Other bulletins in this series include:

Breast Surgery

Tuesday, 15 April 2008

Drotrecogin Alfa ( Activated ) : Surviving Sepsis by Chance

Author(s): Pravinkumar , S . E .
ISSUE: 2008 ; VOL 177 ; PART 6
Journal Title: American Journal of Respiratory and Critical Care Medicine From Free Medical Journals . com (/1997 - /Embargo: 1 year) Full text available.

From Proquest NHS (02/2003 - /)
Page: 669-671
Search the Web: [article] [author(s)]

More Critical Care articles

Critical Care Nursing management of patients with a chest drain
Author(s): Sullivan , B .
ISSUE: 2008 ; VOL 17 ; PART 6
Journal Title: British Journal of Nursing ( Formerly : Nursing ) From EBSCO ( CINAHL with Full Text ) - via Athens (04/1992 - /)

From Proquest NHS (01/1999 - 06/2005)
Customer Notes: 1997 v5/22 - Print Location: Macclesfield
Page: 388-393 Search the Web: [article] [author(s)]

Simulation Enhances Resident Confidence in Critical Care and Procedural Skills
Author(s): Cooke , J . M . ; Larsen , J . ; Hamstra , S . J . ; Andreatta , P . B .
ISSUE: 2008 ; VOL 40 ; PART 3
Journal Title: Family Medicine Journal From Free Medical Journals . com (/1998 - /)
Page: 165-167 Search the Web: [article] [author(s)]

Learning , Decisions and Transformation in Critical Care Nursing Practice

Author(s): M Catherine Hough
ISSUE: 2008 ; VOL 15 ; PART 3 (2008-May)
Journal Title: Nursing Ethics From EBSCO ( CINAHL with Full Text ) via Athens (01/1997-/)
From Proquest NHS (01/1997 - /) Page: 322 - 331 Search the Web: [article] [author(s)]

Critical Care resources from Kootenai Medical Center, Idaho

US website: http://www.kmcmedicallibrary.org/CriticalCare.htm

Did you know according to this article, The Checklist, in The New Yorker, that "On any given day in the United States, some ninety thousand people are in intensive care. " by Atul Gawande (Good cartoon)

Specific collections on:
Pain Management articles
Nutrition and metabolism
Mechanical ventilation
cardiac and circulatory
Inflamation and infection
Hematologic problems
End of life decisions

Societies and web links

BMJ Learning:

Severe sepsis and septic shock: diagnosis and management

Evidence-based online module.

Target audience:
Foundation programme International Practice nurse
CPDHospital doctor CPDGP CPDGP trainee
Other healthcare professionals
The Royal New Zealand College of General Practitioners
Practice manager CPD

Adverse physiological events under anaesthesia and sedation : a pilot audit of electronic patient records

Author(s): Grant , C . ; Ludbrook , G . ; Hampson , E . A . ; Semenov , R . ; Willis , R .
ISSUE: 2008 ; VOL 36 ; PART 2
Journal Title: Anaesthesia and Intensive Care From Proquest NHS (02/1998 - 04/2007) Customer Notes: 1997 v25/1 - 2006 v34/4
Print Location: Macclesfield
Page: 222-229 Search the Web: [article] [author(s)]

Tackling Sundowning in a Patient with Alzheimer's Disease

Author(s): Sharer , J .
ISSUE: 2008 ; VOL 17 ; PART 1
Journal Title: Medsurg Nursing From EBSCO ( CINAHL with Full Text ) - via Athens (02/1999 - /)

From Proquest NHS (02/1998 - 12/2007)
Page: 27-30 Search the Web: [article] [author(s)]

Liver histology in ICU patients dying from sepsis: A clinico-pathological study.

