Skip to main content
Top
Published in: Intensive Care Medicine 3/2014

01-03-2014 | Year in Review 2013

Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients

Authors: Elie Azoulay, Giuseppe Citerio, Jan Bakker, Matteo Bassetti, Dominique Benoit, Maurizio Cecconi, J. Randall Curtis, Glenn Hernandez, Margaret Herridge, Samir Jaber, Michael Joannidis, Laurent Papazian, Mark Peters, Pierre Singer, Martin Smith, Marcio Soares, Antoni Torres, Antoine Vieillard-Baron, Jean-François Timsit

Published in: Intensive Care Medicine | Issue 3/2014

Login to get access

Excerpt

Intensive Care Medicine has taken part this year in the ongoing controversy about sedation strategies for the critically ill. Shehabi et al. [1] replicated the ANZ SPICE study design in 11 Malaysian ICUs to assess whether early sedation depth was independently associated with delayed extubation and increased mortality. They performed a prospective multicenter study that included 259 medical/surgical patients who were sedated and ventilated for at least 24 h. Deep sedation, defined as Richmond Agitation Sedation Score (RASS) ≤ −3, occurred in 71 % of patients at first assessment. Multivariable Cox proportional hazard regression analysis adjusting for confounders confirmed that early deep sedation was independently associated with longer time to extubation, hospital and 180-day mortality. Delirium occurred in 114 (44 %) of patients but was not associated with sedation length upon first assessment. The performance and the feasibility of an automated administration of sedation were evaluated in a phase II randomized controlled trial (RCT) by Le Guen et al. [2]. Thirty-one patients were allocated to receive either propofol or remifentanil, through either an automated or a manual system. In the two groups, targeted bispectral index (BIS) values were between 40 and 60. Propofol consumption was reduced by 50 % in the automated group with a median change of infusion rates of 39 ± 9 times per hour compared to only 2 ± 1 propofol dose changes per hour in the manual group. Similarly, the median number of changes in infusion rates was 40 ± 9 for remifentanil in the automated group, compared to 1 ± 1 dose changes per hour in the manual group. In a single-center pilot study of critically ill patients in spontaneous ventilation undergoing flexible fiberoptic bronchoscopy, the safety and efficacy of sedation with remifentanil target-controlled infusion (Remi-TCI) were assessed by Chalumeau-Lemoine et al. [3]. The procedure was successful, comfortable, and safe in all patients. Patients reported low level of pain and good satisfaction with the procedure. …
Literature
2.
go back to reference Le Guen M, Liu N, Bourgeois E et al (2013) Automated sedation outperforms manual administration of propofol and remifentanil in critically ill patients with deep sedation: a randomized phase II trial. Intensive Care Med 39:454–462. doi:10.1007/s00134-012-2762-2 PubMedCrossRef Le Guen M, Liu N, Bourgeois E et al (2013) Automated sedation outperforms manual administration of propofol and remifentanil in critically ill patients with deep sedation: a randomized phase II trial. Intensive Care Med 39:454–462. doi:10.​1007/​s00134-012-2762-2 PubMedCrossRef
7.
9.
10.
go back to reference Blankman P, Hasan D, van Mourik MS, Gommers D (2013) Ventilation distribution measured with EIT at varying levels of pressure support and neurally adjusted ventilatory assist in patients with ALI. Intensive Care Med 39:1057–1062. doi:10.1007/s00134-013-2898-8 PubMedCrossRef Blankman P, Hasan D, van Mourik MS, Gommers D (2013) Ventilation distribution measured with EIT at varying levels of pressure support and neurally adjusted ventilatory assist in patients with ALI. Intensive Care Med 39:1057–1062. doi:10.​1007/​s00134-013-2898-8 PubMedCrossRef
12.
14.
