamics and prognostic value of the hypothalamus –pituitary–adrenal axis responses to pediatric critical illness and association with corticosteroid treatment: a prospective observational study
AbstractPurposeIncreased systemic cortisol availability during adult critical illness is determined by reduced binding-proteins and suppressed breakdown rather than elevated ACTH. Dynamics, drivers and prognostic value of hypercortisolism during pediatric critical illness remain scarcely investigated.MethodsThis preplanned secondary analysis of the PEPaNIC-RCT (N = 1440), after excluding 420 children treated with corticosteroids before PICU-admission, documented (a) plasma ACTH, (free)cortisol and cortisol-metabolism at PICU-admission, day-3 and last PICU-day, their prognostic value, and impact of withholding...
Source: Intensive Care Medicine - November 11, 2019 Category: Intensive Care Source Type: research

Massage therapy reduces arterial puncture-induced pain: the randomized cross-over bi-center TORREA study
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 11, 2019 Category: Intensive Care Source Type: research

The Janus faces of bicarbonate therapy in the ICU
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 11, 2019 Category: Intensive Care Source Type: research

Disordered swallowing associated with prolonged oral endotracheal intubation in critical illness
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 11, 2019 Category: Intensive Care Source Type: research

Right upper lobe pulmonary edema
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 11, 2019 Category: Intensive Care Source Type: research

Do critical care patients hibernate? Theoretical support for less is more
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 8, 2019 Category: Intensive Care Source Type: research

Effect of lung recruitment maneuver on oxygenation, physiological parameters and mortality in acute respiratory distress syndrome patients: a systematic review and meta-analysis
AbstractPurposeAmong acute respiratory distress syndrome (ARDS) patients in intensive care units, the efficacy of lung recruitment maneuver (LRM) use is uncertain taking into account the most recent randomized controlled trials (RCTs). We aimed to estimate the effect of LRMs on mortality from ARDS.MethodsIn this systematic review and meta-analysis, we searched for RCTs comparing mechanical ventilation with and without LRMs in adults with ARDS. We generated pooled relative risks (RR), mean difference, performed trial-sequential-analysis and cumulative meta-analysis. The primary outcome was 28-day mortality. The secondary ou...
Source: Intensive Care Medicine - November 7, 2019 Category: Intensive Care Source Type: research

Post-operative abdominal infections: epidemiology, operational definitions, and outcomes
AbstractPostoperative abdominal infections are an important and heterogeneous health challenge in intensive care units (ICU) and encompass postoperative infectious processes developing within the abdominal cavity that may be caused by either bacterial or fungal pathogens. In this narrative review, we discuss postoperative bacterial and fungal abdominal infections, covering also multidrug-resistant (MDR) pathogens. We also cover clinically preeminent aspects such as the definition of postoperative abdominal infections, which still remains difficult owing to their heterogeneity in patient characteristics, clinical presentati...
Source: Intensive Care Medicine - November 7, 2019 Category: Intensive Care Source Type: research

Rapid developing and rupture of an infectious aneurysm
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 7, 2019 Category: Intensive Care Source Type: research

Ethical climate and intention to leave among critical care clinicians: an observational study in 68 intensive care units across Europe and the United States
ConclusionThis is the first large multicenter study showing an independent association between clinicians ’ intent to leave and the quality of the ethical climate in the ICU. Interventions to reduce intent to leave may be most effective when they focus on improving mutual respect, interdisciplinary reflection and active decision-making at EOL. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 5, 2019 Category: Intensive Care Source Type: research

Prognostic impact of sustained new-onset atrial fibrillation in critically ill patients
ConclusionsSustained new-onset AF was time-dependently associated with hospital mortality in ICU patients, albeit with some uncertainty since AF duration longer than 48  h was not independently associated with in-hospital death or stroke. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 4, 2019 Category: Intensive Care Source Type: research

Ten things ICU specialists need to know about new valvular procedures in interventional cardiology
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 4, 2019 Category: Intensive Care Source Type: research

Characterization and validation of a novel measure of septic shock severity
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 4, 2019 Category: Intensive Care Source Type: research

Leptospirosis: one of the forgotten diseases
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - November 4, 2019 Category: Intensive Care Source Type: research

Worsening hypoxemia with mechanical ventilation in posttraumatic ventricular septal defect
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 23, 2019 Category: Intensive Care Source Type: research

Camel shape in transpulmonary thermodilution monitoring
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 23, 2019 Category: Intensive Care Source Type: research