Liver histology in ICU patients dying from sepsis : A clinico - pathological study

Author(s): Koskinas J . ; Gomatos I . P . ; Tiniakos D . G . ; Memos N . ; Boutsikou M . ; Garatzioti A . ; Archimandritis A . ; Betrosian A .
ISSUE: 2008 ; VOL 14 ; PART 9 (03-07-2008)
Journal Title: World Journal of Gastroenterology From Free Medical Journals . com (/1995 - /) Page: 1389-1393
Search the Web: [article] [author(s)]

AIM: To determine end-stage pathologic changes in the liver of septic patients dying in the intensive care unit.
METHODS: Needle liver biopsies obtained immediately after death from 15 consecutive patients with sepsis and no underlying liver disease were subjected to routine histological examination. Liver function tests and clinical monitoring measurements were also recorded.

RESULTS: Liver biochemistries were increased in the majority of patients before death. Histology of liver biopsy specimens showed portal inflammation in 73.3%, centrilobular necrosis in 80%, lobular inflammation in 66.7%, hepatocellular apoptosis in 66.6% and cholangitis/cholangiolitis in 20% of patients. Mixed hepatitic/cholestatic type of liver injury was observed in 6/15 (40%) patients and hepatitc in 9/15 (60%). Steatosis was observed in 11/15 (73.3%) patients affecting 5%-80% of liver parenchyma. Among the histological features, the presence of portal inflammation in liver biopsy was associated with increased hospitalization in the ICU prior death (P = 0.026).

CONCLUSION: Features of hepatitis and steatosis are the main histological findings in the liver in the majority of patients dying from sepsis.

BMJ: 12 April 2008

News articles:

Are doctors heartless about death?
Jerome P Kassirer

The self critical doctor: helping students become more reflective
Erik Driessen, Jan van Tartwijk, and Tim Dornan

Doctors are mostly happy in their work, but concerned at staffing levels, survey shows
Lynn Eaton

UK doctors show most interest in falls among elderly people, but French more curious about type 2 diabetes
Roger Dobson

BMA asks government to support campaign for more consultants
Lynn Eaton

Exhibition explores the last taboo: death
Zosia Kmietowicz

BMA angered by below inflation pay offer
Lynn Eaton

Critical Care: 12March - 10 April

Review Clinical review: Airway hygiene in the intensive care unit
Jelic S, Cunningham J, Factor PCritical Care, 2008 12:209 ( 31 March 2008 )
[Abstract][Full text] [PDF]

Review Clinical review: Medication errors in critical care
Moyen E, Camiré E, Stelfox HCritical Care, 2008 12:208 ( 12 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Patient-level glucose reporting: averages, episodes, or something in between? Braithwaite SCritical Care, 2008 12:133 ( 10 April 2008 ) [PDF]

Commentary Vasopressin in vasodilatory shock: is the heart in danger?
Hauser B, Asfar P, Calzia E, Laporte R, Georgieff M, Radermacher PCritical Care, 2008 12:132 ( 10 April 2008 ) [PDF]

Commentary Delirium assessment in the intensive care unit: patient population matters
Pisani MCritical Care, 2008 12:131 ( 7 April 2008 ) [Abstract][Full text] [PDF]

Commentary The pursuit of a high central venous oxygen saturation in sepsis: growing concerns Bellomo R, Reade M, Warrillow SCritical Care, 2008 12:130 ( 7 April 2008 )
[Abstract][Full text] [PDF]

Commentary Myocardial infarction on the ICU: can we do better?
Webb I, Coutts JCritical Care, 2008 12:129 ( 3 April 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Tracheostomy decannulation: marathons and finish lines
Heffner JCritical Care, 2008 12:128 ( 31 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Pulmonary artery occlusion pressure estimation by transesophageal echocardiography: is simpler better?
Voga GCritical Care, 2008 12:127 ( 31 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Circulating pro-apoptotic mediators in burn septic acute renal failure Oudemans-van Straaten HCritical Care, 2008 12:126 ( 31 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Knowing who would respond to a recruitment maneuver before actually doing it – this might be a way to go
Kuhlen RCritical Care, 2008 12:125 ( 31 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Insulin, intracerebral glucose and bedside biochemical monitoring utilizing microdialysis
Nordström CCritical Care, 2008 12:124 ( 31 March 2008 ) [PDF]

Commentary Optimal vasopressor drug therapy during resuscitation
Ornato JCritical Care, 2008 12:123 ( 31 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Lost in translation? The pursuit of lung-protective ventilation
Jones ACritical Care, 2008 12:122 ( 31 March 2008 ) [PDF]

