Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia

Continuous endotracheal tube cuff pressure control system protects against ventilator-associated pneumonia. Critical Care, 2014, 18:R77

Lorente, L., et al.

http://ccforum.com/content/pdf/cc13837.pdf

The use of a system for continuous control of endotracheal tube cuff pressure reduced the 
incidence of ventilator-associated pneumonia (VAP) in one randomized controlled trial 
(RCT) with 112 patients but not in another RCT with 142 patients. In several guidelines on 
the prevention of VAP, the use of a system for continuous or intermittent control of 
endotracheal cuff pressure is not reviewed. The objective of this study was to compare the incidence of VAP in a large sample of patients (n=284) treated with either continuous or intermittent control of endotracheal tube cuff pressure. 

Parenteral glutamine supplementation in critical illness: a systematic review

Parenteral glutamine supplementation in critical illness: a systematic review. Critical Care, 2014, 18:R76.

Wischmeyer, P.E. et al.

http://ccforum.com/content/pdf/cc13836.pdf

The potential benefit of parenteral glutamine (GLN) supplementation has been one of the most commonly studied nutritional interventions in the critical care setting. The aim of this systematic review was to incorporate recent trials of traditional parenteral GLN supplementation in critical illness with previously existing data. 

Do heart rate and respiratory rate variability improve prediction of extubation outcomes in critically ill patients?

Do heart rate and respiratory rate variability improve prediction of extubation outcomes in critically ill patients? Critical Care, 2014, 18:R65

Seely, AJE, et al.

http://ccforum.com/content/pdf/cc13822.pdf

Prolonged ventilation and failed extubation are associated with increased harm and cost. The 
added value of heart and respiratory rate variability (HRV and RRV) during spontaneous 
breathing trials (SBTs) to predict extubation failure remains unknown. 

Ventriculo-arterial decoupling in human septic shock

Ventriculo-arterial decoupling in human septic shock.  Critical Care 2014, 18:R80

Guarracino, F., et al.

http://ccforum.com/content/pdf/cc13842.pdf

Septic shock is the most severe manifestation of sepsis. It is characterized as a hypotensive 
cardiovascular state associated with multiorgan dysfunction and metabolic disturbances. 
Management of septic shock is targeted to preserve an adequate organ perfusion pressure 
without precipitating pulmonary edema or massive volume overload. Cardiac dysfunction 
often occurs in septic shock patients and can significantly affect outcome; one physiologic 
approach to disclose the interaction between the heart and the circulation when both are 
affected is to examine ventriculo-arterial coupling defined by the ratio of arterial elastance 
(Ea) and left ventricular elastance (Ees). We aimed to analyze ventriculo-arterial coupling in 
a cohort of patients admitted to ICUs presenting or not with septic shock.

A systematic review of therapeutic hypothermia for adult patients following traumatic brain injury

A systematic review of therapeutic hypothermia for adult patients following traumatic brain injury. Critical Care 2014, 18:R75

Crossley, S., et al.

http://ccforum.com/content/pdf/cc13835.pdf

Research into therapeutic hypothermia following traumatic brain injury has been 
characterised by small trials of poor methodological quality, producing variable results. The 
Cochrane review, published in 2009, now requires updating. The aim of this systematic 
review is to assess the effectiveness of the application of therapeutic hypothermia to reduce 
death and disability when administered to adult patients who have been admitted to hospital 
following traumatic brain injury. 

Effect of statin therapy on mortality from infection and sepsis

Effect of statin therapy on mortality from infection and sepsis: a meta-analysis of randomized and observational studies. Critical Care 2014, 18:R71

You-Dong Wan, et al.

http://ccforum.com/content/pdf/cc13828.pdf

Observational data have suggested that statin therapy may reduce mortality in patients with 
infection and sepsis; however, results from randomized studies are contradictory and do not 
support the use of statins in this context. Here, we performed a meta-analysis to investigate 
the effects of statin therapy on mortality from infection and sepsis.

