Intensive Care Society State-of-the-Art Meeting 10-12th December 2018

State of the Art (SOA) this year is in central London, at the QEII Centre. The three-day programme has ninety of the very best speakers, over thirty concurrent sessions, opening and closing plenary’s.  This year also have the SOAp Box with relaxed mini-talks in the Exhibition Hall, Cauldron, PechaKucha, E-posters, and a Learning Suite, including immersive simulation, echo and POCUS live demonstrations. There are also five different opportunities to present your work to peers.
More details including registration are available via this link.

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Body temperature measurement methods and targets in Australian and New Zealand intensive care units.

This research by Cutuli and colleagues was published in the “Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine” in September 2018.
Objective:  In Australian and New Zealand (ANZ) intensive care units (ICUs), the preferred measurement methods and targets for temperature remain uncertain, but are crucial for future interventional studies. We aimed to investigate the reported use of temperature measurement methods and targets in ANZ ICUs.
Design, setting and participants:  Structured online questionnaire delivered via the email list of the Australian and New Zealand Intensive Care Society Clinical Trials Group.
Main outcomes measures:  Measurements methods and targets for temperature in ANZ ICUs.
Results:  Of 209 respondents, 130 were nurses (62.2%) and 79 were doctors (37.8%). Only 21.5% of the respondents reported having a unit protocol for measuring body temperature. However, invasive temperature measurement methods were preferred by doctors (69.8% v 55.3%) and non-invasive methods by nurses (29.9% v 44.2%). Moreover, among non-invasive methods, tympanic measurement was preferred by doctors (66.0% v 26.9%) and axillary by nurses (11.7% v 51.9%). Both professions reported a wide range of temperature thresholds that they believed required cooling interventions, but 16.7% of doctors and 42.4% of nurses reported that, in patients with cardiac arrest, they would actively cool patients only if the temperature was ≥ 38°C.
Conclusion:  In ANZ ICUs, preferred temperature measurement methods and targets are typically not governed by protocol, vary greatly and differ between doctors and nurses. Targeted temperature management after cardiac arrest is not fully established. Future studies of the comparative accuracy of non-invasive temperature measurements methods and practice in patients with cardiac arrest appear important.
To access the full text of this article via the journal’s homepage you require a personal subscription to the journal.  Library members can order individual articles via the Rotherham NHS Foundation Trust Library and Knowledge Service using the article requests online via this link.

Determinants of long-term outcome in ICU survivors: results from the FROG-ICU study

This cohort study by Gayat et al was published in the journal “Critical Care”.

Background:  Intensive care unit (ICU) survivors have reduced long-term survival compared to the general population. Identifying parameters at ICU discharge that are associated with poor long-term outcomes may prove useful in targeting an at-risk population. The main objective of the study was to identify clinical and biological determinants of death in the year following ICU discharge.

Methods:  FROG-ICU was a prospective, observational, multicenter cohort study of ICU survivors followed 1 year after discharge, including 21 medical, surgical or mixed ICUs in France and Belgium. All consecutive patients admitted to intensive care with a requirement for invasive mechanical ventilation and/or vasoactive drug support for more than 24 h following ICU admission and discharged from ICU were included. The main outcome measure was all-cause mortality at 1 year after ICU discharge. Clinical and biological parameters on ICU discharge were measured, including the circulating cardiovascular biomarkers N-terminal pro-B type natriuretic peptide, high-sensitive troponin I, bioactive-adrenomedullin and soluble-ST2. Socioeconomic status was assessed using a validated deprivation index (FDep).

Results: Of 1570 patients discharged alive from the ICU, 333 (21%) died over the following year. Multivariable analysis identified age, comorbidity, red blood cell transfusion, ICU length of stay and abnormalities in common clinical factors at the time of ICU discharge (low systolic blood pressure, temperature, total protein, platelet and white cell count) as independent factors associated with 1-year mortality. Elevated biomarkers of cardiac and vascular failure independently associated with 1-year death when they are added to multivariable model, with an almost 3-fold increase in the risk of death when combined (adjusted odds ratio 2.84 (95% confidence interval 1.73-4.65), p < 0.001).

Conclusions:  The FROG-ICU study identified, at the time of ICU discharge, potentially actionable clinical and biological factors associated with poor long-term outcome after ICU discharge. Those factors may guide discharge planning and directed interventions.

The full text of this article is available without password via this link.

Latest issue of “Journal of Critical Care” Volume 43 February 2018

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The current issue content page can be accessed via this link.

The issue contained a series of special articles on dengue fever, ebola, malaria and leptospirosis together with a range of other articles including “Initial fluid resuscitation following adjusted body weight dosing is associated with improved mortality in obese patients with suspected septic shock” and “Clinical management of pressure control ventilation: An algorithmic method of patient ventilatory management to address “forgotten but important variables””

To access the full text of these articles direct from the journal’s homepage requires a personal subscription.  Individual articles can be ordered via the Rotherham NHS Foundation Trust Library and Knowledge Service.  Registered members of the library can make article requests online via this link.

Critical Care Reviews Newsletter 314 17th December 2017

The 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.  Research contained in the newsletter includes: “Adjunctive rifampicin for Staphylococcus aureus bacteraemia (ARREST): a multicentre, randomised, double-blind, placebo-controlled trial”, “Targeted Temperature Management After Cardiac Arrest: Systematic Review and Meta-analyses” and “Hypovitaminosis C and vitamin C deficiency in critically ill patients despite recommended enteral and parenteral intakes.”
The full copy of newsletter 314 17th December 2017 can be accessed via this link.

Latest issue of “Intensive and Critical Care Nursing” Volume 40 June 2017

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Titles of articles published in this issue include “Does good critical thinking equal effective decision-making among critical care nurses? A cross-sectional survey”, “The clinical surveillance process as carried out by expert nurses in a critical care context: A theoretical explanation” and “Nasal care in intensive care unit patients”.

The content page of this issue can be accessed via this link.

To see the full text of any of these articles direct from the journal’s homepage requires a personal subscription.  Individual articles can be ordered via the Rotherham NHS Foundation Trust Library and Knowledge Service.  Registered members of the library can make article requests online via this link.

Issues of Intensive and Critical Care Nursing from issue older than one year ago can have their full text accessed via this link.  A Rotherham NHS Athens password is required.  Eligible staff can register for an Athens password via this link.

Critical Care Reviews Newsletter 313 10th December 2017

The 313th Critical Care Reviews Newsletter brings you the best critical care research and open access articles from across the medical literature over the past seven days.  “The highlights of this week’s issue are two RCTs in out-of-hospital cardiac arrest, investigating inhaled xenon and prehospital cooling respectively, meta analyses on strecritcal care reviewsss ulcer prophylaxis, polymyxin B-immobilized hemoperfusion insepsis, and lung and diaphragmatic ultrasound to predict weaning outcome; plus observational studies on prone positioning in ARDS and hypoxemic respiratory failure in immunocompromised patients. There are also guidelines on bleeding in patients on oral anticoagulants and emergency airway management; and excellent narrative reviews on high-frequency oscillatory ventilation in ARDS , high-flow nasal oxygen and renal replacement therapy for acute brain injury.”

The full copy of newsletter 313 10th December 2017 can be accessed via this link.