Commentary KL-6 in acute lung injury: will it leave its mark?
Shyamsundar M, McAuley DCritical Care, 2008 12:121 ( 31 March 2008 ) [PDF]

Commentary Recently published papers: Sepsis – guidelines, treatment and novel approaches Kalsi N, Forni LCritical Care, 2008 12:120 ( 31 March 2008 ) [Abstract] [Full text] [PDF]

Commentary Towards goal-directed therapy of hepatorenal syndrome: we have the tools but we need the trials
Mookerjee R, Jalan RCritical Care, 2008 12:119 ( 19 March 2008 )
[Abstract][Full text] [PDF] [PubMed]

Commentary Cardiovascular and metabolic responses to catecholamine and sepsis prognosis: a ubiquitous phenomenon?
Collin S, Sennoun N, Levy BCritical Care, 2008 12:118 ( 17 March 2008 )
[Abstract] [Full text] [PDF] [PubMed]

Research Early acute kidney injury and sepsis: a multicentre evaluation
Bagshaw S, George C, Bellomo RCritical Care, 2008 12:R47 ( 10 April 2008 )
[Abstract] [Provisional PDF]

Research Introduction of medical emergency teams in Australia and New Zealand: a multi-centre study
Jones D, George C, Bellomo R, Hart G, Martin JCritical Care, 2008 12:R46 ( 7 April 2008 )
[Abstract] [Provisional PDF] [PubMed]

Research Risk factors for the development of nosocomial pneumonia and mortality on intensive care units: application of competing risks models
Wolkewitz M, Vonberg R, Grundmann H, Beyersmann J, Gastmeier P, Baerwolff S, Geffers C, Behnke M, Rueden H, Schumacher MCritical Care, 2008 12:R44 ( 2 April 2008 )
[Abstract] [Provisional PDF] [PubMed]

Letter Saccharomyces boulardii fungaemia in an intensive care unit patient treated with caspofungin
Nikolaos L, Dimitrios V, Hellen M, Sofia K, Aristea V, Charis T, Chronis T, Angellos P, Ioannis PCritical Care, 2008 12:414 ( 9 April 2008 ) [Abstract] [Full text] [PDF]

Letter Prehospital therapeutic hypothermia in cardiac arrest: will there ever be evidence? Schefold J, Storm C, Hasper DCritical Care, 2008 12:413 ( 9 April 2008 ) [PDF]

Letter Discriminating invasive fungal infection from colonization
Blot S, Vandewoude K, Vogelaers DCritical Care, 2008 12:412 ( 3 April 2008 ) [PDF]

BMJ Table of Contents: 12 April

Continuous deep sedation in patients nearing death
Scott A Murray, Kirsty Boyd, and Ira Byock

Cardiopulmonary resuscitation for out of hospital cardiac arrest
Jasmeet Soar and Jerry P Nolan

Oral bisphosphonates and atrial fibrillation
Sumit R Majumdar

Selecting medical students
Celia A Brown and Richard J Lilford

BioMed Central: Influence of airway management strategy ...

Research article Influence of airway management strategy on No-Flow-Time during an Advanced Life Support Course for intensive care nurses - a single rescuer resuscitation manikin study Wiese C, Bartels U, Schultens A, Steffen T, Torney A, Bahr J, Graf
BBMC Emergency Medicine, 2008 8:4 ( 10 April 2008 )
[Abstract] [Provisional PDF]

Dexmedetomidine as an adjunct to epidural analgesia after abdominal surgery in elderly intensive care patients: A prospective, double-blind, clinical

Current Therapeutic Research, Volume 69, Issue 1, February 2008,
Pages 16-28
Sule Akin, Anis Aribogan and Gulnaz Arslan

Sedation articles

Sedation With Dexmedetomidine vs Lorazepam in Mechanically Ventilated Patients
Author(s): Hannah Wunsch
ISSUE: 2008 ; VOL 299 ; PART 13 (2008-April-2)
Journal Title: JAMA - Journal of the American Medical Association From Publisher (/1998 - /) Customer Notes: 1997 v277/1 - 2005 v295/5 Print Location: Macclesfield

