The 'B' List - discards from the ICM Hit Parade

This page contains references that have been dropped from (or narrowly failed to reach) the 'Top 100' of the ICM Literature Hit Parade.

ORGANISATIONAL ISSUES

UK Department of Health.
Comprehensive Critical Care: Executive Summary.
National policy and political buzz from the DoH review of 2000.
Search the DOH website for 'critical care' for updates, interesting stats and promises for the future!
Full Text (pdf) - new link

Audit Commission for Local Authorities and the NHS in England and Wales.
Critical to Success.
1999. London
National facts, figures and recommendation. The facts and figures may be dated, but many of the recommendations still hold.........
Full Text (large (2Mb) pdf file!)

Critical Care Stakeholder Forum
Quality Critical Care: Beyond 'Comprehensive Critical Care'
UK Department of Health 2005
The UK political buzz - it's beyond comprehensive........
Recommendation Summary Full Text

National Confidential Enquiry into Patient Outcome and Death
An acute problem?
NCEPOD 2005 Report
What a storm of discussion in medical and lay press alike! Was it of the teacup variety, or not?
NCEPOD Executive Summary NCEPOD Full Text

Clemmer TP, Spuhler VJ, Oniki TA, Horn SD
Results of a collaborative quality improvement program on outcomes and costs in a tertiary critical care unit.
Critical Care Medicine 1999; 27: 1768-74.
Audit and applied clinical research really can make a difference (and save money!)
PubMed Abstract

Burns SM, Earven S, Fisher C, Lewis R, Merrell P et al.; University of Virginia Long Term Mechanical Ventilation Team.
Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: one-year outcomes and lessons learned.
Critical Care Medicine 2003; 31: 2752-2763
Better ICU care costs less! A nurse-led team recapitulates the results of Clemmer et al.
PubMed Abstract

Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV.
Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study.
British Medical Journal 2002; 324: 387-390.
The seminal Australian paper on METs – lots of controversy, so read the correspondence as well, and watch out for the forthcoming MERIT study!
PubMed Abstract BMJ Full Text

Hillman K, Chen J, Cretikos M, Bellomo R, Brown D, Doig G, Finfer S, Flabouris A; MERIT study investigators.
Introduction of the medical emergency team (MET) system: a cluster-randomised controlled trial.
Lancet. 2005; 365: 2091-7.
The Australians brought METS into the world, and they'll take them out again............
PubMed Abstract

McQuillan P, Pilkington S, Allan A, Taylor B, Short A, Morgan G et al.
Confidential inquiry into quality of care before admission to intensive care.
British Medical Journal 1998; 316: 1853-1858.
A bread-and-butter British study!
PubMed Abstract BMJ Full Text

Kahn JM, Goss CH, Heagerty PJ, Kramer AA, O'Brien CR, Rubenfeld GD.
Hospital volume and the outcomes of mechanical ventilation.
New England Journal of Medicine 2006; 355: 41-50.
Alas, it seems size does matter!
PubMed Abstract NEJM Full Text

Pronovost PJ, Jenckes MW, Dorman T, Garrett E, Breslow MJ, Rosenfeld BA et al.
Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery.
Journal of the American Medical Association 1999; 281: 1310-1317.
American study. AAA is just one model – the same factors probably influence outcome across the board.
PubMed Abstract JAMA Full Text (free but requires registration)

Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL.
Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review.
Journal of the American Medical Association 2002; 288: 2151-62
Meta-analysis proves that intensivists are better at intensive care than non-intensivists (whew!)
PubMed Abstract JAMA Full Text (free but requires registration)

Lyons RA, Wareham K, Hutchings HA, Major E, Ferguson B.
Population requirement for adult critical-care beds: a prospective quantitative and qualitative study.
Lancet 2000; 355: 595-598.
How many beds is enough? A controversial study from Wales
PubMed Abstract Search Lancet for (free) full Text

Goldhill DR, Sumner A.
Outcome of intensive care patients in a group of British intensive care units.
Critical Care Medicine 1998; 26: 1337-1345.
A comprehensive survey of British ICU mortality, and suggestions for improvements.
PubMed Abstract

Ridley S.
Severity of illness scoring systems and performance appraisal.
Anaesthesia 1998; 53: 1185-1194.
Review of the principles of scoring systems in general, and pros and cons of particular systems.
PubMed Abstract

Knaus WA, Draper EA, Wagner DP, Zimmerman JE.
APACHE II: a severity of disease classification system.
Critical Care Medicine 1985; 13: 818-829.
The daddy of ICU severity scores
PubMed Abstract

Goldfrad C, Rowan K.
Consequences of discharges from intensive care at night.
Lancet 2000; 355: 1138-1142.
Do you worry about pushing patients out early to make beds? Well, you should!
PubMed Abstract

Daly K, Beale R, Chang RW.
Reduction in mortality after inappropriate early discharge from intensive care unit: logistic regression triage model.
British Medical Journal 2001; 322: 1274-1276
Whom to push and whom to keep?
PubMed Abstract BMJ Full Text

Ball C, Kirkby M, Williams S.
Effect of the critical care outreach team on patient survival to discharge from hospital and readmission to critical care: non-randomised population based study.
British Medical Journal 2003; 327: 1014-1016
Hampstead does for post-ICU outreach what Australia did for METs!
PubMed Abstract BMJ Full Text

Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E et al.
Effect of reducing interns' work hours on serious medical errors in intensive care units.
New England Journal of Medicine 2004; 351: 1838-48
Even the Americans - even Harvard! - are reducing their juniors' hours.
PubMed Abstract NEJM Full Text

Ridley SA, Booth SA, Thompson CM; Intensive Care Society's Working Group on Adverse Incidents.
Prescription errors in UK critical care units.
Anaesthesia 2004; 59: 1193-200.
3% of ICU prescriptions are potentially life-threatening!
PubMed Abstract

Singer EA, Müllner M
Implications of the EU directive on clinical trials for emergency medicine.
British Medical Journal 2002; 324: 1169-1170
The EU accidentally wipes out clinical research in critical care! The consent issue has softened, but there are still problems - look for recent news and correspondence in the BMJ, Lancet, ICM and Anaesthesia. An up-to-date view on the position in different EU countries is given in this article. See also an excellent recent review in Current Opinion.
BMJ Full Text

Lemaire F.
The European Directive 2001/20 for clinical research: friend or foe?
Intensive Care Medicine 2006; 32: 1689-90.
The EU Directive issue simmers on! For more on the history of this debacle, see the Discard list (under Singer)
PubMed (no abstract) For the latest UK legal development, see this news in the BMJ

Silverman HJ, Lemaire F.
Ethics and research in critical care.
Intensive Care Medicine 2006; 32: 1697-705.
An important topic in its own right, and also in the context of the EU Directive and the recent TeGenero incident
PubMed Abstract

RESPIRATORY SUPPORT

Murray JF, Matthay MA, Luce JM, Flick MR.
An expanded definition of the adult respiratory distress syndrome.
American Review of Respiratory Disease 1988; 138: 720-723.
The official definition of ARDS
PubMed (no abstract available)

Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A.
Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes?
American Journal of Respiratory and Critical Care Medicine 1998; 158: 3-11.
I’m not convinced, but my examiners were!
PubMed Abstract AJRCCM Full Text

Adhikari N, Burns KE, Meade MO.
Pharmacologic therapies for adults with acute lung injury and acute respiratory distress syndrome.
Cochrane Database of Systematic Reviews 2004
Once they update it with the ARDSNET steroid study, pentoxifylline will be the only horse left in the race....
PubMed Abstract Cochrane Full Text

The Acute Respiratory Distress Syndrome Network.
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.
New England Journal of Medicine 2000; 342: 1301-1308.
Perhaps the most controversial paper in intensive care since Connors......
PubMed Abstract NEJM Full Text

Yu M, Tomasa G.
A double-blind, prospective, randomized trial of ketoconazole, a thromboxane synthetase inhibitor, in the prophylaxis of the adult respiratory distress syndrome.
Critical Care Medicine 1993; 21: 1635-1642.
Ketoconazole seems effective in preventing ARDS ………..
PubMed Abstract

The ARDS Network.
Ketoconazole for early treatment of acute lung injury and acute respiratory distress syndrome: a randomized controlled trial.
Journal of the American Medical Association 2000; 283: 1995-2002.
………….. but not effective in treating it.
PubMed Abstract JAMA Full Text (free but requires registration)

Gattinoni L, Mascheroni D, Torresin A, Marcolin R, Fumagalli R et al.
Morphological response to positive end expiratory pressure in acute respiratory failure. Computerized tomography study.
Intensive Care Medicine 1986; 12: 137-142.
The classic CT description of gravity-dependent atelectasis
PubMed Abstract

Langer M, Mascheroni D, Marcolin R, Gattinoni L.
The prone position in ARDS patients. A clinical study.
Chest 1988; 94: 103-107.
The logical response to dependent atelectasis ………..
PubMed Abstract

Gattinoni L, Tognoni G, Pesenti A, Taccone P, Mascheroni D, Labarta V et al.
Effect of prone positioning on the survival of patients with acute respiratory failure.
New England Journal of Medicine 2001; 345: 568-573.
Does prone ventilation improve outcome?
PubMed Abstract NEJM Full Text

