Critical Care & Anaesthesia- August 2013

Welcome to the August bulletin of 2013 highlighting new evidence published on selected topics relating to Critical Care, Anaesthesia, Pain and Resuscitation. The format of the next issue will be different as it will be circulated widely across the region and hence will be incorporating more topics than currently included. Full text articles can be accessed via your UHB Athens ID.


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: Immunomodulatory effects of total intravenous and balanced inhalation anesthesia in patients with bladder cancer undergoing elective radical Cystectomy: Preliminary results

Citation: Journal of Experimental and Clinical Cancer Research, 2013, vol./is. 32/1, 1756-9966 (2013)Author(s): Sofra M., Fei P.C., Fabrizi L., et al.

Abstract: The aim of this study was to investigate the influence of total intravenous anesthesia with target-controlled infusion (TIVA-TCI) and balanced inhalation anesthesia (BAL) on the peri-operative levels of inflammatory cytokines and regulatory T cells (Tregs) in patients with bladder cancer undergoing surgery.

Full Text: Available from BioMedCentral in Journal of Experimental and Clinical Cancer Research

Title: BIS-guided anesthesia decreases postoperative delirium and cognitive decline.

Citation: Journal of Neurosurgical Anesthesiology, January 2013, vol./is. 25/1(33-42), 0898-4921;1537-1921 (2013 Jan)Author(s): Chan MT, Cheng BC, Lee TM et al.

Abstract: In a randomized controlled trial, the study tested the effect of BIS monitoring on POCD in 921 elderly patients undergoing major noncardiac surgery.

Title: Analgesic efficacy of ultrasound-guided adductor canal blockade after arthroscopic anterior cruciate ligament reconstruction: A randomised controlled trial

Citation: European Journal of Anaesthesiology, July 2013, vol./is. 30/7(422-428), 0265-0215;1365-2346 (July 2013)Author(s): Espelund M., Fomsgaard J.S., Haraszuk J., et al.

Abstract: To investigate the analgesic effect of ACB in patients receiving a basic analgesic regimen of paracetamol and ibuprofen after arthroscopic ACL reconstruction under general anaesthesia.

Title: Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function

Citation: Anesthesiology, June 2013, vol./is. 118/6(1307-1321), 0003-3022;1528-1175 (June 2013)Author(s): Severgnini P., Selmo G., Lanza C., et al.

Abstract: The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function.

Full Text: Available from Ovid in Anesthesiology

Title: Postoperative recovery with bispectral index versus anesthetic concentration-guided protocols

Citation: Anesthesiology, May 2013, vol./is. 118/5(1113-1122), 0003-3022;1528-1175 (May 2013)Author(s): Fritz B.A., Rao P., Mashour G.A., et al.

Abstract: The purpose of this substudy of the B-Unawareand BAG-RECALL trials was to assess whether a BIS-based anesthetic protocol was superior to an end-tidal anesthetic concentration-based protocol in decreasing recovery time and postoperative complications.

Full Text: Available from Ovid in Anesthesiology

Title: Ultrasound-guided transversusabdominis plane block in children: A randomised comparison with wound infiltration

Citation: European Journal of Anaesthesiology, July 2013, vol./is. 30/7(409-414), 0265-0215;1365-2346 (July 2013)Author(s): Sahin L., Sahin M., Gul R., et al.

Abstract: The present study was designed to evaluate the analgesic efficacy of ultrasound-guided TAP block with high volume local anaesthetic (0.5 ml kg <sup>-1</sup>) during the first 24 h after surgery in children undergoing inguinal hernia repair.

Title: Superior haemodynamic stability during off-pump coronary surgery with thoracic epidural anaesthesia: Results from a prospective randomized controlled trial

Citation: Interactive Cardiovascular and Thoracic Surgery, May 2013, vol./is. 16/5(602-607), 1569-9293;1569-9285 (May 2013)Author(s): Rajakaruna C., Rogers C., Pike K., et al.

Abstract: The aim of this randomized controlled trial was to evaluate the impact of thoracic epidural anaesthesia on intraoperative haemodynamics in patients undergoing OPCAB surgery.

Full Text: Available from Free Access Content in Interactive Cardiovascular and Thoracic Surgery

Title: Thoracic epidural for post-thoracotomy and thoracomyoplasty pain: A comparative study of three concentrations of fentanyl with plain ropivacaine

Citation: Anaesthesia, Pain and Intensive Care, April 2013, vol./is. 17/1(22-27), 1607-8322 (April 2013)Author(s): Chaudhary A.K., Singh D., Bogra J.S., et al.

Abstract: The aim of this prospective, double blind, randomised controlled trial was to compare the analgesic and adverse effects of three concentrations of fentanyl with 0.2% ropivacaine in thoracic epidural in patients undergoing thoracotomy andthoracomyolpasty.

Full Text: Available from Directory of Open Access Journals in Anaesthesia, Pain and Intensive Care


Title: Laparoscopic cholecystectomy under spinal anaesthesia: A prospective, randomised study

Citation: Journal of Minimal Access Surgery, April 2013, vol./is. 9/2(65-71), 0972-9941;1998-3921 (April-June 2013).