From Free Medical Journals . com (/1998 - /Embargo: 6 months)

From HighWire (/1998 - /) Page: 1540 - 1541 Search the Web: [article] [author(s)]

Sedation With Dexmedetomidine vs Lorazepam in Mechanically Ventilated Patients - Reply
Author(s): Pratik P . Pandharipande
ISSUE: 2008 ; VOL 299 ; PART 13 (2008-April-2)
Journal Title: JAMA - Journal of the American Medical Association From Publisher (/1998 - /) Customer Notes: 1997 v277/1 - 2005 v295/5 Print Location: Macclesfield

From Free Medical Journals . com (/1998 - /Embargo: 6 months)

From HighWire (/1998 - /) Page: 1542 - 1542 Search the Web: [article] [author(s)]

Critical Care Medicine: April 2008 Vol 36 Issue 4

Numerous articles in the link below which focus on Acute Kidney Injury in the ICU

April 2008, Volume 36, Issue 4 Suppl

Crital Care Editorials and Letters: Vol 36 Issue 4

Validating predictive models of mortality: More than meets the eye
Andrew A. Kramer, PhD

Lung-protective higher frequency oscillatory ventilation
Stephen Derdak, DO

Clinical practice guidelines: Culture eats strategy for breakfast, lunch, and dinner
I Alan Fein, MD, MPH; Robert R. Corrato, MD, MBA

Bull’s eye missed by the magic bullet: Preclinical investigations, publication bias, and promising new interventions
Jyrki J. Tenhunen, MD, PhD

Donation after cardiac death: Should we fear the reaper?
David Crippen, MD, FCCM

End-of-life organ donation for transplantation: Stretching the ethical and legal boundaries of medical practice in society
Joseph L. Verheijde, MBA, PhD; Mohamed Y. Rady, MD, PhD; Joan L. McGregor, PhD

Role of sedation and analgesia in mechanical ventilation
Graziano C. Carlon, MD; Arthur Combs, MD

“The truth, if it exists, is in the details”
David Gilbert, MD

The generic septic response
Donald E. Fry, MD, FACS

Redefine acute renal failure? Not yet, thanks
Lawrence S. Weisberg, MD; Jean-Sebastien Rachoin, MD

The search for a good death—Are there quality insights accessible from medical records?
Richard A. Mularski, MD, MSHS, MCR

Monkey see, monkey do: Adhering to scientific principles
M Susan Mandell, MD, PhD

The latest in resting energy expenditure prediction: New! Improved! Better?
Marc J. Popovich, MD, FCCM

Since when did sedatives start to save lives?
Huang-Ping Yu, MD, PhD; Ying-Tung Lau, PhD

Electrical impedance tomography—A new toy for boys or the future for mechanically ventilated patients?
Marcus J. Schultz, MD, PhD, FCCP

Critical illness myopathy: A direct role for endotoxin
G Bryan Young, MD, FRCPC

Investigating the role of bacterial zinc-containing metalloproteases in the pathogenesis of complicated pneumococcal pneumonia
Michael Eisenhut

Right data, wrong conclusions
Giora Netzer, MD, MSCE; Richard P. Dutton, MD, MBA; John R. Hess, MD, MPH

Critical care workforce crisis: Time to look in the mirror
Mark A. Kelley, MD

Letters to the Editors
From “inconvenient truth” to “assault on reason”
Marcus J. Schultz, MD, PhD; Mart J. de Graaff; Michael A. Kuiper; Peter E. Spronk

From “inconvenient truth” to “assault on reason”
James S. Krinsley, MD, FCCM; Aarti Grover, MD

Not euthanasia, simply compassionate clinical care
Robert D. Truog, MD

Euthanasia in the critical care setting
Alberto Giannini, MD

Euthanasia in the critical care setting
Erwin J. O. Kompanje, PhD; Inez D. de Beaufort, PhD; Jan Bakker, MD, PhD

