ccr logo 246x225 13121Critical Care Reviews Newsletter

July 15th 2012





Welcome to the 32nd 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 been a relatively quiet week for research, with no major studies being published, although there is a wide variety of new review articles linked to, including great papers on venothromboembolism prophylaxis in traumatic brain injury and the interesting technique of submental tracheal intubation.

The topic for This Week's Papers is circulatory monitoring, and starts with a review on cardiac output monitoring in today's Paper of the Day. It's an easy way to stay up-to-date with your reading.

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JAMA:     Coronary Artery Bypass Grafting

Newman et al performed a multi-centre, randomized, placebo-controlled trial investigating acadesine, a first-in-class adenosine-regulating agent, on a composite endpoint of all-cause mortality, nonfatal stroke, or need for mechanical support for severe left ventricular dysfunction in the setting of coronary artery bypass grafting surgery. The trial was stopped for futility after 3080 of the planned 7500 study participants were randomized. There was no difference in the primary outcome {placebo group: 75/1493 (5.0%) versus acadesine group: 76/1493 (5.1%); odds ratio 1.01 [95% CI, 0.73-1.41]} or secondary outcomes.

Full Text:  Newman. Effect of Adenosine-Regulating Agent Acadesine on Morbidity and Mortality Associated With Coronary Artery Bypass GraftingThe RED-CABG Randomized Controlled Trial. JAMA 2012;308(2):157-164


Anesthesia & Analgesia:     Perioperative Oxygen Therapy

In a follow up of the PROXI study cohort, Meyhoff et al compared the outcomes of1382 of 1386 patients who underwent abdominal surgery a median 2.3 years post randomisation to either 30% or 80% perioperative oxygen therapy. Mortality was significantly increased in the hyperoxia group {159/685 (23.2%) vs 128/701 (18.3%); hazard risk 1.30, 95% CI 1.03 to 1.64, P=0.03). The difference was significant for patients undergoing cancer surgery (HR 1.45; 95% CI, 1.10 to 1.90; P = 0.009) but not for patients undergoing non-cancer surgery (HR 1.06; 95% CI, 0.69 to 1.65; P = 0.79).

Abstract:  Mayhoff. Increased Long-Term Mortality After a High Perioperative Inspiratory Oxygen Fraction During Abdominal Surgery: Follow-Up of a Randomized Clinical Trial. Anesth Analg 2012


Critical Care:     Acute Kidney Injury

In a registry study, Gammelager et al evaluated the mortality risk of acute kidney injury in 30,762 critically ill Danish patients, of which 4,793 (15.6%) had AKI at ICU admission. 30 day mortality, with corresponding hazard ratios relative to non-AKI patients, for patients using the RIFLE classification, were: No AKI - 12.8%,  Risk - 35.5%, HR 1.96 (95% CI 1.80-2.13); Injury - 44.2%, HR 2.60 (95% CI: 2.38-2.85); Failure - 41.0%, HR 2.41 (95% CI: 2.21-2.64). For patients surviving 30 days (n=25,539), 1 year mortality with associated hazard ratios, were: No AKI - 10.7%; Risk - 20.5%, HR 1.33 (95% CI: 1.17-1.51); Injury - 23.8%, HR 1.60 (95% CI: 1.37-1.87); Failure - 23.2%, HR 1.64 (95% CI: 1.42-1.90).

Full Text:  Gammelager. One-year mortality among Danish intensive care patients with acute kidney injury: a cohort study. Critical Care 2012;16:R124


Review - Clinical

Chest:     Ventilator-Associated Pneumonia


Journal of Anaesthesiology Clinical Pharmacology:     Submental Intubation


Journal of Anaesthesiology Clinical Pharmacology:     Renal Replacement Therapy


Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine:     Massive Haemorrhage


Annals of Intensive Care:     Systemic Inflammatory Response Syndrome


European Surgical Research:     Tissue Engineering


European Surgical Research:     Wound Repair


European Surgical Research:     Enhanced Recovery


European Journal of Anaesthesiology:     Neonatal Resuscitation


Minerva Anestesiologica:     Neuromonitoring


Minerva Anestesiologica:     Procalcitonin


Minerva Anestesiologica:     Respiratory Failure


Minerva Anestesiologica:     Non-Invasive Ventilation


Review - Non-Clinical

 Canadian Medical ssociation Journal:     Professionalism



I hope you find these brief summaries and links useful.

Until next week