COVID-19 mortality risk for older men and women.

Background: Case-fatality from COVID-19 has been reported to be relatively high in patients age 65 years or older. We sought to determine the age-specific rates of COVID-19 mortality at the population level.

Methods: We obtained information regarding the total number of COVID-19 reported deaths for six consecutive weeks beginning at the 50th recorded death, among 16 countries that reported a relatively high number of COVID-19 cases as of April 12, 2020.

Haemodynamic monitoring in the intensive care unit: results from a web-based Swiss survey.

Background: The aim of this survey was to describe, in a situation of growing availability of monitoring devices and parameters, the practices in haemodynamic monitoring at the bedside.

Methods: We conducted a Web-based survey in Swiss adult ICUs (2009-2010). The questionnaire explored the kind of monitoring used and how the fluid management was addressed.

Epoetin administrated after cardiac surgery: effects on renal function and inflammation in a randomized controlled study.

Background: Experimentally, erythropoietin (EPO) has nephroprotective as well as immunomodulatory properties when administered after ischemic renal injury. We tested the hypothesis that different doses of recombinant human EPO administered to patients after cardiac surgery would minimize kidney lesions and the systemic inflammatory response, thereby decreasing acute kidney injury (AKI) incidence.

Methods: In this double-blinded randomized control study, 80 patients admitted to the ICU post-cardiac surgery were randomized by computer to receive intravenously isotonic saline (n = 40) versus α-Epoetin (n = 40): either 40000 IU (n = 20) or 20000 IU (n = 20).

ScvO(2) as a marker to define fluid responsiveness.

Background: Definition of the hemodynamic response to volume expansion (VE) could be useful in shocked critically ill patients in absence of cardiac index (CI) measurements. The aim of this study is to evaluate whether central venous oxygen saturation variations (ΔScvO(2)) after VE could be an alternative to classify responders (R) and nonresponders (NR) to volume therapy.

Methods: A total of 30 patients requiring VE were included in this prospective cohort study, all equipped with radial arterial line and pulmonary artery catheters.

Influence of tidal volume on pulse pressure variations in hypovolemic ventilated pigs with acute respiratory distress-like syndrome.

Background: Sensitivity and specificity of respiratory change in pulse pressure (DeltaPP) to predict preload dependency has been questioned at small tidal volumes (VT) in critically ill patients suffering from acute respiratory distress syndrome (ARDS). We studied DeltaPP in pigs with ARDS-like syndrome during reversible hemorrhagic shock.

Methods: Prospective, observational animal study in a Laboratory Investigation Unit.

Randomized trial of light versus deep sedation on mental health after critical illness.

Objectives: : To investigate if light sedation favorably affects subsequent patient mental health compared with deep sedation. Symptoms of posttraumatic stress disorder are common in patients after they have undergone prolonged mechanical ventilation and are associated with sedation depth.

Design: : Randomized, open-label, controlled trial.

Atrial and brain natriuretic peptide concentrations and the response to inhaled nitric oxide in patients with acute respiratory distress syndrome.

Purpose: The response to inhaled nitric oxide (iNO) is inconsistent in patients with acute respiratory distress syndrome (ARDS). We sought to determine whether the response to iNO, defined as 20% Pao(2)/Fio(2) increase from baseline, depends on the level of cardiac natriuretic peptides.

Materials And Methods: This is a prospective cohort study including 11 consecutive patients with ARDS who were eligible to receive iNO.

Differences in critical care practice between an industrialized and a developing country.

Background: Few data are available on intensive care unit (ICU) patient populations and critical care medicine practices in developing countries.

Methods: This prospective study evaluated differences in patient characteristics, ICU practice, and outcome between the ICUs of a Mongolian 400-bed tertiary university hospital (MonICU) and an Austrian 429-bed secondary hospital (AutICU). Demographics, chronic health status, clinical parameters, disease and therapeutic severity scores, and outcome were documented for all patients admitted to the two ICUs during a period of four and a half months.

Reducing pain in patients undergoing cardiac surgery after implementation of a quality improvement postoperative pain treatment program.

Purpose: The aim of this study was to test the effectiveness of a quality improvement postoperative pain treatment program after cardiac surgery.

Materials And Methods: This was a prospective, quasiexperimental study using nonequivalent groups comprising 3 periods: baseline (group baseline), implementation of the algorithm for acute pain management, and reassessment (group reassessment). Inclusion of 133 patients after elective cardiac surgery at an 18-bed surgical intensive care unit (SICU) at a Swiss university hospital.

Long intraaortic balloon treatment time leads to more vascular complications.

Intraaortic balloon counterpulsation is an established and efficient therapy. Limb ischemia is the most common complication. The impact of treatment duration on balloon-related complications was analyzed retrospectively in 135 patients who underwent balloon counterpulsation between 1998 and 2004.

The effects of hypothermic cardiopulmonary bypass on Doppler cerebral blood flow during the first 24 postoperative hours.

To provide understanding of influence of cardiopulmonary bypass (CPB) on cerebral blood flow (CBF), we investigated the effect of CPB on patients' cerebral haemodynamic parameters. Twenty-three patients were prospectively enrolled. CBF was estimated by transcranial Doppler (TCD) to measure blood velocity in the middle cerebral artery (MVMCA), preoperatively T(0) and at four postoperative times (T(1), T(2), T(3), T(4)).

Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review.

Introduction: Raised intracranial pressure (ICP) has been consistently associated with poor neurological outcome. Our purpose was to systematically review the literature to estimate the association between ICP values and patterns and short- and long-term vital and neurological outcome.

Methods: Systematic review of studies identified from MEDLINE, EMBASE, and COCHRANE Registry search from 1966 to 2005, and reference lists of identified articles, with independent assessment of methodological quality, population, ICP values and patterns, management of raised ICP and neurological outcomes.