go back to reference Caldarelli V, Borel JC, Khirani S et al (2013) Polygraphic respiratory events during sleep with noninvasive ventilation in children: description, prevalence, and clinical consequences. Intensive Care Med 39:739–746. doi:10.1007/s00134-012-2806-7 PubMedCrossRef Caldarelli V, Borel JC, Khirani S et al (2013) Polygraphic respiratory events during sleep with noninvasive ventilation in children: description, prevalence, and clinical consequences. Intensive Care Med 39:739–746. doi:10.​1007/​s00134-012-2806-7 PubMedCrossRef
15.
go back to reference Carlucci A, Schreiber A, Mattei A et al (2013) The configuration of bi-level ventilator circuits may affect compensation for non-intentional leaks during volume-targeted ventilation. Intensive Care Med 39:59–65. doi:10.1007/s00134-012-2696-8 PubMedCrossRef Carlucci A, Schreiber A, Mattei A et al (2013) The configuration of bi-level ventilator circuits may affect compensation for non-intentional leaks during volume-targeted ventilation. Intensive Care Med 39:59–65. doi:10.​1007/​s00134-012-2696-8 PubMedCrossRef
22.
24.
26.
go back to reference Hernandez G, Pedrosa A, Ortiz R et al (2013) The effects of increasing effective airway diameter on weaning from mechanical ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med 39:1063–1070. doi:10.1007/s00134-013-2870-7 PubMedCrossRef Hernandez G, Pedrosa A, Ortiz R et al (2013) The effects of increasing effective airway diameter on weaning from mechanical ventilation in tracheostomized patients: a randomized controlled trial. Intensive Care Med 39:1063–1070. doi:10.​1007/​s00134-013-2870-7 PubMedCrossRef
27.
31.
go back to reference Hernu R, Wallet F, Thiollière F et al (2013) An attempt to validate the modification of the American-European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital. Intensive Care Med 39:2161–2170. doi:10.1007/s00134-013-3122-6 PubMedCrossRef Hernu R, Wallet F, Thiollière F et al (2013) An attempt to validate the modification of the American-European consensus definition of acute lung injury/acute respiratory distress syndrome by the Berlin definition in a university hospital. Intensive Care Med 39:2161–2170. doi:10.​1007/​s00134-013-3122-6 PubMedCrossRef
32.
go back to reference Villar J, Perez-Mendez L, Blanco J et al (2013) A universal definition of ARDS: the PaO2/FiO(2) ratio under a standard ventilatory setting-a prospective, multicenter validation study. Intensive Care Med 39:583–592. doi:10.1007/s00134-012-2803-x PubMedCrossRef Villar J, Perez-Mendez L, Blanco J et al (2013) A universal definition of ARDS: the PaO2/FiO(2) ratio under a standard ventilatory setting-a prospective, multicenter validation study. Intensive Care Med 39:583–592. doi:10.​1007/​s00134-012-2803-x PubMedCrossRef
34.
go back to reference Adamzik M, Broll J, Steinmann J et al (2013) An increased alveolar CD4+CD25+Foxp3+T-regulatory cell ratio in acute respiratory distress syndrome is associated with increased 30-day mortality. Intensive Care Med 39:1743–1751. doi:10.1007/s00134-013-3036-3 PubMedCrossRef Adamzik M, Broll J, Steinmann J et al (2013) An increased alveolar CD4+CD25+Foxp3+T-regulatory cell ratio in acute respiratory distress syndrome is associated with increased 30-day mortality. Intensive Care Med 39:1743–1751. doi:10.​1007/​s00134-013-3036-3 PubMedCrossRef
40.
go back to reference Gattinoni L, Pesenti A, Carlesso E (2013) Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure: impact and clinical fallout through the following 20 years. Intensive Care Med 39:1909–1915. doi:10.1007/s00134-013-3066-x PubMedCrossRef Gattinoni L, Pesenti A, Carlesso E (2013) Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure: impact and clinical fallout through the following 20 years. Intensive Care Med 39:1909–1915. doi:10.​1007/​s00134-013-3066-x PubMedCrossRef
41.
