Critical Care Medicine

Waleed Alhazzani, Morten Hylander Møller, Yaseen M Arabi, Mark Loeb, Michelle Ng Gong, Eddy Fan, Simon Oczkowski, Mitchell M Levy, Lennie Derde, Amy Dzierba, Bin Du, Michael Aboodi, Hannah Wunsch, Maurizio Cecconi, Younsuck Koh, Daniel S Chertow, Kathryn Maitland, Fayez Alshamsi, Emilie Belley-Cote, Massimiliano Greco, Matthew Laundy, Jill S Morgan, Jozef Kesecioglu, Allison McGeer, Leonard Mermel, Manoj J Mammen, Paul E Alexander, Amy Arrington, John E Centofanti, Giuseppe Citerio, Bandar Baw, Ziad A Memish, Naomi Hammond, Frederick G Hayden, Laura Evans, Andrew Rhodes
BACKGROUND: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. METHODS: We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU...
March 27, 2020: Critical Care Medicine
Hon-Kan Yip, Wen-Feng Fang, Yi-Chen Li, Fan-Yen Lee, Chen-Hsiang Lee, Sung-Nan Pei, Ming-Chun Ma, Kuan-Hung Chen, Pei-Hsun Sung, Mel S Lee
OBJECTIVES: To investigate the safety, feasibility, and possible adverse events of single-dose human umbilical cord-derived mesenchymal stem cells in patients with moderate-to-severe acute respiratory distress syndrome. DESIGN: Prospective phase I clinical trial. SETTING: Medical center in Kaohsiung, Taiwan. PATIENTS: Moderate-to-severe acute respiratory distress syndrome with a PaO2/FIO2 ratio less than 200. INTERVENTIONS: Scaling for doses was required by Taiwan Food and Drug Administration as follows: the first three patients received low-dose human umbilical cord-derived mesenchymal stem cells (1...
March 13, 2020: Critical Care Medicine
Tanuwong Viarasilpa, Nicha Panyavachiraporn, Seyed Mani Marashi, Meredith Van Harn, Robert G Kowalski, Stephan A Mayer
OBJECTIVES: To identify risk factors and develop a prediction score for in-hospital symptomatic venous thromboembolism in critically ill patients. DESIGN: Retrospective cohort study. SETTING: Henry Ford Health System, a five-hospital system including 18 ICUs. PATIENTS: We obtained data from the electronic medical record of all adult patients admitted to any ICU (total 264 beds) between January 2015 and March 2018. INTERVENTIONS: None...
March 13, 2020: Critical Care Medicine
Pei Chien Tah, Zheng-Yii Lee, Bee Koon Poh, Hazreen Abdul Majid, Vineya-Rai Hakumat-Rai, Mohd Basri Mat Nor, Chee Cheong Kee, Mazuin Kamarul Zaman, M Shahnaz Hasan
OBJECTIVES: Several predictive equations have been developed for estimation of resting energy expenditure, but no study has been done to compare predictive equations against indirect calorimetry among critically ill patients at different phases of critical illness. This study aimed to determine the degree of agreement and accuracy of predictive equations among ICU patients during acute phase (≤ 5 d), late phase (6-10 d), and chronic phase (≥ 11 d). DESIGN: This was a single-center prospective observational study that compared resting energy expenditure estimated by 15 commonly used predictive equations against resting energy expenditure measured by indirect calorimetry at different phases...
March 10, 2020: Critical Care Medicine
Sapna R Kudchadkar, Archana Nelliot, Ronke Awojoodu, Dhananjay Vaidya, Chani Traube, Tracie Walker, Dale M Needham
OBJECTIVES: With decreasing mortality in PICUs, a growing number of survivors experience long-lasting physical impairments. Early physical rehabilitation and mobilization during critical illness are safe and feasible, but little is known about the prevalence in PICUs. We aimed to evaluate the prevalence of rehabilitation for critically ill children and associated barriers. DESIGN: National 2-day point prevalence study. SETTING: Eighty-two PICUs in 65 hospitals across the United States...
March 10, 2020: Critical Care Medicine
Sarah J Doran, Rebecca J Henry, Kari Ann Shirey, James P Barrett, Rodney M Ritzel, Wendy Lai, Jorge C Blanco, Alan I Faden, Stefanie N Vogel, David J Loane
OBJECTIVES: Respiratory infections in the postacute phase of traumatic brain injury impede optimal recovery and contribute substantially to overall morbidity and mortality. This study investigated bidirectional innate immune responses between the injured brain and lung, using a controlled cortical impact model followed by secondary Streptococcus pneumoniae infection in mice. DESIGN: Experimental study. SETTING: Research laboratory. SUBJECTS: Adult male C57BL/6J mice...