Author(s): Tiwari S., Chauhan A., Chaterjee P et al.

Abstract: A prospective, randomised study aimed to evaluate efficacy, safety and cost benefit of conducting laparoscopic cholecystectomy under spinal anaesthesia (SA) in comparison to general anaesthesia(GA) Spinal anaesthesia can be recommended to be the anaesthesia technique of choice for conducting laparoscopic cholecystectomy in hospital setups in developing countries where cost factor is a major factor.

Full Text: Available from Directory of Open Access Journals in Journal of Minimal Access Surgery

Title: Bispectral index-guided induction of general anaesthesia in patients undergoing major abdominal surgery using propofol or etomidate: a double-blind, randomized, clinical trial.

Citation: British Journal of Anaesthesia, March 2013, vol./is. 110/3(388-96), 0007-0912;1471-6771 (2013 Mar). Author(s): Moller Petrun A, Kamenik M

Abstract: Comparison of the haemodynamic effects of a bispectral index (BIS)-guided etomidate and propofol infusion for anaesthesia induction in patients undergoing major abdominal surgery. The use of propofol resulted in less hypertension and tachycardia at and after intubation than etomidate. But even with the reduced doses given with the BIS-guided protocol, it often caused significant hypotension.

Full Text: Available from Free Access Content in BJA: British Journal of Anaesthesia

Title: Combined paravertebral and intrathecalvs thoracic epidural analgesia for post-thoracotomy pain relief.

Citation: British Journal of Anaesthesia, March 2013, vol./is. 110/3(443-9), 0007-0912;1471-6771 (2013 Mar). Authors: Dango S, Harris S,Offner K, et al.

Abstract: Comparison of thoracic paravertebral block (PVB) in addition to intrathecal opioid (ITO) administration as an alternative to the gold standard thoracic epidural analgesia (TEA) for post-thoracotomy pain relief.

Full Text: Available from Free Access Content in BJA: British Journal of Anaesthesia

Title: Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: Multiple treatment comparison

Citation: Canadian Journal of Anesthesia, March 2013, vol./is. 60/3(230-243), 0832-610X;1496-8975 (March 2013). Authors: Rashiq S.,Vandermeer B., Abou-Setta A.M. et al.

Abstract: This study was designed to determine the most effective peripheral nerve block supplement to standard anesthesia management for hip fracture patients. The combination of obturator and lateral femoral cutaneous nerve blockade had the highest probability of being the most effective against acute postoperative pain. Fascia iliaca blockade had the highest probability of being the most effective against delirium.

Title: Feasibility study of analgesia via epidural versus continuous wound infusion after laparoscopic colorectal resection

Citation: British Journal of Surgery, February 2013, vol./is. 100/3(395-402), 0007-1323;1365-2168 (February 2013). Author(s): Boulind C.E., Ewings P., Bulley S.H., et al.

Abstract: This pilot trial assessed the feasibility of a randomized controlled trial (RCT) comparing epidural analgesia and use of a local anaesthetic wound infusion catheter (WIC) following LCR.

Full Text: Available from EBSCOhost EJS in British Journal of Surgery: BJS

Title: High thoracic epidural analgesia decreases stress hyperglycemia and insulin need in cardiac surgery patients.

Citation: ActaAnaesthesiologicaScandinavica, February 2013, vol./is. 57/2(171-7), 0001-5172;1399-6576 (2013 Feb). Author(s): Greisen J, Nielsen DV, Sloth E, Jakobsen CJ

Abstract:The aim was to evaluate the effect of high thoracic epidural analgesia (HTEA) on the blood glucose (BG) level and insulin requirement in patients undergoing cardiac surgery.Conclusion: HTEA preserves glucose metabolism better and leads to a lesser degree of 'stress hyperglycaemia' in cardiac surgery patients

Title: Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: A systematic review and meta-analysis

Citation: Anesthesia and Analgesia, January 2013, vol./is. 116/1(133-144), 0003-2999 (January 2013). Author(s): George R.B., Allen T.K., Habib A.S.

Abstract: In a systematic review of randomized controlled trials (RCTs), the effect of intermittent epidural bolus (IEB) was compared to standard CEI dosing with or without patient-controlled epidural analgesia on patient satisfaction, the need for manual anesthesia interventions, labor progression, and mode of delivery in healthy women receiving labor epidural analgesia.

Full Text: Available from Ovid in Anesthesia and Analgesia

Title: Influence of epidural mixture and surgery on bladder function after open renal surgery: A randomized clinical trial

Citation: Anesthesiology, January 2013, vol./is. 118/1(70-77), 0003-3022;1528-1175 (January 2013). Author(s): Wuethrich P.Y., Metzger T., Mordasini L. Et al.

Abstract: This study aimed to investigate the individual contribution of epidurally administrated drugs and surgery in bladder dysfunction. Thoracic epidurally administrated bupivacaine resulted in clinically relevant PVRs based on impaired detrusor function. The addition of fentanyl enhanced this effect without generating greater PVRs.