Severe hypoglycemia in critically ill: Risk and outcomes
T M. Vriesendorp, MD, PhD; J H. DeVries, MD, PhD; F Rosendaal, MD, PhD; J B. L. Hoekstra, MD, PhD

Severe hypoglycemia in critically ill: Risk and outcomes
James S. Krinsley, MD, FCCM; Aarti Grover, MD

Tight glucose control and hypoglycemia
Jean-Charles Preiser, MD, PhD; Frank Brunkhorst

Tight glucose control and hypoglycemia
James S. Krinsley, MD, FCCM; Aarti Grover, MD

Acid base balances

Acid base balances
John A. Kellum, MD, FCCM

Book Review
Manual of Overdoses and Poisons
James H. Diaz, MD, MPH, DrPH, FCCP, FAAP, FCCM

Critical Care Medicine: April 2008, Volume 36, Issue 4

Feature Articles
Veterans Affairs intensive care unit risk adjustment model: Validation, updating, recalibration
Marta L. Render, MD; James Deddens, PhD; Ron Freyberg, MS; Peter Almenoff, MD; Alfred F. Connors, Jr, MD; Douglas Wagner, PhD; Timothy P. Hofer, MD, MSc

Feasibility of very high-frequency ventilation in adults with acute respiratory distress syndrome
Henry E. Fessler, MD; David N. Hager, MD; Roy G. Brower, MD

Quality of professional society guidelines and consensus conference statements in critical care
Tasnim Sinuff, MD, PhD; Rakesh V. Patel, MD, PharmD, MSc; Neill K. J. Adhikari, MD, CM, MSc; Maureen O. Meade, MD, MSc; Holger J. Schünemann, MD, PhD; Deborah J. Cook, MD, MSc

Clinical Investigations
Use of sedatives, opioids, and neuromuscular blocking agents in patients with acute lung injury and acute respiratory distress syndrome
for the Acute Respiratory Distress Syndrome Network

Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: A multicenter, randomized study
Jean Chastre, MD; Richard Wunderink, MD; Philippe Prokocimer, MD; Michael Lee, PhD; Koné Kaniga, PhD; Ian Friedland, MD

Effect of infections on 30-day mortality among critically ill patients hospitalized in and out of the intensive care unit
George Mnatzaganian, RN, MPH; Charles L. Sprung, MD; Yana Zitser-Gurevich, MD, MPH; Noya Galai, PhD; Nethanel Goldschmidt, MA; Leon Levi, MD, MPH; Yaron Bar-Lavi, MD; Fabio Zveibil, MD; Inbal Weiss Salz, MD, MPH; Anat Ekka-Zohar, RN, MPH; Elisheva Simchen, MD, MPH

Building a continuous multicenter infection surveillance system in the intensive care unit: Findings from the initial data set of 9,493 patients from 71 Italian intensive care units
for the Italian Group for the Evaluation of Interventions in Intensive Care Medicine

Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection
Babak Sarani, MD, FACS; W Jonathan Dunkman, BA; Laura Dean;; Seema Sonnad, PhD; Jeffrey I. Rohrbach, RN, MSN; Vicente H. Gracias, MD, FACS

Patients with respiratory failure increase ambulation after transfer to an intensive care unit where early activity is a priority
George E. Thomsen, MD; Gregory L. Snow, PhD; Larissa Rodriguez, AS; Ramona O. Hopkins, PhD

Gene-expression profiling of Gram-positive and Gram-negative sepsis in critically ill patients
Benjamin M.P. Tang, MD; Anthony S. McLean, MD; Ian W. Dawes, PhD; Stephen J. Huang, PhD; Mark J. Cowley, PhD; Ruby C.Y. Lin, PhD

Impact of minimal increases in serum creatinine on outcome in patients after cardiothoracic surgery: Do we have to revise current definitions of acute renal failure?
Andrea Lassnigg, MD; Edith R. Schmid, MD; Michael Hiesmayr, MD; Christian Falk, MD; Wilfred Druml, MD; Peter Bauer, PhD; Daniel Schmidlin, MD

