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.
Friday, 31 July 2009
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.
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.
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.
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
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]
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
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.
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).
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.
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.
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.
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.
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.
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.
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.
Subscribe to:
Posts (Atom)