The 288th issue of the Critical Care Reviews Newsletter includes the latest research from across the medical literature during the last week. Highlights of this latest issue include the REVIVE RCT investigating an exercise programme post discharge home after critical illness, a paediatric trail examining the FAST scan in trauma and an RCT on icatibant for ACE inhibitor induced upper airway angioedema.
To view Intensive Care Medicine’s latest issue’s contents page follow this link.
This issue includes a systematic review on “Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients”, “LICRA pragmatic controlled clinical trial on effects of restricting perioperative use of intravenous chloride on kidney injury in patients undergoing cardiac surgery” and a review on “Current state of the art for renal replacement therapy in critically ill patients with acute kidney injury”.
To read the full text of these articles from the journal’s homepage a personal subscription to “Intensive Care Medicine” is required. Individual articles can be ordered from 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.
This conference will be held at the Arena and Convention Centre Liverpool on 4th to 6th December 2017. The format has been redesigned to be more interactive and provide plenty of chance to ask questions, exchange views and network. Content highlights will include “peri-op medicine and ICU: the interface”, “all new all day trauma track” and “Is there a place for standalone HDUs?”. A full programme and booking details will be available soon. For more details see the meetings’ website via this link.
The 287th issue of the Critical Care Reviews Newsletter includes the latest research from across the medical literature from the previous week. Highlights include “the pilot TOP-UP and SPIRIT randomised controlled trials, a worrying study on data fabrication in anaesthetic and general medical journals, a guideline on acute kidney injury reviews on fluid responsiveness, clinical examination in circulatory shock, continuous renal replacement therapy forty year anniversary and an interesting discussion on the management of septic shock”.
The full text of the newsletter can be accessed via this link.
Sinks in patient rooms are associated with hospital-acquired infections | Antimicrobial Resistance & Infection Control
Background: The aim of this study was to evaluate the effect of removal of sinks from the Intensive Care Unit (ICU) patient rooms and the introduction of ‘water-free’ patient care on gram-negative bacilli colonization rates.
Conclusions: Removal of sinks from patient rooms and introduction of a method of ‘water-free’ patient care is associated with a significant reduction of patient colonization with GNB, especially in patients with a longer ICU length of stay.
Full reference: Hopman, J. et al. (2017) Reduced rate of intensive care unit acquired gram-negative bacilli after removal of sinks and introduction of ‘water-free’ patient care. Antimicrobial Resistance & Infection Control. 6:59
We have significantly improved hospital mortality from sepsis and critical illness in last 10 years; however, over this same period we have tripled the number of ‘ICU survivors’ going to rehabilitation | Current Opinion in Critical Care
Furthermore, as up to half the deaths in the first year following ICU admission occur post-ICU discharge, it is unclear how many of these patients ever returned home or a meaningful quality of life. For those who do survive, recent data reveals many ‘ICU survivors’ will suffer significant functional impairment or post-ICU syndrome (PICS). Thus, new innovative metabolic and exercise interventions to address PICS are urgently needed. These should focus on optimal nutrition and lean body mass (LBM) assessment, targeted nutrition delivery, anabolic/anticatabolic strategies, and utilization of personalized exercise intervention techniques, such as utilized by elite athletes to optimize preparation and recovery from critical care.
New data for novel LBM analysis technique such as computerized tomography scan and ultrasound analysis of LBM are available showing objective measures of LBM now becoming more practical for predicting metabolic reserve and effectiveness of nutrition/exercise interventions. 13C-Breath testing is a novel technique under study to predict infection earlier and predict over-feeding and under-feeding to target nutrition delivery. New technologies utilized routinely by athletes such as muscle glycogen ultrasound also show promise. Finally, the role of personalized cardiopulmonary exercise testing to target preoperative exercise optimization and post-ICU recovery are becoming reality.
Full reference: Wischmeyer, P.E. et al. (2017) Muscle mass and physical recovery in ICU: innovations for targeting of nutrition and exercise. Current Opinion in Critical Care: Published online: June 7, 2017
There is a distinct gap between theory and practice with respect to research use in clinical practice, particularly in critical care units, that could be related to the presence of a number of barriers that hinder the use of research findings | Dimensions of Critical Care Nursing
Aims: The aims of the study were to identify barriers and facilitators to research use as perceived by Jordanian nurses in critical care units and to examine the predictors of research use among those nurses.
Conclusions: Research use has not been widely implemented yet in Jordan because of various barriers. The organization-related barriers were the most influential. Factors hindering research use are multidimensional, and optimizing them should be a shared responsibility of nurse managers, researchers, clinicians, and academicians. Further initiatives are required to raise awareness of the importance of using evidence-based practice.
Full reference: Hweidi, I. et al. (2017) Research Use of Nurses Working in the Critical Care Units: Barriers and Facilitators. Dimensions of Critical Care Nursing. 36(4) pp. 226–233