Guerin C, Gaillard S, Lemasson S, Ayzac L, Girard R et al.
Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.
Journal of the American Medical Association 2004; 292: 2379-87
Another, even bigger study to tell us that prone ventilation doesn't improve outcome
PubMed Abstract JAMA Full Text (free but requires registration)

Hickling KG, Walsh J, Henderson S, Jackson R.
Low mortality rate in adult respiratory distress syndrome using low- volume, pressure-limited ventilation with permissive hypercapnia: a prospective study.
Critical Care Medicine 1994; 22: 1568-1578.
Not a RCT, but a seminal paper asking does low-volume ventilation improve ARDS survival? …………
PubMed Abstract

Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP et al.
Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome.
New England Journal of Medicine 1998; 338: 347-354.
Yes it does………….
PubMed Abstract NEJM Full Text

Stewart TE, Meade MO, Cook DJ, Granton JT, Hodder RV, Lapinsky SE et al.
Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. Pressure- and Volume-Limited Ventilation Strategy Group.
New England Journal of Medicine 1998; 338: 355-361.
…………. no it doesn’t ……………. (but what about ARDSNET?!)
PubMed Abstract NEJM Full Text

Brower RG, Lanken PN, MacIntyre N, Matthay MA, Morris A et al.: ARDS Clinical Trials Network.
Higher versus lower positive end-expiratory pressures in patients with the acute respiratory distress syndrome.
New England Journal of Medicine 2004; 351: 327-336
ARDS-Net got quite a lot of flak for this one as well!
PubMed Abstract NEJM Full Text

Yang KL, Tobin MJ.
A prospective study of indexes predicting the outcome of trials of weaning from mechanical ventilation.
New England Journal of Medicine 1991; 324: 1445-1450.
How can you tell if your patient is ready to wean from the ventilator?
PubMed Abstract

Esteban A, Frutos F, Tobin MJ, Alia I, Solsona JF, Valverdu I et al.
A comparison of four methods of weaning patients from mechanical ventilation. Spanish Lung Failure Collaborative Group.
New England Journal of Medicine 1995; 332: 345-350.
What’s the best mode for weaning?
PubMed Abstract NEJM Full Text

Kollef MH, Shapiro SD, Silver P, St John RE, Prentice D, Sauer S et al.
A randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation.
Critical Care Medicine 1997; 25: 567-574.
A faster way to wean.
PubMed Abstract

Krishnan JA, Moore D, Robeson C, Rand CS, Fessler HE.
A prospective, controlled trial of a protocol-based strategy to discontinue mechanical ventilation.
American Journal of Respiratory and Critical Care Medicine 2004; 169: 673-8
So protocols make for faster weaning? Well, depends on your staffing........
PubMed Abstract AJRCCM Full Text

Kress JP, Pohlman AS, O'Connor MF, Hall JB.
Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation.
New England Journal of Medicine 2000; 342: 1471-1477.
Another faster way to wean.........
PubMed Abstract NEJM Full Text

Kress JP, Gehlbach B, Lacy M, Pliskin N, Pohlman AS, Hall JB.
The long-term psychological effects of daily sedative interruption on critically ill patients.
American Journal of Respiratory and Critical Care Medicine 2003; 168: 1457-1461
.......... and it actually reduces ICU recall and PTSD !
PubMed Abstract AJRCCM Full Text

Ferrer M, Esquinas A, Arancibia F, Bauer TT, Gonzalez G, Carrillo A, Rodriguez-Roisin R, Torres A.
Noninvasive ventilation during persistent weaning failure: a randomized controlled trial.
American Journal of Respiratory and Critical Care Medicine 2003; 168: 70-6
And if they fail to wean? Aaah, just pull the tube anyway and put them on NIV...........!
PubMed Abstract AJRCCM Full Text

Nava S, Gregoretti C, Fanfulla F, Squadrone E, Grassi M et al.
Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients.
Critical Care Medicine 2005; 33: 2465-70
Nava vs. Esteban: prevention is better than cure!
PubMed Abstract

Peter JV, Moran JL, Phillips-Hughes J, Warn D
Noninvasive ventilation in acute respiratory failure--a meta-analysis update
Critical Care Medicine 2002; 30: 555-62
Why tube, if NIV can halve your mortality and intubation rate?
PubMed Abstract

Masip J, Roque M, Sanchez B, Fernandez R, Subirana M, Exposito JA.
Noninvasive ventilation in acute cardiogenic pulmonary edema: systematic review and meta-analysis.
Journal of the American Medical Association 2005; 294: 3124-30
... and it works for acute LVF as well.
PubMed Abstract JAMA Full Text (free but requires registration)

Rossaint R, Falke KJ, Lopez F, Slama K, Pison U, Zapol WM.
Inhaled nitric oxide for the adult respiratory distress syndrome.
New England Journal of Medicine 1993; 328: 399-405.
The seminal paper for inhaled nitric oxide ………….
PubMed Abstract NEJM Full Text

Sokol J, Jacobs SE, Bohn D.
Inhaled nitric oxide for acute hypoxemic respiratory failure in children and adults.
Cochrane Database of Systematic Reviews 2004
The bitter truth about nitric oxide!
PubMed Abstract Cochrane Full Text

Cuthbertson BH, Dellinger P, Dyar OJ, Evans TE, Higenbottam T et al.
UK guidelines for the use of inhaled nitric oxide therapy in adult ICUs. American-European Consensus Conference on ALI/ARDS.
Intensive Care Medicine 1997; 23: 1212-1218.
So when and how should we use nitric, then?
PubMed Abstract

Germann P, Braschi A, Della Rocca G, Dinh-Xuan AT, Falke K, Frostell C et al.
Inhaled nitric oxide therapy in adults: European expert recommendations.
Intensive Care Medicine 2005; 31: 1029-41
So what else can we use nitric for........?
PubMed Abstract

Bein T, Weber F, Philipp A, Prasser C, Pfeifer M et al.
A new pumpless extracorporeal interventional lung assist in critical hypoxemia/hypercapnia
Critical Care Medicine 2006; 34: 1372-77
Goodbye nitric, hello iLA? Impressive ABGs, but will it really improve survival?
PubMed Abstract See also the earlier BJA article (Full Text)

Antonelli M, Conti G, Rocco M, Bufi M, De Blasi RA, Vivino G et al.
A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure.
New England Journal of Medicine 1998; 339: 429-435.
Why tube if you can mask-BiPAP?
PubMed Abstract NEJM Full Text

Lightowler JV, Wedzicha JA, Elliott MW, Ram FSF
Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease:
Cochrane systematic review and meta-analysis.
British Medical Journal 2003; 326:185.
Why indeed, if you can halve your mortality and intubation rate?
PubMed Abstract BMJ Full Text Cochrane Full Text

Dulguerov P, Gysin C, Perneger TV, Chevrolet JC.
Percutaneous or surgical tracheostomy: a meta-analysis.
Critical Care Medicine 1999; 27: 1617-1625.
Is percutaneous trache such a good thing after all?
PubMed Abstract

Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB.
A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients.
Critical Care Medicine 2004; 32: 1689-94
What implications does this have for the UK's forthcoming TracMan study?
PubMed Abstract

Griffiths J, Barber VS, Morgan L, Young JD.
Systematic review and meta-analysis of studies of the timing of tracheostomy in adult patients undergoing artificial ventilation.
British Medical Journal 2005; 330: 1243-1248.
Laying the groundwork for TracMan..............
PubMed Abstract BMJ Full Text

Delaney A, Bagshaw SM, Nalos M.
Percutaneous dilatational tracheostomy versus surgical tracheostomy in critically ill patients: a systematic review and meta-analysis.
Critical Care. 2006; 10: R55.
But what type of trache should we do?
PubMed Abstract Critical Care Full Text

Collard HR, Saint S, Matthay MA
Prevention of ventilator-associated pneumonia: an evidence-based systematic review
Annals of Internal Medicine 2003; 138: 494-501
So what really prevents VAP: SDD? Subglottic aspiration? Circuit changes? Positioning?
PubMed Abstract AIM Full Text

Gibot S, Cravoisy A, Levy B, Bene MC, Faure G, Bollaert PE.
Soluble triggering receptor expressed on myeloid cells and the diagnosis of pneumonia.
New England Journal of Medicine 2004; 350: 451-458
sTREM-1 - a quick-and-easy way of diagnosing VAP?
PubMed Abstract NEJM Full Text

Spragg RG, Lewis JF, Walmrath HD, Johannigman J, Bellingan G et al.
Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome.
New England Journal of Medicine 2004; 351: 884-892
Protein C, the new wonder drug - let's see if it works down the lungs as well!
PubMed Abstract NEJM Full Text
(P.S. Yes, I know surfactant protein C is not the same as Protein C........!)