go back to reference Bein T, Weber-Carstens S, Goldmann A et al (2013) Lower tidal volume strategy (approximate to 3 ml/kg) combined with extracorporeal CO2 removal versus “conventional” protective ventilation (6 ml/kg) in severe ARDS. Intensive Care Med 39:847–856. doi:10.1007/s00134-012-2787-6 PubMedCentralPubMedCrossRef Bein T, Weber-Carstens S, Goldmann A et al (2013) Lower tidal volume strategy (approximate to 3 ml/kg) combined with extracorporeal CO2 removal versus “conventional” protective ventilation (6 ml/kg) in severe ARDS. Intensive Care Med 39:847–856. doi:10.​1007/​s00134-012-2787-6 PubMedCentralPubMedCrossRef
42.
go back to reference Mauri T, Bellani G, Grasselli G et al (2013) Patient-ventilator interaction in ARDS patients with extremely low compliance undergoing ECMO: a novel approach based on diaphragm electrical activity. Intensive Care Med 39:282–291. doi:10.1007/s00134-012-2755-1 PubMedCrossRef Mauri T, Bellani G, Grasselli G et al (2013) Patient-ventilator interaction in ARDS patients with extremely low compliance undergoing ECMO: a novel approach based on diaphragm electrical activity. Intensive Care Med 39:282–291. doi:10.​1007/​s00134-012-2755-1 PubMedCrossRef
44.
go back to reference Schmidt M, Zogheib E, Roze H et al (2013) The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med 39:1704–1713. doi:10.1007/s00134-013-3037-2 PubMedCrossRef Schmidt M, Zogheib E, Roze H et al (2013) The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med 39:1704–1713. doi:10.​1007/​s00134-013-3037-2 PubMedCrossRef
45.
go back to reference Roch A, Hraiech S, Masson E et al (2013) Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center. Intensive Care Med 40:74–83. doi:10.1007/s00134-013-3135-1 PubMedCrossRef Roch A, Hraiech S, Masson E et al (2013) Outcome of acute respiratory distress syndrome patients treated with extracorporeal membrane oxygenation and brought to a referral center. Intensive Care Med 40:74–83. doi:10.​1007/​s00134-013-3135-1 PubMedCrossRef
46.
go back to reference Pappalardo F, Pieri M, Greco T et al (2013) Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med 39:275–281. doi:10.1007/s00134-012-2747-1 PubMedCrossRef Pappalardo F, Pieri M, Greco T et al (2013) Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score. Intensive Care Med 39:275–281. doi:10.​1007/​s00134-012-2747-1 PubMedCrossRef
47.
go back to reference Distelmaier K, Niessner A, Haider D et al (2013) Long-term mortality in patients with chronic obstructive pulmonary disease following extracorporeal membrane oxygenation for cardiac assist after cardiovascular surgery. Intensive Care Med 39:1444–1451. doi:10.1007/s00134-013-2931-y PubMedCrossRef Distelmaier K, Niessner A, Haider D et al (2013) Long-term mortality in patients with chronic obstructive pulmonary disease following extracorporeal membrane oxygenation for cardiac assist after cardiovascular surgery. Intensive Care Med 39:1444–1451. doi:10.​1007/​s00134-013-2931-y PubMedCrossRef
48.
53.
go back to reference Oeyen SG, Benoit DD, Annemans L et al (2013) Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study. Intensive Care Med 39:889–898. doi:10.1007/s00134-012-2791-x PubMedCrossRef Oeyen SG, Benoit DD, Annemans L et al (2013) Long-term outcomes and quality of life in critically ill patients with hematological or solid malignancies: a single center study. Intensive Care Med 39:889–898. doi:10.​1007/​s00134-012-2791-x PubMedCrossRef
58.
go back to reference Giannini A, Miccinesi G, Prandi E et al (2013) Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med 39:2180–2187. doi:10.1007/s00134-013-3087-5 Giannini A, Miccinesi G, Prandi E et al (2013) Partial liberalization of visiting policies and ICU staff: a before-and-after study. Intensive Care Med 39:2180–2187. doi:10.​1007/​s00134-013-3087-5
59.
60.
go back to reference Garrouste-Orgeas M, Tabah A, Vesin A et al (2013) The ETHICA study (part II): simulation study of determinants and variability of ICU physician decisions in patients aged 80 or over. Intensive Care Med 39:1574–1583. doi:10.1007/s00134-013-2977-x PubMedCrossRef Garrouste-Orgeas M, Tabah A, Vesin A et al (2013) The ETHICA study (part II): simulation study of determinants and variability of ICU physician decisions in patients aged 80 or over. Intensive Care Med 39:1574–1583. doi:10.​1007/​s00134-013-2977-x PubMedCrossRef
