Other bulletins in this series include:

Breast Surgery

Wednesday 16 December 2009

Association between ICU admission during morning rounds and mortality

Association between ICU admission during morning rounds and mortality. CHEST, Dec. 2009 vol. 136(6), p. 1489-1495.

Afessa, B. et al.

http://chestjournal.chestpubs.org/content/136/6/1489.full

Background: No previous study has evaluated the association between admission to ICUs during round time and patient outcome. The objective of this study was to determine the association between round-time ICU admission and patient outcome. Conclusions: Patients admitted to the ICU during morning rounds have higher severity of illness and mortality rates.

Evaluation of modernisation of adult critical care services in England

Evaluation of modernisation of adult critical care services in England: time series and cost effectiveness analysis. BMJ 2009;339:b4353

Hutchings, A., et al.

http://sccmwww.sccm.org/publications/eNewsletters_Archive/11_19_2009.htm#n1
(Click on link: British Medical Journal, full text)

Objective: To evaluate the impact and cost effectiveness of a programme to transform adult critical care throughout England initiated in late 2000. Design: Evaluation of trends in inputs, processes, and outcomes during 1998-2000 compared with last quarter of 2000-6.
Setting: 96 critical care units in England. Participants: 349 817 admissions to critical care units. Conclusion: Substantial improvements in NHS critical care have occurred in England since 2000. While it is unclear which factors were responsible, collectively the interventions represented a highly cost effective use of NHS resources.

Potential for response bias in family surveys about end-of-life care in the ICU

Potential for response bias in family surveys about end-of-life care in the ICU. CHEST, Dec. 2009, vol. 136 (6), p. 1496-1502.

Kross, E.K., et al.

http://chestjournal.chestpubs.org/content/136/6/1496.full

After-death surveys are an important source of information about the quality of end-of-life care, but response rates generally are low. Our goal was to understand the potential for nonresponse bias in survey studies of family members after a patient's death in the hospital ICU by identifying differences in patient demographics and delivery of palliative care between patients whose families respond to a survey about end-of-life care and those whose families do not.

International study of the prevalence and outcomes of infection in ICUs

International study of the prevalence and outcomes of infection in ICUs. JAMA. 2009;302(21):2323-2329.

Vincent, J.L. et al.

http://jama.ama-assn.org/cgi/content/full/302/21/2323

Infection is a major cause of morbidity and mortality in intensive care units (ICUs) worldwide. However, relatively little information is available about the global epidemiology of such infections. Objective: To provide an up-to-date, international picture of the extent and patterns of infection in ICUs. Conclusions: Infections are common in patients in contemporary ICUs, and risk of infection increases with duration of ICU stay. In this large cohort, infection was independently associated with an increased risk of hospital death.

Wednesday 11 November 2009

ICU admissions after actual or planned hospital discharge

ICU admissions after actual or planned hospital discharge. Chest, vol. 136(5), Nov. 2009, p.1257-1262.

Chawla, S., et al.

http://chestjournal.chestpubs.org/content/136/5/1257.full

Unexpected ICU admissions may result from early or premature discharge from the hospital. We sought to determine the incidence, clinical characteristics, and outcomes of patients admitted to the ICU after actual or planned hospital discharge and to analyze whether the need for ICU admission was related or unrelated to the associated hospitalization.

Caring to the end?

Caring to the end? National confidential enquiry into patient outcome and death. A review of the care of patients who died in hospital within four days of admission. 2009.

Cooper, H. et al.

http://www.ncepod.org.uk/2009report2/Downloads/DAH_report.pdf

This report highlights the process of care of patients who died in acute hospitals within four days of admission. It takes a critical look at the areas where patient care might have been improved. Remediable factors have been identified in the clinical and the organisational care of these patients.

Prolonged acute mechanical ventilation: implications for hospital benchmarking

Prolonged acute mechanical ventilation: implications for hospital benchmarking. Chest, vol. 135(5), May 2009, p.1157-1162.

Zilberberg, M.D. et al.

http://chestjournal.chestpubs.org/content/135/5/1157.full

Hospital performance measures rely on aggregate outcomes. For patients receiving mechanical ventilation (MV), outcomes depend on severity of illness, hospital MV volume, and case mix. Patients requiring prolonged acute MV (PAMV) [MV for ≥ 96 h] comprise a resource-intensive group, but the impact of its volume on aggregate outcomes is unknown. We investigated whether observed outcomes differed from those predicted by APACHE (acute physiology and chronic health evaluation) IV risk adjustment and the relationship between hospital MV volume and outcomes among patients receiving PAMV.

Wednesday 30 September 2009

Age, duration of mechanical ventilation and outcomes of patients who are critically ill

Age, duration of mechanical ventilation and outcomes of patients who are critically ill. Chest vol. 136(3), Sept. 2009, p. 759-764.

Feng, Y. et al.

http://www.chestjournal.org/content/136/3/759.full.pdf+html

Age and duration of mechanical ventilation (MV) are strongly associated with mortality and hospital discharge disposition. Methods: Electronic administrative records from a 425-bed community teaching hospital were obtained for 9,912 patients who were admitted to hospital ICUs between 2003 and 2008. Risk estimates of age and duration of MV for in-hospital mortality and discharge to home vs extended-care facilities (ECFs) also were obtained.
This study suggests that age and duration of MV are strongly associated with mortality
and posthospital disposition.

Wednesday 9 September 2009

Effects on management and outcome of severe sepsis and septic shock patients admitted to the intensive care unit

Effects on management and outcome of severe sepsis and septic shock patients admitted to the intensive care unit after implementation of a sepsis program: a pilot study. Critical care Vol. 13(5), Sept 2009.

Girardis, M., et al.

http://ccforum.com/content/pdf/cc8029.pdf

The application in clinical practice of evidence-based guidelines for the management of patients with severe sepsis/septic shock is still poor in the emergency department, while little data are available for patients admitted to the intensive care unit (ICU). The aim of this study was to evaluate the effect of an in-hospital sepsis program on the adherence to evidence-based guidelines and outcome of patients with severe sepsis/septic shock admitted to the ICU.

Tuesday 1 September 2009

Pain management within the palliative and end-of-life care experience in the ICU

Pain management within the palliative and end-of-life care experience in the ICU. Chest, May 2009, vol. 135(5), 1360-1369.

Mularski, R.A., et al.

http://www.chestjournal.org/content/135/5/1360.full.pdf+html

In the ICU where critically ill patients receive aggressive life-sustaining interventions, suffering is common and death can be expected in up to 20% of patients. High-quality pain management is a part of optimal therapy and requires knowledge and skill in pharmacologic, behavioral, social, and communication strategies grounded in the holistic palliative care approach. This contemporary review article focuses on pain management within comprehensive palliative and end-of-life care.

Wednesday 12 August 2009

Terminal Withdrawal of Mechanical Ventilation at a Long-Term Acute Care Hospital

Terminal Withdrawal of Mechanical Ventilation at a Long-Term Acute Care Hospital: Comparison with a medical ICU. Chest, vol. 136(2), Aug 2009, p.465-470.

White, A.C., et al.

http://www.chestjournal.org/content/136/2/465.full.pdf+html

Long-term acute care hospitals provide care for patients who require prolonged mechanical ventilation (MV) for respiratory failure. A multicenter study found weaning to be unsuccessful in 20% of patients receiving prolonged MV despite a multidisciplinary approach to care. The decision to terminally withdraw MV from critically ill patients in whom MV is no longer considered beneficial is common in ICUs in the United States and in Europe. Updated practice guidelines are available to inform practitioners in the terminal withdrawal of MV in the ICU.

A Randomized Trial of Dental Brushing for Prevening Ventilator-Associated Pneumonia

A Randomized Trial of Dental Brushing for Preventing Ventilator-Associated Pneumonia. Chest, vol. 136(2), Aug. 2009, p. 433-499.