Meduri GU, Headley AS, Golden E, Carson SJ, Umberger RA, Kelso T, Tolley EA.
Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial.
Journal of the American Medical Association 1998; 280: 159-65.
A small but impressive RCT defining the role of steroids in persistent ARDS
PubMed Abstract JAMA Full Text (free but requires registration)

Steinberg KP, Hudson LD, Goodman RB, Hough CL, Lanken PN et al.; for ARDSNET
Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome
New England Journal of Medicine 2006; 354: 1671-84
So what did ARDSNET do 'wrong' compared to Meduri et al.? Too much steroid? Too late? Study too well-powered.........?
PubMed Abstract NEJM Full Text

Meduri GU, Golden E, Freire AX, Taylor E, Zaman M et al.
Methylprednisolone infusion in early severe ARDS: results of a randomized controlled trial.
Chest 2007; 131: 954-63.
Meduri strikes back!
PubMed Abstract             Chest Full Text

Confalonieri M, Urbino R, Potena A, Piattella M, Parigi P
Hydrocortisone infusion for severe community-acquired pneumonia: a preliminary randomized study.
American Journal of Respiratory and Critical Care Medicine 2005; 171:242-8
Steroids - the old new wonder-drug (no SynACTHen test required!)
PubMed Abstract AJRCCM Full Texts e

Francois B, Bellissant E, Gissot V, Desachy A, Normand S et al. Association des Reanimateurs du Centre-Ouest (ARCO).
12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial.
Lancet 2007; 369: 1083-9
More steroids, anyone............?
PubMed Abstract

Perkins GD, McAuley DF, Thickett DR, Gao F.
The beta-agonist lung injury trial (BALTI): a randomized placebo-controlled clinical trial.
American Journal of Respiratory and Critical Care Medicine 2006; 173: 281-7.
I wasn't that impressed with BALTI at first, but now that BALTI-2 is in the pipeline...
PubMed Abstract             AJRCCM Full Text

Derdak S, Mehta S, Stewart TE, Smith T, Rogers M et al.
High-frequency oscillatory ventilation for acute respiratory distress syndrome in adults: a randomized, controlled trial.
American Journal of Respiratory and Critical Care Medicine 2002;166: 801-8.
The Derdak study makes a rare comeback onto the Hit Parade - working up to an OSCAR !
PubMed Abstract            AJRCCM Full Text

Gallart L, Lu Q, Puybasset L, Umamaheswara Rao GS, Coriat P, Rouby JJ.
Intravenous almitrine combined with inhaled nitric oxide for acute respiratory distress syndrome. The NO Almitrine Study Group.
American Journal of Respiratory and Critical Care Medicine 1998; 158: 1770-1777.
Hypoxic pulmonary vasoconstriction in a bottle – but will it improve outcome?
PubMed Abstract AJRCCM Full Text

PA CATHETERS

Connors AF Jr., Speroff T, Dawson NV, Thomas C, Harrell FE Jr. et al.
The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators.
Journal of the American Medical Association 1996; 276: 889-897.
The paper that turned the tide on the PA catheter.
PubMed Abstract

Ivanov R, Allen J, Calvin JE.
The incidence of major morbidity in critically ill patients managed with pulmonary artery catheters: a meta-analysis.
Critical Care Medicine 2000; 28: 615-619.
PA catheters reduce organ failure, with a non-significant trend towards reduced mortality.
PubMed Abstract

Sandham JD, Hull RD, Brant RF, Knox L, Pineo GF et al.
A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients.
New England Journal of Medicine 2003; 348: 5-14.
Another RCT on PA catheters: nope, they still don't improve outcome
PubMed Abstract NEJM Full Text

Richard C, Warszawski J, Anguel N, Deye N, Combes A et al. (French Pulmonary Artery Catheter Study Group).
Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: a randomized controlled trial.
Journal of the American Medical Association 2003; 290: 2713-2720
Another in an increasingly long line of studies showing no outcome benefit from PA catheters
PubMed Abstract JAMA Full Text (free but requires registration)

Young JD.
Right heart catheterization in intensive care.
British Journal of Anaesthesia 2001; 86: 327-329.
The rationale behind the recently-completed PAC-Man study - expect publication in the Lancet soon!
PubMed (no abstract available) BJA Full Text PAC-Man website abstract

Harvey S, Harrison DA, Singer M, Ashcroft J, Jones CM, Elbourne D et al.; PAC-Man study collaboration.
Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial.
Lancet 2005; 366: 472-7.
The latest and greatest of the PA catheter RCTs!
PubMed Abstract PAC-Man website abstract

Wheeler AP, Bernard GR, Thompson BT, Schoenfeld D, Wiedemann HP et al for ARDSNET.
Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury.
New England Journal of Medicine 2006; 354: 2213-24.
Nope - doesn't work here either.
PubMed Abstract NEJM Full Text

Mitchell JP, Schuller D, Calandrino FS, Schuster DP.
Improved outcome based on fluid management in critically ill patients requiring pulmonary artery catheterization.
American Review of Respiratory Disease 1992; 145: 990-998.
One of two (underpowered) RCTs suggesting that TPTD (e.g. PiCCO) may succeed in improving outcome where the PA catheter has failed.
PubMed Abstract

HAEMODYNAMIC THERAPY

Shoemaker WC, Appel PL, Kram HB, Waxman K, Lee TS.
Prospective trial of supranormal values of survivors as therapeutic goals in high-risk surgical patients.
Chest 1988; 94: 1176-1186.
The paper that started goal-directed therapy............
PubMed Abstract

Boyd O, Grounds RM, Bennett ED.
A randomized clinical trial of the effect of deliberate perioperative increase of oxygen delivery on mortality in high-risk surgical patients.
Journal of the American Medical Association 1993; 270: 2699-2707.
Well, dopexamine works in surgical patients ……………
PubMed Abstract

Gattinoni L, Brazzi L, Pelosi P, Latini R, Tognoni G, Pesenti A, Fumagalli R.
A trial of goal-oriented hemodynamic therapy in critically ill patients. SvO2 Collaborative Group.
New England Journal of Medicine 1995; 333: 1025-1032.
…….. but in general, goal-directed therapy doesn’t work …………….
PubMed Abstract NEJM Full Text

Kern JW, Shoemaker WC.
Meta-analysis of hemodynamic optimization in high-risk patients.
Critical Care Medicine 2002; 30: 1686-92
And the meta-analysis says...... BONG! Yes, it only works if you start before organ failure sets in
PubMed Abstract

Wilson J, Woods I, Fawcett J, Whall R, Dibb W, Morris C, McManus E.
Reducing the risk of major elective surgery: randomised controlled trial of preoperative optimisation of oxygen delivery.
British Medical Journal 1999; 318: 1099-1103.
……. pre-optimisation works – but was it the fluid, the inotrope or the monitoring that did it?
PubMed Abstract BMJ Full Text

Velmahos GC, Demetriades D, Shoemaker WC, Chan LS, Tatevossian R et al.
Endpoints of resuscitation of critically injured patients: normal or supranormal? A prospective randomized trial.
Annals of Surgery 2000; 232: 409-418.
It’s not the goal-directed therapy that improves outcome, but the ability of the patients to achieve the goals (clear as mud?).
PubMed Abstract Full Text from PubMed Central

Mullner M, Urbanek B, Havel C, Losert H, Waechter F, Gamper G.
Vasopressors for shock.
Cochrane Database of Systematic Reviews 2004
Does it even matter which inotrope we use? Precious little evidence to go on.....
PubMed Abstract Cochrane Full Text

F Follath, J G F Cleland, H Just, J G Y Papp, H Scholz, K Peuhkurinen et al.
Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study)
Lancet 2002; 360: 196-202
Are dobutamine's days numbered? And if so, how will that affect the success of goal-directed therapy?
PubMed Abstract

Mebazaa A, Nieminen MS, Packer M, Cohen-Solal A, Kleber FX, Pocock SJ et al. (the SURVIVE Investigators).
Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial.
Journal of the American Medical Association 2007; 297: 1883-91
So what did SURVIVE do differently from LIDO?
PubMed Abstract

TRIUMPH Investigators; Alexander JH, Reynolds HR, Stebbins AL, Harrington RA, Van de Werf F, Hochman JS.
Effect of tilarginine acetate in patients with acute myocardial infarction and cardiogenic shock: the TRIUMPH randomized controlled trial.
Journal of the American Medical Association 2007; 297: 1657-66
TRIUMPH, eh? That's just asking for a disappointing result..........
PubMed Abstract

Hanique G, Dugernier T, Laterre PF, Dougnac A, Roeseler J, Reynaert MS.
Significance of pathologic oxygen supply dependency in critically ill patients: comparison between measured and calculated methods.
Intensive Care Medicine 1994; 20: 12-18.
Mathematical coupling – a body blow to the supply-dependency theory.
PubMed Abstract

FLUID AND TRANSFUSION THERAPY

Bickell WH, Wall MJ, Jr., Pepe PE, Martin RR, Ginger VF, Allen MK, Mattox KL.
Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries.
New England Journal of Medicine 1994; 331: 1105-1109.
“Withhold IV fluid from a hypovolaemic bleeding patient? Ridiculous” ……………
PubMed Abstract NEJM Full Text

Vincent JL, Baron JF, Reinhart K, Gattinoni L et al. for the ABC (Anemia and Blood Transfusion in Critical Care) Investigators.
Anemia and blood transfusion in critically ill patients.
Journal of the American Medical Association 2002; 288: 1499-507
A large, observational, propensity-controlled study confirming the impact of transfusion on mortality
PubMed Abstract JAMA Full Text (free but requires registration)