Full Text: Available from Free Access Content in Anesthesiology

Title: The efficacy of the semi-blind approach of transversusabdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: A prospective randomized double-blind study

Citation: Local and Regional Anesthesia, 2013, vol./is. 6/1, 1178-7112 (2013)

Author(s): Ebru Salman A., Yetisir F., Yurekli B., et al.

Abstract: In this prospective, randomized, double-blind study, the aim was to compare the analgesic efficacy of the semi-blind approach of transversusabdominis plane (TAP) block with a placebo block in patients undergoing unilateral inguinal hernia repair.

Full Text: Available from Directory of Open Access Journals in Local and Regional Anesthesia

Title: Cell salvage for obstetric patients who decline blood transfusion: a national survey.

Citation: Transfusion Medicine, February 2013, vol./is. 23/1(64-5), 0958-7578;1365-3148 (2013 Feb)Author(s): Jennings A, Brennan C

Publication Type: Letter

Title: Reduction of blood loss with the use of a new combined intra-operative and post-operative autologous blood transfusion system compared with no drainage in primary total hip replacement.

Citation: Bone & Joint Journal, May 2013, vol./is. 95-B/5(616-22), 2049-4408 (2013 May)

Author(s): Horstmann WG, Swierstra MJ, Ohanis D, et al.

Abstract: A randomised controlled blinded study was conducted comparing a new combined intra- and post-operative autotransfusion filter system with no-drainagein total hip replacement (THR).

Title: Intraoperative cell salvage in a combat support hospital: a prospective proof of concept study.

Citation: Transfusion, April 2013, vol./is. 53/4(805-10), 0041-1132;1537-2995 (2013 Apr)

Author(s): Bhangu A, Nepogodiev D, Doughty H, et al.

Abstract: A "salvage-only" Intraoperative blood salvage (IBS)  feasibility study was undertaken in a deployed, combat support hospital. Salvage is most successful in patients with GSWs and cavity injuries and less appropriate for limb and blast injuries.

Title: Controversy over the use of intraoperative blood salvage autotransfusion during liver transplantation for hepatocellular carcinoma patients

Citation: World Journal of Gastroenterology, June 2013, vol./is. 19/22(3371-3374), 1007-9327;2219-2840 (June 2013). Author(s): Zhai B., Sun X.-Y.

Abstract: A review of the literature to determine the safety of intraoperative blood salvage autotransfusion (IBSA) in hepatocellular carcinoma (HCC) patients undergoing liver transplantation. Randomized, controlled and prospective trials are urgently required to clarify the uncertainty.

Full Text: Available from Free Access Content in World Journal of Gastroenterology

Title: Does single use of an autologous transfusion system in TKA reduce the need for allogenic blood?: a prospective randomized trial.

Citation: Clinical Orthopaedics & Related Research, April 2013, vol./is. 471/4(1319-25), 0009-921X;1528-1132 (2013 Apr).

Author(s): Cip J, Widemschek M, Benesch T, et al.

Abstract: In a prospective, randomized, controlled study, we enrolled 151 patients undergoing TKA to determine whether autologous retransfusion systems for WSB can reduce postoperative allogenic blood transfusions (ABTs).

Title: Post-Operative Auto-Transfusion in Total Hip or Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

Citation: PLoS ONE, January 2013, vol./is. 8/1, 1932-6203 (30 Jan 2013)

Author(s): Haien Z., Yong J., Baoan M., et al.

Abstract: A Cochrane systematic review conducted toevaluate the efficacy of post-operative auto-transfusion (PAT) in Total hip or knee arthroplastypatients.The use of a PAT reinfusion system reduced significantly the demand for ABT, the number of patients who require ABT and the cost of hospitalization after total knee and hip arthroplasty

Full Text: Available from National Library of Medicine in PLoS ONE


Cardiac arrests/cardiopulmonary resuscitation (CPR)

The following sub-topics are covered:

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


Title: Increasing cardiopulmonary resuscitation provision in communities with low bystander cardiopulmonary resuscitation rates: a science advisory from the American Heart Association for healthcare providers, policymakers, public health departments, and community leaders.

Citation: Circulation. 2013 Mar 26;127(12):1342-50. doi: 10.1161/CIR.0b013e318288b4dd. Epub 2013 Feb 25.

Authors: Sasson C, Meischke H, Abella BSet al.

Title: An institutionwide approach to redesigning management of cardiopulmonary resuscitation.

Citation:Joint Commission journal on quality and patient safety. 2013 Apr;39(4):157-66.

Authors:Lighthall GK, Mayette M, Harrison TK.

Abstract: Despite widespread training in basic life support (BLS) and advanced cardiovascular life support (ACLS) among hospital personnel, the likelihood of survival from in-hospital cardiac arrests remains low. In 2006 a university-affiliated tertiary medical center initiated a cardiopulmonary (CPR) resuscitation redesign project.

Title: Advances in recognition, resuscitation, and stabilization of the critically ill child.

Citation: .Pediatric Clinics of North America. 2013 Jun;60(3):605-20. doi: 10.1016/j.pcl.2013.02.014.Epub 2013 Mar 25.

Authors:Topjian AA, Berg RA, Nadkarni VM.

