Annual Update in Intensive Care and Emergency Medicine 2011

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Table of Contents IX Prediction of Neurological Outcome after Cardiac Arrest C. Sandroni, F. Cavallaro, and M. Antonelli ..................... 654 Neuroprotection in Sepsis by Complement Inhibition and Immunoglobin Therapy F. Esen .......................................................... 664 Ethics in Disorders of Consciousness A.Demertzi,S.Laureys,and M.-A. Bruno ......................... 675 XVI Metabolic Disorders and Nutrition Metformin and Lactic Acidosis S. Vecchio, P. Papa, and A. Protti ................................. 685 Energy Goals in the Critically Ill Adult S.L. Peake, E. Ridley, and M. Chapman ............................ 694 XVII ICU Organization and Management Frailty: A New Conceptual Framework in Critical Care Medicine R.C. McDermid and S.M. Bagshaw ................................ 711 Access Block and Emergency Department Overcrowding R. Forero, S. McCarthy, and K. Hillman .......................... 720 Triage of High-risk Surgical Patients for Intensive Care J. Sobol and H. Wunsch .......................................... 729 Transportation of the Critically Ill: Moving in the Right Direction P.G. Brindley and T. O’Leary ..................................... 741 Should we Still Order Chest X-rays in the ICU? V. Ioos, A. Galbois, and BGuidet................................. 753 The Effect of Light on Critical Illness R.Castro,D.C.Angus,and M.R. Rosengart ....................... 766 Context Information in Critical Care G.Murias,B.Sales,and L. Blanch ............................... 781 XVIII The Future Ambient Intelligence in the Intensive Care Unit: Designing the Electronic Medical Record of the Future B.W. Pickering, J.M. Litell, and O. Gajic .......................... 793 Simulation in Critical Care Medicine: The Next Ten Years P.G. Brindley .................................................... 803 Intensive Care Medicine: Where We Are and Where We Want to Go? R.P. Moreno and A. Rhodes ....................................... 813 Subject Index ...................................................... 823
List of Contributors Abroug F Intensive Care Unit CHU Fatouma Bourguiba Av. du 1er Juin 5000 Monastir Tunisia Achouiti A Center for Experimental and Molecular Medicine and Center for Infection and Immunity Academic Medical Center Meibeergdreef 9, Room G2–130 1105 AZ Amsterdam Netherlands Alhashemi JA Department of Anesthesia and Critical Care King Abdulaziz University PO Box 31648 21418 Jeddah Saudi Arabia Angeli P Department of Clinical and Experimental Medicine University of Padova Via Giustiniani 2 35100 Padova Italy Angus DC Department of Critical Care Medicine University of Pittsburgh 614 Scaife Hall 3550 Terrace Street Pittsburgh, PA 15261 USA Antonelli M Department of Anesthesiology and Intensive Care Catholic University School of Medicine Largo Gemelli 8 00168 Rome Italy Azoulay E Intensive Care Department Hôpital St Louis 1avenueClaudeVellefaux 75010 Paris France Bagshaw SM Division of Critical Care Medicine University of Alberta Hospital 3C1.12 Walter C. Mackenzie Centre 8440–122 Street Edmonton, AB T6G 2B7 Canada Ball J General Intensive Care Unit 1st Floor, St James’ Wing St George’s Hospital London SW17 0QT United Kingdom Bassetti M Clinica Malattie Infettive A.O.U. San Martino L.go R. Benzi 10 16132 Genoa Italy XI
Page 1 and 2: Annual Update in Intensive Care and
Page 3 and 4: The series Annual Update in Intensi
Page 5 and 6: VI Table of Contents IV Endotrachea
Page 7: VIII Table of Contents XI Periopera
Page 11 and 12: Cecconi M Department of General Int
Page 13 and 14: Garcia X Department of Critical Car
Page 15 and 16: Jog S Department of Intensive Care
Page 17 and 18: Murias G Intensive Care Unit Clinic
Page 19 and 20: Reuter DA Department of Anesthesiol
Page 21 and 22: Sobol J Department of Anesthesiolog
Page 23 and 24: Wunsch H Department of Anesthesiolo
Page 25 and 26: Section I 1 I Mechanisms of Sepsis
Page 27 and 28: 4 M.A.D. van Zoelen, A. Achouiti, a
Page 33 and 34: 10 M.A.D. van Zoelen, A. Achouiti,
Page 39 and 40: 16 I The Endocannabinoid System: A
Page 41 and 42: 18 C. Lehmann, V. Cerny, and M. Mat
Page 49 and 50: 26 I Remote Ischemic Conditioning a
Page 51 and 52: 28 P. Meybohm and B. Bein I Remote
Page 53 and 54: 30 P. Meybohm and B. Bein I other i
Page 55 and 56: 32 P. Meybohm and B. Bein I determi
Page 57 and 58: 34 P. Meybohm and B. Bein I to enco
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36 P. Meybohm and B. Bein I 39. Wal
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38 S.N. Heyman, S. Rosen, and C. Ro
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Section II 49 II Coagulation System
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52 X. Delabranche, F. Toti, and F.
