Other bulletins in this series include:

Breast Surgery

Wednesday 3 June 2009

The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients

The impact of delirium on clinical outcomes in mechanically ventilated surgical and trauma patients. Critical Care Medicine vol. 37(6), June 2009, pp 1898-1905.

Lat, I., McMillian, W., Taylor, S., Janzen, J.M., Papadopoulos, S., Korth, L., Ehtisham, A., Nold, J., Agarwal, S., Azocar, R., Burke, P.Issue:

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c11%7csl_10

Delirium is classically defined as an acute cognitive impairment accompanied with fluctuating mental status, inattention, and disorganized thought. Several validated tools exist to assist in the diagnosis of delirium in the critically ill population. The Society of Critical Care Medicine has recommended the implementation of delirium assessments as a standard of care. The development of delirium is frequent in critically ill patients. Prior work has demonstrated that delirium is an independent risk factor for mortality, longer intensive care unit (ICU) and hospital stays, and is associated with numerous complications.

Comparison of delirium assessment tools in a mixed intensive care unit

Comparison of delirium assessment tools in a mixed intensive care unit. Critcal Care Medicine, vol. 37(6), June 2009, pp 1881-1885 [journal article]

van Eijk, M.M.J., van Marum, R.J., Klijn, I.A.M., de Wit, N., Kesecioglu, J., Slooter, A.J.C.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c8%7csl_10

Delirium is a frequent problem in the intensive care unit (ICU) associated with poor prognosis. Delirium in the ICU is underdiagnosed by nursing and medical staff. Several detection methods have been developed for use in ICU patients. The aim of this study was to compare the value of three detection methods (the Confusion Assessment Method for the ICU [CAM-ICU], the Intensive Care Delirium Screening Checklist [ICDSC] and the impression of the ICU physician with the diagnosis of a psychiatrist, neurologist, or geriatrician).

Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma

Procalcitonin as a prognostic and diagnostic tool for septic complications after major trauma. Critical Care Medicine, vol 37(6), June 2009, pp 1845-1849 [journal article]

Castelli, G.P., Pognani, C., Cita, M., Paladini, R.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.65.67%7c2%7csl_10

Severe trauma is a potent cause of the systemic inflammatory response syndrome (SIRS). Although SIRS is present in >90% of the surgical intensive care unit (ICU) patients, classic inflammatory criteria such as body temperature, heart rate, white blood cell count, and respiratory rate are often variable and do not seem useful in predicting infection or severity of illness. Although early diagnosis and treatment of infection are associated with improved mortality, diagnosis of infection in these patients is often delayed due to long culture times and difficulties in isolation from local colonization.

Influence of respiratory rate on stroke volume variation in mechanically ventilaed patients

Influence of respiratory rate on stroke volume variation in mechanically ventilated patients. Anesthesiology, vol. 110(5), May 2009, pp 1092-1097

De Backer, D., Taccone, F.S., Holsten, R., Ibrahimi, F., Vincent, J.L.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.53.59%7c25%7csl_10

Heart-lung interactions are used to evaluate fluid responsiveness in mechanically ventilated patients, but these indices may be influenced by ventilatory conditions. The authors evaluated the impact of respiratory rate (RR) on indices of fluid responsiveness in mechanically ventilated patients, hypothesizing that pulse pressure variation and respiratory variation in aortic flow would decrease at high RRs.

In death, truth lies: why do patients with sepsis die?

In death, truth lies: why do patients with sepsis die? Anaesthesia & Analgesia, vol 108(6), June 2009, p 1731-1733. [editorial]

Tenhunen, J. J.

http://ovidsp.uk.ovid.com/spa/ovidweb.cgi?&S=NODKPDLLCDHFJNDMFNFLOGHHMNONAA00&Link+Set=S.sh.2.14.16.17.20.44%7c3%7csl_10

It is no news that, even today, sepsis is associated with high mortality. All of us who regularly practice intensive care medicine have seen our patients with sepsis die. Yet, it seems acceptable to claim that we do not know ultimately why these patients die. Some die despite full continuing therapeutic efforts, although others die after therapy has been withheld or withdrawn. Most patients who die with or because of sepsis, die with established multiple organ dysfunction or failure. Although the clinical cause of death can be classified as “refractory septic shock,” “multiple organ failure,” or “acute circulatory failure,” the actual causes and mechanisms for treatment failure and death remain mostly unidentified.