Latest Issue of Journal of Critical Care April 2016 Volume 42 Issue 1

The most recent issue of Journal of Critical Care’s content page can be accessed via this link.

The highlights of the issue include “Determination of death after circulatory arrest by intensive care physicians: a survey of current practice in the Netherlands” and “Predicting mortality rates: comparison of an administrative predictive model (hospital standardized mortality ratio) with a physiological predictive model (acute physiology and chronic health evaluation IV) – a cross sectional study”.

To access the full text of the articles freely from the journals homepage website a personal subscription is required.  Alternatively individual articles can be ordered via the Rotherham NHS Foundation Trust Library and Knowledge Service.

Latest Issue of Intensive Care Medicine March 2016 Volume 42 Issue 3

The current issue of Intensive Care Medicine content pages can be accessed via this link.

The articles contained in this issue include “Systematic review including re-analyses of 1148 individual data sets of central venous pressure as a predictor of fluid responsiveness”, “Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome” and “LiFe: a liver injury score to predict outcome in critically ill patients”.

Certain articles are available free to all full text.  However, the majority of articles require a personal subscription to the journal in order to view the full text.  Individual articles can be ordered via the Library and Knowledge Service of Rotherham NHS Foundation Trust.

Effect of Acetazolamide vs Placebo on Duration of Invasive Mechanical Ventilation Among Patients With Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial

This randomised double blind multicentre trial including 382 patients aimed to determine whether acetazolamide reduces mechanical ventilation duration in critically ill patients with COPD and metabolic alkalosis.  Acetazolamide (500-1000 mg, twice daily) was compared with placebo administered intravenously in cases of pure or mixed metabolic alkalosis, initiated within 48 hours of ICU admission and continued during the ICU stay for a maximum of 28 days.

The primary outcome was the duration of invasive mechanical ventilation via endotracheal intubation or tracheotomy. Secondary outcomes included changes in arterial blood gas and respiratory parameters, weaning duration, adverse events, use of non-invasive ventilation after extubation, successful weaning, the duration of ICU stay, and in-ICU mortality.

The results showed that for the acetazolamide group (n = 187), compared with the placebo group (n = 193), no significant between-group differences were found for median duration of mechanical ventilation (−16.0 hours; 95% CI, −36.5 to 4.0 hours; P = .17), duration of weaning off mechanical ventilation (−0.9 hours; 95% CI, −4.3 to 1.3 hours; P = .36), daily changes of minute-ventilation (−0.0 L/min; 95% CI, −0.2 to 0.2 L/min; P = .72), or partial carbon-dioxide pressure in arterial blood (−0.3 mm Hg; 95% CI, −0.8 to 0.2 mm Hg; P = .25), although daily changes of serum bicarbonate (between-group difference, −0.8 mEq/L; 95% CI, −1.2 to −0.5 mEq/L; P < .001) and number of days with metabolic alkalosis (between-group difference, −1; 95% CI, −2 to −1 days; P < .001) decreased significantly more in the acetazolamide group. Other secondary outcomes also did not differ significantly between groups.

Among patients with COPD receiving invasive mechanical ventilation, the use of acetazolamide, compared with placebo, did not result in a statistically significant reduction in the duration of invasive mechanical ventilation. However, the magnitude of the difference was clinically important, and it is possible that the study was underpowered to establish statistical significance.

The full text of this article is available in JAMA volume 315 issue 5 of which there is a paper copy in Rotherham Hospital Healthcare Library.  The content page of this issue of JAMA is available via this link.  However, you will require a personal subscription to access the full text from this site.

Latest Issue of Intensive Care Medicine February 2016 Volume 42 Issue 2

The contents page of the latest issue of this journal is available via this link.

Amongst the articles included in the issue are a systematic review on the quality of life of the survivors of acute kidney injury in the intensive care unit and a randomised controlled trial of daily sedation interruption in critically ill children.

A personal subscription to the journal is required to access the full text of the articles from the website.  However, individual articles can be ordered via the Library and Knowledge Service of Rotherham NHS Foundation Trust.

Belatacept and Long-Term Outcomes in Kidney Transplantation

This randomised controlled trail compared kidney transplant recipients compared a more-intensive belatacept regimen, a less-intensive belatacept regimen, or a cyclosporine regimen over an 84 month period.  Seven years after transplantation, patient and graft survival and the mean estimated glomerular filtration rate (eGFR) were significantly higher for both belatacept regimes than for cyclosporine.

The article was published in the New England journal of medicine, vol. 374, no. 4, p. 333-343 (January 28, 2016).  The full text can be seen in the Healthcare Library on D Level of Rotherham Hospital or via this link.  Please note that most articles in the NEJM are not available freely full text hence the library has a subscription to the physical journal.