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62 II The Inflammatory Potential of
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64 C. Jennewein, N. Tran, and K. Za
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70 II Iron Deficiency in Critically
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72 N.Heming,P.Montravers,andS.Lasoc
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80 II Heparin-induced Thrombocytope
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82 Y. Sakr II increase the risk of
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84 Y. Sakr II Thrombotic Complicati
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86 Y. Sakr II used. The agglutinati
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88 Y. Sakr II In30%ofpatientswhoare
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90 Y. Sakr II The Challenge of Diag
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92 Y. Sakr II tures of heparin-indu
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Section III 95 III Acute Respirator
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98 N.J. Meyer and J.D. Christie III
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100 N.J. Meyer and J.D. Christie II
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110 F. Dachraoui, L. Ouanes-Besbes,
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118 I. Galvin and N.D. Ferguson III
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Rapid Sequence Intubation: Overview
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Pre-hospital Rapid Sequence Intubat
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ecommend its use in the setting of
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Table 1. Hypnotic agents Agent Dose
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Conclusion Rapid sequence intubatio
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Alterations in Oral Microbial Ecolo
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pharynx is deemed to play an import
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Table 1. The BRUSHED Assessment Mod
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Research Priorities in Oral Care fo
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Conclusion Research Priorities in O
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Research Priorities in Oral Care fo
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Pros and Cons of Assisted Mechanica
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NoisyPSVhasanadvantageoverotherassi
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improvement in lung elastance, with
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controlled mechanical ventilation [
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References Pros and Cons of Assiste
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Can ’Permissive’ Hypercapnia Mo
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However, concerns persist, particul
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NAVA: Why, When, Who? 189 Restricte
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Table 1. Summary of recent human ph
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Essentially, neural (EAdi) monitori
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NAVA: Why, When, Who? 195 16. Girar
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Therapeutic Aerosols in Mechanicall
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a) Jet nebulizer b) Ultrasonic nebu
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References Therapeutic Aerosols in
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Section VI 207 VI Cardiac Crises VI
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210 S. Scolletta, B. Biagioli, and
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220 VI Evolving Rationale for Minim
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222 J.G. Wigginton, A.H. Idris, and
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Hypoalbuminemia as a Risk Factor fo
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Microcirculation Possibly, at least
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Tubular Function Tubular concentrat
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injury, failure, need for renal rep
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Developing Biological Markers 247 a
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Conclusion The discovery of several
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Biomarkers of Acute Kidney Injury i
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and acute tubular necrosis is unpro
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utility (Breathing Not Properly stu
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NGAL, in various other complexes wi
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tantly, a positive association with
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References Biomarkers of Acute Kidn
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Cardio-renal Syndromes: A Complex S
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�� Cardio-renal Syndro
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Blood Purification in Sepsis and Ac
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The Lymphatic Vasculature as a Part
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FormationofLymph The Lymphatic Vasc
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The Interstitium and Lymphatics hav
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Fluid is a Drug that can be Overdos
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Table 1. Fluid overload and outcome
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Conclusion The studies discussed ab
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Crystalloid or Colloid Fluids: A Ma
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More Saline than Colloid Needed? Cr
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The Cyclic Effects of Mechanical Ve
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PracticalUseofPPVinPatientswithARDS
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Meaning of Pulse Pressure Variation
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References Meaning of Pulse Pressur
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Meaning of Pulse Pressure Variation
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however, an overall assessment of t
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Fig. 2. Varying response to stoke v
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Table 1. An example of a safety pro
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References The Fluid Challenge 339
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Facing the Challenge: A Rational St
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Section IX 353 IX The Microcirculat
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356 M.A. Puskarich and A.E. Jones I
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366 IX How Can We Use Tissue Carbon
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368 E. Futier, J.-L. Teboul, and B.
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376 X.Garcia,F.X.Guyette,andM.R.Pin
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378 X.Garcia,F.X.Guyette,andM.R.Pin
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380 IX The Microcirculation of the
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382 A.P.C. Top, R.C. Tasker, and C.
