Critical Care & Anaesthesia- August 2011

 

 

Critical Care & Anaesthesia – Evidence Update  

August- 2011

 

 

 


Welcome to the third bulletin highlighting new evidence published on selected topics relating to Critical Care, Anaesthesia, Pain and Resuscitation. Journals such as – Lancet, BMJ, JAMA, NEJM and American Journal of Critical Care Medicine have been scanned to identify relevant articles. Articles from other journals as retrieved via searches on MEDLINE and EMBASE are also listed. This bulletin features evidence published in the previous four weeks. Full text articles can be accessed via your HEFT Athens ID.

Anaesthesia

 

The following sub-topics are covered:

  • Cell salvage in surgery (including obstetric surgery)
  • Anaesthesia and surgical outcomes (including epidurals, regional anaesthesia)
  • Anaesthesia and Immunomodulation
  • Anaesthesia and post operative confusion

 

Title: Chemoprophylaxis without intra-articular wound drainage can replace autotransfusion in primary TKA

Citation: Orthopedics, June 2011, vol./is. 34/6, 0147-7447 (June 2011) Author(s): Hourlier H., Fennema P.

Abstract: The study compared outcomes in 2 groups undergoing total knee arthroplasty (TKA) with different blood-saving strategies (ie, chemoprophylaxis vs reinfusion).

Full Text: Available in fulltext at ProQuest (Legacy Platform)


 

Title: Does use of intraoperative cell-salvage delay recovery in patients undergoing elective abdominal aortic surgery?

Citation: Interactive Cardiovascular and Thoracic Surgery, June 2011, vol./is. 12/6(1028-1032), 1569-9293;1569-9285 (June 2011) Author(s): Tavare A.N., Parvizi N.

Abstract: The study concluded that the use of ICS does not cause increased morbidity or mortality when compared to standard practise of transfusion of allogenic blood, and may actually improve some clinical outcomes. ICS is a useful and safe strategy to minimise use of allogenic blood. Full Text: Available in fulltext at Highwire Press


 

Title: Anesthesia and postoperative delirium in older adults undergoing hip surgery

Citation: Journal of the American Geriatrics Society, July 2011, vol./is. 59/7(1313-1319), 0002-8614;1532-5415 (July 2011) Author(s): Slor C.J., De Jonghe J.F.M., Vreeswijk R., Groot E., Ploeg T.V.D., Van Gool W.A., Eikelenboom P., Snoeck M., Schmand B., Kalisvaart K.J.

Abstract: Ojective of the study was to examine the effects of general anesthesia on the risk of incident postoperative delirium in older adults undergoing hip surgery. Full Text: Available in fulltext at EBSCO Host EJS


 

Title: A liberal preoperative fasting regimen improves patient comfort and satisfaction with anesthesia care in day-stay minor surgery

Citation: Minerva Anestesiologica, July 2011, vol./is. 77/7(680-686), 0375-9393 (July 2011)

Author(s): Bopp C., Hofer S., Klein A., Weigand M.A., Martin E., Gust R.

Abstract: Background. The aim of this study was to evaluate whether a single preoperative limited oral intake of a carbohydrate drink could improve perioperative patient comfort and satisfaction with anesthesia care in elective day-stay ophthalmologic surgery.


 

Title: Rocuronium and sugammadex for rapid sequence induction of obstetric general anaesthesia

Citation: Acta Anaesthesiologica Scandinavica, July 2011, vol./is. 55/6(694-699), 0001-5172; 1399-6576 (July 2011) Author(s): Williamson R.M., Mallaiah S., Barclay P.

Abstract: The study aimed to determine whether rocuronium 1.2mg/kg used for RSI in the obstetric population would provide good intubating conditions at 60 s and would be effectively reversed by sugammadex at the end of surgery.


 

Title: Perioperative cardiac arrest after thoracic epidural analgesia in a patient with increased pulmonary artery pressure

Citation: British Journal of Anaesthesia, July 2011, vol./is. 107/1(108-109), 0007-0912;1471-6771 (July 2011) Author(s): Subash G., Mohammed S.

Full Text: Available in fulltext at EBSCO Host EJS Available in print at Solihull Staff Library


 

Title: Risk, error, outcome, and prevention in pediatric anesthesia: So many issues, lots of good solutions, but where do we find the resources?

Citation: Paediatric Anaesthesia, July 2011, vol./is. 21/7(713-715), 1155-5645;1460-9592 (July 2011) Author(s): Cote C.J.