Wilkes MM, Navickis RJ.
Patient survival after human albumin administration. A meta-analysis of randomized, controlled trials.
Annals of Internal Medicine 2001; 135: 149-164.
Is albumin really that bad? Well, it doesn’t seem to be any good either.
PubMed Abstract AIM Full Text (.pdf)

Cochrane Injuries Group Albumin Reviewers.
Human albumin administration in critically ill patients: systematic review of randomised controlled trials.
British Medical Journal 1998; 317: 235-240.
The death knell of IV albumin? – but read the correspondence as well!
PubMed Abstract BMJ Full Text PubMed Cochrane Abstract (updated with SAFE!) Cochrane Full Text

Schierhout G, Roberts I.
Fluid resuscitation with colloid or crystalloid solutions in critically ill patients: a systematic review of randomised trials.
British Medical Journal 1998; 316: 961-964.
From the team that brought you the death of albumin: poor prognosis for colloids?
PubMed Abstract BMJ Full Text PubMed Cochrane Abstract (updated with SAFE) Cochrane Full Text

Choi PT, Yip G, Quinonez LG, Cook DJ.
Crystalloids vs. colloids in fluid resuscitation: a systematic review.
Critical Care Medicine 1999; 27: 200-210.
Colloids aren’t so bad, except in trauma.
PubMed Abstract

Bunn F, Roberts I, Tasker R, Akpa E.
Hypertonic versus isotonic crystalloid for fluid resuscitation in critically ill patients.
Cochrane Database of Systematic Reviews 2004; CD 002045
Does ‘small-volume resuscitation’ really work?
PubMed Abstract Cochrane Full Text

Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM
Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis
Annals of Surgery 2003; 237: 319-334
It's like goal-directed therapy: hypoalbuminaemia predicts death, treating it doesn't improve outcome, but ability to respond to treatment does. Simple?
PubMed Abstract Full Text from PubMed Central

Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G et al.
A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group.
New England Journal of Medicine 1999; 340: 409-417.
The reason why transfusion is no longer fashionable ………..
PubMed Abstract NEJM Full Text

Hill SR, Carless PA, Henry DA, Carson JL, Hebert PC, McClelland DB et al.
Transfusion thresholds and other strategies for guiding allogeneic red blood cell transfusion.
Cochrane Database of Systematic Reviews 2000
A meta-analysis to prove why transfusion is no longer fashionable.
PubMed Abstract Cochrane Full Text

Barrett NA, Kam PC.
Transfusion-related acute lung injury: a literature review.
Anaesthesia. 2006; 61: 777-85.
This topic cropped up in the 2004 exam - will it be asked again?
PubMed Abstract

NUTRITION

The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group.
Perioperative total parenteral nutrition in surgical patients.
New England Journal of Medicine 1991; 325: 525-532.
The study that proved that you have to be really sick to deserve TPN.
PubMed Abstract

Moore FA, Feliciano DV, Andrassy RJ, McArdle AH, Booth FV et al.
Early enteral feeding, compared with parenteral, reduces postoperative septic complications. The results of a meta-analysis.
Annals of Surgery 1992; 216: 172-183.
One of the earliest meta-analyses in critical care.
PubMed Abstract Full Text from PubMed Central

Heyland DK, MacDonald S, Keefe L, Drover JW.
Total parenteral nutrition in the critically ill patient: a meta-analysis.
Journal of the American Medical Association 1998; 280: 2013-2019.
TPN might be good for general surgical patients, but it’s definitely bad for ICU patients.
PubMed Abstract JAMA Full Text (free but requires registration)

Gramlich L, Kichian K, Pinilla J, Rodych NJ, Dhaliwal R, Heyland DK.
Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature.
Nutrition 2004; 20: 843-8
Surprisingly little effect on mortality, but otherwise: yes, it does.........
PubMed Abstract

Marik PE, Zaloga GP.
Early enteral nutrition in acutely ill patients: a systematic review.
Critical Care Medicine 2001; 29: 2264-2270.
OK, feed the surgical patients, but where are all the medical patients?
PubMed Abstract

Marik PE, Zaloga GP.
Gastric versus post-pyloric feeding: a systematic review
Critical Care 2003; 7: R46-51
Looks like these two have carved out their niche.........
PubMed Abstract Critical Care Full Text

Marik PE, Zaloga GP.
Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis.
British Medical Journal 2004; 328: 1407-1410
Any surprise at their findings? But try convincing your local surgeon..........
PubMed Abstract BMJ Full Text

Heyland DK, Dhaliwal R, Suchner U, Berger MM.
Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient.
Intensive Care Medicine 2005; 31: 327-337
Immunonutrition? So passé - antioxidants are the current nutrition topic!
PubMed Abstract

Pontes-Arruda A, Aragao AM, Albuquerque JD.
Effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic shock.
Critical Care Medicine 2006; 34: 2325-33.
Waaaaaay better than drotrecogin............?
PubMed Abstract

Heyland DK, Novak F, Drover JW, Jain M, Su X, Suchner U.
Should immunonutrition become routine in critically ill patients? A systematic review of the evidence.
Journal of the American Medical Association 2001; 286: 944-953.
Enteral immunonutrition reduces infections, but only arginine might also reduce mortality.
PubMed Abstract JAMA Full Text (free but requires registration)

Griffiths RD, Jones C, Palmer TE.
Six-month outcome of critically ill patients given glutamine-supplemented parenteral nutrition.
Nutrition 1997; 13: 295-302.
The one immuno-nutrient that actually seems to improve mortality........
PubMed Abstract

Hall JC, Dobb G, Hall J, De Sousa R, Brennan L, McCauley R
A prospective randomized trial of enteral glutamine in critical illness
Intensive Care Medicine 2003; 29: 1710-6
........ but not if you give it enterally.........
PubMed Abstract

Novak F, Heyland DK, Avenell A, Drover JW, Su X
Glutamine supplementation in serious illness: a systematic review of the evidence
Critical Care Medicine 2002; 30: 2022-9
.......... only if you give it parenterally.
PubMed Abstract

Beale RJ, Bryg DJ, Bihari DJ.
Immunonutrition in the critically ill: a systematic review of clinical outcome.
Critical Care Medicine 1999; 27: 2799-2805.
Enteral immunonutrition reduces infections, but not mortality.
PubMed Abstract

Montejo JC, Zarazaga A, Lopez-Martinez J, Urrutia G, Roque M et al.; Spanish Society of Intensive Care Medicine and Coronary Units.
Immunonutrition in the intensive care unit. A systematic review and consensus statement.
Clinical Nutrition 2003; 22: 221-33
Supported by Novartis? Maybe that's why they came to the opposite conclusion to the Canadian Consensus
PubMed Abstract

Booth CM, Heyland DK, Paterson WG
Gastrointestinal promotility drugs in the critical care setting: a systematic review of the evidence
Critical Care Medicine 2002; 30: 1429-35
It looks like metoclopramide is best for feed absorption, but erythromycin is best for passing NJ tubes...
PubMed Abstract

Meissner W, Dohrn B, Reinhardt K.
Enteral naloxone reduces gastric tube reflux and frequency of pneumonia in critical care patients during opioid analgesia.
Critical Care Medicine 2003; 31: 776-780
One of those 'I wish I'd thought of that' ideas - and it works!
PubMed Abstract

Martin CM, Doig GS, Heyland DK, Morrison T, Sibbald WJ; Southwestern Ontario Critical Care Research Network.
Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT).
Canadian Medical Association Journal 2004; 170: 197-204
Oh dear. Once again, protocols prove better than doctors.........
PubMed Abstract CMAJ Full Text

ULCER PROPHYLAXIS

Cook DJ, Reeve BK, Guyatt GH, Heyland DK, Griffith LE, Buckingham L, Tryba M.
Stress ulcer prophylaxis in critically ill patients. Resolving discordant meta-analyses.
Journal of the American Medical Association 1996; 275: 308-314.
A useful methodological paper: what do you do when different meta-analyses give contradictory answers? …………
PubMed Abstract

Messori A, Trippoli S, Vaiani M, Gorini M, Corrado A.
Bleeding and pneumonia in intensive care patients given ranitidine and sucralfate for prevention of stress ulcer: meta-analysis of randomised controlled trials.
British Medical Journal 2000; 321: 1103-1106.
…….. Do another meta-analysis, of course – which shows that none of them work!
PubMed Abstract BMJ Full Text

Kantorova I, Svoboda P, Scheer P, Doubek J, Rehorkova D et al.
Stress ulcer prophylaxis in critically ill patients: a randomized controlled trial.
Hepatogastroenterology 2004; 51: 757-61.
Sucralfate, PPIs, H2-blockers - or nothing at all?
PubMed Abstract

INFECTION

Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH et al.
The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study.
Journal of the American Medical Association 1995; 274: 639-644.
EPIC by name, EPIC by nature.
PubMed Abstract

Veenstra DL, Saint S, Saha S, Lumley T, Sullivan SD.
Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection: a meta-analysis.
Journal of the American Medical Association 1999; 281: 261-267.
Perhaps we should be using these routinely.
PubMed Abstract JAMA Full Text (free but requires registration)