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384 A.P.C.Top,R.C.Tasker,andC.Ince
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Heart Rate as Prognostic Marker and
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Fig. 3. Effects of baseline heart r
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heart rate 140 120 100 80 60 40 20
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in conjunction with cardiogenic sho
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Table 1. Summary of different hemod
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Hemodynamic Monitoring in Cardiogen
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variations of the left sided time-v
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Non-Invasive Estimation of Left Ven
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Fig. 1. Original theory by Otto Fra
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Hemodynamics from the Periphery 427
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Totally Non-invasive Continuous Car
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There are some limitations to the u
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Cardiac Output Monitoring: An Integ
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occurring signal variation with dif
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Table 2. (continued) Additional var
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Fig. 2. Integrative concept for the
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Section XI 457 XI Perioperative Med
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460 N. Brienza, L. Dalfino, and M.T
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472 S.G. De Hert and P.F. Wouters X
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A New Approach to Ventilator-associ
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Underlying Diseases A New Approach
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organisms in acute respiratory infe
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Selective Decontamination of the Di
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SDD/SOD and Antibiotic Resistance A
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study the effects of SDD and SOD on
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Selective Decontamination of the Di
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New Treatment Options against Gram-
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Table 1. Classification schemes for
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are currently no antibacterials in
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activity of BAL 30376 against vario
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Panipenem/betamipron New Treatment
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References New Treatment Options ag
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The ‘Bug’ In order to ensure ou
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tum [38].Allthreecompoundsarefungic
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Antifungal Therapy in The ICU: The
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Renal Dysfunction Antifungal Therap
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For fusariosis, voriconazole, posac
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Mycobacterial Sepsis and Multiorgan
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Other Systems Seeding of every orga
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mediuminthepresenceandabsenceofanti
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Table 1. Suggested treatment regime
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Pentraxin 3 (PTX3): Possible Role i
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patients, anti-PTX3 antibodies are
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Fig. 2. Pentraxin 3 (PTX3) in septi
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Pentraxin3(PTX3):PossibleRoleinCrit
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The Role of IgM- and IgA-enriched I
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Spontaneous Bacterial Peritonitis i
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of the splanchnic sympathetic nervo
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concomitant malignancy or traumatic
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These criteria seem to be very sens
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Prognosis When SBP was initially de
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significant effect on the probabili
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Fig. 1. The ‘critical mass’ con
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Acute-on-chronic Liver Failure: An
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Fig. 4. Representative scheme of th
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Survival benefit with MARS in patie
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Section XIV 589 XIV Trauma and Emer
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XIV 592 J.E. Hollander and A.M. Cha
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XIV 600 C. Hommers and J. Nolan sys
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XIV 602 C. Hommers and J. Nolan 97-
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XIV 604 C. Hommers and J. Nolan exp
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XIV 606 C. Hommers and J. Nolan per
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XIV 608 C. Hommers and J. Nolan 4.
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XIV 610 C. Hommers and J. Nolan 49.
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XIV 612 H. Schoechl, W. Voelckel, a
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XIV 620 H.Schoechl,W.Voelckel,andC.
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Section XV 629 XV Neurological Aspe
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632 S. Legriel, F. Pico, and E. Azo
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654 XV Prediction of Neurological O
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656 C. Sandroni, F. Cavallaro, and
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664 XV Neuroprotection in Sepsis by
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666 F. Esen XV leading to further n
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668 F. Esen XV can activate complem
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670 F. Esen XV tested the neuroprot
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672 F. Esen XV In sepsis, the use o
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674 F. Esen XV 41. Mocco J, Mack WJ
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676 A. Demertzi, S. Laureys, and M.
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Metformin and Lactic Acidosis S. Ve
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note, lactic acidosis may develop e
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unexplained lactic acidosis and hav
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17 ± 5 mmol/l. In one fatal case,
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Metformin and Lactic Acidosis 693 2
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Determination of Energy Goals Indir
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acy rates (defined as < 15 % error
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Energy Goals in the Critically Ill
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ing. Hence, while a brief period of
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lipogenesis, hepatic steatosis, inc
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educed metabolic demands of adipose
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Energy Goals in the Critically Ill
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Frailty: A New Conceptual Framework
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Although the concept of frailty has
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tion in the development of acquired
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digm that includes those processes
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Frailty: A New Conceptual Framework
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In the last decade, the UK reduced
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Access Block and Emergency Departme
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Potential Solutions Access Block an
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Access Block and Emergency Departme
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Triage of High-risk Surgical Patien
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is another system calculated from s
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ICU Admission Guidelines Triage of
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Transportation of the Critically Il
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sum of several smaller - seemingly
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shown that intra-hospital transport
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is stationary, the external ventric
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Should We Still Order Chest X-rays
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Table 1. Item wording of the Delphi
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on-demand approach, such as increas
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Fig. 2. Assessment of intragastricp
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Fig. 4. Assessment of lung sliding
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Conclusion We have convincingly sho
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Should We Still Order Chest X-rays
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tor cells of rods (low-level light)
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Box 1. Examples of immune effects a
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The Effect of Light on Critical Ill
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Box 2. Some beneficial health effec
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still many nebulous aspects, and wi
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Context Information in Critical Car
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Fig. 2. Alternative medical problem
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of intensivist specialty expertise
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Fig. 3. XML file for context inform
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Context Information in Critical Car
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Ambient Intelligence in the Intensi
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cognitive networks, likely without
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Conclusion The application of rules
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Simulation in Critical Care Medicin
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Engineering a Better Simulation Exp
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skills development before any patie
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decade has to be about reaching out
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seriously we take the safety of our
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Intensive Care Medicine: Where We A
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direction and orientation of a prim
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Subject Index Abdominal compartment
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C-reactive protein (CRP) 57, 268, 5
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Information 781 Injury severity sco
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Phenytoin 648 Phorbol myristate ace
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Vagal activity 398 - stimulation 74
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