Myocarditis in fulminant meningococcemia
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 23, 2019 Category: Intensive Care Source Type: research

Calculation of the mechanical power for pressure-controlled ventilation: a response
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 22, 2019 Category: Intensive Care Source Type: research

Diffuse varicella zoster virus reactivation in critically ill immunocompromised patient
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 18, 2019 Category: Intensive Care Source Type: research

Tracheostomy: what is known and what remains to be determined
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 18, 2019 Category: Intensive Care Source Type: research

Short-term dialysis catheter versus central venous catheter infections in ICU patients: a post hoc analysis of individual data of 4 multi-centric randomized trials
ConclusionsThe daily risk of colonization and MCRI was significantly higher in DC compared to CVC within the first 7 days of catheter maintenance. Targeted prevention strategies for DC should mostly focus on the period following the insertion. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 17, 2019 Category: Intensive Care Source Type: research

The association of cardiovascular failure with treatment for ventilator-associated lower respiratory tract infection
AbstractPurposeVentilator associated-lower respiratory tract infections (VA-LRTIs), either ventilator-associated pneumonia (VAP) or tracheobronchitis (VAT), accounts for most nosocomial infections in intensive care units (ICU) including. Our aim was to determine if appropriate antibiotic treatment in patients with VA-LRTI will effectively reduce mortality in patients who had cardiovascular failure.MethodsThis was a pre-planned subanalysis of a large prospective cohort of mechanically ventilated patients for at least 48  h in eight countries in two continents. Patients with a modified Sequential Organ Failure Assessmen...
Source: Intensive Care Medicine - October 16, 2019 Category: Intensive Care Source Type: research

Focus on ventilation and ARD: recent insights
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 16, 2019 Category: Intensive Care Source Type: research

The urea-creatinine ratio as a novel biomarker of critical illness-associated catabolism
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 16, 2019 Category: Intensive Care Source Type: research

Conventional amphotericin B should remain in the armamentarium as a cheap and efficient waiting solution
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 16, 2019 Category: Intensive Care Source Type: research

An algorithm for patients with intracranial pressure monitoring: filling the gap between evidence and practice
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 15, 2019 Category: Intensive Care Source Type: research

‘Less is more’ in modern ICU: blessings and traps of treatment limitation
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 11, 2019 Category: Intensive Care Source Type: research

Invasive pulmonary aspergillosis in critically ill patients with hematological malignancies
AbstractPurposeInvasive pulmonary aspergillosis (IPA) is a dreadful event in patients with hematological malignancies (HM). Recent advances have standardized diagnostic, prophylactic and curative therapeutic strategies. We sought to assess whether these advances actually translate into improved survival in critically ill patients with acute respiratory failure and IPA.MethodsThis was a retrospective, multicenter study. Adult patients with HM, IPA, admitted to the ICU for acute respiratory failure over a 20-year period (January 1998 –December 2017) were included. A cox regression model was used to identify variables i...
Source: Intensive Care Medicine - October 10, 2019 Category: Intensive Care Source Type: research

Airway closure and fiberoptic evidence of bronchial collapse during the acute respiratory distress syndrome
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 10, 2019 Category: Intensive Care Source Type: research

Oxygen toxicity in major emergency surgery —anything new?
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 10, 2019 Category: Intensive Care Source Type: research

Pre-excited atrial fibrillation
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 10, 2019 Category: Intensive Care Source Type: research

My wife ’s turn in the ICU
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 9, 2019 Category: Intensive Care Source Type: research

Frailty and invasive mechanical ventilation: association with outcomes, extubation failure, and tracheostomy
ConclusionsThe presence of frailty among patients receiving mechanical ventilation is associated with increased odds of hospital mortality, discharge to long-term care, extubation failure, and need for tracheostomy. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 8, 2019 Category: Intensive Care Source Type: research

ICU staffing feature phenotypes and their relationship with patients ’ outcomes: an unsupervised machine learning analysis
ConclusionPatients treated in ICUs combining 24/7 expert intensivist coverage, a dedicated pharmacist and nurses with greater autonomy had the best outcomes. All of these features represent achievable targets that should be considered by policy makers with an interest in promoting equal and optimal ICU care. (Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 8, 2019 Category: Intensive Care Source Type: research

Normalization of mechanical power to anthropometric indices: impact on its association with mortality in critically ill patients
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 8, 2019 Category: Intensive Care Source Type: research

When kidneys are too bright …a rare cause of shock
(Source: Intensive Care Medicine)
Source: Intensive Care Medicine - October 8, 2019 Category: Intensive Care Source Type: research