March 5, 2020: Critical Care Medicine
Daniel E Leisman, Michael O Harhay, David J Lederer, Michael Abramson, Alex A Adjei, Jan Bakker, Zuhair K Ballas, Esther Barreiro, Scott C Bell, Rinaldo Bellomo, Jonathan A Bernstein, Richard D Branson, Vito Brusasco, James D Chalmers, Sudhansu Chokroverty, Giuseppe Citerio, Nancy A Collop, Colin R Cooke, James D Crapo, Gavin Donaldson, Dominic A Fitzgerald, Emma Grainger, Lauren Hale, Felix J Herth, Patrick M Kochanek, Guy Marks, J Randall Moorman, David E Ost, Michael Schatz, Aziz Sheikh, Alan R Smyth, Iain Stewart, Paul W Stewart, Erik R Swenson, Ronald Szymusiak, Jean-Louis Teboul, Jean-Louis Vincent, Jadwiga A Wedzicha, David M Maslove
Prediction models aim to use available data to predict a health state or outcome that has not yet been observed. Prediction is primarily relevant to clinical practice, but is also used in research, and administration. While prediction modeling involves estimating the relationship between patient factors and outcomes, it is distinct from casual inference. Prediction modeling thus requires unique considerations for development, validation, and updating. This document represents an effort from editors at 31 respiratory, sleep, and critical care medicine journals to consolidate contemporary best practices and recommendations related to prediction study design, conduct, and reporting...
March 4, 2020: Critical Care Medicine
M Elizabeth Wilcox, David A Harrison, Akshay Patel, Kathryn M Rowan
OBJECTIVES: To determine whether patients admitted to an ICU during times of strain, when compared with its own norm (i.e. accommodating a greater number of patients, higher acuity of illness, or frequent turnover), is associated with a higher risk of death in ICUs with closed models of intensivist staffing. DESIGN: We conducted a large, multicenter, observational cohort study. Multilevel mixed effects logistic regression was used to examine relationships for three measures of ICU strain (bed census, severity-weighted bed census, and activity-weighted bed census) on the day of admission with risk-adjusted acute hospital mortality...
March 3, 2020: Critical Care Medicine
Markita L Suttle, Margaret A Chase, William C Sasser, Melissa Moore-Clingenpeel, Tensing Maa, Jason A Werner, Meredith F Bone, Donald L Boyer, Karen J Marcdante, Katherine E Mason, Megan E McCabe, Richard B Mink, Felice Su, David A Turner
OBJECTIVES: Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development. DESIGN: Cross-sectional observational study. SETTING: Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs across the United States. SUBJECTS: Pediatric critical care medicine fellows and program directors...
March 1, 2020: Critical Care Medicine
Tiago Granja, Kurt Hohenstein, Patricia Schüssel, Claudius Fischer, Thomas Prüfer, David Schibilsky, Hans Peter Wendel, Karl Jaschonek, Lina Serna-Higuita, Christian Schlensak, Helene Häberle, Peter Rosenberger, Andreas Straub
OBJECTIVES: Extracorporeal membrane oxygenation is used to stabilize severe cardiocirculatory and/or respiratory failure. However, extracorporeal membrane oxygenation is associated with a coagulopathy characterized by thromboembolic and hemorrhagic complications. This study aimed to characterize the pathomechanism of the extracorporeal membrane oxygenation-associated coagulopathy and identify options to optimize its monitoring and therapy. DESIGN: Prospective observational clinical trial...
February 28, 2020: Critical Care Medicine
Anthony J Wilson, Fraser Magee, Michael Bailey, David V Pilcher, Craig French, Alistair Nichol, Andrew Udy, Carol L Hodgson, D James Cooper, Michael C Reade, Paul Young, Rinaldo Bellomo
OBJECTIVES: To compare the characteristics of adults admitted to the ICU in Australia and New Zealand after trauma with nonelective, nontrauma admissions. To describe trends in hospital mortality and rates of discharge home among these two groups. DESIGN: Retrospective review (2005-2017) of the Australia and New Zealand Intensive Care Society's Center for Outcome and Resource Evaluation Adult Patient Database. SETTING: Adult ICUs in Australia and New Zealand...
February 27, 2020: Critical Care Medicine
Erin F Carlton, John P Donnelly, Matthew K Hensley, Timothy T Cornell, Hallie C Prescott
OBJECTIVES: Severe sepsis is a significant cause of healthcare utilization and morbidity among pediatric patients. However, little is known about how commonly survivors acquire new medical devices during pediatric severe sepsis hospitalization. We sought to determine the rate of new device acquisition (specifically, tracheostomy placement, gastrostomy tube placement, vascular access devices, ostomy procedures, and amputation) among children surviving hospitalizations with severe sepsis...
February 27, 2020: Critical Care Medicine
Sung-Min Cho, Romergryko G Geocadin, Giorgio Caturegli, Vanessa Chan, Bartholomew White, Jeffrey Dodd-O, Bo Soo Kim, Marc Sussman, Chun Woo Choi, Glenn Whitman, Liam L Chen
OBJECTIVES: Current studies lack information on characteristics of acute brain injury in patients with extracorporeal membrane oxygenation. We sought to characterize the types, timing, and risk factors of acute brain injury in extracorporeal membrane oxygenation. DESIGN: Retrospective analysis. SETTING: We reviewed the extracorporeal membrane oxygenation patients who had undergone brain autopsy with gross and microscopic examinations from January 2009 to December 2018 from a single tertiary center...