Pobo, A., et al.

http://www.chestjournal.org/content/136/2/433.full.pdf+html

Poor oral hygiene is associated with respiratory pathogen colonization and secondary
lung infection. The impact of adding electric toothbrushing to oral care in order to reduce
ventilator-associated pneumonia (VAP) incidence is unknown. The study design was a prospective, simple-blind, randomized trial of adult patients intubated for > 48 h. Controlling for exposure to antibiotic treatment, patients were randomized to oral care every 8 h with 0.12% chlorhexidine digluconate (standard group) or standard oral care plus electric toothbrushing (toothbrush group). VAP was documented by quantitative respiratory cultures. Mechanical ventilation duration, hospital ICU length of stay, antibiotic use, and hospital ICU mortality were secondary end points.

Friday 31 July 2009

Experiences of intensive care nurses assessing sedation/agitation in critically ill patients

Experiences of intensive care nurses assessing sedation/agitation in critically ill patients. Nursing in critical care, vol. 13(4), 2008. [journal article]

Weir, S. and O'Neill, A.

http://www3.interscience.wiley.com/cgi-bin/fulltext/119878662/PDFSTART

Patients admitted to the intensive care unit (ICU) will more often than not require sedative and analgesic drugs to enable them to tolerate the invasive procedures and therapies caused as a result of their underlying condition and/or necessary medical interventions. This article reports a study exploring the perceptions and experiences of intensive care nurses using a sedation/agitation scoring (SAS) tool to assess and manage sedation and agitation amongst critically ill patients.
Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit. New England Journal of Medicine, vol. 349(12), Sept. 2003. [journal article]

Cook, D., et al.

http://content.nejm.org/cgi/reprint/349/12/1123.pdf

In critically ill patients who are receiving mechanical ventilation, the factors associated with physicians’ decisions to withdraw ventilation in anticipation of death are unclear. The objective of this study was to examine the clinical determinants that were associated with the withdrawal of mechanical ventilation.

Non-invasive ventilation: don't push too hard

Non-invasive ventilation: don't push too hard. New england journal of medicine, Vol. 350(24), June 2004. [journal article]

Truwit, J.D. and Bernard, G.R.

http://content.nejm.org/cgi/reprint/350/24/2512.pdf

Noninvasive mechanical ventilation has been used increasingly over the past decade in an effort to avoid endotracheal intubation and to accelerate the discontinuation of mechanical ventilation. Noninvasive ventilation as adjunctive therapy can be applied before intubation or after extubation. The literature indicates that in both settings, outcomes in patients with chronic obstructive pulmonary disease (COPD) or cardiogenic pulmonary edema are successful.

Hydrocortisone therapy for patients with septic shock

Hydrocortisone therapy for patients with septic shock. New england journal of medicine, Vol 358 (2), January 2008 [journal article]

Sprung, C.L., et al.

http://content.nejm.org/cgi/reprint/358/2/111.pdf


Hydrocortisone is widely used in patients with septic shock, even though a survival benefit has been reported only in patients who remained hypotensive after fluid and vasopressor resuscitation and whose plasma cortisol levels did not rise appropriately after the administration of corticotropin.

Determinants of weaning success in patients with prolonged mechanical ventilation

Determinants of weaning success in patients with prolonged mechanical ventilation. Critical care 13(3), June 2009 [journal article]

Carlucci, A., et al.

http://ccforum.com/content/13/3/R97

Physiological determinants of weaning success and failure are usually studied in ventilator-supported patients, comparing those who failed a trial of spontaneous breathing with those who tolerated such a trial and were successfully extubated. A major limitation of these studies was that the two groups may be not comparable, concerning the severity of the underlying disease and the presence of comorbidities. In this physiological study, we assessed the determinants
of weaning success in patients acting as their own control, once they are eventually liberated from the ventilator.

Wednesday 8 July 2009

Ventilator-associated pneumonia in patients undergoing major heart surgery

Ventilator-associated pneumonia in patients undergoing major heart surgery: an incidence study in Europe. Critical Care 13(3), June 2009. [journal article]

Hortal, J., Munoz, P., Cuerpo, G., Litvan, H., Rosseel, P.M., Bouza, E.

http://ccforum.com/content/13/3/R80

Tuesday 7 July 2009

Critical Care

Mechanical ventilation during experimental sepsis increases deposition of advanced glycation end products and myocardial inflammation
Kneyber MC, Gazendam RP, Niessen HW, Kuiper J, Dos Santos CC, Slutsky AS, Plotz FB Critical Care 2009, 13:R87 (9 June 2009)
[Abstract] [Provisional PDF] [PubMed]

Thursday 25 June 2009

New books in the Library

Quick reference to critical care by Nancy Diepenbrock 3rd edition 2008 is now available in the Health Sciences Library. Shelved at 616.028 DIE

Principles and practice of high dependency nursing edited by Sheppard and Wright 2006 is now available in the Health Sciences Library. Shelved at 616.028 SHE

Wednesday 3 June 2009

The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients

The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Critical Care Medicine vol. 37(6), June 2009, pp 1898-1905.

Lat, I., McMillian, W., Taylor, S., Janzen, J.M., Papadopoulos, S., Korth, L., Ehtisham, A., Nold, J., Agarwal, S., Azocar, R., Burke, P.Issue:

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c11%7csl_10

Delirium is classically defined as an acute cognitive impairment accompanied with fluctuating mental status, inattention, and disorganized thought. Several validated tools exist to assist in the diagnosis of delirium in the critically ill population. The Society of Critical Care Medicine has recommended the implementation of delirium assessments as a standard of care. The development of delirium is frequent in critically ill patients. Prior work has demonstrated that delirium is an independent risk factor for mortality, longer intensive care unit (ICU) and hospital stays, and is associated with numerous complications.

Comparison of delirium assessment tools in a mixed intensive care unit

Comparison of delirium assessment tools in a mixed intensive care unit. Critcal Care Medicine, vol. 37(6), June 2009, pp 1881-1885 [journal article]

van Eijk, M.M.J., van Marum, R.J., Klijn, I.A.M., de Wit, N., Kesecioglu, J., Slooter, A.J.C.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c8%7csl_10

Delirium is a frequent problem in the intensive care unit (ICU) associated with poor prognosis. Delirium in the ICU is underdiagnosed by nursing and medical staff. Several detection methods have been developed for use in ICU patients. The aim of this study was to compare the value of three detection methods (the Confusion Assessment Method for the ICU [CAM-ICU], the Intensive Care Delirium Screening Checklist [ICDSC] and the impression of the ICU physician with the diagnosis of a psychiatrist, neurologist, or geriatrician).

Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma

Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma. Critical Care Medicine, vol 37(6), June 2009, pp 1845-1849 [journal article]

Castelli, G.P., Pognani, C., Cita, M., Paladini, R.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c2%7csl_10

Severe trauma is a potent cause of the systemic inflammatory response syndrome (SIRS). Although SIRS is present in >90% of the surgical intensive care unit (ICU) patients, classic inflammatory criteria such as body temperature, heart rate, white blood cell count, and respiratory rate are often variable and do not seem useful in predicting infection or severity of illness. Although early diagnosis and treatment of infection are associated with improved mortality, diagnosis of infection in these patients is often delayed due to long culture times and difficulties in isolation from local colonization.

Influence of respiratory rate on stroke volume variation in mechanically ventilaed patients

Influence of respiratory rate on stroke volume variation in mechanically ventilated patients. Anesthesiology, vol. 110(5), May 2009, pp 1092-1097

De Backer, D., Taccone, F.S., Holsten, R., Ibrahimi, F., Vincent, J.L.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.53.59%7c25%7csl_10

Heart-lung interactions are used to evaluate fluid responsiveness in mechanically ventilated patients, but these indices may be influenced by ventilatory conditions. The authors evaluated the impact of respiratory rate (RR) on indices of fluid responsiveness in mechanically ventilated patients, hypothesizing that pulse pressure variation and respiratory variation in aortic flow would decrease at high RRs.

In death, truth lies: why do patients with sepsis die?

In death, truth lies: why do patients with sepsis die? Anaesthesia & Analgesia, vol 108(6), June 2009, p 1731-1733. [editorial]

Tenhunen, J. J.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.20.44%7c3%7csl_10

It is no news that, even today, sepsis is associated with high mortality. All of us who regularly practice intensive care medicine have seen our patients with sepsis die. Yet, it seems acceptable to claim that we do not know ultimately why these patients die. Some die despite full continuing therapeutic efforts, although others die after therapy has been withheld or withdrawn. Most patients who die with or because of sepsis, die with established multiple organ dysfunction or failure. Although the clinical cause of death can be classified as “refractory septic shock,” “multiple organ failure,” or “acute circulatory failure,” the actual causes and mechanisms for treatment failure and death remain mostly unidentified.

