Welcome to the 302nd Critical Care Reviews Newsletter, bringing you the best critical care research and open access articles from across the medical literature over the past seven days. With the 30th Annual ESICM Congress just starting in Vienna, there are a host of trials released, with more to come over the next few days. As a result, it's a massive newsletter, with no less than 10 RCTs in total, including the EAT-ICU trial, evaluating early goal-directed nutrition, an interesting trial on airway pressure release ventilation, with results that seem a little too good to be true (or maybe I'm just a skeptic about APRV...), spontaneous breathing trials and a biomarker-based strategy for early discontinuation of empirical antifungal treatment. There are also great guidelines, including one on the management of cardiogenic shock and another on paediatric mechanical ventilation.
If you're struggling to get through this vast range of great papers, and just want one narrative review to read, try this paper on augmented renal clearance in critical Illness.
Three of the big trials we will be discussing at the Critical Care Reviews Meeting 2018 will have their results presented at Vienna - TRANSFUSE, BREATHE & ART. Usually the hot topics sessions are live streamed on Tuesday and Wednesday afternoons European time, but I'm not sure this year as there is no information regarding this on the ESICM website at present. I'll aim to send out the traditional supplementary newsletter on Wednesday evening, providing links to all the published hot trials.
Randomised Controlled Trials
- Abstract: Allingstrup. Early goal-directed nutrition versus standard of care in adult intensive care patients: the single-centre, randomised, outcome assessor-blinded EAT-ICU trial. Intensive Care Med 2017;epublished September 22nd
- Full Text: Zhou. Early application of airway pressure release ventilation may reduce the duration of mechanical ventilation in acute respiratory distress syndrome. Intensive Care Med 2017;epublished September 22nd
- Abstract: Fernandez. Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicenter randomized controlled trial. Intensive Care Med 2017;epublished September 22nd
- Abstract: Rouzé. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial. Intensive Care Med 2017;epublished September 22nd
- Abstract: Flaatten. The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years). Intensive Care Med 2017;epublished September 22nd
- Abstract: Robert. Terminal weaning or immediate extubation for withdrawing mechanical ventilation in critically ill patients (the ARREVE observational study). Intensive Care Med 2017;epublished September 22nd
- Abstract: Chanques. Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients (SOS-Ventilation): a randomised, parallel-group clinical trial. Lancet Respir Med 2017;epublished September 18th
- Abstract: Lei. Cerebral oximetry and postoperative delirium after cardiac surgery: a randomised, controlled trial. Anaesthesia 2017;epublished September 22nd
- Abstract: Bassi. Randomized, multicenter trial of lateral Trendelenburg versus semirecumbent body position for the prevention of ventilator-associated pneumonia. Intensive Care Med 2017;epublished June 20th
- Abstract: Lei. Cerebral oximetry and postoperative delirium after cardiac surgery: a randomised, controlled trial. Anaesthesia 2017;epublished September 22nd
- Full Text: Leung. Perioperative Gabapentin Does Not Reduce Postoperative Delirium in Older Surgical Patients: A Randomized Clinical Trial. Anesthesiology 2017;127:633-644
- Abstract: Hui. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative CareA Randomized Clinical Trial. JAMA 2017;318(11):1047-1056
- Abstract: Wu. Administration of Hypertonic Solutions for Hemorrhagic Shock: A Systematic Review and Meta-analysis of Clinical Trials. Anesth Analg 2017;epublished September 19th