February 25, 2020: Critical Care Medicine
Jakob Wollborn, Christoph Steiger, Soroush Doostkam, Nils Schallner, Nils Schroeter, Fabian A Kari, Lorenz Meinel, Hartmut Buerkle, Martin A Schick, Ulrich Goebel
OBJECTIVES: Neurologic damage following cardiac arrest remains a major burden for modern resuscitation medicine. Cardiopulmonary resuscitation with extracorporeal circulatory support holds the potential to reduce morbidity and mortality. Furthermore, the endogenous gasotransmitter carbon monoxide attracts attention in reducing cerebral injury. We hypothesize that extracorporeal resuscitation with additional carbon monoxide application reduces neurologic damage. DESIGN: Randomized, controlled animal study...
February 24, 2020: Critical Care Medicine
Kollengode Ramanathan, Chuen Seng Tan, Peter Rycus, Marc Anders, Roberto Lorusso, John J Y Zhang, Graeme MacLaren
OBJECTIVES: We examined data from the International Registry of the Extracorporeal Life Support Organization to identify risk factors for mortality in pregnant and peripartum patients receiving extracorporeal membrane oxygenation. DESIGN: Retrospective analysis. SETTING: International Registry of Extracorporeal Life Support Organization. PATIENTS: We collected de-identified data on all peripartum patients who needed extracorporeal membrane oxygenation between 1997 and 2017 using International Classification of Diseases, 9th and 10th Edition criteria...
February 21, 2020: Critical Care Medicine
Nishkantha Arulkumaran, Muska Khpal, Karen Tam, Aravindhan Baheerathan, Carlos Corredor, Mervyn Singer
OBJECTIVE: To investigate methods of antibiotic duration minimization and their effect on mortality and infectious complications in critically ill patients. DATA SOURCES: A systematic search of PubMed, Embase (via Ovid),, and the Cochrane Central Register of Controlled Trials (via Wiley) (CENTRAL, Issue 2, 2015). STUDY SELECTION: Randomized clinical trials comparing strategies to minimize antibiotic duration (days) for patients with infections or sepsis in intensive care...
February 21, 2020: Critical Care Medicine
James O'Rourke, Michal Soták, Gerard F Curley, Aoife Doolan, Tomáš Henlín, Gerard Mullins, Tomáš Tyll, William Omlie, Marco V Ranieri
OBJECTIVES: Maintaining diaphragm work using electrical stimulation during mechanical ventilation has been proposed to attenuate ventilator-induced diaphragm dysfunction. This study assessed the safety and feasibility of temporary percutaneous electrical phrenic nerve stimulation on user-specified inspiratory breaths while on mechanical ventilation. DESIGN: Two-center, nonblinded, nonrandomized study. SETTING: Hospital ICU. PATIENTS: Twelve patients mechanically ventilated from 48 hours to an expected 7 days...
February 21, 2020: Critical Care Medicine
Niccolò Buetti, Stéphane Ruckly, Jean-Christophe Lucet, Anne Perozziello, Olivier Mimoz, Bertrand Souweine, Jean-François Timsit
OBJECTIVES: Little is known on causative pathogens of intravascular catheters infection according to the catheter insertion site. The present study aimed to describe the epidemiology of causative microorganisms of catheter-related infection and colonization according to the insertion site. DESIGN: Multicenter observational study using data from four large randomized controlled trials investigating different prevention strategies in which extensive prospective high-quality data collection at catheter insertion and catheter removal was performed...
February 20, 2020: Critical Care Medicine
Araujo de Franca Sabrina, Wagner M Tavares, Angela S M Salinet, Wellingson S Paiva, Manoel J Teixeira
OBJECTIVES: To elucidate the impact of early tracheostomy on hospitalization outcomes in patients with traumatic brain injury. DATA SOURCES: Lilacs, PubMed, and Cochrane databases were searched. The close-out date was August 8, 2018. STUDY SELECTION: Studies written in English, French, Spanish, or Portuguese with traumatic brain injury as the base trauma, clearly formulated question, patient's admission assessment, minimum follow-up during hospital stay, and minimum of two in-hospital outcomes were selected...
February 20, 2020: Critical Care Medicine
Alexandra Binnie, Jennifer L Y Tsang, Pingzhao Hu, Gabriela Carrasqueiro, Pedro Castelo-Branco, Claudia C Dos Santos
OBJECTIVES: Recent evidence from the fields of microbiology and immunology, as well as a small number of human sepsis studies, suggest that epigenetic regulation may play a central role in the pathogenesis of sepsis. The term "epigenetics" refers to regulatory mechanisms that control gene expression but are not related to changes in DNA sequence. These include DNA methylation, histone modifications, and regulation of transcription via non-coding RNAs. Epigenetic modifications, occurring in response to external stressors, lead to changes in gene expression, and thus lie at the intersection between genetics and the environment...
February 20, 2020: Critical Care Medicine
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"