Thursday 28 May 2009

Prolonged acute mechanical ventilation: implications for hospital benchmarking

Prolonged acute mechanical ventilation: implications for hospital benchmarking. CHEST May 2009, vol. 135 no. 5 1157-1162 [journal article]

Zilberberg, M.D., Kramer, A.A., Higgins, T.L., Shorr, A.F.

http://www.chestjournal.org/content/135/5/1157.short?rss=1

Hospital performance measures rely on aggregate outcomes. For patients receiving mechanical ventilation (MV), outcomes depend on severity of illness, hospital MV volume, and case mix. Patients requiring prolonged acute MV (PAMV) [MV for ≥ 96 h] comprise a resource-intensive group, but the impact of its volume on aggregate outcomes is unknown.

End of life care - nineteenth report of session 2009/09

End of life care - nineteenth report of session 2008/09. House of Commons, Public Accounts Committee, March 2009.

http://www.publications.parliament.uk/pa/cm200809/cmselect/cmpubacc/99/99.pdf

This report examines the scale and quality of end of life care, the current and future approach to commissioning and funding of services, and the capability and capacity of NHS and social care staff to provide such care.

Weaning patients off invasive ventilation

Weaning patients off invasive ventilation. [editorial] BMJ 2009; 338:b728

http://www.bmj.com/cgi/content/full/338/may21_1/b728

At any given time, 30-70% of patients in the intensive care unit (ICU) are receiving mechanical ventilatory support; 70-80% of them are rapidly weaned off this support, often within a few days. Weaning is more problematic in the remaining 20-30% of patients, usually because of unfavourable respiratory mechanics, residual disease processes, cardiac dysfunction, respiratory muscle weakness, high secretion volumes, or altered mental status.

Wednesday 20 May 2009

Cytomegalovirus infection in critically ill patients: a systematic review

Cytomegalovirus infection in critically ill patients: a systematic
review. Critical Care 2009, 13: R68 [Article]

Osawa, R., Singh, N.

http://ccforum.com/content/13/3/R68

The precise role of cytomegalovirus (CMV) infection in contributing to outcomes in critically ill immunocompetent patients has not been fully defined. Studies in which critically ill
immunocompetent adults were monitored for CMV infection in the intensive care unit (ICU) were reviewed. Potential risk factors for CMV infection include sepsis, requirement of mechanical ventilation, and transfusions. CMV infection frequently occurs in critically ill immunocompetent patients and may be associated with poor outcomes.

Dexmedetomidine vs haloperidol in delirious, agitated, intubated patients

Dexmedetomidine vs. haloperidol in delirious, agitated, intubated
patients: a randomised open-label trial. Critical Care 2009 13:R75 [Journal article]

Reade, M.C., O'Sullivan, K., Bates, S., Goldsmith, D., StJ Ainslie, W.R., Bellomo, R.

http://ccforum.com/content/13/3/R75

Agitated delirium is common in patients undergoing mechanical ventilation, and is often treated with haloperidol despite concerns about safety and efficacy. Use of conventional sedatives to control agitation can preclude extubation. Dexmedetomidine, a novel sedative and anxiolytic agent, may have particular utility in these patients. We sought to compare the efficacy of haloperidol and
dexmedetomidine in facilitating extubation. In this preliminary pilot study, we found dexmedetomidine a promising agent for the treatment of ICU-associated delirious agitation, and we suggest this warrants further testing in a definitive double-blind multi-centre trial.

Model for predicting short-term mortality of severe sepsis

Model for predicting short-term mortality of severe sepsis. Critical Care 2009, 13:R72 [journal article].

Adrie, C., Francais, A., Alvarez-Gonzalez, A., Mounier, R., Azoulay, E., Zahar, J.R., Clec'h, C., Godgran-Toledano, D., Hammer, L., Descorps-Declere, A., Jamali, S., Timsit, J.F.

http://ccforum.com/content/13/3/R72

Development of a prognostic model for predicting 14-day mortality in ICU patients with severe sepsis.

Risk factors for delirium in intensive care patients: a prospective cohort study

Risk factors for delirium in intensive care patients: a prospective cohort study. Critical Care 2009, 13:R77 [journal article]

Van Rompaey, B., Elseviers, M.M., Schuurmans, M.J., Shortridge-Baggett, L.M., Truijen, S., Bossaert, L.

http://ccforum.com/content/13/3/R77

This multicenter study indicated risk factors for delirium in the intensive care unit related to patient characteristics, chronic pathology, acute illness and the environment. Several factors are suitable for preventive action.

Thursday 14 May 2009

Evaluation of pain in ICU patients

Evaluation of pain in ICU patients. CHEST vol 135(4), April 2009, p.1069-1074 [journal article].

Puntillo, K., Pasero, C., Li, D., Mularski, R.A., Grap, J.M., Erstad, B.L., Varkey, B., Gilbert, H.C., Medina, J. Sessler, C.N.

http://www.chestjournal.org/content/135/4/1069.short?rss=1

Pain is a common and distressing symptom in ICU patients. Yet a major challenge exists in assessing and evaluating the pain. Although the patient's self-report of pain is the "gold standard" for pain assessment, other methods must be considered when patients are unable
to self-report.

Pain management principles in the critically ill

Pain management principles in the critically ill. CHEST vol. 135(4), April 2009, p.1075-1086. [journal article]

Erstad, B.L., Puntillo, K., Gilbert. H.C., Grap, M.J., Li, D., Medina, J., Mularski, R.A. Pasero, C., Varkey, B., Sessler, C.N.

http://www.chestjournal.org/content/135/4/1075.short?rss=1

This article addresses conventional pharmacologic and nonpharmacologic treatment of pain in patients in ICUs.





Pain management within the palliative and end-of-life care experience in the ICU.

CHEST vol 135(5), May 2009, p1360-1369 [journal article]. Pain management within the palliative and end-of-life care experience in the ICU.

Mularski, R. A., Puntillo, K., Varkey, B., Erstad, B. L., Grap, M. J., Gilbert, H. C., Li, D., Medina,
J., Pasero, C., Sessler, C. N.

http://www.chestjournal.org/content/135/5/1360.full.pdf+html

High-quality pain management is a part of optimal therapy and requires knowledge and skill in
pharmacologic, behavioral, social, and communication strategies grounded in the holistic palliative care approach. This contemporary review article focuses on pain management within comprehensive palliative and end-of-life care.

Wednesday 6 May 2009

Infection prevention and control: minimum standards

Infection prevention and control: minimum standards. [Care Guideline] These are the minimum standards that the Royal College of Nursing and the Infection Control Nurses' Association believe should be accepted and mandated by Government, UK departments of health and, where applicable, all independent health care organisations.
http://www.rcn.org.uk/downloads/publications/public_pub/002725.pdf

Ryl Coll of Nursing, 01 Jan 2009.

National Library for Health - Change of Name

The National Library for Health has changed its name to NHS Evidence.

The web address is: http://www.library.nhs.uk

The link to NHS Evidence - surgery, anaesthesia, perioperative and critical care
specialist collection (previously specialist library) is:

http://www.library/nhs.uk/theatres

Thursday 30 April 2009

Medication errors in an intensive care unit

Medication errors in an intensive care unit.
Bohomol, E., Ramos, L.H., D'Innocenzo, M.


Report of a study to investigating the incidence types and causes of medication errors (MEs) and the consequences for patients. Background. Medication errors are a common problem in hospitals around the world, including those in Brazil.Method. An exploratory, quantitative survey design was used and 44 adult inpatients were studied over a 30-day period in 2006. Findings. A total of 305 MEs was observed. Conclusion. There is a need to develop a culture of safety and quality in patient care. An understanding of the profile of ME types and frequencies in an institution is fundamental to raise awareness and implement measures to avoid them. Structural and procedural changes in hospital organization, with a focus on the efficacy, efficiency, and effectiveness of the medication system are needed to reduce MEs.

