ccr logo 246x225 13121Critical Care Reviews Newsletter

June 18th 2012





Welcome to the 28th Critical Care Reviews Newsletter. Every week over two 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 study that sank APC having being published, and the first guideline to recommend largely avoiding the use of colloids in the critically ill being released by the European Society of Intensive Care Medicine. 

The topic for This Week's Papers is thyroid disorders, starting with thyroid dysfunction in today's Paper of the Day. It's a free and easy way to stay up-to-date with your reading.



Lancet:     Tissue Engineering

Olausson et al report  the management of a 10 year old girl with extrahepatic portal vein obstruction treated with a novel venous bypass between the superior mesenteric vein and the intrahepatic left portal vein. A 9 cm segment of allogeneic donor iliac vein was decellularised and subsequently recellularised with endothelial and smooth muscle cells differentiated from stem cells obtained from the bone marrow of the recipient. The graft immediately provided the recipient with a functional blood supply enabling substantially improved physical and mental function and growth. No anti-endothelial cell antibodies developed and no immunosuppressive drugs have been required.

Abstract: Olausson. Transplantation of an allogeneic vein bioengineered with autologous stem cells: a proof-of-concept study. Lancet 2012; epublished ahead of print


Lancet:     Stroke

Dávalos et al undertook an international, randomised, placebo-controlled, sequential trial of citicoline in 2298 patients with moderate-to-severe acute ischaemic stroke. The trial was stopped early for futility as global recovery was similar in both groups (odds ratio 1·03, 95% CI 0·86—1·25; p=0·364). No significant differences were reported in the safety variables nor in the rate of adverse events.

Abstract: Dávalos. Citicoline in the treatment of acute ischaemic stroke: an international, randomised, multicentre, placebo-controlled study (ICTUS trial). Lancet 2012; epublished ahead of print


Stroke:     Subarachnoid Haemorrhage

To assess the efficacy of clazosentan, an endothelin receptor antagonist, to reduce vasospasm after aneurysmal subarachnoid hemorrhage (SAH), MacDonald et al performed a double-blind, placebo-controlled, randomized phase III trial in 577 patients with SAH treated with endovascular coiling, comparing intravenous clazosentan (5 or 15 mg/h) with placebo. Although clazosenten significantly reduced the primary composite endpoint (all-cause mortality; vasospasm-related new cerebral infarcts or delayed ischemic neurological deficits; rescue therapy for vasospasm) {50/189 of placebo-treated patients (27%), compared with 47/194 patients (24%) treated with clazosentan 5 mg/h (odds ratio [OR], 0.786; 95% CI, 0.479–1.289; P=0.340), and 28/188 patients (15%) treated with clazosentan 15 mg/h (OR, 0.474; 95% CI, 0.275–0.818; P=0.007}, overall outcomes as measured with the extended Glasgow Outcome Scale were not significantly different.

Full Text: MacDonald. Randomized Trial of Clazosentan in Patients With Aneurysmal Subarachnoid Hemorrhage Undergoing Endovascular Coiling. Stroke. 2012; 43:1463-1469


Critical Care:     Trauma PanScan

Yequiayan and colleagues performed a multicenter cohort study on 1950 consecutive patients with severe blunt trauma requiring admission to ICU. The majority of patients (87%) were given whole-body CT, and had significantly lower crude 30-day mortality rate  (16% vs 22%; p=0.02), and mortality risk (adjusted OR = 0.58, 95% CI: 0.34-0.99) in comparison to selective CT patients (p=0.02). Compared to the TRISS predicted survival, survival significantly improved for Only whole-body CT was associated with improved survival compared to TRISS predicted survival; in addition, the pattern of early surgical and medical procedures significantly differed between the two groups.

Full Text: Yeguiayan. Impact of whole-body computed tomographyon mortality and surgical management of severe blunt trauma. Critical Care 2012, 16:R101



Stroke:     Subarachnoid Haemorrhage

Full Text: Connolly. Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage. A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2012; 43: 1711-1737


Review - Clinical

Current Opinion in Critical Care:     Circulatory Monitoring


Cardiology:     Heart Failure


International Journal of General Medicine:     Abdominal Radiograph


Digestive Surgery:     Acute Mesenteric Ischaemia


Clinical and Translational Medicine:     Acute Lung Injury


The Clinical Respiratory Journal:     Pulmonary Fibrosis


Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science


Review - Non-Clinical

 Annals of Intensive Care:     Systems Modeling



I hope you find these brief summaries and links useful.

Until next week