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See detailUpdate on the role of extracorporeal CO2 removal
MORIMONT, Philippe ULg; BATCHINSKY, Andriy; LAMBERMONT, Bernard ULg

in Critical Care (2015)

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found ... [more ▼]

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2015 and co-published as a series in Critical Care. Other articles in the series can be found online at http://ccforum.com/series/annualupdate2015. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901. [less ▲]

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See detailRelation between global end-diastolic volume and left ventricular end-diastolic volume
Pironet, Antoine ULg; MORIMONT, Philippe ULg; Kamoi, S. et al

in Critical Care (2015), 19(Suppl 1), 175

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See detailVitamin D status in critically ill patients: back to basics!
ROUSSEAU, Anne-Françoise ULg; CAVALIER, Etienne ULg

in Critical Care (2014), 18(6), 611

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See detailClinical review: Consensus recommendations on measurement of blood glucose and reporting glycemic control in critically ill adults.
Finfer, Simon; Wernerman, Jan; PREISER, Jean-Charles ULg et al

in Critical Care (2013), 17(3), 229

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin ... [more ▼]

The management reporting and assessment of glycemic control lacks standardization. The use of different methods to measure the blood glucose concentration and to report the performance of insulin treatment yields major disparities and complicates the interpretation and comparison of clinical trials. We convened a meeting of 16 experts plus invited observers from industry to discuss and where possible reach consensus on the most appropriate methods to measure and monitor blood glucose in critically ill patients and on how glycemic control should be assessed and reported. Where consensus could not be reached, recommendations on further research and data needed to reach consensus in the future were suggested. Recognizing their clear conflict of interest, industry observers played no role in developing the consensus or recommendations from the meeting. Consensus recommendations were agreed for the measurement and reporting of glycemic control in clinical trials and for the measurement of blood glucose in clinical practice. Recommendations covered the following areas: How should we measure and report glucose control when intermittent blood glucose measurements are used? What are the appropriate performance standards for intermittent blood glucose monitors in the ICU? Continuous or automated intermittent glucose monitoring - methods and technology: can we use the same measures for assessment of glucose control with continuous and intermittent monitoring? What is acceptable performance for continuous glucose monitoring systems? If implemented, these recommendations have the potential to minimize the discrepancies in the conduct and reporting of clinical trials and to improve glucose control in clinical practice. Furthermore, to be fit for use, glucose meters and continuous monitoring systems must match their performance to fit the needs of patients and clinicians in the intensive care setting. [less ▲]

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See detailAMP-activated protein kinase controls liposaccharide-induced hyperpermeability
Castanares-Zapatero, Diego; Overtus, M; Communi, Didier et al

in Critical Care (2012, March), 16(suppl 1), 17

Organ dysfunction determines the severity of sepsis and is correlated to mortality. Endothelial increased permeability contributes to the development of organ failure. AMP-activated protein kinase (AMPK ... [more ▼]

Organ dysfunction determines the severity of sepsis and is correlated to mortality. Endothelial increased permeability contributes to the development of organ failure. AMP-activated protein kinase (AMPK) has been shown to modulate cytoskeleton and could mediate endothelial permeability. Our hypothesis is that AMPK controls sepsis-induced hyperpermeability in the heart and is involved in septic cardiomyopathy. Sepsis was induced by intraperitoneal injection of liposaccharide, 10 mg/kg (LPS). Alpha-1 AMPK knockout mice (α1KO) were compared with wild-type. Vascular permeability was characterized by Evans blue extravasation. Inflammatory cytokine mRNA expression was determined by qPCR analysis. Left ventricular mass was assessed by echocardiography. In addition, to emphasize the beneficial role of AMPK on heart vascular permeability, AMPK activator (acadesine) was administered to C57Bl6 mice before LPS injection. The ANOVA test with Bonferroni's post hoc test and the log-rank test were used. P < 0.05 was considered as significant. Increased cardiac vascular permeability was observed in the LPS group in comparison to untreated animals (2.5% vs. 16%; P < 0.05). The α1KO mice exhibited an increase vascular permeability after LPS injection in comparison to wild-type mice (41.5% vs. 16%; P < 0.05). α1KO animals had a significant mortality increase after LPS injection (70% vs. 10%; P < 0.05). LPS markedly induced the production of proinflammatory cytokines (TNFα, IL-1β, IL-6) that were significantly higher in the α1KO animals. More importantly, LPS treatment leads to an increased left ventricular mass in the α1KO mice within 24 hours, suggesting the onset of edema. Finally LPS-induced vascular hyperpermeability was greatly reduced after AMPK activation by acadesine (13.2% vs. 40%; P < 0.05). AMPK importantly regulates cardiac vascular permeability and could control the sepsis-induced cardiomyopathy. AMPK could represent a new pharmacological target of sepsis. [less ▲]

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See detailPilot Trial of STAR in Medical ICU
Fisk, LM; Le Compte, A; Shaw, GM et al

in Critical Care (2012), 16 (Suppl 1)

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See detailRespiratory system elastance monitoring during PEEP titration
Chiew, YS; Chase, JG; Shaw, GM et al

in Critical Care (2012), 34 (Suppl 1)

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See detailComputer-based monitoring of global cardiovascular dynamics during acute pulmonary embolism and septic shock in swine
Revie, JA; Stevenson, D; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailVariability of insulin sensitivity during the first 4 days of critical illness
Pretty, Christopher ULg; Le Compte, A; Chase, JG et al

in Critical Care (2012), 16 (Suppl 1)

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See detailEnhanced insulin sensitivity variability in the first 3 days of ICU stay: Implications for TGC
Chase, J. Geoffrey; Le Compte, Aaron; Penning, Sophie ULg et al

in Critical Care (2011, March)

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See detailValidation of a virtual patient and virtual trials method for accurate prediction of TGC protocol performance
Suhaimi, Fatanah; Le Compte, Aaron; Penning, Sophie ULg et al

in Critical Care (2011, March)

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See detailModel-based cardiovascular monitoring of acute pulmonary embolism in porcine trials
Revie, JA; Stevenson, DJ; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailPulmonary embolism diagnostics from the driver function
Stevenson, DJ; Revie; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailModel-based cardiovascular monitoring of large pore hemofiltration during endotoxic shock in pigs
Revie, JA; Stevenson, DJ; Chase, JG et al

in Critical Care (2011), 15 (Suppl 1)

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See detailRespiratory variability in mechanically ventilated patients
Desaive, Thomas ULg; Piquilloud, L.; Moorhead, KT et al

in Critical Care (2011), 15 (Suppl 1)

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See detailOrgan failure and tight glycemic control in the SPRINT study.
Chase, J Geoffrey; Pretty, Christopher G; Pfeifer, Leesa et al

in Critical Care (2010), 14(4), 154

INTRODUCTION: Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful ... [more ▼]

INTRODUCTION: Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality. METHODS: A retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA </=5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components </=2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB >/=0.5) to SOFA </=5 using conditional and joint probabilities. RESULTS: Admission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: 13 days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA </=5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB >/=0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB >/=0.5) increased the likelihood SOFA </=5. CONCLUSIONS: SPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB >/=0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials. [less ▲]

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