61.
63.
66.
67.
73.
go back to reference Pelieu I, Djadi-Prat J, Consoli SM et al (2013) Impact of organizational culture on preventability assessment of selected adverse events in the ICU: evaluation of morbidity and mortality conferences. Intensive Care Med 39:1214–1220. doi:10.1007/s00134-013-2923-y PubMedCrossRef Pelieu I, Djadi-Prat J, Consoli SM et al (2013) Impact of organizational culture on preventability assessment of selected adverse events in the ICU: evaluation of morbidity and mortality conferences. Intensive Care Med 39:1214–1220. doi:10.​1007/​s00134-013-2923-y PubMedCrossRef
74.
go back to reference Ten Have ECM, Nap RE, Tulleken JE (2013) Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale. Intensive Care Med 39:1800–1807. doi:10.1007/s00134-013-3002-0 PubMedCrossRef Ten Have ECM, Nap RE, Tulleken JE (2013) Quality improvement of interdisciplinary rounds by leadership training based on essential quality indicators of the Interdisciplinary Rounds Assessment Scale. Intensive Care Med 39:1800–1807. doi:10.​1007/​s00134-013-3002-0 PubMedCrossRef
80.
go back to reference Thiolliere F, Serre-Sapin AF, Reignier J et al (2013) Epidemiology and outcome of thrombocytopenic patients in the intensive care unit: results of a prospective multicenter study. Intensive Care Med 39:1460–1468. doi:10.1007/s00134-013-2963-3 PubMedCrossRef Thiolliere F, Serre-Sapin AF, Reignier J et al (2013) Epidemiology and outcome of thrombocytopenic patients in the intensive care unit: results of a prospective multicenter study. Intensive Care Med 39:1460–1468. doi:10.​1007/​s00134-013-2963-3 PubMedCrossRef
84.
go back to reference Kahn SR (2012) Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST J 141:e195S. doi:10.1378/chest.11-2296 CrossRef Kahn SR (2012) Prevention of VTE in nonsurgical patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. CHEST J 141:e195S. doi:10.​1378/​chest.​11-2296 CrossRef
85.
go back to reference Vignon P, Dequin P-F, Renault A et al (2013) Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial. Intensive Care Med 39:872–880. doi:10.1007/s00134-013-2814-2 PubMedCrossRef Vignon P, Dequin P-F, Renault A et al (2013) Intermittent pneumatic compression to prevent venous thromboembolism in patients with high risk of bleeding hospitalized in intensive care units: the CIREA1 randomized trial. Intensive Care Med 39:872–880. doi:10.​1007/​s00134-013-2814-2 PubMedCrossRef
86.
go back to reference Matějková S, Scheuerle A, Wagner F et al (2013) Carbamylated erythropoietin-FC fusion protein and recombinant human erythropoietin during porcine kidney ischemia/reperfusion injury. Intensive Care Med 39:497–510. doi:10.1007/s00134-012-2766-y PubMedCrossRef Matějková S, Scheuerle A, Wagner F et al (2013) Carbamylated erythropoietin-FC fusion protein and recombinant human erythropoietin during porcine kidney ischemia/reperfusion injury. Intensive Care Med 39:497–510. doi:10.​1007/​s00134-012-2766-y PubMedCrossRef
Metadata
Title
Year in review in Intensive Care Medicine 2013: II. Sedation, invasive and noninvasive ventilation, airways, ARDS, ECMO, family satisfaction, end-of-life care, organ donation, informed consent, safety, hematological issues in critically ill patients
Authors
Elie Azoulay
Giuseppe Citerio
Jan Bakker
Matteo Bassetti
Dominique Benoit
Maurizio Cecconi
J. Randall Curtis
Glenn Hernandez
Margaret Herridge
Samir Jaber
Michael Joannidis
Laurent Papazian
Mark Peters
Pierre Singer
Martin Smith
Marcio Soares
Antoni Torres
Antoine Vieillard-Baron
Jean-François Timsit
Publication date
01-03-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 3/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3217-8

Other articles of this Issue 3/2014

Intensive Care Medicine 3/2014 Go to the issue