Full Text: Available in fulltext at EBSCO Host


 

Cardiac arrests/cardiopulmonary resuscitation (CPR)

The following sub-topics are covered:

  • Quality of CPR
  • Use of feedback devices
  • Leadership and team factors

 

Title: New guidelines for newborn resuscitation - A critical evaluation

Citation: Acta Paediatrica, International Journal of Paediatrics, August 2011, vol./is. 100/8(1058-1062), 0803-5253;1651-2227 (August 2011) Author(s): Saugstad O.D.

Abstract: There are still no clear recommendations regarding ventilation, inspiratory time, use of positive end expiratory pressure or continuous positive airway pressure. The guidelines do not mention which paCO<sub>2</sub> level might be optimal. As colour pink assessment and routine suctioning of airways are not recommended anymore, there is an urgent need to obtain international consensus and create a new and revised Apgar score without these two variables.


 

Title: Delivering high-quality cardiopulmonary resuscitation in-hospital

Citation: Current Opinion in Critical Care, June 2011, vol./is. 17/3(225-230), 1070-5295;1531-7072 (June 2011) Author(s): Soar J., Edelson D.P., Perkins G.D.

Abstract: This review discusses recent data relating to delivering high-quality cardiopulmonary resuscitation (CPR) to patients with in-hospital cardiac arrest.


Kindly note the journal literature has not highlighted any evidence on – use of feedback devices in CPR.


 

Critical Care

The following sub-topics are covered:

  • Sepsis – the use of statins, biomarker MMP9
  • Acute lung injury (ALI)/adult respiratory distress syndrome (ARDS)
  • Use of non invasive ventilation (NIV) in weaning
  • Ventilator associate pneumonia (including E.Coli)

 

Title: A matrix metalloprotease-PAR1 system regulates vascular integrity, systemic inflammation and death in sepsis

Citation: EMBO Molecular Medicine, July 2011, vol./is. 3/7(370-384), 1757-4676;1757-4684 (July 2011) Author(s): Tressel S.L., Kaneider N.C., Kasuda S., Foley C., Koukos G., Austin K., Agarwal A., Covic L., Opal S.M., Kuliopulos A.

Abstract: The study identified mouse MMP-1a as an agonist of protease-activated receptor-1 (PAR1) on endothelial cells. MMP-1a was released from endothelial cells in septic mice. Blockade of MMP-1 activity suppressed endothelial barrier disruption, disseminated intravascular coagulation (DIC), lung vascular permeability as well as the cytokine storm and improved survival, which was lost in PAR1-deficient mice. Infusion of human MMP-1 increased lung vascular permeability in normal wild-type mice but not in PAR1-deficient mice. Full Text: Available in fulltext at Wiley


 

Title: The first MMP in sepsis

Citation: EMBO Molecular Medicine, July 2011, vol./is. 3/7(367-369), 1757-4676;1757-4684 (July 2011) Author(s): Vandenbroucke R.E., Dejager L., Libert C.

Full Text: Available in fulltext at Wiley


Citation: Crit Care Med. 2011 Jun 30. [Epub ahead of print]

Title: Effect of pravastatin on the frequency of ventilator-associated pneumonia and on intensive care unit mortality: Open-label, randomized study. Authors:  Makris D, Manoulakas E, Komnos A, Papakrivou E, Tzovaras N, Hovas A, Zintzaras E, Zakynthinos E.

Abstract: The objective of this study was to investigate whether the use of pravastatin reduces the frequency of ventilator-associated pneumonia and whether it is related to favourable outcomes in critical care patients.


 

Title: Update in acute lung injury and critical care 2010.

Citation: American Journal of Respiratory & Critical Care Medicine, May 2011, vol./is. 183/9(1147-52), 1073-449X;1535-4970 (2011 May 1)

Author(s): Vadasz I, Sznajder JI

Full Text: Available in fulltext at ProQuest (Legacy Platform)


 

Title: Con: corticosteroids are not indicated for treatment of acute lung injury from H1N1 viral pneumonia.

Citation: American Journal of Respiratory & Critical Care Medicine, May 2011, vol./is. 183/9(1127-8), 1073-449X;1535-4970 (2011 May 1)

Author(s): Matthay MA, Liu KD

Full Text: Available in fulltext at ProQuest (Legacy Platform)


 

 

 

Title: The challenge of modeling human acute respiratory distress syndrome: A new model of lung injury due to sepsis with impaired alveolar edema fluid removal

Citation: American Journal of Physiology - Lung Cellular and Molecular Physiology, July 2011, vol./is. 301/1(20-22), 1040-0605;1522-1504 (July 2011)

Author(s): Clerici C.