- Abstract: Dupont. Antifungal Prevention of Systemic Candidiasis in Immunocompetent ICU Adults: Systematic Review and Meta-Analysis of Clinical Trials. Crit Care Med 2017;epublished August 28th
- Abstract: Ng. Continuous infusion vs. intermittent bolus injection of furosemide in acute decompensated heart failure: systematic review and meta-analysis of randomised controlled trials. Anaesthesia 2017;epublished September 22ndepublished September 22nd
- Abstract: Pieters. Videolaryngoscopy vs. direct laryngoscopy use by experienced anaesthetists in patients with known difficult airways: a systematic review and meta-analysis. Anaesthesia 2017;epublished September 22nd
- Abstract: Bikdeli. Inferior Vena Cava Filters to Prevent Pulmonary Embolism. Systematic Review and Meta-Analysis. JACC 2017;70(13):
- Abstract: Póvoa. Effect of antibiotics administered via the respiratory tract in the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis. J Crit Care 2017;epublished September 16th
- Abstract: Hartings. Subarachnoid blood acutely induces spreading depolarizations and early cortical infarction. Brain 2017;epublished September 6th
- Abstract: Wandling. Association of Prehospital Mode of Transport With Mortality in Penetrating TraumaA Trauma System–Level Assessment of Private Vehicle Transportation vs Ground Emergency Medical Services. JAMA Surg 2017;September 20th
- Abstract: Lilley. End-of-Life Care in Older Patients After Serious or Severe Traumatic Brain Injury in Low-Mortality Hospitals Compared With All Other Hospitals. JAMA Surg 2017;epublished September 20th
- Abstract: Skrifvars. Erythropoietin in patients with traumatic brain injury and extracranial injury-A post hoc analysis of the erythropoietin traumatic brain injury trial. J Trauma Acute Care Surg 2017;83(3):449-456
- Veltkamp. Management of Spontaneous Intracerebral Hemorrhage. Curr Neurol Neurosci Rep 2017;17:80
- Viski. Use of Transcranial Doppler in Intensive Care Unit. The Journal of Critical Care Medicine 2017;3(3):99-104
- Mizuma. Anti-Inflammatory Targets for the Treatment of Reperfusion Injury in Stroke. Front Neurol 2017;8:467
- Stovell. Assessing Metabolism and Injury in Acute Human Traumatic Brain Injury with Magnetic Resonance Spectroscopy: Current and Future Applications. Front Neurol 2017;8:426
- Bai. A Review of Resting-State Electroencephalography Analysis in Disorders of Consciousness. Front Neurol 2017;8:471
- Hoffer. Repositioning drugs for traumatic brain injury - N-acetyl cysteine and Phenserine. J Biomed Sci 2017;24:71
- Singh. Echocardiographic Evaluation of Hemodynamics in Neonates and Children. Front Pediatr 2017;5:201
- Tan. A review of bioresorbable scaffolds: hype or hope? Singapore Med J 2017;58(9):512-515
- Y-Hassan. Epidemiology, pathogenesis, and management of takotsubo syndrome. Clinical Autonomic Research 2017;epublished September 15th
- Cahova. Parenteral Nutrition-Associated Liver Disease: The Role of the Gut Microbiota. Nutrients 2017;9(9):987
- Lauterio. Liver transplantation in the treatment of severe iatrogenic liver injuries. World J Hepatol 2017;9(24):1022-1029
- Mahmoud. Augmented Renal Clearance in Critical Illness: An Important Consideration in Drug Dosing. Pharmaceutics 2017;9(3):36
- Mohsenin. Practical approach to detection and management of acute kidney injury in critically ill patient. Journal of Intensive Care 2017;5:57
- Almegren. Reversal of direct oral anticoagulants. Vasc Health Risk Manag 2017;13:287-292
- Young. How I treat pediatric venous thromboembolism. Blood 2017;130:1402-1408
- Piperaki. Klebsiella pneumoniae: Virulence, Biofilm and Antimicrobial Resistance. Pediatric Infectious Disease Journal 2017;36(10):1002–1005
- Orfanu. The Importance of Haemogram Parameters in the Diagnosis and Prognosis of Septic Patients. The Journal of Critical Care Medicine 2017;3(3):105-110
- Matt. The Biological Basis of Chronic Traumatic Encephalopathy following Blast Injury: A Literature Review. Journal of Neurotrauma 2017;34(S1):S-26-S-43
- Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association. Circulation 2017;epublished September 18th
- Kneyber. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC). Intensive Care Med 2017;epublished September 22nd
- The Chinese Stroke Association scientific statement: intravenous thrombolysis in acute ischaemic stroke. Stroke and Vascular Neurology 2017;2:e000074
- 2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non–ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes 2017;10:e000032
- Kelley. Military Blast Exposure and Chronic Neurodegeneration: Summary of Working Groups and Expert Panel Findings and Recommendations. Journal of Neurotrauma 2017;34(S1):S-18-S-25
- Hodgson. Measuring physical function after ICU: one step at a time. Intensive Care Med 2017;epublished September 22nd
- Brown. Focus on palliative care in the ICU. Intensive Care Med 2017;epublished September 20th
- Au. Highlights for Improvement of Scientific Writing for Publication in High Impact Journals. The Journal of Critical Care Medicine 2017;3(3):97-98
- Eldawlatly. Has goal directed fluid therapy and glycocalyx a role in enhanced recovery after anesthesia?. Saudi J Anaesth 2017;11:381-3
- Ibrahim. Seeing is Believing: Using Visual Abstracts to Disseminate Scientific Research. Am J Gastroenterol 2017;epublished September 19th
- Samuel. Immunotherapy in liver transplantation. Journal of Hepatology 2017;67(4):874-875
- Chawla. 'One-size-fits-all’ threshold for P values under fire. Nature 2017;epublished September 19th
It's now just 4 months until the Critical Care Reviews Meeting 2018, where the chief investigators for the best critical care trials of 2017 come to discuss their work and try to answer the question clinicians want to know - should I change my practice based on this trial? From Brisbane, Australia, Prof Bala Ventakesh will explore the ADRENAL trial, examining hydrocortisone in septic shock in the biggest sepsis trial ever undertaken. Working between Dublin and Melbourne, Prof Alistair Nichol will explain the findings of the TRANSFUSE trial, comparing transfusion of the freshest available blood with standard issued red cells. From Nantes, France, Dr Jean-Baptiste Lascarrou will consider the findings of the MACMAN trial, evaluating video laryngoscopy in the ICU. Dr Ashish Khanna, from the Cleveland Clinic, USA, will reflect on ATHOS-3 the first large clinical trial examining angiotensin II in septic shock. Prof Gavin Perkins, from Warwick in England, will discuss his multi-centre randomized controlled trial Breathe, evaluating the role of extubation to non-invasive ventilation in patients failing spontaneous breathing trials. Prof John Simpson, from Newcastle, England, will discuss the VAP-RAPID trial, evaluating the use of a biomarker-guided approach to exclude ventilator-associated pneumonia. The final trial added to the programme is the ART Trial. Prof Alexandre Biasi Cavalcanti (São Paulo) will explain this Brazilian investigation testing alveolar recruitment in ARDS.
We also have Prof Andrew Rhodes, from London, exploring the latest iteration of the Surviving Sepsis Campaign, published earlier this year and Dr Sophie Wallace (Perth, Australia), who will deliver the honorary John Hinds Trauma Lecture, entitled "Disaster on Everest - Trauma at the Top of the World"
We sold out #CCR17 and had to turn people away. At present we are way up on registrations compared to the same time-point in 2016. So, if you intend on coming, don't leave it too late to register. There is plenty of space still at present, but I expect the meeting will sell out well before it's date of Friday January 19th. Don't worry if you can't make it, as the talks will be recorded and put online for free viewing as usual. However, there is nothing like being there in person and having the opportunity to chat with these chief investigators. Numbers are strictly limited to ensure this remains a small, intimate meeting. It would be a shame to miss out......