Walder B, Pittet D, Tramer MR
Prevention of bloodstream infections with central venous catheters treated with anti-infective agents depends on catheter type and insertion time: evidence from a meta-analysis
Infection Control and Hospital Epidemiology 2002; 23: 748-56
Which works better - antibiotic coating or antiseptic coating?
PubMed Abstract ICHE Full Text (.pdf)

Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K et al.
Eliminating catheter-related bloodstream infections in the intensive care unit.
Critical Care Medicine 2004; 32: 2014-20
OK, you can have expensive coated CVP lines, or cheap ordinary lines and good antiseptic policy - which works better?
PubMed Abstract

Langgartner J, Linde HJ, Lehn N, Reng M, Scholmerich J, Gluck T.
Combined skin disinfection with chlorhexidine/propanol and aqueous povidone-iodine reduces bacterial colonisation of central venous catheters.
Intensive Care Medicine 2004; 30: 1081-1088
Chlorhexidine or Betadine? Use both!
PubMed Abstract

Zurcher M, Tramer MR, Walder B.
Colonization and bloodstream infection with single- versus multi-lumen central venous catheters: a quantitative systematic review.
Anesthesia and Analgesia 2004; 99: 177-182
But I really like my penta-lumen catheters.............!
PubMed Abstract

Kollef MH, Rello J, Cammarata SK, Croos-Dabrera RV, Wunderink RG.
Clinical cure and survival in Gram-positive ventilator-associated pneumonia: retrospective analysis of two double-blind studies comparing linezolid with vancomycin.
Intensive Care Medicine 2004; 30: 388-394
Are you still using vancomycin for Staph VAP?
PubMed Abstract

Paul M, Benuri-Silbiger I, Soares-Weiser K, Leibovici L.
Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials.
British Medical Journal 2004; 328: 668-672
Cef and gent for your Gram-negative bacteraemia? Naaah.............. (but they weren't all ICU patients.........)
PubMed Abstract BMJ Full Text Cochrane Full Text (updated)

Luzzani A, Polati E, Dorizzi R, Rungatscher A, Pavan R, Merlini A.
Comparison of procalcitonin and C-reactive protein as markers of sepsis.
Critical Care Medicine 2003; 31: 1737-1741
Procalcitonin takes another step towards dethroning CRP
PubMed Abstract

Simon L, Gauvin F, Amre DK, Saint-Louis P, Lacroix J.
Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis.
Clinical Infectious Diseases 2004; 39: 206-17
Marginally better for double the cost? Hmmm........
PubMed Abstract Clinical Infectious Disease Full Text

de Jonge E, Schultz MJ, Spanjaard L, Bossuyt PM, Vroom MB, Dankert J, Kesecioglu J
Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial
Lancet 2003; 362: 1011-6
SDD is back on the agenda!
PubMed Abstract

D'Amico R, Pifferi S, Leonetti C, Torri V, Tinazzi A, Liberati A.
Effectiveness of antibiotic prophylaxis in critically ill adult patients: systematic review of randomised controlled trials.
British Medical Journal 1998; 316: 1275-1285.
Does SDD really work? Depends on your definitions.
PubMed Abstract BMJ Full Text Cochrane Full Text (updated)

Liberati A, D'Amico R, Pifferi S, Torri V, Brazzi L, Gensini GF, Gusinu R.
Antibiotic prophylaxis to prevent nosocomial infections in patients in intensive care units: evidence that struggle to convince practising clinicians.
Internal and Emergency Medicine 2006; 1: 160-2. (a brand-new journal! Much needed, no doubt.........)
Bad grammar aside, why is it that the evidence struggle to convince?
PubMed Abstract Cochrane Full Text

Vardakas KZ, Samonis G, Michalopoulos A, Soteriades ES, Falagas ME.
Antifungal prophylaxis with azoles in high-risk, surgical intensive care unit patients: a meta-analysis of randomized, placebo-controlled trials.
Critical Care Medicine 2006; 34: 1216-24
Two meta-analyses from CCM on the same topic in six months? Must be important...........
PubMed Abstract

Cepeda JA, Whitehouse T, Cooper B, Hails J, Jones K, Kwaku F et al.
Isolation of patients in single rooms or cohorts to reduce spread of MRSA in intensive-care units: prospective two-centre study.
Lancet 2005; 365: 295-304.
Thank goodness - it doesn't work! Lots of correspondence, though........
PubMed Abstract

Bartlett JG, Perl TM.
The new Clostridium difficile--what does it mean?
New England Journal of Medicine 2005; 353: 2503-5
An editorial commenting on two papers in the same issue, by McDonald et al. (CDC) and Loo et al. (Quebec). See this IDSA article from Medscape for a quick run-down on 'New-variant C. diff.'
PubMed (no abstract)

METABOLIC AND CYTOKINE THERAPIES IN SEPSIS

Bernard GR, Vincent JL, Laterre PF, LaRosa SP, Dhainaut JF et al.
Efficacy and safety of recombinant human activated protein C for severe sepsis.
New England Journal of Medicine 2001; 344: 699-709.
The PROWESS study has since been extensively data-mined for more papers!
PubMed Abstract NEJM Full Text

Abraham E, Laterre PF, Garg R, Levy H, Talwar D et al.
Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death.
New England Journal of Medicine 2005; 353:1332-41
ADDRESS confirms what PROWESS suspected - only the sickest patients benefit from this expensive drug (whew!). See ENHANCE for more on APC.
PubMed Abstract NEJM Full Text

Panacek EA, Marshall JC, Albertson TE, Johnson DH, Johnson S et al.: The MONARCS Study Investigators
Efficacy and safety of the monoclonal anti-tumor necrosis factor antibody F(ab')2 fragment afelimomab in patients with severe sepsis and elevated interleukin-6 levels.
Critical Care Medicine 2004; 32: 2173-2182
So why hasn't afelimomab caught on like drotrecogin has? Could it be the need to measure IL-6 - or is it the statistical 'inflation' of the RR reduction?
PubMed Abstract

Abraham E, Wunderink R, Silverman H, Perl TM, Nasraway S, Levy H et al. TNF-alpha MAb Sepsis Study Group.
Efficacy and safety of monoclonal antibody to human tumor necrosis factor alpha in patients with sepsis syndrome. A randomized, controlled, double-blind, multicenter clinical trial.
Journal of the American Medical Association 1995; 273: 934-941.
The magic bullet that missed…………
PubMed Abstract

Cohen J, Carlet J. International Sepsis Trial Study Group.
INTERSEPT: an international, multicenter, placebo-controlled trial of monoclonal antibody to human tumor necrosis factor-alpha in patients with sepsis.
Critical Care Medicine 1996; 24: 1431-1440.
………. missed again ………….
PubMed Abstract

Opal SM, Fisher CJ Jr, Dhainaut JF, Vincent JL, Brase R et al. The Interleukin-1 Receptor Antagonist Sepsis Investigator Group.
Confirmatory interleukin-1 receptor antagonist trial in severe sepsis: a phase III, randomized, double-blind, placebo-controlled, multicenter trial.
Critical Care Medicine 1997; 25: 1115-1124
........... and again, dammit............
PubMed Abstract

Abraham E, Anzueto A, Gutierrez G, Tessler S, San Pedro G, Wunderink R et al.
Double-blind randomised controlled trial of monoclonal antibody to human tumour necrosis factor in treatment of septic shock. NORASEPT II Study Group.
Lancet 1998; 351: 929-933.
.......... more misses from the magic bullet ………..
PubMed Abstract Search Lancet for (free) full Text

Warren BL, Eid A, Singer P, Pillay SS, Carl P, Novak I, Chalupa P et al.
High-dose antithrombin III in severe sepsis: a randomized controlled trial.
Journal of the American Medical Association 2001; 286: 1869-1878.
……… another dud magic bullet …………
PubMed Abstract JAMA Full Text (free but requires registration)

Abraham E, Reinhart K, Opal S et al (the OPTIMIST Study Group)
Efficacy and safety of tifacogin (recombinant tissue factor pathway inhibitor) in severe sepsis: a randomized controlled trial
Journal of the American Medical Association 2003; 290: 238-47
How could a magic bullet start SO right and then go SO wrong?
PubMed Abstract JAMA Full Text (free but requires registration)

Opal S, Laterre PF, Abraham E, Francois B, Wittebole X et al.; Controlled Mortality Trial of Platelet-Activating Factor Acetylhydrolase in Severe Sepsis Investigators.
Recombinant human platelet-activating factor acetylhydrolase for treatment of severe sepsis: results of a phase III, multicenter, randomized, double-blind, placebo-controlled, clinical trial.
Critical Care Medicine 2004; 32: 332-341
The latest dud magic bullet - but I'm sure there'll be another along soon..........
PubMed Abstract

Busund R, Koukline V, Utrobin U, Nedashkovsky E.
Plasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial.
Intensive Care Medicine 2002; 28: 1434-9
Never mind magic bullets, this is a magic machine-gun!
PubMed Abstract

Alejandria MM, Lansang MA, Dans LF, Mantaring JBV
Intravenous immunoglobulin for treating sepsis and septic shock
Cochrane Database of Systematic Reviews 2001
Another magic machine-gun - should we all be using this?
PubMed Abstract Cochrane Full Text