Abstract: Advances in early recognition, effective response, and high-quality resuscitation

before, during, and after cardiac arrest have resulted in improved survival for infants and children over the past 10 years. This review addresses several key factors that can make a difference in survival outcomes.

Title: Chest compression quality over time in pediatric resuscitations.

Citation:Pediatrics. 2013 Mar;131(3):e797-804. doi: 10.1542/peds.2012-1892. Epub 2013 Feb 25.

Authors:Badaki-Makun O, Nadel F, Donoghue A, et al.

Abstract: Chest compression (CC) quality deteriorates with time in adults, possibly because of rescuer fatigue. Little data exist on compression quality in children or on work done to perform compressions in general. We hypothesized that compression quality, work, and rescuer fatigue would differ in child versus adult manikin models.

Title: Effect of physical fatigue on the quality CPR: a water rescue study of lifeguards: physical fatigue and quality CPR in a water rescue.

Citation:The American Journal of Emergency Medicine. 2013 Mar;31(3):473-7. doi: 10.1016/j.ajem.2012.09.012. Epub2012  Oct 22.

Authors:Barcala-Furelos R, Abelairas-Gomez C, Romo-Perez V, Palacios-Aguilar J.

Abstract: The purpose of the study is to analyze the influence of the fatigue caused by a water rescue on the cardiopulmonary resuscitation (CPR) performance.

Title: LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue-a prospective, randomized, cross-over manikin study.

Citation:The American Journal of Emergency Medicine. 2013 Feb;31(2):384-9. doi: 10.1016/j.ajem.2012.07.018. Epub 2012 Sep 20.

Authors:Putzer G, Braun P, Zimmermann A, Pedross Fet al.

Abstract: Comparison of a mechanical chest-compression device (Lund University Cardiac Assist System [LUCAS];  and manual chest-compressions in a simulated cardiopulmonary resuscitation scenario during helicopter rescue. LUCAS compared to manual chest-compressions increased CPR quality and reduced hands-off time, but prolonged the time interval to the first defibrillation.

Title: Performance measures to promote quality improvement in sudden cardiac arrest prevention and treatment.

Citation: American Heart Journal, June 2013, vol./is. 165/6(862-8), 0002-8703;1097-6744 (2013 Jun)Author(s): Al-Khatib SM, Fonarow GC, Hayes DL, Curtis AB, Sears SF Jr, Sanders GD, Hernandez AF, Mirro MJ, Thomas KL, Eapen ZJ, Russo AM, Yancy CW

Full Text: Available from MD Consult in American Heart Journal; Note: ; Notes: You will need to register (free of charge) with MD Consult the first time you use it.

Title: Team training - The BEST approach to continuing education in resuscitation

Citation: Trends in Anaesthesia and Critical Care, June 2013, vol./is. 3/3(140-145), 2210-8440 (June 2013)Author(s): Svavarsdottir H., Brattebo G.

Abstract: This paper discusses the background and development of the BEST (Better & Systematic Team Training) approach in continuing resuscitation education as one feasible strategy to improve teamwork in resuscitation situations. 2013 Elsevier Ltd.

Title: Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial.

Citation: JAMA Pediatrics, June 2013, vol./is. 167/6(528-36), 2168-6203;2168-6211 (2013 Jun)Author(s): Cheng A, Hunt EA, Donoghue A, Nelson-McMillan K, Nishisaki A, Leflore J, Eppich W, Moyer M, Brett-Fleegler M, Kleinman M, Anderson J, Adler M, Braga M, Kost S, Stryjewski G, Min S, Podraza J, Lopreiato J, Hamilton MF, Stone K, Reid J, Hopkins J, Manos J, Duff J, Richard M, Nadkarni VM, EXPRESS Investigators

Abstract: To determine whether use of a scripted debriefing by novice instructors and/or simulator physical realism affects knowledge and performance in simulated cardiopulmonary arrests.

Title: Importance of leadership in cardiac arrest situations: From simulation to real life and back

Citation: Swiss Medical Weekly, April 2013, vol./is. 143/, 1424-7860;1424-3997 (18 Apr 2013)Author(s): Hunziker S., Tschan F., Semmer N.K., Marsch S.

Abstract: In this review we provide a comprehensive summary of data derived from clinical studies that investigated the importance of leadership in cardiopulmonary resuscitation (CPR).

Full Text: Available from Free Access Content in Swiss Medical Weekly

Title: Motion detection technology as a tool for cardiopulmonary resuscitation (CPR) quality training: A randomised crossover mannequin pilot study

Citation: Resuscitation, April 2013, vol./is. 84/4(501-507), 0300-9572;1873-1570 (April 2013)Author(s): Semeraro F., Frisoli A., Loconsole C., Banno F., Tammaro G., Imbriaco G., Marchetti L., Cerchiari E.L.

Abstract: The present study evaluates a new CPR feedback system (Mini-VREM: Mini-Virtual Reality Enhanced Mannequin) designed to improve CC during training.

Full Text: Available from Elsevier in Resuscitation; Note: ; Notes: You will need to register (free of charge) with Science Direct the first time you use it.

Title: Can lightweight rescuers adequately perform CPR according to 2010 resuscitation guideline requirements?.