Is it now time to promote mixed enteral and parenteral nutrition for the critically ill patient?

Background: Intensive care outcome measured by morbidity and mortality is altered in the severely malnourished ICU patient, and nutritional support of the critically ill is accepted as a standard of care. Current recommendations suggest starting enteral feeding as soon as possible whenever the gastrointestinal tract is functioning. The disadvantage of enteral support is that inadequate energy and protein intake can occur.

Hospitalized mechanically ventilated patients are at higher risk of enteral underfeeding than non-ventilated patients.

Background & Aims: Enteral nutrition (EN) is the preferred method of nutrition support in hospitalized patients but only 50-90% of the required calories are actually delivered. In order to identify where our nutrition support team (NST) should focus its activity, we prospectively evaluated the level of coverage of energy and protein needs during the first 5 days of EN in intensive care unit (ICU) and non-ICU patients and the relationship of energy and protein coverage with serum albumin, transthryretin, insulin-like growth factor-1 (IGF-1) and C-reactive protein (CRP).

Methods: Subjects (n=183) who required nutrition support and received EN were prospectively recruited.

Continuous cardiac output monitoring after cardiopulmonary bypass: a comparison with bolus thermodilution measurement.

Objective: The interchangeability of continuous measurement of cardiac output (CO) with the traditional bolus method in patients after cardiopulmonary bypass (CPB) is uncertain.

Design: Prospective observational clinical study.

Setting: A 20-bed surgical ICU at a university hospital.

Misplacement of central vein catheters in patients with hemothorax: a new approach to resolve the problem.

Background: In emergency and pre-hospital care, the verification of the correct position of a central venous catheter is based on the observation of blood color reflow as well as pressure changes with respiration. However, in trauma patient with hemothorax, these indices may not always be reliable signs as the catheter is in a blood-filled pleural space.

Methods: A review of reports published describing patients presenting hemothorax and equipped with central venous catheter wrongly assumed to be in the correct position was performed.

Fluid responsiveness in spontaneously breathing patients: a review of indexes used in intensive care.

Objective: In spontaneously breathing patients, indexes predicting hemodynamic response to volume expansion are very much needed. The present review discusses the clinical utility and accuracy of indexes tested as bedside indicators of preload reserve and fluid responsiveness in hypotensive, spontaneously breathing patients.

Data Source: We conducted a literature search of the MEDLINE database and the trial register of the Cochrane Group.

Infection and rejection in liver transplant patients: a 10-year Swiss single-centre experience.

Introduction: Graft rejection and infection remain major morbidities following orthotopic liver transplantation (OLT). Rejection treatment may be associated with an increased rate of infectious complications. The aim of this study was to determine the relationship between rejection, rejection therapy and the risk of associated infections.

A nationwide survey of intensive care unit discharge practices.

Objective: To describe intensive care unit (ICU) discharge practices, examine factors associated with physicians' discharge decisions, and explore ICU and hospital characteristics and clinical determinants associated with the discharge process.

Design: Survey in adult ICUs affiliated with the Swiss Society of Intensive Care Medicine.

Interventions: Questionnaire inquiring about ICU structure and organization mailed to 73 medical directors.

Transcutaneous PCO2 monitoring in critically ill adults: clinical evaluation of a new sensor.

Objective: In critically ill patients, arterial blood gas analysis is the gold standard for evaluating systemic oxygenation and carbon dioxide partial pressure. A new miniaturized carbon dioxide tension Pco2-Spo2 single sensor (TOSCA, Linde Medical Sensors AG, Basel, Switzerland) continuously and noninvasively (transcutaneously) monitors both Paco2 and oxygen saturation by pulse oximetry (Spo2). The present study was designed to investigate the usability and the accuracy of this device in critically ill patients.

Management of the critically ill patient with severe acute pancreatitis.

Objective: Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course requiring only brief hospitalization to a rapidly progressive, fulminant illness resulting in the multiple organ dysfunction syndrome (MODS), with or without accompanying sepsis. The goal of this consensus statement is to provide recommendations regarding the management of the critically ill patient with severe acute pancreatitis (SAP).

Data Sources And Methods: An international consensus conference was held in April 2004 to develop recommendations for the management of the critically ill patient with SAP.

Higher calorie prescription improves nutrient delivery during the first 5 days of enteral nutrition.

Aims: It is unclear whether prescribing a higher amount of calories by enteral nutrition (EN) increases actual delivery. This prospective controlled study aimed at comparing the progression of EN of two study populations with different levels of calorie prescriptions, during the first 5 days of EN.

Methods: The daily calorie prescription of group 1 (n=346) was 25 and 20 kcal/kg body weight for women <60 and > or =60 years, respectively, and 30 and 25 kcal/kg body weight for men <60 and > or =60 years, respectively.

Transpulmonary lactate gradient after hypothermic cardiopulmonary bypass.

Objective: Several studies demonstrated that the lungs could produce lactate in patients with acute lung injury (ALI). Because after cardiopulmonary bypass (CPB) some patients develop ALI, the effect of CPB on pulmonary lactate release was investigated.

Design: Prospective observational clinical study.

Randomized trial of the effect of antipyresis by metamizol, propacetamol or external cooling on metabolism, hemodynamics and inflammatory response.

Objective: We investigated the metabolic, hemodynamic, and inflammatory responses of pharmacological and physical therapies aimed at reducing body temperature in febrile critically ill patients.

Design And Setting: Open-label, randomized trial in a surgical ICU in a tertiary university hospital.

Patients: Thirty analgosedated, mechanically ventilated patients with a temperature of 38.