The ANZICS/ACCCN Annual Scientific Meeting, which incorporates the annual Paediatric and Neonatal Intensive Care Conference, will be held at the Gold Coast Convention and Exhibition Centre, 11-13 October 2017. The Annual Scientific Meeting will be the preeminent critical care conference in Australasia for the calendar year and will be an important platform that will allow doctors, nurses and allied health practitioners to meaningfully connect and discuss new developments and research in the field of intensive and critical care.
The theme of the Meeting is “Thinking Outside the Flags” and will focus upon innovative and challenging advances that lie outside the safe zone of current practice, as well as the potential dangers that they may bring. A number of highly regarded international speakers will join our distinguished national and local speakers, experts in the field of intensive care medicine, nursing and allied health, promising delegates an exciting and challenging program.
Registration and the call for abstracts will open on 20 March 2017. For further information or to express your interest in attending, please visit http://intensivecareasm2017.com.au/.
#BMBTL17 is a conference on resuscitation that focuses on the skills and knowledge needed to bring your critically ill patients…back to life !
With cutting edge topics and a world class faculty, the conferences will be packed with clinical pearls and only the stuff that matters !
Ventilation, airway, EKGs, pediatric pearls, ultrasound and so much more…don’t miss this amazing conference ! It will be held on October 16th 2017 in downtown Montreal.
FemInEM.org is excited to bring you our first ever, in person conference, FIX2017! The FemInEM Idea Exchange is all about education, inspiration and motivation. Our world renowned faculty will speak from their hearts and minds, providing the substance and spark for you to change the world. We will meet, greet and motivate each other, pushing the limits of our previous selves. You won't want to miss it - October 4th to 6th, NYC.
State-of-the-Art is back, for the 3rd year of its new format and an all-new venue in Liverpool for 2017. The futurism and innovation theme continues with novel topics including robotics, optical imaging of bacterial infection, new technology in patient recovery, and new device interventions in acute cardiology.
However, the focus on day-to-day care is not lost, and there are clinical updates in acute medicine, ARDS, mechanical ventilation, trauma, nutrition, rehabilitation, endocrine management in ICU, cancer patients in ICU, the difficult and altered airway, and much more. Pragmatic "how I treat..." sessions proved popular last year and will continue, along with meaningful debates on UK critical care, including the trend toward centralisation.
In addition, the trademark vibe of SOA will still be there with pop-up talks, panel debates, 'meet the expert' booths, new generation video e-posters, parent and infant facilities, two drinks evenings, and a new final night after-party. Registration and abstract submission is now open at http://soa.ics.ac.uk.
We are very pleased to announce the 6th International Fluid Academy Days (iFAD), which will take place on November 23-25th 2017 at the Hilton Hotel in Antwerp, Belgium. The iFAD is an innovative Critical Care Educational meeting in true SMACC spirit. This conference provides the highest quality of Critical Care education and is guaranteed to innovate and inspire. Recent advances in fluid management, and hemodynamic and organ function monitoring in the critical care setting will be reviewed in a comprehensive manner for intensivists, anaesthesiologists and emergency physicians as well as interested internists and surgeons.
The iFAD Faculty is the most provocative, engaging, motivating and inspiring group of international educational speakers and as organizing committee we want to ensure we have the participants, sponsors and endorsers to match. Together, we make iFAD stand apart from other Critical Care conferences.
Critical Care Horizons is a fresh new voice in the critical care literature, offering thought-provoking, cutting-edge commentary and opinion papers, plus state-of-the-art review articles. The journal is free to publish with and free to read, opening authorship opportunity to all. The energetic editorial board consists of a deliberate mix of clinicians active in social media and world renowned academics, all driven by a desire to improve the care we offer our patients, and operate without financial gain or incentive. If you have an idea for a paper, and can say it in an engaging manner, please get in touch. We also need peer reviewers.
COI - I am the editor-in-chief of this new journal, but work in a voluntary capacity, as do all the editors.
I hope you find these links useful.
Until next week
Supported by the Health Research Board