Citation: Emergency Medicine Journal, February 2013, vol./is. 30/2(159-60), 1472-0205;1472-0213 (2013 Feb)Author(s): Krikscionaitiene A, Stasaitis K, Dambrauskiene M, Dambrauskas Z, Vaitkaitiene E, Dobozinskas P, Vaitkaitis D

Abstract: To evaluate associations between rescuers' anthropometric characteristics and chest compressions (CC) depth according to 2010 resuscitation guidelines.

Full Text: Available from Free Access Content in Emergency Medicine Journal

Title: Defibrillator charging before rhythm analysis significantly reduces hands-off time during resuscitation: a simulation study.

Citation: American Journal of Emergency Medicine, February 2013, vol./is. 31/2(395-400), 0735-6757;1532-8171 (2013 Feb)Author(s): Hansen LK, Folkestad L, Brabrand M

Abstract: The objective was to reduce hands-off time during cardiopulmonary resuscitation as increased hands-off time leads to higher mortality.

Full Text: Available from ProQuest in American Journal of Emergency Medicine, The

Title: Real-time feedback systems in CPR

Citation: Trends in Anaesthesia and Critical Care, December 2012, vol./is. 2/6(287-294), 2210-8440 (December 2012)Author(s): Gruber J., Stumpf D., Zapletal B., Neuhold S., Fischer H.

Abstract: This review aims to give an overview of feedback devices for use by laypersons or healthcare providers during actual cardiac arrest. It summarizes the effect of such devices on CPR quality in simulation or real life and possible dangers or limitations. 2012 Elsevier Ltd.

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)
  • Delirium


Title: Do probiotics decrease the incidence of ventilator-associated pneumonia in critically ill patients?

Citation:Critical Care Medicine. 2013;41:e28-9 ; Authors:GU WJ, Liu JC.

Abstract: Comment onProbiotics in the critically ill: a systematic review of the randomized trial evidence.

Full Text:

Title: Randomized double-blind placebo-controlled trial of 40 mg/day of atorvastatin in reducing the severity of sepsis in ward patients (ASEPSIS Trial)

Citation: Critical Care, December 2012, vol./is. 16/6, 1364-8535;1466-609X (11 Dec 2012)

Author(s): Patel J.M., Snaith C., Thickett D.R., et al.

Abstract: The aim of this study was to determine if the acute administration of atorvastatin reduces sepsis progression in statin naive patients hospitalized with sepsis.Conclusions: Acute administration of atorvastatin in patients with sepsis may prevent sepsis progression.

Full Text: Available from Free Access Content in Critical Care

Title: Statins and sepsis: potential benefit but more unanswered questions.

Citation: American journal of respiratory and critical care medicine. 2013 Apr 187(7):672-4.

Authors: O'Kane CM, Perkins GD, McAuley DF.

Abstract: Comment onAmerican journal of respiratory and critical care medicine. 2013 Apr 1;187(7):743-50.

Full Text: Available from Proquest

Title: A multicenter randomized trial of atorvastatin therapy in intensive care patientswith severe sepsis.

Citation:American journal of respiratory and critical care medicine. 2013 Apr 1;187(7):743-50. doi:10.1164/rccm.201209-1718OC.

Authors:Kruger P, Bailey M, Bellomo R, et al.

Abstract:Phase II, multicenter, prospective, randomized, double-blind,placebo-controlled trial to test whether atorvastatin therapy affects biologic and clinicaloutcomes in critically ill patients with severe sepsis.

Title: Nutritional immunomodulation in critically ill children with acute lung injury: feasibility and impact on circulating biomarkers.

Citation: Pediatric Critical Care Medicine, January 2013, vol./is. 14/1(e45-56), 1529-7535;1529-7535 (2013 Jan)

Author(s): Jacobs BR, Nadkarni V, Goldstein B, et al.

Abstract: Prospective, blinded, randomized, controlled, multicenter trial to determine if continuous feeding of enteral nutrition containing eicosapentaenoic acid, -linolenic acid, and antioxidants was feasible in critically ill children with acute lung injury or acute respiratory distress syndrome.

Title: Paracrine activity of stem cells in therapy for acute lung injury and adult respiratory distress syndrome.

Citation: The Journal of Trauma and Acute Care Surgery, May 2013, vol./is. 74/5(1351-6), 2163-0763 (2013 May)

Author(s): Zhu F, Xia ZF

Title:One year outcomes in patients with acute lung injury randomised to initial trophic or full enteral feeding: prospective follow-up of EDEN randomised trial

Citation: BMJ 2013;346:f1532

Authors: Dale M Needham, Victor D Dinglas, O Joseph Bienvenu, et al.

Abstract: To evaluate the effect of initial low energy permissive underfeeding (“trophic feeding”) versus full energy enteral feeding (“full feeding”) on physical function and secondary outcomes in patients with acute lung injury.

Full Text: Via BMJ

Title: What you call it does matter: new definitions of ARDS and VAP.

Citation:American Journal of Critical Care. 2012 Sep;21(5):305-7.

Authors:Munro CLSavel RH.