Jacobs S, Price Evans DA, Tariq M, Al Omar NF
Fluconazole improves survival in septic shock: a randomized double-blind prospective study
Critical Care Medicine 2003; 31: 1938-46
... but does it work as an antibiotic or as a cytokine?
PubMed Abstract

Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F et al.
Intensive insulin therapy in critically ill patients.
New England Journal of Medicine 2001; 345: 1359-1367.
But who needs expensive magic bullets, when cheap insulin works better?
PubMed Abstract NEJM Full Text

Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ et al.
Intensive insulin therapy in the medical ICU.
New England Journal of Medicine 2006; 354: 449-61.
Does it really improve mortality? Perhaps GluControl will be the final answer - or maybe NICE SUGAR...........?
PubMed Abstract NEJM Full Text

Wiener RS, Wiener DC, Larson RJ
Benefits and risks of tight glucose control in critically ill adults: a meta-analysis.
Journal of the American Medical Association 2008; 300: 933-44
Is this the end of tight glucose control? Wait - there's still NICE SUGAR to come....
PubMed Abstract JAMA Full Text

Turgeon AF, Hutton B, Fergusson DA, McIntyre L, Tinmouth AA, Cameron DW, Hebert PC.
Meta-analysis: intravenous immunoglobulin in critically ill adult patients with sepsis.
Annals of Internal Medicine 2007; 146: 193-203
Another magic machine-gun - cheaper than drotrecogin and twice as effective!
PubMed Abstract AIM Full Text

Annane D, Sebille V, Charpentier C, Bollaert PE, Francois B et al.
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.
Journal of the American Medical Association 2002; 288: 862-71
Annane's steroid renaissance - read the editorial as well
PubMed Abstract JAMA Full Text (free but requires registration)

Annane D, Bellissant E, Bollaert P, Briegel J, Keh D, Kupfer Y.
Corticosteroids for treating severe sepsis and septic shock.
British Medical Journal 2004; 329: 480-483
High-dose steroids bad, low-dose steroids good? See the recently-completed CORTICUS study........
PubMed Abstract BMJ Full Text Cochrane Full Text

Minneci PC, Deans KJ, Banks SM, Eichacker PQ, Natanson C.
Meta-analysis: the effect of steroids on survival and shock during sepsis depends on the dose.
Annals of Internal Medicine 2004; 141: 47-56
The same five papers as Annane's meta-analysis, the same conclusions? Well, more-or-less...
PubMed Abstract AIM Full Text

Malerba G, Romano-Girard F, Cravoisy A, Dousset B, Nace L, Levy B, Bollaert PE.
Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilation.
Intensive Care Medicine 2005; 31: 388-392
Etomidate, anyone..........?
PubMed Abstract

Finney SJ, Zekveld C, Elia A, Evans TW.
Glucose control and mortality in critically ill patients.
Journal of the American Medical Association 2003; 290: 2041-2047
Is it the euglycaemia or the insulin that improves the outcome?
PubMed Abstract JAMA Full Text (free but requires registration)

Krinsley JS
Effect of an intensive glucose management protocol on the mortality of critically ill adult patients.
Mayo Clinic Proceedings 2004; 79: 992-1000
... and it seems to work impressively in a more mixed ICU as well - albeit in a cohort study. Watch out for Van den Bergh's 'sequel' RCT....
PubMed Abstract Mayo Clin Proc Full Text

Kruger P, Fitzsimmons K, Cook D, Jones M, Nimmo G.
Statin therapy is associated with fewer deaths in patients with bacteraemia.
Intensive Care Medicine 2006; 32: 75-9
"New Hot Topic!" say Hackam et al., Martin et al, and Thomsen et al.; "New? Says who?" Liappis et al. reply.
PubMed Abstract

Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T et al.; Surviving Sepsis Campaign Management Guidelines Committee.
Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.
Critical Care Medicine 2004; 32: 858-873
Intensive Care Medicine 2004; 30: 536-555
A high-profile Delphi consensus summarising current evidence in treating sepsis
PubMed Abstract (ICM) CCM Full Text Surviving Sepsis website

Gao F, Melody T, Daniels DF, Giles S, Fox S.
The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study.
Critical Care 2005; 9: R764-70
"Me too!" say Kortgen et al, Shapiro et al. and Micek et al. Don't suppose anyone will dare do a RCT of sepsis care bundles now.........?.
PubMed Abstract Critical Care Full Text

RENAL SUPPORT

Kellum JA, Angus DC, Johnson JP, Leblanc M, Griffin M et al.
Continuous versus intermittent renal replacement therapy: a meta- analysis.
Intensive Care Medicine 2002; 28: 29-37.
CVVH is probably better than intermittent dialysis.
PubMed Abstract

Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G.
Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial.
Lancet 2000; 356: 26-30
More and sooner.
PubMed Abstract

Saudan P, Niederberger M, De Seigneux S, Romand J, Pugin J et al.
Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure.
Kidney International 2006; 70: 1312-7.
So CVVHDF is better then CVVH - how does that tie in with Ronco's study?
PubMed Abstract

Bellomo R, Chapman M, Finfer S, Hickling K, Myburgh J.
Low-dose dopamine in patients with early renal dysfunction: a placebo- controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group.
Lancet 2000; 356: 2139-2143.
Another nail in the coffin of renal-dose dopamine.
PubMed Abstract

Kellum JA, Decker M.
Use of dopamine in acute renal failure: a meta-analysis.
Critical Care Medicine 2001; 29: 1526-1531.
The final nail in the coffin of renal-dose dopamine?
PubMed Abstract

Mathur VS.
The role of the DA1 receptor agonist fenoldopam in the management of critically ill, transplant, and hypertensive patients.
Reviews in Cardiovascular Medicine 2003; Suppl 1: S35-40.
Is this the new renal dopamine?
PubMed Abstract RICM Full Text (link broken)

Mathur VS, Swan SK, Lambrecht LJ, Anjum S, Fellmann J, McGuire D et al.
The effects of fenoldopam, a selective dopamine receptor agonist, on systemic and renal hemodynamics in normotensive subjects.
Critical Care Medicine 1999; 27: 1832-1837.
Is this the new renal dopamine?
PubMed Abstract

Allgren RL, Marbury TC, Rahman SN, Weisberg LS, Fenves AZ et al.
Anaritide in acute tubular necrosis. Auriculin Anaritide Acute Renal Failure Study Group.
New England Journal of Medicine 1997; 336: 828-834.
……… or is this it?!
PubMed Abstract NEJM Full Text

Schrier RW, Wang W.
Acute renal failure and sepsis.
New England Journal of Medicine 2004; 351: 159-169
An excellent review explaining why sepsis is so hard on the kidneys
PubMed Abstract

Humes HD, Weitzel WF, Bartlett RH, Swaniker FC, Paganini EP, Luderer JR, Sobota J.
Initial clinical results of the bioartificial kidney containing human cells in ICU patients with acute renal failure.
Kidney International 2004; 66: 1578-1588
We have the technology! (but will it work?)
PubMed Abstract

Mehta RL, Pascual MT, Soroko S, Chertow GM; PICARD Study Group.
Diuretics, mortality, and nonrecovery of renal function in acute renal failure.
Journal of the American Medical Association 2002; 288: 2547-53.
DON'T USE DIURETICS FOR OLIGURIA!
PubMed Abstract JAMA Full Text (free but requires registration)

Uchino S, Doig GS, Bellomo R, Morimatsu H, Morgera S et al.; Beginning and Ending Supportive Therapy for the Kidney (B.E.S.T. Kidney) Investigators.
Diuretics and mortality in acute renal failure.
Critical Care Medicine 2004; 32: 1669-77.
All right then, DO use diuretics for oliguria - if you can survive the geigenanalysis of the collinearity.........
PubMed Abstract

HEAD INJURY

The Cochrane Injuries Group has produced several very useful meta-analyses in this area, many of which are listed below.

