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June 20, 2013

Concise Critical Appraisal

Prone Positioning Found to Improve Survival in Severe ARDS

Education

Webcast on GRADE Methodology for SSC Guidelines
Attend WFSICCM’s 11th Congress in South Africa
Vision Grant Now Includes New Categories for Research Projects

SCCM News

Has Your Team Improved Family-Centered Care in the ICU?
Sessions on Delirium, Nutrition and More Added to LearnICU.org
Participate in an International Study on Mechanical Ventilation
Prone Positioning Found to Improve Survival in Severe ARDS

In two meta-analyses and one previous observational study, prone positioning was associated with improved survival for patients with severely hypoxemic acute respiratory distress syndrome (ARDS). However, the findings in these studies were in contradistinction to previously conducted randomized trials. To further evaluate the effectiveness of early prone positioning in severe ARDS, Guerin and colleagues from the PROSEVA Study Group designed a randomized controlled trial comparing early application of prone positioning versus supine positioning for patients with severe ARDS. Results were published in a recent issue of The New England Journal of Medicine.

There were 229 patients assigned to the supine group and 237 assigned to the prone group. Patients were similar within the two groups with the exception of a higher Sequential Organ Failure Assessment (SOFA) score and more vasopressor use in the supine group, as well as more neuromuscular blocker use in the prone group. Mortality at day 28 was significantly lower in the prone group (16%) compared to the supine group (32.8%; p<0.001). After adjustment for the SOFA score, patients in the prone group had a lower hazard of death compared to the supine group (hazard ratio = 0.42; 95% confidence interval [CI], 0.26-0.66; p<0.001). Patients in the prone group also had improved 90-day survival and more ventilator-free days compared to the supine group. The external generalizability of this work may be limited in centers where technical and logistical expertise for prone positioning is limited. Read the full Concise Critical Appraisal.

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Has Your Team Improved Family-Centered Care in the ICU?

Are you part of an intensive care unit team that not only commits itself to securing the highest quality care for its patients but also shows compassion toward each patient’s family in innovative ways? If so, consider applying for the Family-Centered Care Innovation Award. This honor is awarded to a unit or program that demonstrates novel, effective methods of providing care to critically ill and injured patients and their families. The selected team will receive a commemorative plaque and one free registration to the43rd Critical Care Congress. The deadline to submit an application is August 1, 2013. For more information, email Patient and Family Support Committee Staff Partner Amanda Cozza at acozza@sccm.org.

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Sessions on Delirium, Nutrition and More Added to LearnICU.org

Several videos featuring the industry-supported sessions from the Society’s Critical Care Congress in San Juan, Puerto Rico, are now available free of charge at LearnICU.org. Access these presentations and earn continuing education credit:

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Participate in an International Study on Mechanical Ventilation

The International Observational Study Investigators are looking at mechanical ventilation (MV) discontinuation practices internationally in intensive care units (ICU). The goal of the study is to characterize practice variation in weaning critically ill adults from invasive MV, as well as the influence of selected discontinuation strategies on important outcomes. Each ICU will be asked to collect data on at least 10 consecutive discontinuation events – one event (e.g., tracheostomy, direct extubation, initial successful spontaneous breathing trial) per patient receiving invasive ventilation for at least 24 hours and all patients who die before any attempt at MV discontinuation. Those interested in participating should email ioswean@smh.ca.

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Webcast on GRADE Methodology for SSC Guidelines

SSC LogoThe Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology is based on a sequential assessment of the quality of evidence, followed by the benefits, risks, burden, and cost, leading to development and grading of a management recommendation.

The Society of Critical Care Medicine’s (SCCM) webcast, GRADE Methodology, will take place on Thursday, June 27, 2013, from 3:00 p.m. to 4:00 p.m. Central Time. Mark E. Nunnally, MD, FCCM, will provide information on the GRADE system engaged for the 2012 Surviving Sepsis Campaign  (SSC) guidelines. Topics to be covered include:

  • Translating evidence into graded recommendations
  • Identify features that reduce or increase the quality of evidence
  • Appraising clinical data to determine the quality of evidence
  • Integrating the quality of evidence for an intervention with its costs, and the balance between desirable and undesirable effects and values to determine the strength of a recommendation

This event, part of SCCM’s webcast series, provides strategies for successful application of the SSC guidelines. An initiative of the European Society of Intensive Care Medicine (ESICM) and SCCM, the SSC aims to improve the management, diagnosis and treatment of sepsis in order to reduce its high mortality rate.

Register online today. Registration is complimentary for all participants. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.

Programs are supported by the Gordon and Betty Moore Foundation:

Moore

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Attend WFSICCM’s 11th Congress in South Africa

The World Federation of Societies of Intensive and Critical Care Medicine will hold its11th Congress, August 28 to September 1, 2013, in Durban, South Africa. Pre-registration for the conference will be available until August, 20, 2013. After this date, only on-site registration will be accepted. Please refer to www.criticalcare2013.com for additional information about travel and hotel accommodations.

Embark on a Study Mission to South Africa
Get the most out of your trip to South Africa by joining the Society of Critical Care Medicine (SCCM) for its  Study Mission to South Africa, August 25 to September 2, 2013. Enjoy an afternoon at the WFSICCM’s 11th Congress, in addition to visiting several critical care units in South Africa for an amazing opportunity to expand your knowledge of the scope and practice of care. Space is limited, the deadline to register is July 13,2013, so make your reservation today to ensure your spot! An optional trip to Cape Town, September 2 to 6,  will be available at the end of the Study Mission. Visit www.sccm.org/StudyMission, or call SCCM Customer Service at +1 847 827-6888.

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Vision Grant Now Includes New Categories for Research Projects

Through generous funding from the Society of Critical Care Medicine (SCCM), a Vision Grant of $50,000 is offered to support member researchers. Basic, translational and clinical research submissions are encouraged. Submit your application by August 31, 2013, to be considered for grant support in 2014.

Eligible research should focus on one or more of the following areas of investigation:

  • Basic research: Expand our understanding of complex critical illness processes.
  • Bench to bedside: Improve patient care by translating basic scientific findings into therapeutic interventions for critical care patients.
  • Clinical outcomes: Advance our understanding of patient outcomes and continuous improvement practices.

For more information or to download the application, visit www.sccm.org/VisionGrant.

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