Full Text:

Title: Using evidence-based practice to prevent ventilator-associated pneumonia

Citation:Critical Care Nursing. 2012;32:41-51.

Authors:Sedwick MB, Lance-Smith M, Reeder SJ, Nardi J, et al.

Abstract: Strategies to develop a ventilator bundle and care practices for nurses in critical care units to reduce the rate of ventilator-associated pneumonia.

Full Text: Critical Care Nurse

Title: Year in review in Intensive Care Medicine 2012. II: Pneumonia and infection, sepsis, coagulation, hemodynamics, cardiovascular and microcirculation, critical care organization, imaging, ethics and legal issues.

Citation:Intensive Care Medicine. 2013.

Authors:Antonelli M, Bonten M, Cecconi M, Chastre J, et al.

Full Text:PubMed:

Title: Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation,monitoring and patient-ventilator interactions, acute respiratory distress  syndrome, sedation, paediatrics and miscellanea.

Citation:Intensive Care Medicine 2013.

Authors:AntonelliM, Bonten M, Cecconi M, Chastre J, et al.

Full Text:PubMed

Title: High-Frequency Oscillation for Acute Respiratory Distress Syndrome

Citation:The New England Journal of Medicine 368. 9 (Feb 28, 2013): 806-13.

Authors: Young, Duncan; Lamb, Sarah E; Shah, Sanjoy; MacKenzie, Iain; Tunnicliffe, William; et al.

Abstract: Patients with the acute respiratory distress syndrome (ARDS) require mechanical ventilation to maintain arterial oxygenation, but this treatment may produce secondary lung injury. High-frequency oscillatory ventilation (HFOV) may reduce this secondary damage

Full Text: Via Proquest

Title: The role of angiogenic factors and their soluble receptors in acute lung injury (ALI)/ acute respiratory distress syndrome (ARDS) associated with critical illness

Citation: Journal of Inflammation (United Kingdom), 2013, vol./is. 10/1, 1476-9255 (2013)

Author(s): Wada T., Jesmin S., Gando S., et al.

Abstract: The aim of the study was to assess the relationship between angiogenic factors, their soluble receptors and ALI/ARDS associated with critically ill patients, including sepsis, severe trauma, and post-cardiac arrest syndrome (PCAS). Conclusions: Angiogenic factors and their soluble receptors, particularly sVEGFR2 and Ang2, are considered to be valuable predictive biomarkers in the development of ALI/ARDS associated with critical illness and mortality in ALI/ARDS patients.

Full Text: Available from Directory of Open Access Journals in Journal of Inflammation

Title: Hyperoxic acute lung injury

Citation: Respiratory Care, January 2013, vol./is. 58/1(123-140), 0020-1324;1943-3654 (01 Jan 2013)Author(s): Kallet R.H., Matthay M.A.

Abstract: Prolonged breathing of very high F IO2uniformly causes severe hyperoxic acute lung injury (HALI) and, without a reduction of F IO2is usually fatal. The severity of HALI is directly proportional to PO2 (particularly above 450 mm Hg, or an FIO2 of 0.6) and exposure duration.

Full Text: Available from Highwire Press in Respiratory Care

Title: Preoperative and intraoperative predictors of postoperative acute respiratory distress syndrome in a general surgical population.

Citation: Anesthesiology, January 2013, vol./is. 118/1(19-29), 0003-3022;1528-1175 Author(s): Blum JM, Stentz MJ, Dechert R, et al.

Abstract: A review of common adult surgical procedures conducted using risk-matched analysis and a combination of clinical and research data sets, to determine the incidence and risk factors for the development of Acute respiratory distress syndrome (ARDS)  in this general surgical population.

Full Text: Available from Ovid in Anesthesiology

Title: Anesthesiology and the acute respiratory distress syndrome: an ounce of prevention is worth a pound of cure.

Citation: Anesthesiology, January 2013, vol./is. 118/1(1-4), 0003-3022;1528-1175 (2013 Jan)Author(s): Kor DJ, Talmor D

Full Text: Available from Ovid in Anesthesiology

Title: Protective ventilation for patients without acute respiratory distress syndrome [1]

Citation: JAMA - Journal of the American Medical Association, February 2013, vol./is. 309/7(654-655), 0098-7484;1538-3598 (13 Feb 2013)

Author(s): Fuller B.M., Mohr N.M., Carpenter C.R.

Full Text: Available from Free Access Content in J A M A

Title: Protective ventilation for patients without acute respiratory distress syndrome [2]

Citation: JAMA - Journal of the American Medical Association, February 2013, vol./is. 309/7(654), 0098-7484;1538-3598 (13 Feb 2013)Author(s): Zhang Z.

Full Text: Available from Free Access Content in J A M A

Title: Protective ventilation for patients without acute respiratory distress syndrome: Reply

Citation: JAMA - Journal of the American Medical Association, February 2013, vol./is. 309/7(655), 0098-7484;1538-3598 (13 Feb 2013)Author(s): Neto A.S., Schultz M.J.

Full Text: Available from Free Access Content in J A M A

Title: Quantitative cultures of bronchoscopically obtained specimens should be performed for optimal management of ventilator-associated pneumonia

Citation: Journal of Clinical Microbiology, March 2013, vol./is. 51/3(740-744), 0095-1137;1098-660X (March 2013)Author(s): Baselski V., Klutts J.S.

