July 1st 2012
Welcome to the 30th Critical Care Reviews Newsletter. Every week, now over three hundred clinical and scientific journals are monitored and the most important and interesting research publications in critical care are highlighted. These studies are added to the Current Articles section of the website on a daily basis, as publication occurs. A link to either the full text or abstract, depending on the publishers degree of open access, is attached. Also, links to other important papers, such as guidelines or consensus statements are included. Free review articles from across the medical literature are also highlighted.
It's a very interesting newsletter this week, with the landmark Scandanavian 6S study providing further evidence of the dangers of hydroxyethyl starch in the critically ill, with increased mortality and no lower safe dose identified.
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New England Journal of Medicine: Fluid Resuscitation
New England Journal of Medicine: Infective Endocarditiis
In a randomized trial Kang et al compared early valve surgery with conventional-treatment in 76 patients with left-sided infective endocarditis, severe valve disease, and large vegetations. The primary end point, a composite of in-hospital death and embolic events that occurred within 6 weeks after randomization, occurred in 1 patient (3%) in the early-surgery group as compared with 9 (23%) in the conventional-treatment group (hazard ratio 0.10; 95% CI 0.01 to 0.82; P=0.03). Although there was no significant difference in all-cause mortality at 6 months in the early-surgery and conventional-treatment groups (3% and 5%, respectively; hazard ratio, 0.51; 95% CI, 0.05 to 5.66; P=0.59), the rate of the composite end point of death from any cause, embolic events, or recurrence of infective endocarditis at 6 months was 3% in the early-surgery group and 28% in the conventional-treatment group (HR 0.08; 95% CI 0.01 to 0.65; P=0.02).
As meropenem bactericidal activity depends on the duration of free drug concentration above the minimum inhibitory concentration, Chytra et al compared the clinical and microbiological efficacy of continuous versus intermittent meropenem dosing in 240 critically ill patients. Although clinical cure was similar between the two therapies (infusion: 83.0% versus bolus: 75.0%; P = 0.180), microbiological success was higher in the infusion group (90.6% vs. 78.4%; P = 0.020), with multivariate logistic regression identifying continuous administration as an independent predictor of microbiological success (OR = 2.977; 95% CI = 1.050 to 8.443; P = 0.040). Additionally, continuous infusion was associated with shorter ICU length-of-stay (10 [7-14] days vs. 12 [7-19] days; P = 0.044), as well as shorter duration of meropenem therapy (7 [6-8] days vs. 8 [7-10] days; P = 0.035) and lower total dose of meropenem (24 [21-32] grams vs. 48 [42-60] grams; P <0.0001). No severe adverse events related to meropenem administration in either group were observed.
Critical Care: Sepsis
In an interetsing paper, Tao et al compile the top 50 most cited clinical studies in sepsis. A large American influence is identified, with the majority of studies being American, published in American journals and being cited by American authors. The most influential journals were NEJM and JAMA. The most cited paper was the PROWESS study, being cited 2932 times.
- Tao. The top cited clinical research articles on sepsis: a bibliometric analysis. Critical Care 2012, 16:R110
European Heart Journal: Heart Failure
Full Text: McMurray. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012 epublished ahead of print
Journal of Parenteral & Enteral Nutrition: Glycaemic Control
Perioperative Medicine: Fluid Management
Review - Clinical
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine: Sepsis
- Perman. Initial Emergency Department Diagnosis and Management of Adult Patients with Severe Sepsis and Septic Shock.Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:41
Cerebrovascular Diseases: Stroke
Pulmonary Circulation: Pulmonary Hypertension
- Perez. Diagnosis and management of pulmonary hypertension associated with left ventricular diastolic dysfunction. Pulm Circ 2012;2:163-169
Respirology: Morbid Obesity
- Bahammam. Managing acute respiratory decompensation in the morbidly obese. Respirology 2012;17:759–771
Open Access Emergency Medicine: Pleural Effusion
- Karkhanis. Pleural effusion: diagnosis, treatment, and management. Open Access Emergency Medicine 2012:4 31–52
Infection and Drug Resistance: Linezolid
- Ager. Clinical update on linezolid in the treatment of Gram-positive bacterial infections. Infection and Drug Resistance 2012:5 87–102
Review - Non-Clinical
Respirology: Research Grants
- Eastwood. How to write research papers and grants: 2011 Asian Pacific Society for Respirology Annual Scientific Meeting Postgraduate Session. Respirology 2012;17: 792–801
I hope you find these links and brief summaries useful.
Until next week