Infection, prevention and control

Infection, prevention and control
Theory and practice for healthcare professionals [Book]
Debbie Wilson
614.48 Macc HS Library

Tuesday 28 April 2009

End of life treatment and care: good practice in decision-making - a consultation

End of life treatment and care: good practice in decision-making - a consultation

The General Medical Council (GMC) is consulting on new draft guidance, 'End of life treatment and care: good practice in decision-making'. The guidance is intended mainly for doctors but may also help patients and the public and other health and social care staff to understand what they can expect from doctors involved in caring for patients who are dying. The consultation runs until 13 July 2009. (GMC - news)

Hand hygiene adherence is influenced by the behavior of role models.

Pediatr Crit Care Med. 2009 Mar 25. [Epub ahead of print] LinkOut
Hand hygiene adherence is influenced by the behavior of role models.
Schneider J, Moromisato D, Zemetra B, Rizzi-Wagner L, Rivero N, Mason W, Imperial-Perez F, Ross L.

From the Department of Anesthesiology Critical Care Medicine (JS, DM, BZ, LR-W, NR, FI-P); Division of Infectious Diseases (WM, LR); Department of Pediatric Critical Care Medicine (JS), Childrens Hospital Los Angeles, Los Angeles, CA.

OBJECTIVE:: Proper hand hygiene (HH) reduces nosocomial infections. Therefore, factors that influence HH behavior of healthcare workers are of great interest. We hypothesized that strict HH adherence by supervisor role models would improve the HH behavior of junior staff.

DESIGN:: Prospective observational study.
SETTING:: Pediatric and cardiac intensive care units of a tertiary care children's hospital. SUBJECTS:: Two critical care fellows and four nurse orientees.
INTERVENTIONS:: First, we observed and recorded HH adherence of the fellows and nurse orientees and their respective supervising attending physician or nurse preceptor during daily patient care. Subsequently, we paired the same fellows and nurse orientees with a different supervisor who maintained strict HH adherence, and again noted HH adherence. We used measures of HH opportunities and HH adherence consistent with guidelines set by the Centers for Disease Control and Association for Professionals in Infection Control and Epidemiology.

MEASUREMENTS AND MAIN RESULTS:: HH adherence by fellows and nurse orientees at baseline was 22% of 200 HH opportunities, and improved to 56% of 234 opportunities as a result of role modeling-an average increase of 34% points (95% confidence interval, 18.7-51; p < 0.01 by linear regression), representing a HH adherence rate greater than 1.5 times that of the baseline. The control senior practitioners' HH adherence rate was 20% of 180 opportunities compared with the study senior practitioners' HH adherence of 94% of 187 opportunities-an average difference of 72%points higher compared with the control senior practitioners (95% confidence interval, 56-88.3; p < 0.01 by linear regression).

CONCLUSIONS:: HH adherence of junior practitioners improved under the supervision of adherent role models. These results suggest that HH behavior of senior practitioners plays a crucial influence on other staff. Senior healthcare practitioners should consider the important role they may play in reinforcing or weakening a culture of patient safety and proper HH.
PMID: 19325501 [PubMed - as supplied by publisher]

Monday 20 April 2009

Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensiv

Surgery Today. 2009;39(4):295-9. Epub 2009 Mar 25. LinkOut
Readmission to the intensive care unit: An indicator that reflects the potential risks of morbidity and mortality of surgical patients in the intensive care unit.
Chan KS, Tan CK, Fang CS, Tsai CL, Hou CC, Cheng KC, Lee MC.
Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan, Taiwan.

PURPOSE: To investigate the characteristics and outcomes of surgical patients who were readmitted to the intensive care unit (ICU).

METHODS: The data were collected for all readmissions to the surgical ICUs in a tertiary hospital in the year 2003.

RESULTS: Of all the 945 ICU discharges, 110 patients (11.6%) were readmitted. They had a longer initial ICU stay (8.05 +/- 7.17 vs 5.22 +/- 4.95, P < p =" 0.049)." p =" 0.001)" p =" 0.010).">

CONCLUSION: The mortality of surgical patients with ICU readmission was high with respiratory complications being the most important issue.
PMID: 19319635 [PubMed - in process]

Considerations in Caring for the Critically Ill Older Patient.

JOURNAL OF INTENSIVE CARE MEDICINE
VOL 24; NUMB 2; 2009
ISSN 0885-0666
pp. 83-95
Considerations in Caring for the Critically Ill Older Patient.
Pisani, M.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247950331&field=zid

Comparison of acceptability, skin tolerance, and compliance between handwashing and alcohol-based handrub in ICUs: results of a multicentric study.

Comparison of acceptability, skin tolerance, and compliance between handwashing and alcohol-based handrub in ICUs: results of a multicentric study.
Souweine B, Lautrette A, Aumeran C, Bénédit M, Constantin JM, Bonnard M, Guélon D, Amat G, Aublet B, Bonnet R, Traoré O.
Intensive Care Med. 2009 Apr 15. [Epub ahead of print]PMID: 19367395 [PubMed - as supplied by publisher]
Related Articles

Articles: Current Opinion in Critical Care

pp. 139-143
When should stress ulcer prophylaxis be used in the ICU?.
Quenot, J.-P.; Thiery, N.; Barbar, S.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812438&field=zid

pp. 144-148
Probiotics in the intensive care unit.
Morrow, L.E.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812440&field=zid

pp. 149-153
Clostridium difficile infection: current perspectives.
Janka, J.; O Grady, N.P.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812451&field=zid


pp. 163-167
Practical management of acute liver failure in the intensive care unit.
Trotter, J.F.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247812476&field=zid

'Pain in the ICU'

'Pain in the ICU' report suggests comprehensive approach Apr 7, 2009 ... However, new reports suggest that taking a comprehensive approach to pain management may be the key to managing pain in the ICU and even ...
http://www.eurekalert.org/pub_releases/2009-04/acoc-it040709.php

Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis

Critical Care
Very old patients admitted to intensive care in Australia and New Zealand: a multi-centre cohort analysis
Bagshaw SM, Webb SA, Delaney A, George C, Pilcher D, Hart GK, Bellomo R Critical Care 2009, 13:R45 (1 April 2009)[Abstract] [Provisional PDF] [PubMed]

A multicentre case-control study of nonsteroidal anti-inflammatory drugs as a risk factor for severe sepsis and septic shock Legras A, Giraudeau B, Jonville-Bera A, Camus C, Francois B, Runge I, Kouatchet A, Veinstein A, Tayoro J, Villers D, Autret-Leca E Critical Care 2009, 13:R43 (30 March 2009)[Abstract] [Provisional PDF] [PubMed]

The End of Life Care Horizon Scanning Bulletin

The End of Life Care Horizon Scanning Bulletin has now been published at http://palliativecarenwpctl.wordpress.com/

To subscribe to future issues of the newsletter, visit http://feedburner.google.com/fb/a/mailverify?uri=PalliativeCareHorizonScanning&loc=en_US

McArdle LibraryIntegrated Library Service
Education CentreWirral University Teaching Hospital NHS TrustArrowe Park Hospital Arrowe Park Road Upton Wirral

Death, empathy and self preservation: the emotional labour of caring for families of the critically ill in adult intensive care

Death, empathy and self preservation: the emotional labour of caring for families of the critically ill in adult intensive care
Louise Caroline Stayt
Abstract
Published Online: 8 Apr 2009DOI 10.1111/j.1365-2702.2008.02712.x

Incidence and risk factors for pressure ulcers in the intensive care unit

Incidence and risk factors for pressure ulcers in the intensive care unit
Nele Nijs, Adinda Toppets, Tom Defloor, Kris Bernaerts, Koen Milisen, Greet Van Den Berghe
Abstract
Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02554.x

A critical review of daily sedation interruption in the intensive care unit

Journal of Clinical Nursing Volume18, Issue9,2009. Early View (Articles Available Online in Advance of Print) © 2009 Blackwell Publishing Ltd

p1239-1249
A critical review of daily sedation interruption in the intensive care unit
Mark O'Connor, Tracey Bucknall, Elizabeth Manias
Abstract Published Online: 11 Dec 2008DOI 10.1111/j.1365-2702.2008.02513.x

Dementia or delirium: Do you know the difference?.