Intensive care unit depth of sleep

Intensive care unit depth of sleep: proof of concept of a simple electroencephalography index in the non-sedated. Critical Care 2014, 18:R66

Reinke, L., et al.

http://ccforum.com/content/pdf/cc13823.pdf

Intensive care unit (ICU) patients are known to experience severely disturbed sleep, with 
possible detrimental effects on short- and long- term outcomes. Investigation into the exact 
causes and effects of disturbed sleep has been hampered by cumbersome and time consuming 
methods of measuring and staging sleep. We introduce a novel method for ICU depth of sleep 
analysis, the ICU depth of sleep index (IDOS index), using single channel 
electroencephalography (EEG) and apply it to outpatient recordings. A proof of concept is 

shown in non-sedated ICU patients.

Impact of critical care nursing on 30-day mortality of mechanically ventilated older adults

Impact of critical care nursing on 30-day mortality of mechanically ventilated older adults. Critical Care Medicine, May 2014, Vol. 42(5), p.1089-95.

Kelly, D.M., et al.

http://journals.lww.com/ccmjournal/Abstract/2014/05000/Impact_of_Critical_Care_Nursing_on_30_Day.9.aspx

The mortality rate for mechanically ventilated older adults in ICUs is high. A robust research literature shows a significant association between nurse staffing, nurses’ education, and the quality of nurse work environments and mortality following common surgical procedures. A distinguishing feature of ICUs is greater investment in nursing care. The objective of this study is to determine the extent to which variation in ICU nursing characteristics—staffing, work environment, education, and experience—is associated with mortality, thus potentially illuminating strategies for improving patient outcomes.

The highs and lows of blood pressure

The highs and lows of blood pressure: toward meaningful clinical targets in patients with shock. Critical Care Medicine, May 2014, Vol. 42(5), p.1241-51.

Magder, S.A.

http://journals.lww.com/ccmjournal/Abstract/2014/05000/The_Highs_and_Lows_of_Blood_Pressure__Toward.26.aspx

Measurement of blood pressure is fundamental for the management of patients in shock, yet the physiological basis and meaning of blood pressure measurements are complex and often not well understood. This article is in two parts: part 1 deals with the mechanical and physiological aspects of blood pressure and its measurement and part 2 deals with the role of changes in regional resistances in the determination of tissue perfusion and bedside approaches to management of shock.

Rehabilitation interventions for postintensive care syndrome

Rehabilitation interventions for postintensive care syndrome: A systematic review. Critical Care Medicine, May 2014, Vol. 42(5), p.1263-71.

Mehlhorn, J., et al.

http://journals.lww.com/ccmjournal/Abstract/2014/05000/Rehabilitation_Interventions_for_Postintensive.28.aspx

An increasing number of ICU patients survive and develop mental, cognitive, or physical impairments. Various interventions support recovery from this postintensive care syndrome. Physicians in charge of post-ICU patients need to know which interventions are effective.

Family presence during brain death evaluation

Family presence during brain death evaluation: A randomized controlled trial. Critical Care Medicine, April 2014, Vol. 42(4), p.934-42.

Tawil, I., et al.

http://journals.lww.com/ccmjournal/Abstract/2014/04000/Family_Presence_During_Brain_Death_Evaluation__A.21.aspx

To evaluate if a family presence educational intervention during brain death evaluation improves understanding of brain death without affecting psychological distress.

Psychological wellbeing, health related quality of life and memories of intensive care

Psychological wellbeing, health related quality of life and memories of intensive care and a specialised weaning centre reported by survivors of prolonged mechanical ventilation. Intensive and Critical Care Nursing, June 2014, Vol. 30(3), p.145-51.

Rose, L., et al.

http://www.intensivecriticalcarenursing.com/article/S0964-3397(13)00116-X/abstract?rss=yes

To compare memories and recall of intensive care unit and specialised weaning centre admission, characterise health-related quality of life and psychological morbidity, and examine the relationship between delusional memories and psychological outcomes.