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.

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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.

Latest Issue of “Intensive Care Medicine” Volume 43 Number 12

intensive-care-medicineTo access Intensive Care Medicine’s latest issue’s contents page follow this link.

Articles in this issue include “Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)”, “Terminal weaning or immediate extubation for withdrawing mechanical ventilation in critically ill patients (the ARREVE observational study)” and “The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (≥ 80 years)”.

To access the full text of these articles from the journal’s homepage requires a personal subscription to the journal.  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.

The full text of articles from issues older than one year ago is available via this link to an archive of issues of Intensive Care Medicine.  A Rotherham NHS Athens password is required.  Eligible staff can register for an Athens password via this link.  Please speak to the library staff for more details.

Critical Care Reviews Newsletter 312 3rd December 2017

The 312nd 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 the latest issue are “The highlights of this week’s issue are randomised controlled trials investigating prehospital antibiotics for sepsis & reducing discomfort in critically ill patients; narrative reviews on blood pressure management in acute intracerebral hemorrhage, non-invasive cardiac output monitoring, managing persistent hypoxemia & ventilator-associated pneumonia; as well as commentaries on 10 false beliefs in adult critical care nephrology, medical preprints and five ways to fix statistics.”

The full copy of newsletter 312 3rd December 2017 can be accessed via this link.