NURSING CRITICAL CARE
VOL 4; NUMB 2; 2009
ISSN 1558-447X

pp. 24-31
Dementia or delirium: Do you know the difference?.
Forrant, J.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247673518&field=zid

Care bundles - evidence update

Critical care: evidence update care bundles, cost-effectiveness ...
Status: Approved,
Classification: Public (Internet) / NHS Wales (Intranet)
/ NPHS ...
3.1.2 Evidence of effectiveness of Ventilator Care Bundle ... that could be applied to improve ICU care, was carried out with the evidence graded. ...

Delirium in the intensive care unit: a review

Delirium in the intensive care unit: a review
Emma Arend, Martin Christensen
Abstract
Published Online: 1 Apr 2009DOI 10.1111/j.1478-5153.2008.00324.x

Reduction of catheter related bloodstream infections in intensive care: one for all, all for one?

Nursing in Critical Care Volume14, Issue3,2009.
Onno K Helder, Jos M Latour
Abstract
Published Online: 1 Apr 2009DOI 10.1111/j.1478-5153.2009.00340.x

EfCCNa survey: European intensive care nurses' attitudes and beliefs towards end-of-life care
Jos M Latour, Paul Fulbrook, John W Albarran
Abstract
Published Online: 1 Apr 2009DOI 10.1111/j.1478-5153.2008.00328.x

A preliminary study of atorvastatin plasma concentrations in critically ill patients with sepsis.

INTENSIVE CARE MEDICINE
VOL 35; NUMBER 4; 2009
ISSN 0342-4642

pp. 717-721
A preliminary study of atorvastatin plasma concentrations in critically ill patients with sepsis.
Kruger, P. S.; Freir, N. M.; Venkatesh, B.; Robertson, T. A.; Roberts, M. S.; Jones, M.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247251206&field=zid


pp. 623-630
End-of-life practices in 282 intensive care units: data from the SAPS 3 database.
Azoulay, l.; Metnitz, B.; Sprung, C. L.; Timsit, J. F.; Lemaire, F. o.; Bauer, P.; Schlemmer, B. t.; Moreno, R.; Metnitz, P.; on behalf, o. t.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN247251236&field=zid

Tuesday 7 April 2009

Critical care - rehabillitation

Nice Website
Clinical guidelines
NICE News
March 2009

Critical care - rehabillitation

Reducing ventilator-associated pneumonias using care bundles

Reducing ventilator-associated pneumonias using care bundles
pneumonias using care bundles at NHS Tayside, Tayside University Hospitals
NHS Trust ... Staff on the intensive care unit (ICU) believed ...

http://www.health.org.uk/document.rm?id=1017 PDF file

Daily goals checklist--a goal-directed method to eliminate nosocomial infection in the intensive care unit.

Daily goals checklist--a goal-directed method to eliminate nosocomial infection in the intensive care unit.
Khorfan F.J Healthc Qual. 2008 Nov-Dec;30(6):13-7.PMID: 19160870
[PubMed - indexed for MEDLINE]Related Articles

Recognizing sepsis in the adult patient

Recognizing sepsis in the adult patient.
Nelson DP, Lemaster TH, Plost GN, Zahner ML.Am J Nurs. 2009 Mar;109(3):40-5; quiz 46.PMID: 19240494
[PubMed - indexed for MEDLINE]
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Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007.

Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007.
Burton DC, Edwards JR, Horan TC, Jernigan JA, Fridkin SK.JAMA. 2009
Feb 18;301(7):727-36. PMID: 19224749
[PubMed - indexed for MEDLINE]
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Neutropenic sepsis: a guide to diagnosis and management

BMJ Learning modules
.. a comprehensive account of the diagnosis and management of neutropenic sepsis. It outlines how you should treat patients and how quickly.
Neutropenic sepsis: a guide to diagnosis and management


BMJ Learning

Implementation of a multimodal infection control program during an Acinetobacter outbreak.

Intensive and Critical CAre Nursing
pp. 57-63
Implementation of a multimodal infection control program during an Acinetobacter outbreak.
Rose, L.; Rogel, K.; Redl, L.; Cade, J. F.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246506564&field=zid

Intensive care or merely therapy?.

INTENSIVE AND CRITICAL CARE NURSING
VOL 25; NUMBER 2; 2009
ISSN 0964-3397

pp. 55-56
Intensive care or merely therapy?.
Dawson, D.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246506551&field=zid

JOURNAL OF CRITICAL CARE articles

JOURNAL OF CRITICAL CARE
VOL 24; NUMBER 1; 2009
ISSN 0883-9441
pp. A1-A2

Contents.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414166&field=zid

pp. 1-4
Have we learned how to relax our patients, by thinking outside the box?.
Lee, C.; Katz, R. L.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414188&field=zid

pp. 66-73
Perceived barriers to the use of sedation protocols and daily sedation interruption: A multidisciplinary survey.
Tanios, M. A.; de Wit, M.; Epstein, S. K.; Devlin, J. W.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414279&field=zid

pp. 74-80
Observational study of patient-ventilator asynchrony and relationship to sedation level.
de Wit, M.; Pedram, S.; Best, A. M.; Epstein, S. K.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414281&field=zid

pp. 81-88
Extended prone position ventilation in severe acute respiratory distress syndrome: A pilot feasibility study.
Romero, C. M.; Cornejo, R. A.; Gálvez, L. R.; Llanos, O. P.; Tobar, E. A.; Berasaín, M. A.; Arellano, D. H.; Larrondo, J. F.; Castro, J. S.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414293&field=zid

pp. 114-121
Patterns and density of early tracheal colonization in intensive care unit patients.
Durairaj, L.; Mohamad, Z.; Launspach, J. L.; Ashare, A.; Choi, J. Y.; Rajagopal, S.; Doern, G. V.; Zabner, J.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN246414334&field=zid

Tuesday 17 March 2009

Observational study of patient-ventilator asynchrony and relationship to sedation level.

Observational study of patient-ventilator asynchrony and relationship to sedation level.
de Wit M, Pedram S, Best AM, Epstein SK.
J Crit Care. 2009 Mar;24(1):74-80. Epub 2009 Jan 17.PMID: 19272542 [PubMed - in process]Related Articles


Perceived barriers to the use of sedation protocols and daily sedation interruption: a multidisciplinary survey.
Tanios MA, de Wit M, Epstein SK, Devlin JW.
J Crit Care. 2009 Mar;24(1):66-73. Epub 2008 Jun 30.PMID: 19272541 [PubMed - in process]Related Articles

The effect of comorbidities on risk of intensive care readmission during the same hospitalization: a linked data cohort study

The effect of comorbidities on risk of intensive care readmission during the same hospitalization: a linked data cohort study.
Ho KM, Dobb GJ, Lee KY, Finn J, Knuiman M, Webb SA.
J Crit Care. 2009 Mar;24(1):101-7. Epub 2008 Apr 18.PMID: 19272545 [PubMed - in process]Related Articles

Patterns and density of early tracheal colonization in intensive care unit patients.

Patterns and density of early tracheal colonization in intensive care unit patients.
Durairaj L, Mohamad Z, Launspach JL, Ashare A, Choi JY, Rajagopal S, Doern GV, Zabner J.
J Crit Care. 2009 Mar;24(1):114-21.PMID: 19272547 [PubMed - in process]
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Impact of bedside open lung biopsies on the management of mechanically ventilated immunocompromised patients with acute respiratory distress syndrome

Impact of bedside open lung biopsies on the management of mechanically ventilated immunocompromised patients with acute respiratory distress syndrome of unknown etiology.
Charbonney E, Robert J, Pache JC, Chevrolet JC, Eggimann P.
J Crit Care. 2009 Mar;24(1):122-8. Epub 2008 Apr 18.PMID: 19272548 [PubMed - in process]
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Pubmed: MRSA articles

Decreasing MRSA infections: an end met by unclear means.
Climo MW.JAMA. 2009 Feb 18;301(7):772-3. No abstract available. PMID: 19224756 [PubMed - indexed for MEDLINE]
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Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007.
Burton DC, Edwards JR, Horan TC, Jernigan JA, Fridkin SK.JAMA. 2009 Feb 18;301(7):727-36. PMID: 19224749 [PubMed - indexed for MEDLINE]
Related Articles

Routine delirium monitoring in a UK critical care unit

Routine delirium monitoring in a UK critical care unit
Page VJ, Navarange S, Gama S, McAuley DF Critical Care 2009, 13:R16 (9 February 2009)[Abstract] [Full text] [PDF] [PubMed]

The use of personal protective equipment for control of influenza among critical care clinicians: A survey study*

Crit Care Med. 2009 Feb 24. [Epub ahead of print] LinkOut

Daugherty EL, Perl TM, Needham DM, Rubinson L, Bilderback A, Rand CS.