Using the medical record to evaluate the quality of end-of-life care in the intensive care unit
Bradford J. Glavan, MD; Ruth A. Engelberg, PhD; Lois Downey, MA; J Randall Curtis, MD, MPH

Influence of renal dysfunction on the accuracy of procalcitonin for the diagnosis of postoperative infection after vascular surgery
Julien Amour, MD, PhD; Aurélie Birenbaum, MD; Olivier Langeron, MD, PhD; Yannick Le Manach, MD; Michèle Bertrand, MD; Pierre Coriat, MD; Bruno Riou, MD, PhD; Maguy Bernard, MD, PhD; Pierre Hausfater, MD, PhD

A simple device to increase rates of compliance in maintaining 30-degree head-of-bed elevation in ventilated patients
Zev Williams, MD, PhD; Rodney Chan, MD; Edward Kelly, MD

Discordance between perception and treatment practices associated with intensive care unit-acquired bacteriuria and funguria: A Canadian physician survey
Clarence Chant, PharmD, BCPS; Claudia C. Dos Santos, MD; Paola Saccucci, PharmD; Orla M. Smith, RN, MN, CNCC(C); John C. Marshall, MD, FRCS(C); Jan O. Friedrich, MD, DPhil, FRCP(C)

The costs and cost-effectiveness of an integrated sepsis treatment protocol
Daniel Talmor, MD, MPH; Dan Greenberg, PhD; Michael D. Howell, MD; Alan Lisbon, MD; Victor Novack, MD, PhD; Nathan Shapiro, MD, MPH

Validation of a predictive method for an accurate assessment of resting energy expenditure in medical mechanically ventilated patients
Jean-François Savard, MD, FRCPC; Christophe Faisy, MD, PhD; Nicolas Lerolle, MD; Emmanuel Guerot, MD; Jean-Luc Diehl, MD; Jean-Yves Fagon, MD, PhD

Clinical outcome and prognostic factors of patients with pyogenic liver abscess requiring intensive care
Wei Chen, MD; Chia-Hung Chen, MD; Kuo-Liang Chiu, MD; Hsueh-Chou Lai, MD; Kuan-Fu Liao, MD; Yung-Jen Ho, MD; Wu-Huei Hsu, MD

Neurologic Critical Care
Impact of age of transfused blood on cerebral oxygenation in male patients with severe traumatic brain injury
Santiago Ramón Leal-Noval, MD, PhD; Manuel Muñoz-Gómez, Prof MD, PhD; Victoria Arellano-Orden, MD; Antonio Marín-Caballos, MD, PhD; Rosario Amaya-Villar, MD, PhD; Ana Marín, MD; Antonio Puppo-Moreno, MD, PhD; Carmen Ferrándiz-Millón, MD; Juan Manuel Flores-Cordero, MD, PhD; Francisco Murillo-Cabezas, MD, PhD

Health is yearning--experiences of being conscious during ventilator treatment in a critical care unit.

Request this article through
Health Sciences Library Macclesfield District General Hospital (Inter Library Loan)

Source Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, {Intensive-Crit-Care- Nurs}, Feb 2008 (epub: 03 Aug 2007),
vol. 24, no. 1, p. 41-50,
Author(s) Karlsson-Veronika, Forsberg-Anna.

The aim of this study was to investigate experiences of being conscious during ventilator treatment in the ICU from a patient perspective. Hermeneutic, phenomenological methods were used. Eight patients who had received ventilator treatment were interviewed. The time on a ventilator varied from 1 day to several months. Some patients had been more heavily sedated during the acute phase while some were only lightly sedated and others had no sedation at all. The motor activity assessment scale was used to rate the sedation level. The patients had been sufficiently conscious to communicate with the help of the alphabet board, by means of facial expression or by nodding or shaking their head. The results show that the experience of care by patients who were conscious during ventilator treatment was described under the headings of: memories, mastering the situation and individual consequences. Health in the ICU is associated with yearning. The patient undergoes different stages of yearning as part of his or her recovery process. The patient who is conscious during ventilator treatment views him/herself and his/her worth on the basis of the attitude and behaviour of the caregivers, where the value of caring consists of the holistic confirmation of individual suffering.