Roberts I, Yates D, Sandercock P, Farrell B, Wasserberg J et al.: CRASH trial collaborators.
Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial)
Lancet 2004; 364: 1321-8
Oh well - that answers that one, then! Now for CRASH 2...........
PubMed Abstract

Roberts I.
The CRASH trial: the first large-scale, randomised, controlled trial in head injury.
Critical Care 2001; 5: 292-293.
One of several references outlining the forthcoming make-or-break study into steroids and head injury.
PubMed Abstract Critical Care Free Text BMJ Editorial CRASH website

Alderson P, Roberts I.
Corticosteroids in acute traumatic brain injury: systematic review of randomised controlled trials.
British Medical Journal 1997; 314: 1855-1859.
The evidence so far: not very encouraging, although at least they don’t predispose to infection.
PubMed Abstract BMJ Full Text Cochrane Full Text (updated)

Roberts I.
Barbiturates for acute traumatic brain injury.
Cochrane Database of Systematic Reviews 1999
Thiopentone: do the risks cancel out the benefits?
PubMed Abstract Cochrane Full Text

Pratt OW, Bowles B, Protheroe RT.
Brain stem death testing after thiopental use:A survey of UK neuro critical care practice.
Anaesthesia 2006; 61: 1075-8.
A scary survey!
PubMed Abstract

Schierhout G, Roberts I.
Anti-epileptic drugs for preventing seizures following acute traumatic brain injury.
Cochrane Database of Systematic Reviews 2001
How odd – preventing the fits doesn’t improve the outcome!
PubMed Abstract Cochrane Full Text

Forsyth R, Baxter P, Elliott T.
Routine intracranial pressure monitoring in acute coma.
Cochrane Database of Systematic Reviews 2001
Is there any good evidence to support ICP monitoring......?
PubMed Abstract Cochrane Full Text

Cremer OL, van Dijk GW, van Wensen E, Brekelmans GJ, Moons KG et al.
Effect of intracranial pressure monitoring and targeted intensive care on functional outcome after severe head injury.
Critical Care Medicine 2005; 33: 2207-13
Will the ICP monitor turn out to be the PA catheter of head injury?
PubMed Abstract

Marion DW, Penrod LE, Kelsey SF, Obrist WD, Kochanek PM, Palmer AM et al.
Treatment of traumatic brain injury with moderate hypothermia.
New England Journal of Medicine 1997; 336: 540-546.
Hypothermia works in brain trauma………
PubMed Abstract NEJM Full Text

Clifton GL, Miller ER, Choi SC, Levin HS, McCauley S, Smith KR, Jr. et al.
Lack of effect of induction of hypothermia after acute brain injury.
New England Journal of Medicine 2001; 344: 556-563.
………. no it doesn’t …………
PubMed Abstract NEJM Full Text

Alderson P, Gadkary CS, Signorini DF.
Therapeutic hypothermia for head injury.
Cochrane Database of Systematic Reviews 2004
So does it work or doesn’t it? ……..
PubMed Abstract Cochrane Full Text

McIntyre LA, Fergusson DA, Hébert PC, Moher D, Hutchison JS
Prolonged therapeutic hypothermia after traumatic brain injury in adults: a systematic review
Journal of the American Medical Association 2003; 289: 2992-2999
Therapeutic hypothermia works, if you do it right?
PubMed Abstract JAMA Full Text (free but requires registration)

Cooper DJ, Myles PS, McDermott FT, Murray LJ, Laidlaw J et al.; HTS Study Investigators.
Prehospital hypertonic saline resuscitation of patients with hypotension and severe traumatic brain injury: a randomized controlled trial.
Journal of the American Medical Association 2004; 291: 1350-7
It makes sense, but..........
PubMed Abstract JAMA Full Text (free but requires registration)

Eker C, Asgeirsson B, Grande PO, Schalen W, Nordstrom CH.
Improved outcome after severe head injury with a new therapy based on principles for brain volume regulation and preserved microcirculation.
Critical Care Medicine 1998; 26: 1881-1886.
An outline of the highly promising ‘Lund therapy’ – but we're still waiting for the RCT !
PubMed Abstract

Nordstrom CH.
Physiological and biochemical principles underlying volume-targeted therapy--the "Lund concept".
Neurocritical Care 2005; 2: 83-95.
There has to be a better way to manage brain injury - but is this it?
PubMed Abstract Neurocritical Care Full Text (click on "Download 30-day Evaluation" - requires (free) registration)

Morris CG, McCoy EP, Lavery GG.
Spinal immobilisation for unconscious patients with multiple injuries.
British Medical Journal 2004; 329: 495-9
I bet Jones et al. must have rejoiced when this came out three months ahead of their publication!
PubMed Abstract BMJ Full Text

RESUSCITATION

Advanced Life Support Working Group of the European Resuscitation Council.
The 1998 European Resuscitation Council guidelines for adult advanced life support.
British Medical Journal 1998; 316: 1863-1869.
This goes into a bit more detail than your average ALS refresher course. The abstract for the 2000 Guidelines is available here. The complete 2000 Guidelines (all 447 pages-worth!) comprise Volume 46 of Resuscitation.
PubMed (no abstract available) BMJ Full Text

Gabbott D et al.; Royal College of Anaesthetists; Royal College of Physicians of London; Intensive Care Society; Resuscitation Council.
Cardiopulmonary resuscitation standards for clinical practice and training in the UK.
Resuscitation 2005; 64: 13-9.
The previous reference tells you what to do - this one tells you how to get it done
PubMed Abstract

Tunstall-Pedoe H, Bailey L, Chamberlain DA, Marsden AK, Ward ME, Zideman DA.
Survey of 3765 cardiopulmonary resuscitations in British hospitals (the BRESUS Study): methods and overall results.
British Medical Journal 1992; 304: 1347-1351.
It does what it says in the title …………….
PubMed Abstract

Kause J, Smith G, Prytherch D, Parr M, Flabouris A, Hillman K.
A comparison of antecedents to cardiac arrests, deaths and emergency intensive care admissions in Australia and New Zealand, and the United Kingdom--the ACADEMIA study.
Resuscitation 2004; 62: 275-82.
Let's see any fancy cardiology study try to beat THAT acronym!
PubMed Abstract Resuscitation Full Text (compliments of the ICS!)

Aung K, Htay T.
Vasopressin for cardiac arrest: a systematic review and meta-analysis.
Archives of Internal Medicine 2005; 165: 17-24.
OK, so it's no good for cardiac arrest - and mixed results from the VASST study - what future for vasopressin?
PubMed Abstract AIM Full Text

Spöhr F, Böttiger BW.
Thrombolytics in CPR. Current advantages in cardiopulmonary resuscitation.
Minerva Anestesiologica 2005; 71: 291-6.
Advantages? Is that why the TROICA study still isn't published?
PubMed Abstract            Minerva Full Text

Bottiger BW, Bode C, Kern S, Gries A, Gust R, Glatzer R et al.
Efficacy and safety of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation: a prospective clinical trial.
Lancet 2001; 357: 1583-1585.
Far from being contra-indicated, thrombolysis may actually improve CPR success – but what about long-term outcomes?
PubMed Abstract Search Lancet for (free) Full Text

Lafuente-Lafuente C, Melero-Bascones M.
Active chest compression-decompression for cardiopulmonary resuscitation.
Cochrane Database of Systematic Reviews 2001; CD002751.
Another trendy and logical therapy failing to live up to its initial promise.
PubMed Abstract Cochrane Full Text

Levine RL, Wayne MA, Miller CC.
End-tidal carbon dioxide and outcome of out-of-hospital cardiac arrest.
New England Journal of Medicine 1997; 337: 301-306.
One way of deciding whether to stop CPR.
PubMed Abstract NEJM Full Text

van Walraven C, Forster AJ, Parish DC, Dane FC, Chandra KM et al.
Validation of a clinical decision aid to discontinue in-hospital cardiac arrest resuscitations.
Journal of the American Medical Association 2001; 285: 1602-1606.
Another way of deciding whether to stop CPR.
PubMed Abstract JAMA Full Text (free but requires registration)

Booth CM, Boone RH, Tomlinson G, Detsky AS.
Is this patient dead, vegetative, or severely neurologically impaired? Assessing outcome for comatose survivors of cardiac arrest.
Journal of the American Medical Association 2004; 291: 870-9
NOW what do we do with them?
PubMed Abstract JAMA Full Text (free, but requires registration)

Aufderheide TP, Sigurdsson G, Pirrallo RG, Yannopoulos D, McKnite S et al.
Hyperventilation-induced hypotension during cardiopulmonary resuscitation.
Circulation 2004; 109: 1960-1965
OK, it's a small study, it's observational, and it's mostly animal work - but it's changed my practice and might change yours.
PubMed Abstract Circulation Full Text

Nolan JP, Morley PT, Vanden Hoek TL, Hickey RW et al. (for ILCOR)
Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation
Circulation 2003; 108: 118-21
Cooling post cardiac arrest is in - ILCOR says so!
PubMed (no abstract) Circulation Full Text

Davis PG, Tan A, O'Donnell CP, Schulze A.
Resuscitation of newborn infants with 100% oxygen or air: a systematic review and meta-analysis.
Lancet 2004; 364: 1329-33
Guess which is better? You might be surprised!
PubMed Abstract Cochrane Full Text

MISCELLANEOUS

American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference
Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.
Critical Care Medicine 1992; 20: 864-874.
Know these definitions by heart!
PubMed Abstract

Goris RJ, te Boekhorst TP, Nuytinck JK, Gimbrere JS.
Multiple-organ failure. Generalized autodestructive inflammation?
Archives of Surgery 1985; 120: 1109-1115.
The article that led to the concept of SIRS (and introduced the MOF score)
PubMed Abstract

Singer M, De Santis V, Vitale D, Jeffcoate W.
Multiorgan failure is an adaptive, endocrine-mediated, metabolic response to overwhelming systemic inflammation.
Lancet 2004; 364: 545-548
Maybe multiple organ failure is a protective mechanism ........... hmmm, I'll have to think about that!
PubMed Abstract

Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J et al.
Results from the International Conference of Experts on Intra-abdominal Hypertension and Abdominal Compartment Syndrome. I. Definitions.
Intensive Care Medicine 2006; 32: 1722-32
It must be important - have a look at the title of the accompanying editorial (and who wrote it............)
PubMed Abstract