Abstract: Ventilator-associated pneumonia (VAP) is a leading cause of health care-associated infection. It has a high rate of attributed mortality, and this mortality is increased in patients who do not receive appropriate empirical antimicrobial therapyHowever, there is no consensus in the clinical microbiology community as to whether these specimens should be cultured quantitatively, or by a semiquantitative approach.

Full Text: Available from Free Access Content in Journal of Clinical Microbiology

Title: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) as a diagnostic marker of ventilator-associated pneumonia.

Citation: Respiratory Care, December 2012, vol./is. 57/12(2052-8), 0020-1324;0020-1324 (2012 Dec). Author(s): Palazzo SJ, Simpson TA, Simmons JMet al.

Abstract: To determine the utility of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) levels in bronchoalveolar lavage fluid (BALF) and exhaled breath condensate (EBC) samples from patients who underwent bronchoscopy for a clinical suspicion of ventilator-associated pneumonia (VAP), to categorize patients as VAP positive and VAP negative, when compared to quantitative culture results of BALF.

Full Text: Available from Highwire Press in Respiratory Care

Title: Inadequate treatment of ventilator-associated and hospital-acquired pneumonia: risk factors and impact on outcomes.

Citation: BMC Infectious Diseases, 2012, vol./is. 12/(268), 1471-2334;1471-2334 (2012)

Author(s): Piskin N, Aydemir H, Oztoprak Net al.

Abstract: In this study aimed to identify the risk factors for inadequate initial antimicrobial therapy (AB) and to determine its subsequent impact on outcomes in both ventilator associated pneumonia (VAP) and hospital acquired pneumonia (HAP).

Full Text: Available from EBSCOhost in BMC Infectious Diseases

Title: Effect of pressure support vs unassisted breathing through a tracheostomy collar on weaning duration in patients requiring prolonged mechanical ventilation: a randomized trial.

Citation: JAMA, February 2013, vol./is. 309/7(671-7), 0098-7484;1538-3598 (2013 Feb 20)

Author(s): Jubran A, Grant BJ, Duffner LA, et al.

Abstract: Study designed to compare weaning  from prolonged mechanical ventilation duration with pressure support vs unassisted breathing through a tracheostomy collar in patients transferred to along-term acute care hospital(LTACH) for weaning from prolonged ventilation.

Full Text: Available from Free Access Content in J A M A

Title:Prone Positioning in Severe Acute Respiratory Distress Syndrome

Citation:The New England Journal of Medicine368. 23 (Jun 6, 2013): 2159-68

Authors:Guérin, Claude; Reignier, Jean; Richard, Jean-Christophe; et al..

Abstract: Previous trials involving patients with the acute respiratory distress syndrome (ARDS) have failed to show a beneficial effect of prone positioning during mechanical ventilatory support on outcomes. We evaluated the effect of early application of prone positioning on outcomes in patients with severe ARDS.

Title: Pleural effusion in patients with acute lung injury: a CT scan study.

Citation:Critical Care Medicine. 2013;41:935-44.

Authors: CHIUMELLO D, Marino A, Cressoni M, Mietto C, et al.

Abstract: Pleural effusion is a frequent finding in patients with acute respiratory distress syndrome. To assess the effects of pleural effusion in patients with acute lung injury on lung volume, respiratory mechanics, gas exchange, lung recruitability, and response to positive end-expiratory pressure.

Title: Acute kidney injury in the critically ill: is iodinated contrast medium really harmful?

Citation: Critical Care Medicine. 2013;41:1017-26.

Authors:Ehrmann S, Badin J, Savath L, Pajot O, et al.

Abstract: To assess whether the use of iodinated contrast medium increases the incidence of acute kidney injury in ICU patients, compared with patients not receiving iodinated contrast medium.

Title: Clinical Decision Support System and Incidence of Delirium in Cognitively

Impaired Older Adults Transferred to Intensive Care

Citation: American Journal of Critical Care. 2013;22:257-262.

Authors: KHAN BA, Calvo-Ayala E, Campbell N, Perkins A, et al.

Abstract: Elderly patients with cognitive impairment are at increased risk of developing delirium, especially in the intensive care unit. Study aimed to evaluate the efficacy of a computer-based clinical decision support system to reduce the incidence of delirium.

Title:Pharmacodynamics of imipenem in critically ill patients withventilator-associated pneumonia.

Citation:Journal of the Medical Association of Thailand2013 May;96(5):551-7

Authors:Jaruratanasirikul S, Aeinlang N, Jullangkoon M, Wongpoowarak W.

Abstract: Drug dispositions are altered in critically ill patients, includingventilator-associated pneumonia (VAP) when compared with healthy subjects leading to fluctuations of plasma concentrations.The aim of the study was to compare the probability of target attainment (PTA) and cumulativefraction of response (CFR) for imipenem between administration by 0.5-hour and2-hour infusions.

Title: Residual gastric volume and risk of ventilator-associated pneumonia.

