Other bulletins in this series include:

Breast Surgery

Monday 28 January 2013

Fluctuations in serum sodium level are associated with an increased risk of death in surgical ICU patients

Fluctuations in serum sodium level are associated with an increased risk of death in surgical ICU patients. Critical care medicine, Jan 2013, Vol. 41(1), p.133-142.

Sakr, Y., et al.


http://journals.lww.com/ccmjournal/Abstract/2013/01000/Fluctuations_in_Serum_Sodium_Level_Are_Associated.16.aspx

Dysnatremia may have an impact on outcomes in critically ill patients, but this has not been widely investigated in surgical ICU patients. We investigated the epidemiology of dysnatremia in a large cohort of surgical ICU patients and evaluated the possible influence of the time of acquisition of dysnatremia and fluctuations in serum sodium concentrations on hospital mortality in these patients.

Methods of blood pressure measurement in the ICU

Methods of blood pressure measurement in the ICU.  Critical care medicine, Jan 2013, Vol. 41(1), p.34-40.

Lehman, L.H., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/01000/Methods_of_Blood_Pressure_Measurement_in_the_ICU_.5.aspx

Minimal clinical research has investigated the significance of different blood pressure monitoring techniques in the ICU and whether systolic vs. mean blood pressures should be targeted in therapeutic protocols and in defining clinical study cohorts. The objectives of this study are to compare real-world invasive arterial blood pressure with noninvasive blood pressure, and to determine if differences between the two techniques have clinical implications.

The role of venous return in critical illness and shock: Physiology

The role of venous return in critical illness and shock: Physiology. Critical care medicine, Jan 2013, Vol. 41(1), p.255-262.

Funk, D., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/01000/The_Role_of_Venous_Return_in_Critical_Illness_and.28.aspx

The usual teaching of cardiac physiology focuses on left ventricular function. As a result of the wide array of shock states with which intensivists contend, an approach that takes into account the function of the venous system and its interaction with the right and left heart may be more useful. This two-part review focuses on the function of the venous system and right heart under normal and stressed conditions. 

Haloperidol prophylaxis in critically ill patients with a high risk of delirium

Haloperidol prophylaxis in critically ill patients with a high risk of delirium.  Critical care, 2013, 17: R9.

van den Boogaard, M., et al.

http://ccforum.com/content/17/1/R9/abstract

Delirium is associated with increased morbidity and mortality. We implemented a delirium prevention policy in intensive care unit (ICU) patients with a high risk to develop delirium, and evaluated if our policy resulted in quality improvement of relevant delirium outcome measures.

Lower tidal volume at initiation of mechanical ventilation may reduce progression to acute respiratory distress syndrome

Lower tidal volume at initiation of mechanical ventilation may reduce progression to acute respiratory distress syndrome: A systematic review. Critical care, 2013, 17: R11.

Fuller, B.M., et al.

http://ccforum.com/content/17/1/R11/abstract

The most appropriate tidal volume in patients without acute respiratory distress syndrome (ARDS) is controversial, and has not been rigorously examined. The objective was to determine whether a mechanical ventilation strategy using lower tidal volume is associated with a decreased incidence of progression to ARDS when compared to a higher tidal volume strategy.


Phenomenological analysis of healthcare worker perceptions of intensive care unit diaries

Phenomenological analysis of healthcare worker perceptions of intensive care unit diaries. Critical care, 2013, 17: R13.

Perier, A., et al.

http://ccforum.com/content/17/1/R13/abstract

Studies have reported associations between diaries kept for intensive care unit (ICU) patients and long-term quality-of-life and psychological outcomes in patients and their relatives. Little was known about perceptions of healthcare workers reading and writing in the diaries. We investigated healthcare worker perceptions to better understand their opinions and responses to reading and writing in the diaries.

Toothbrushing for critically ill mechanically ventilated patients

Toothbrushing for critically ill mechanically ventilated patients: A systematic review and meta analysis of randomized trials evaluating ventilator-associated pneumonia. Critical care medicine, Feb 2013, Vol. 41(2), p.646-655.

Alhazzani, W. et al.

http://journals.lww.com/ccmjournal/Abstract/2013/02000/Toothbrushing_for_Critically_Ill_Mechanically.26.aspx

Oral care may decrease ventilator-associated pneumonia in the ICU. The objective of this review was to summarize and critically appraise randomized trials in mechanically ventilated patients in the ICU testing the effect of oral care strategies involving toothbrushing on ventilator-associated pneumonia. 

Role of the venous return in critical illness and shock

Role of the venous return in critical illness and shock: Shock and mechanical ventilation. Critical care medicine, Feb 2013, Vol. 41(2), p.573-9.

Funk, D., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/02000/Role_of_the_Venous_Return_in_Critical_Illness_and.23.aspx

The usual clinical teaching of cardiac physiology focuses on left ventricular pathophysiology and pathology. Due to the wide array of shock states dealt with by intensivists, an integrated approach that takes into account the function of the venous system and its interaction with the right heart may be more useful.

Delirium in the cardiovascular ICU

Delirium in the cardiovascular ICU: Exploring modifiable risk factors. Critical care medicine, Feb. 2013, Vol.  41(2), p.405-13.

McPherson, J.A., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/02000/Delirium_in_the_Cardiovascular_ICU___Exploring.5.aspx

Delirium, an acute organ dysfunction, is common among critically ill patients leading to significant morbidity and mortality; its epidemiology in a mixed cardiology and cardiac surgery ICU is not well established. We sought to determine the prevalence and risk factors for delirium among cardiac surgery ICU patients.




Can surgical outcomes be prevented by postoperative admission to critical care?

Can surgical outcomes be prevented by postoperative admission to critical care? Critical care, Vol. 17: 110,  January 2013.  [Editorial]

Rhodes, A. & Cecconi, M.

http://ccforum.com/content/17/1/110

Postoperative complications are hugely important for both the patient involved and also the health-care system that they develop within. Potentially disastrous for the patient, they cause prolonged lengths of stay and can be an expensive problem to resolve. Indeed, recent data suggest that these costs may not just be relevant to the short-term hospital stay but may result in significant increased costs for the longer term following repeated hospital admissions and chronic ill health.