De Gans J, Van de Beek D; European Dexamethasone in Adulthood Bacterial Meningitis Study Investigators.
Dexamethasone in adults with bacterial meningitis.
New England Journal of Medicine 2002; 347: 1549-56
Another comeback for steroids!
PubMed Abstract NEJM Full Text

Thwaites CL, Yen LM, Loan HT, Thuy TT, Thwaites GE, Stepniewska K et al.
Magnesium sulphate for treatment of severe tetanus: a randomised controlled trial.
Lancet. 2006; 368: 1436-43.
OK, so you probably don't see very much tetanus - but what a good exam topic it would be!
PubMed Abstract(no(

Toy P, Popovsky MA, Abraham E, Ambruso DR, Holness LG et al. National Heart, Lung and Blood Institute Working Group on TRALI.
Transfusion-related acute lung injury: definition and review.
Critical Care Medicine 2005; 33: 721-6.
A recent DICM viva topic - will they ask it again?
PubMed Abstract

Hennersdorf MG, Perings SM, Zuhlke C, Heidland UE, Perings C et al.
Conversion of recent-onset atrial fibrillation or flutter with ibutilide after amiodarone has failed.
Intensive Care Medicine 2002; 28: 925-9
If amiodarone is the new lignocaine, maybe ibutilide is the new amiodarone......
PubMed Abstract

Bernard EO, Schmid ER, Schmidlin D, Scharf C, Candinas R, Germann R.
Ibutilide versus amiodarone in atrial fibrillation: a double-blinded, randomized study.
Critical Care Medicine 2003; 31: 1031-4.
Ibutilide is as good as amiodarone, if not better (see the Hennersdorf paper as well)
PubMed Abstract

Martin GS, Mannino DM, Moss M.
The effect of age on the development and outcome of adult sepsis.
Critical Care Medicine 2006; 34: 15-21
Any study involving over 10 million patients has to be worth a look!
PubMed Abstract

Garrouste-Orgeas M, Troche G, Azoulay E, Caubel A, de Lassence A et al.
Body mass index. An additional prognostic factor in ICU patients.
Intensive Care Medicine 2004; 30: 437-43
It might not be what you think..........
PubMed Abstract

Muller M.
Science, medicine, and the future: Microdialysis.
British Medical Journal 2002; 324: 588-591.
The monitoring of the future?
PubMed (no abstract) BMJ Full Text

Ostermann ME, Keenan SP, Seiferling RA, Sibbald WJ.
Sedation in the intensive care unit: a systematic review.
Journal of the American Medical Association 2000; 283: 1451-9
A close hard look at something we often take for granted.
PubMed Abstract JAMA Full Text (free, but requires registration)

Bedi A, Murray JM, Dingley J, Stevenson MA, Fee JP.
Use of xenon as a sedative for patients receiving critical care.
Critical Care Medicine 2003; 31: 2470-2477
Too expensive? But they did this study on the NHS!
PubMed Abstract

Lee N, Hui D, Wu A, Chan P, Cameron P et al.
A major outbreak of Severe Acute Respiratory Syndrome in Hong Kong
New England Journal of Medicine 2003; 348: 1986-94
SARS - the new 'flu - the major journals sure got to that one fast!
PubMed Abstract NEJM Full Text

Manocha S, Walley KR, Russell JA.
Severe acute respiratory distress syndrome (SARS): A critical care perspective.
Critical Care Medicine 2003; 31: 2684-92.
A recent hot topic - when will the next wave hit?
PubMed Abstract

Beigel JH, Farrar J, Han AM, Hayden FG, Hyer R et al.; Writing Committee of the WHO Consultation on Human Influenza A/H5.
Avian influenza A (H5N1) infection in humans.
New England Journal of Medicine 2005; 353: 1374-85
The next plague: if it's not SARS II, it'll be bird 'flu; if it's not bird 'flu, it'll be something else....
PubMed (no abstract) NEJM Full Text IDSA Conference summary (Medscape)

Suntharalingam G, Perry MR, Ward S, Brett SJ, Castello-Cortes A, Brunner MD, Panoskaltsis N.
Cytokine storm in a phase 1 trial of the anti-CD28 monoclonal antibody TGN1412.
New England Journal of Medicine 2006; 355: 1018-28.
... and the horoscope says: "Beware of tampering with mysterious forces for financial gain"
PubMed Abstract NEJM Full Text

Kjaergard LL, Liu J, Als-Nielsen B, Gluud C
Artificial and bioartificial support systems for acute and acute-on-chronic liver failure: a systematic review.
Journal of the American Medical Association 2003; 289: 217-22
"I'm not sure you can compare apples and pears that way" (Wendon, ICM 2004; 11(4): 67)
PubMed Abstract JAMA Full Text Cochrane Abstract (spot the 'new' author!) Cochrane Full Text

Sen S, Jalan R, Williams R
Liver failure: basis of benefit of therapy with the Molecular Adsorbents Recirculating System.
International Journal of Biochemistry and Cell Biology 2003; 35: 1306-11
MARS - the new liver dialysis - the major journals have yet to get there!
PubMed Abstract

Khuroo MS, Khuroo MS, Farahat KL.
Molecular adsorbent recirculating system for acute and acute-on-chronic liver failure: a meta-analysis.
Liver Transplant 2004; 10: 1099-106
MARS marches on - will it reach the mainstream or won't it?
PubMed Abstract Liver Transplant Full Text

Moss M, Burnham EL.
Alcohol abuse in the critically ill patient.
Lancet 2006; 368: 2231-42.
Hmmm - could this be a 'hot topic' for the year?
PubMed Abstract

Mackle IJ, Swann DG, Cook B.
One year outcome of intensive care patients with decompensated alcoholic liver disease.
British Journal of Anaesthesia 2006; 97: 496-8.
... and will there still be life after MARS?
PubMed Abstract

Klerk CP, Smorenburg SM, Buller HR.
Thrombosis prophylaxis in patient populations with a central venous catheter: a systematic review.
Archives of Internal Medicine 2003; 163: 1913-1921
But surely ICU patients are getting thromboprophylaxis anyway? Great methodology, lousy question.
PubMed Abstract AIM Full Text

Levi M, Peters M, Buller HR.
Efficacy and safety of recombinant factor VIIa for treatment of severe bleeding: a systematic review.
Critical Care Medicine 2005; 33: 883-90.
A wise demonstration of why systematic reviews don't always need a meta-analysis.
PubMed Abstract

Mayer SA, Brun NC, Begtrup K, Broderick J, Davis S, Diringer MN et al. Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators.
Recombinant activated factor VII for acute intracerebral hemorrhage.
New England Journal of Medicine 2005; 352: 777-85.
So it's not just a drug for hopeless trauma bleeds..........
PubMed Abstract NEJM Full Text

Ely EW, Shintani A, Truman B, Speroff T, Gordon SM et al.
Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit.
Journal of the American Medical Association 2004; 291: 1753-1762
It's a bad sign, no matter how you look at it.
PubMed Abstract JAMA Full Text (free but requires registration)

Milbrandt EB, Kersten A, Kong L, Weissfeld LA, Clermont G, Fink MP, Angus DC.
Haloperidol use is associated with lower hospital mortality in mechanically ventilated patients.
Critical Care Medicine 2005; 33: 226-9
Hmmm - better than drotrecogin, eh? Let's see the RCT!
PubMed Abstract

Jones C, Skirrow P, Griffiths RD, Humphris GH, Ingleby S, Eddleston J, Waldmann C, Gager M
Rehabilitation after critical illness: A randomized, controlled trial
Critical Care Medicine 2003; 31: 2456-61
Such a simple thing as handing out a rehab manual can make such a difference....
PubMed Abstract

Dowdy DW, Eid MP, Sedrakyan A, Mendez-Tellez PA, Pronovost PJ et al.
Quality of life in adult survivors of critical illness: a systematic review of the literature.
Intensive Care Medicine 2005; 31: 611-20.
After all, isn't that what it's all about?
PubMed Abstract

Schneiderman LJ, Gilmer T, Teetzel HD, Dugan DO, Blustein J, Cranford R et al.
Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: a randomized controlled trial
Journal of the American Medical Association 2003; 290: 1166-72
A randomised controlled trial of ethics - is that ethical? A fascinating paper by a 'GP' department!
PubMed Abstract JAMA Full Text (free but requires registration)

Sirker AA, Rhodes A, Grounds RM, Bennett ED.
Acid-base physiology: the 'traditional' and the 'modern' approaches.
Anaesthesia 2002; 57: 348-356.
A useful overview of Stewart’s ‘strong ion theory’, the challenger to the Henderson-Hasselbalch approach.
PubMed Abstract

Vincent JL.
Give your patient a FAST HUG (at least) once a day.
Critical Care Medicine 2005; 33: 1225-9.
..... and see how many of them return the favour!
PubMed Abstract

Ridley S
State of the Art: Critical Care
Anaesthesia 2003; 58: 1178-83
A quick run-down of the major ICU papers of 2000-2002
PubMed (no abstract) Anaesthesia Full Text (free sample issue - requires registration with Blackwell)

Wyncoll DL.
The management of severe acute necrotising pancreatitis: an evidence-based review of the literature.
Intensive Care Medicine 1999; 25: 146-156.
A useful review that was once a DICM dissertation.
PubMed Abstract