From the Division of Pulmonary/Critical Care Medicine (ELD, DMN, AB, CSR), and Division of Infectious Diseases (TMP), Johns Hopkins University School of Medicine, Baltimore, MD; and Division of Pulmonary/Critical Care Medicine (LR), Department of Medicine, University of Washington, Seattle, WA.

BACKGROUND:: Intensive care units (ICUs) are potential high-risk areas for transmission of viruses causing febrile respiratory illness, such as influenza. Health care-associated influenza is prevented through healthcare worker (HCW) vaccination and effective use of U.S. Centers for Disease Control and Prevention recommended infection control practices, including use of personal protective equipment (PPE). Although effective PPE use may significantly reduce health care-associated influenza transmission, PPE adherence among ICU HCWs for preventing nosocomial influenza infection has not been evaluated. OBJECTIVE:: To characterize ICU HCW behavior, knowledge, and attitudes about recommended precautions for the prevention of health care-associated influenza infections.

DESIGN, SETTING, AND PARTICIPANTS:: A survey of 292 internal medicine housestaff, pulmonary/critical care fellows and faculty, nurses, and respiratory care professionals working in four ICUs in two hospitals in Baltimore, MD.
MEASUREMENTS AND MAIN RESULTS:: Of those surveyed, 84% (n = 244) completed the survey. Only 55% of respondents were able to correctly identify adequate influenza PPE, and 61% reported high adherence (>80%) with PPE use for prevention of nosocomial influenza. In multivariable modeling, odds of high adherence varied by clinician type. Respondents who believed adherence was inconvenient had lower odds of high adherence (odds ratio 0.43, 95% confidence interval 0.22-0.82), and those reporting likelihood of being reprimanded for nonadherence were more likely to adhere (odds ratio 2.16, 95% confidence interval 1.13-4.11).

CONCLUSIONS:: ICU HCWs report suboptimal levels of influenza PPE adherence. This finding in a high-risk setting is particularly concerning, given that it likely overestimates actual behavior. Both suboptimal adherence levels and significant PPE knowledge gaps indicate that ICU HCWs may be at a substantial risk of developing and/or transmitting nosocomial respiratory viral infection. Improving respiratory virus infection control will likely require closing knowledge gaps and changing organizational factors that influence behavior.PMID: 19242326 [PubMed - as supplied by publisher]

The electronic medical record as a tool for infection surveillance: Successful automation of device-days.

Am J Infect Control. 2009 Mar 6. [Epub ahead of print] LinkOut

The electronic medical record as a tool for infection surveillance: Successful automation of device-days.
Wright MO, Fisher A, John M, Reynolds K, Peterson LR, Robicsek A.
Department of Infection Control, NorthShore University HealthSystem, Evanston, IL.

BACKGROUND: Manual collection of central venous catheter, ventilator, and indwelling urinary catheter device-days is time-consuming, often restricted to intensive care units (ICU) and prone to error.

METHODS: We describe the use of an electronic medical record to extract existing clinical documentation of invasive devices. This allowed automated device-days calculations for device-associated infection surveillance in an acute care setting.

RESULTS: The automated system had high sensitivity, specificity, and positive and negative predictive values (>0.90) compared with chart review. The system is not restricted to ICUs and reduces surveillance efforts by a conservative estimate of over 3.5 work-weeks per year in our setting. Eighty percent of urinary catheter days and 50% of central venous catheter-days occurred outside the ICU.

CONCLUSION: Device-days may be automatically extracted from an existing electronic medical record with a higher degree of accuracy than manual collection while saving valuable personnel resources.PMID: 19269712 [PubMed - as supplied by publisher]

Nosocomial infection surveillance and control: current situation in Spanish hospitals.

1: J Hosp Infect. 2009 Mar 7. [Epub ahead of print] LinkOut

Sánchez-Payá J, Bischofberger C, Lizan M, Lozano J, Platón EM, Navarro J, Paz J, Vicente JA.

We studied healthcare-associated infection (HCAI) surveillance and control programmes in Spanish hospitals in 2006 and the human resources and materials used. A questionnaire on the structure, organisation and resources for HCAI surveillance and control was sent to all hospitals registered in the 2005 National Catalogue of Hospitals. A total of 237 hospitals (29.8%) responded, representing 55.9% of the beds included in the catalogue. Some 92% of hospitals had a surveillance and control programme, although 29.9% had had it for less than five years. Only 17.4% of hospitals had one infection control nurse per 250 beds, and only 36.2% had one infection control doctor per 500 beds. Surveillance is the main activity of those responsible for surveillance and control, and the most widely used systems are reviews of microbiology laboratory test results and studies of outbreaks, prevalence surveys, the incidence of certain procedures and of infection in critical care areas. Collaboration in multicentre studies is variable. EPINE, the prevalence survey of nosocomial infections in Spain, is performed annually in 80.5% of centres; ENVIN-UCI, a study of the incidence of infection in critically ill patients, is carried out in 24.8%, and the European study of the incidence of surgical infection, HELICS, in 22.7%. Priority should be given to improving specialised human resources and establishing common surveillance and control systems.
PMID: 19272670 [PubMed - as supplied by publisher]
» See Reviews... » See All...

Conceptual issues specifically related to health-related quality of life in critically ill patients

Commentary
Conceptual issues specifically related to health-related quality of life in critically ill patients
Hofhuis JG, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J, Spronk PE
Critical Care 2009, 13:118 (19 February 2009)
[Abstract] [Full text] [PDF] [PubMed]

Patients with cancer on the ICU: the times they are changing

Commentary
Patients with cancer on the ICU: the times they are changing
de Jonge E, Bos MM
Critical Care 2009, 13:122 (2 March 2009)
[Abstract] [Full text] [PDF]

Ethics review: End of life legislation – the French model

Critical Care Feb-March 2009

Review
Ethics review: End of life legislation – the French model
Baumann A, Audibert G, Claudot F, Puybasset L Critical Care 2009, 13:204 (23 February 2009)[Abstract] [Full text] [PDF]

Clinical review: Ventilatory strategies for obstetric, brain-injured and obese patients

Critical Care Feb-March 2009

Review
Clinical review: Ventilatory strategies for obstetric, brain-injured and obese patients Lapinsky SE, Posadas-Calleja J, McCullagh I Critical Care 2008, 13:206 (4 March 2009)[Abstract] [Full text] [PDF]

Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units

Critical Care, published between 05-Feb-2009 and 13-Mar-2009

Review
Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units
Xie H, Kang J, Mills GH Critical Care 2009, 13:208 (9 March 2009) [PDF]

Smaller self-inflating bags produce greater guideline consistent ventilation in simulated cardiopulmonary resuscitation

BMC Emergency Medicine, published between 30-Jan-2009 and 13-Mar-2009

Research article
Smaller self-inflating bags produce greater guideline consistent ventilation in simulated cardiopulmonary resuscitation
Nehme Z, Boyle MJ BMC Emergency Medicine 2009, 9:4
(20 February 2009)
[Abstract] [Provisional PDF] [PubMed]

Clinical review: Medication errors in critical care.

Critical Care
VOL 12; NUMBER 2; 2008
ISSN 1364-8535

p. 208
Clinical review: Medication errors in critical care.
Moyen, E.; Camiré, E.; Stelfox, H. T.