 

Title: Gene Therapy for ALI/ARDS

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(705-718), 0749-0704;1557-8232 (July 2011)Author(s): Lin X., Dean D.A. Abstract: This article discusses recent advances in the development of more efficient viral and nonviral gene transfer systems, and the current status of gene therapy applied to ALI/ARDS-associated pulmonary diseases is reviewed.. 2011 Elsevier Inc. Full Text: Available in fulltext at MD Consult


 

Title: Nutrition Therapy for ALI and ARDS

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(647-659), 0749-0704;1557-8232 (July 2011) Author(s): Krzak A., Pleva M., Napolitano L.M. Full Text: Available in fulltext at MD Consult


 

Title: Glucocorticoid Treatment in Acute Lung Injury and Acute Respiratory Distress Syndrome

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(590-607), 0749-0704;1557-8232 (July 2011) Author(s): Marik P.E., Meduri G.U., Rocco P.R.M., Annane D.

Abstract: This article reviews eight controlled studies evaluating corticosteroid treatment initiated before day 14 of ARDS. Available data provide a consistent strong level of evidence for improving outcomes. Treatment was also associated with a markedly reduced risk of death. This low-cost highly effective therapy is well-known, and has a low-risk profile when secondary prevention measures are implemented. The authors recommend prolonged methylprednisolone at 1 mg/kg/d initially in early ARDS, increasing to 2 mg/kg/d after 7 to 9 days of no improvement. Full Text: Available in fulltext at MD Consult


 

Title: Surfactant Therapy for Acute Lung Injury and Acute Respiratory Distress Syndrome

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(525-559), 0749-0704;1557-8232 (July 2011) Author(s): Raghavendran K., Willson D., Notter R.H.

Abstract: This article examines exogenous lung surfactant replacement therapy and its usefulness in mitigating clinical acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS). This article reviews clinical studies of surfactant therapy in pediatric and adult patients with ALI/ARDS, focusing on its potential advantages in patients with direct pulmonary forms of these syndromes. Full Text: Available in fulltext at MD Consult


 

Title: High-Frequency Oscillatory Ventilation in ALI/ARDS

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(487-499), 0749-0704;1557-8232 (July 2011) Author(s): Ali S., Ferguson N.D. Full Text: Available in fulltext at MD Consult


 

Title: ARDS Network (NHLBI) Studies: Successes and Challenges in ARDS Clinical Research

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(460-468), 0749-0704;1557-8232 (July 2011) Author(s): Thompson B.T., Bernard G.R.

Abstract.  Comprehensive information regarding all completed and ongoing ARDSNet clinical trials is available at www.ardsnet.org but a brief summary is provided in this article.

Full Text: Available in fulltext at MD Consult


 

Title: Epidemiology of ARDS and ALI

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(439-458), 0749-0704;1557-8232 (July 2011) Author(s): Blank R., Napolitano L.M.

Abstract: This article identifies the most significant studies and systematic reviews of recent years, defining the incidence, mortality, risk and prognostic factors, and etiologic classes of ARDS/ALI. Full Text: Available in fulltext at MD Consult


 

Title: Definition of ALI/ARDS

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(429-437), 0749-0704;1557-8232 (July 2011) Author(s): Raghavendran K., Napolitano L.M.

Abstract: In this article, definitions that have been recently used for ALI/ARDS in various clinical studies are discussed individually. Full Text: Available in fulltext at MD Consult


 

Title: ALI and ARDS: Challenges and Advances

Citation: Critical Care Clinics, July 2011, vol./is. 27/3(xiii-xiv), 0749-0704;1557-8232 (July 2011) Author(s): Raghavendran K., Napolitano L.M.

Full Text: Available in fulltext at MD Consult


 

 

 

 

 

 

 

 

 

Further information:

 Multiple sources – websites, journals and healthcare databases – have been searched for evidence published in the previous four weeks are identified and highlighted here. For a detailed list of sources that have been scanned, please contact [email protected]

To access the full text links in this bulletin, login with your HEFT Athens ID at

http://www.evidence.nhs.uk/nhs-evidence-content/journals-and-databases ‘before’ clicking on them in order to make them seamless

 

For more information on how to register for Athens, access the Athens Registration leaflet via HEFT Library website www.heftlibrary.nhs.uk

NHS Evidence portal has now changed to www.evidence.nhs.uk  Visit this portal to access your journals and healthcare databases.