Citation: JAMA. 2013 May 22;309(20):2090. doi: 10.1001/jama.2013.4090.

Authors:Elke G, Heyland D.

Abstract:Comment in    JAMA. 2013 May 22;309(20):2090-1.

Comment on    JAMA. 2013 Jan 16;309(3):249-56.

Title: Probiotics for prevention of ventilator-associated pneumonia.

Citation: Chest. 2013 Apr;143(4):1185-6. doi: 10.1378/chest.12-2506

Authors:Siempos II, Ntaidou TK.

Abstract:Comment in    Chest. 2013 Apr;143(4):1186-7.

Comment on    Chest. 2012 Oct;142(4):859-68.

Title:Interventions to improve professional adherence to guidelines for prevention of device-related infections.

Citation:Cochrane Database of Systematic Reviews. 2013 Mar 28;3:CD006559. doi: 10.1002/14651858.CD006559 pub2.

Authors:Flodgren G, Conterno LO, Mayhew A, et al.

Abstract:Healthcare-associated infections (HAIs) are a major threat to patientsafety, and are associated with mortality rates varying from 5% to 35%.The objective of the study was to assess the effectiveness of different interventions, alone or incombination, which target healthcare professionals or healthcare organisations toimprove professional adherence to infection control guidelines on device-related infection rates and measures of adherence.

Full Text: Available via Wiley

Title: Probiotics for ventilator-associated pneumonia: the need for a large, multicenter, randomized controlled trial.

Citation: .Chest. 2013 Mar;143(3):590-2. doi: 10.1378/chest.12-2139

Authors: Boyer AF, Kollef MH.

Abstract:Comment on Chest. 2013 Mar;143(3):646-55.

Title: Diagnosis of ventilator-associated pneumonia: controversies and working toward a gold standard.

Citation:Current opinion in infectious diseases. 2013 Apr;26(2):140-50. doi: 10.1097/QCO.0b013e32835ebbd0

Authors:Grgurich PE, Hudcova J, Lei Y, et al.

Abstract: The aim is to discuss the clinical, microbiologic, andradiological criteria used in the diagnosis of ventilator-associated pneumonia(VAP), distinguish between ventilator-associated tracheobronchitis (VAT) and VAP,and reconcile the proposed Centers for Disease Control surveillance criteria withclinical practice.

Title: Improved outcome of ventilator-associated pneumonia caused by methicillin-resistant Staphylococcus aureus in a trauma population.

Citation: .American Journal of Surgery. 2013 Mar;205(3):255-8; discussion 258. doi:10.1016/j.amjsurg.2012.10.011.  Epub 2013 Jan 30.

Authors: Gonzalez RP, Rostas J, Simmons JD, Allen J, Frotan MA, Brevard SB.

Abstract: The treatment of ventilator-associated pneumonia (VAP) secondary to methicillin-resistant Staphylococcus aureus (MRSA) remains controversial. Trauma patients who develop MRSA VAP appear to have fewer ventilator days and shorter ICU and hospital LOS when treated with linezolid.

Title: Improvements in pulmonary and general critical care reduces mortality following ventilator-associated pneumonia

Citation:The journal of trauma and acute care surgery. 2013 Feb;74(2):568-74. doi:10.1097/ TA.0b013e3182789312.

Authors: Rosenberger LH, Hranjec T, McLeod MD, et al.

Abstract: Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in the intensive care unit, with substantial subsequent mortality. We have shown that mortality following an episode of VAP continues to decrease over time and attribute this to advancements in pulmonary and critical care rather than any specific interventions.

Title: Weaning from the ventilator and extubation in ICU.

Citation:Current opinion in critical care. 2013 Feb 19(1)57-64.doi: 10.1097/MCC.0b013e32835c5095.

Authors:Thille AW, Cortés-Puch I, Esteban A.

Abstract: The decision to extubate is a crucial moment for intubated patients. Both extubation delay and especially the need for reintubation are associated with poor outcomes. We aim to review the recent literature on weaning and to clarify the role of certain interventions intending to help in this process.

Title: Changing trends in the management of end-stage neuromuscular respiratory muscle failure: recommendations of an international consensus.

Citation:American journal of physical medicine & rehabilitation2013 Mar;92(3):267-77. doi: 10.1097/PHM.0b013e31826edcf1.

Authors: Bach JR, Gonçalves MR, Hon A, et al.

Abstract: Respiratory management of patients with end-stage respiratory muscle failure of neuromuscular disease has evolved. Review from a panel experienced in CNVS was charged to analyze changingrespiratory management trends and to make recommendations.

Title: A trial comparing noninvasive ventilation strategies in preterm infants.

Citation: New England Journal of Medicine, August 2013, vol./is. 369/7(611-20), 0028-4793;1533-4406 (2013 Aug 15)Author(s): Kirpalani H, Millar D, Lemyre B, Yoder BA, Chiu A, Roberts RS, NIPPV Study Group

Abstract: BACKGROUND: To reduce the risk of bronchopulmonary dysplasia in extremely-low-birth-weight infants, clinicians attempt to minimize the use of endotracheal intubation by the early introduction of less invasive forms of positive airway pressure.


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