Critical Care Clinics

Plagues in the ICU: A Brief History of Community-Acquired Epidemic and Endemic Transmissible Infections Leading to Intensive Care Admission
R. Bruce Light
pages 67-81

------------------------------------------------------------------------
Sepsis and Septic Shock: A History
Duane J. Funk, Joseph E. Parrillo, Anand Kumar
pages 83-101

------------------------------------------------------------------------
History of Technology in the Intensive Care Unit
Nitin Puri, Vinod Puri, R.P. Dellinger
pages 185-200
http://www.criticalcare.theclinics.com/article/S0749-0704%2808%2900079-1/abstract


Historical Perspectives in Critical Care Medicine: Blood Transfusion, Intravenous Fluids, Inotropes/Vasopressors, and Antibiotics
Ryan Zarychanski, Robert E. Ariano, Bojan Paunovic, Dean D. Bell
pages 201-220
http://www.criticalcare.theclinics.com/article/S0749-0704%2808%2900073-0/abstract

------------------------------------------------------------------------
A History of Ethics and Law in the Intensive Care Unit
John M. Luce, Douglas B. White
pages 221-237
http://www.criticalcare.theclinics.com/article/S0749-0704%2808%2900074-2/abstract

The Shortage of Nurses and Nursing Faculty: What Critical Care Nurses Can Do.

CRITICAL CARE NURSE
VOL 29; NUMB 1; SUPP; 2009
ISSN 0279-5442

The Shortage of Nurses and Nursing Faculty: What Critical Care Nurses Can Do.

Clinical review: Critical care transport and austere critical care.

Critical Care
VOL 12; NUMBER 2; 2008
ISSN 1364-8535
p. 207
Clinical review: Critical care transport and austere critical care.
Rice, D. H.; Kotti, G.; Beninati, W.

Continuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer prevention

Journal of Advanced Nursing April 2009

Kozue Sakai; Hiromi Sanada; Noriko Matsui; Gojiro Nakagami; Junko Sugama;
Continuous monitoring of interface pressure distribution in intensive care patients for pressure ulcer prevention

Delirium in the Intensive Care Unit: Medications as Risk Factors.

Critical Care Nurse

pp. 85-87
Delirium in the Intensive Care Unit: Medications as Risk Factors.

Incompetence Among Critical Care Nurses: A Survey Report.

Critical Care Nurse

pp. 12-17
Incompetence Among Critical Care Nurses: A Survey Report.

Further Validation of the Nonverbal Pain Scale in Intensive Care Patients.

CRITICAL CARE NURSE
VOL 29; NUMB 1; 2009
ISSN 0279-5442

pp. 59-66
Further Validation of the Nonverbal Pain Scale in Intensive Care Patients.
Kabes, A.M.; Graves, J.K.; Norris, J.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245651026&field=zid

Current Opinion in Critical Care: Ventilator articles

pp. 30-35
Ventilator-associated pneumonia.
Valencia, A.M.; Torres, M.A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245565640&field=zid

pp. 36-43
Weaning from ventilatory support.
Epstein, S.K.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245565653&field=zid

pp. 44-51
Mechanical ventilation: epidemiological insights into current practices.
Goligher, E.; Ferguson, N.D.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245565666&field=zid

Sleep and critical care

CURRENT OPINION IN CRITICAL CARE
VOL 15; NUMB 1
Respiratory system; 2009

pp. 25-29
Sleep and critical care.
Bijwadia, J.S.; Ejaz, M.S.

Pleural effusion in the mechanically ventilated patient.

CURRENT OPINION IN CRITICAL CARE
VOL 15; NUMB 1 Respiratory system; 2009
ISSN 1070-5295

pp. 10-17
Pleural effusion in the mechanically ventilated patient.
Graf, J.

pp. 25-29
Sleep and critical care.
Bijwadia, J.S.; Ejaz, M.S.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245565638&field=zid

Incidence of pressure ulcers in intensive care unit patients at risk ..

JOURNAL OF CLINICAL NURSING
VOL 18; NUMBER 5; 2009
ISSN 0962-1067

Incidence of pressure ulcers in intensive care unit patients at risk according to the Waterlow scale and factors influencing the development of pressure ulcers.
Sayar, S.; Turgut, S.; Dogan, H.; Ekici, A.; Yurtsever, S.; Demirkan, F.; Doruk, N.; Tasdelen, B.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245463647&field=zid

Mortality in healthy elderly patients after ICU admission.

Intensive Care Medicine

pp. 550-555
Mortality in healthy elderly patients after ICU admission.
Sacanella, E.; Pérez-Castejón, J. M.; Nicolás, J. M.; Masanés, F.; Navarro, M.; Castro, P.; López-Soto, A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245470810&field=zid

Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough.

Intensive Care medicine

pp. 430-438
Mortality in ICU patients with bacterial community-acquired pneumonia: when antibiotics are not enough.
Rodriguez, A.; Lisboa, T.; Blot, S.; Martin-Loeches, I.; Solé-Violan, J.; Mendoza, D.; Rello, J.; Community-Acquired, P. I.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245470731&field=zid

Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections.

Intensive Care Medicine

pp. 448-454
Diabetes mellitus is an independent risk factor for ICU-acquired bloodstream infections.
Michalia, M.; Kompoti, M.; Koutsikou, A.; Paridou, A.; Giannopoulou, P.; Trikka-Graphakos, E.; Clouva-Molyvdas, P.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245470573&field=zid

Lithium dilution cardiac output measurement in the critically ill patient: determination of precision of the technique.

INTENSIVE CARE MEDICINE
VOL 35; NUMBER 3; 2009
ISSN 0342-4642

pp. 498-504
Lithium dilution cardiac output measurement in the critically ill patient: determination of precision of the technique.
Cecconi, M.; Dawson, D.; Grounds, R. M.; Rhodes, A.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245470563&field=zid

Wednesday 4 March 2009

eBooks

A number of ebooks are available online via MyiLibrary, which is one of the many resources accessible from the National Library for Health, using your Athens login.

Selected titles include:

Managing Chronic Obstructive Pulmonary Disease
Written By Blackler, Laura; Jones, Christine; Mooney, CarolinePublished By Wiley in 2007

Handbook of Palliative Care
Written By Carter, Yvonne; Daniels, Lilian; Faull, ChristinaPublished By Blackwell Publishing in 2005

Principles of Critical Care
Written By Hall, Jesse B.; Schmidt, Gregory A.; Wood, Lawrence D. H.Published By McGraw-Hill Publishing in 2005

Trauma: Critical Care
Written By Wilson, William C; Grande, Christopher M.; Hoyt, David B.Published By Informa Healthcare in 2007

Just the Facts in Critical Care Medicine
Written By Hall, Jesse B.; Schmidt, Gregory A.Published By McGraw-Hill Publishing in 2007

Key Topics in Critical Care
Written By Craft, Tim; Nolan, Jerry; Parr, MikePublished By Taylor & Francis in 2004

Annual Evidence Updates: NLH

NLH: http://www.library.nhs.uk/

Annual Evidence Update on Chest Pain:
more at http://www.library.nhs.uk/cardiovascular/
23-27 February 2009

Annual Evidence Update on Gastrointestinal Symptoms in Supportive and Palliative Care:
9-13 February...
more at http://www.library.nhs.uk/palliative/

Two and a half weeks: Time enough for end-of-life care planning?

Critical Care Medicine
March 2009

Section: Editorials
Pages: 1145
Two and a half weeks: Time enough for end-of-life care planning?
Authors: Howard B. Degenholtz, PhD

Title: Don't ask, don't tell: delirium in the intensive care unit

Critical Care Medicine
March 2009

Section: Editorials
Pages: 1129-1130
Don't ask, don't tell: delirium in the intensive care unit
Authors: Jason P. Caplan, MD

Athens login required

Solutions for care of patients with severe sepsis: Where and how?

Critical Care Medicine
Section: Editorials
Pages: 1128-1129
Solutions for care of patients with severe sepsis: Where and how?
Authors: Vinod K. Puri, MD, FCCM

Developing guidelines that identify patients who would benefit from palliative care services in the surgical intensive care unit

Critical Care Medicine
March 2009
Section: Clinical Investigations
Pages: 946-950
Developing guidelines that identify patients who would benefit from palliative care services in the surgical intensive care unit
Authors: Ciarán T. Bradley, MD; Karen J. Brasel, MD, MPH

Piperacillin penetration into tissue of critically ill patients with sepsis - Bolus versus continuous administration?

Critical Care Medicine
March 2009
Section: Clinical Investigations
Pages: 926-933
Piperacillin penetration into tissue of critically ill patients with sepsis - Bolus versus continuous administration?
Authors: Jason A. Roberts, BPharm (Hons); Michael S. Roberts, DSc; Thomas A. Robertson, PhD; Andrew J. Dalley, PhD; Jeffrey Lipman, FJFICM, MD

Delirium and sedation in the intensive care unit: Survey of behaviors and attitudes of 1384 healthcare professionals

Critical Care Medicine
March 2009
Pages: 825-832
Delirium and sedation in the intensive care unit: Survey of behaviors and attitudes of 1384 healthcare professionals
Authors: Rina P. Patel, SB; Meredith Gambrell, BA; Theodore Speroff, PhD; Theresa A. Scott, MS; Brenda T. Pun, RN, MSN; Joyce Okahashi, RN; Cayce Strength, RN, BSN; Pratik Pandharipande, MD, MSCI; Timothy D. Girard, MD, MSCI; Hayley Burgess, PharmD, BCPP; Robert S. Dittus, MD, MPH; Gordon R. Bernard, MD; E Wesley Ely, MD, MPH

Hospital-wide impact of a standardized order set for the management of

Critical Care Medicine
March 2009

Pages: 819-824
Hospital-wide impact of a standardized order set for the management of
bacteremic severe sepsis

Authors: Steven W. Thiel, MD; Muhammad F. Asghar, MD; Scott T. Micek, PharmD;
Richard M. Reichley, RPh; Joshua A. Doherty, BS; Marin H. Kollef, MD http://ovidsp.ovid.com/ovidweb.cgi?T=JS&MODE=ovid&NEWS=n&PAGE=fulltext&D=ovft&SEARCH=00003246-200903000-00003.an&SOURCE=etoc.ascii&SYNTAX=N

Interaction of vasopressin infusion, corticosteroid treatment, and mortality of septic shock

Journal: Critical Care Medicine
Issue: March 2009, Volume 37 Issue 3

Pages: 811-818
Interaction of vasopressin infusion, corticosteroid treatment, and mortality of septic shock
Authors: Dieter Ayers for the Vasopressin and Septic Shock Trial (VASST)
Investigators

Impact of continuous venovenous hemofiltration on organ failure during

Journal: Critical Care Medicine
Issue: March 2009, Volume 37 Issue 3

Pages: 803-810
Title: Impact of continuous venovenous hemofiltration on organ failure during
the early phase of severe sepsis: A randomized controlled trial
Authors: for the Hemofiltration and Sepsis Group of the Collège National de
Réanimation et de Médecine dUrgence des Hôpitaux extra-Universitaires

Life-support decision making in critical care: Identifying and appraising the qualitative research evidence

Crit Care Med. 2009 Feb 24. [Epub ahead of print]
Related Articles, Links

Life-support decision making in critical care: Identifying and appraising the qualitative research evidence*
Giacomini M, Cook D, Dejean D.
From the Department of Clinical Epidemiology and Biostatistics (MG, DC);
Centre for Health Economics and Policy Analysis (MG, DD); Department of Medicine (DC); Health Research Methodology Programme (DD), McMaster University, Hamilton, ON, Canada.

OBJECTIVE:: The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. DATA SOURCES:: In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings.

STUDY SELECTION:: Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. DATA EXTRACTION:: We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). DATA SYNTHESIS:: Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings.

CONCLUSIONS:: Qualitative evidence often appears outside of clinical journals, with most research from the United States Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and stress). Both designs can provide useful reflections for improving care. Given the diversity of qualitative research in critical care, room for improvement exists regarding both the quality and transparency of reported methodology.

The burden of sepsis-associated mortality in the United States

The burden of sepsis-associated mortality in the United States
from 1999 to 2005: an analysis of multiple-cause-of-death data

Critical Care 2009

Introduction:

Sepsis is the tenth-leading cause of death in the United States. The National Center for Health Statistics' multiple-cause-of-death (MCOD) dataset is a large, publically available, population-based source of information on disease burden in the United States. We have analyzed MCOD data from 1999 to 2005 to investigate trends, assess disparities, and provide population-based estimates of sepsis-associated mortality during this period.

Inhalational therapies for the ICU.

Inhalational therapies for the ICU.
Robinson BR, Athota KP, Branson RD.
Curr Opin Crit Care. 2009 Feb;15(1):1-9.
[PubMed - in process] Related Articles

Pleural effusion in the mechanically ventilated patient.

Pleural effusion in the mechanically ventilated patient.
Graf J.
Curr Opin Crit Care. 2009 Feb;15(1):10-7.
[PubMed - in process] Related Articles


Sleep and critical care

Sleep and critical care.
Bijwadia JS, Ejaz MS.
Curr Opin Crit Care. 2009
Feb;15(1):25-9.
[PubMed - in process] Related Articles


Weaning from ventilatory support

Weaning from ventilatory support.
Epstein SK.
Curr Opin Crit Care. 2009 Feb;15(1):36-43.
[PubMed - in process] Related Articles

Ventilator-associated pneumonia.

Ventilator-associated pneumonia.
Valencia M, Torres A.
Curr Opin Crit Care. 2009 Feb;15(1):30-5.
PubMed - in process] Related Articles

Mechanical ventilation: epidemiological insights into current practices.

Mechanical ventilation: epidemiological insights into current practices.
Goligher E, Ferguson ND.
Curr Opin Crit Care. 2009 Feb;15(1):44-51.
PubMed - in process] Related Articles

Paralytics in critical care: not always the bad guy.

Paralytics in critical care: not always the bad guy.
Forel JM, Roch A, Papazian L.
Curr Opin Crit Care. 2009
Feb;15(1):59-66.
[PubMed - in process] Related Articles

Diagnostic Efficacy and Prognostic Value of Serum Procalcitonin Concentration in Patients With Suspected Sepsis.

JOURNAL OF INTENSIVE CARE MEDICINE
VOL 24; NUMB 1; 2009
ISSN 0885-0666

pp. 63-71
Diagnostic Efficacy and Prognostic Value of Serum Procalcitonin Concentration in Patients With Suspected Sepsis.
Ruiz-Alvarez, M.J.; Garcia-Valdecasas, S.; De Pablo, R.; Sanchez Garcia, M.; Coca, C.; Groeneveld, T.W.; Roos, A.; Daha, M.R.; Arribas, I.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245058506&field=zid

The Impact of a Simple, Low-cost Oral Care Protocol on Ventilator-associated Pneumonia Rates in a Surgical Intensive Care Unit.

JOURNAL OF INTENSIVE CARE MEDICINE
VOL 24; NUMB 1; 2009
ISSN 0885-0666

pp. 54-62
The Impact of a Simple, Low-cost Oral Care Protocol on Ventilator-associated Pneumonia Rates in a Surgical Intensive Care Unit.
Sona, C.S.; Zack, J.E.; Schallom, M.E.; McSweeney, M.; McMullen, K.; Thomas, J.; Coopersmith, C.M.; Boyle, W.A.; Buchman, T.G.; Mazuski, J.E.
http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245058493&field=zid

A new immunomodulatory therapy for severe sepsis: ulinastatin plus thymosin {alpha}

JOURNAL OF INTENSIVE CARE MEDICINE
VOL 24; NUMB 1; 2009
ISSN 0885-0666

http://zetoc.mimas.ac.uk/wzgw?db=etoc&terms=RN245058480&field=zid

Date: 2009
Objectives:
To study the effect of immunomodulatory therapy with ulinastatin plus thymosin alpha( 1) on septic patients. Method: A total of 56 sepsis patients were randomized into a treatment group, receiving immunomodulatory therapy, and a placebo group, a placebo. Acute Physiology and Chronic Health Evaluation II scores, clinical data, lymphocyte subsets, immunological indexes, and coagulation parameters were determined before admission and on the 3rd, 8th, and 28th day after admission to the Intensive Care Unit. Results: The treatment group experienced a 78% cumulative survival, the placebo group experienced a 60% cumulative survival; the survival difference was mirrored by Acute Physiology and Chronic...