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March 20, 2014

Concise Critical Appraisal

Mortality and Predictors of Death Among Survivors of ARDS

Education

Webcast to Review Consent for Research

SCCM News

Drug Shortage Alert: Electrolyte Medication
Participate in an International Study on Mechanical Ventilation
Mortality and Predictors of Death Among Survivors of ARDS

Modern intensive care unit interventions such as low-tidal volume mechanical ventilation may result in short-term improvements in acute respiratory distress syndrome (ARDS) survival, but less is known about the epidemiology of long-term survival. Chen Wang et al conducted a study to quantify the gap between in-hospital and 1-year ARDS mortality rates, and to identify risk factors and causes of death at one year among patients with ARDS.

Patients were selected from an ongoing prospective, multi-unit acute lung injury (ALI) biomarker study (VALID) at a single institution (Vanderbilt University Medical Center, Nashville, TN, USA). Those who met the American European Consensus Committee criteria for ALI/ARDs were included. A sensitivity analysis was also performed to include patients who met the Berlin criteria for ARDS. All were followed until death or for at least 1 year after study enrollment. Logistic regression was used to analyze associations between risk factors and death.
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Webcast to Review Consent for Research

Researchers are at the forefront of advancing knowledge that can be leveraged to treat disease, to improve quality of care, and to enhance patient experiences and outcomes. In the upcoming webcast, Consent for Research in the ICU, from the Controversies in Critical Care series, John Whitcomb, PhD, RN, CCRN, FCCM, Dan Thompson, MD, MA, FCCM, and Alex Kon, MD, FCCM, will discuss the different challenges in pediatric and adult consent for research and present the difficulties for consent in complex research in critically ill patients.

Learning Objectives

  • Discuss the fundamentals of consent for research
  • Explain the issues of consent for research when the patients cannot consent for themselves
  • Describe the difference between pediatric and adult consent for research
  • Explore the problems for consent in complex research in critically ill patients

This webcast will take place on Friday, April 25, 2014, at 1:00 p.m. Central Time.

Register online today. The registration fee for this 60-minute webcast is $30 for SCCM members and $40 for nonmembers. Participants will receive 1 hour of continuing education credit. Please contact SCCM Customer Service at +1 847 827-6888 to inquire about the $200 group rate for institutions that will host multiple participants.

The Controversies in Critical Care webcast series is a joint project of the SCCM Research Committee and the American College of Critical Care Medicine’s Ethics Committee. This series is intended to provide insight into topics in critical care medicine for which there is no clear consensus or unequivocal evidence for guiding practice decisions.

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Drug Shortage Alert: Electrolyte Medication

The Society of Critical Care Medicine’s Drug Shortages Task Force has produced a comprehensive guide for assessing and responding to shortages of sodium acetate injection, concentrated sodium chloride, potassium acetate and chloride injection, phosphate injection, calcium chloride and gluconate injection, and magnesium sulfate injection. Manufacturers report a number of reasons for these shortages, including increased demand, manufacturing delays, suspended production, and discontinuation by the manufacturer.

The alert Electrolyte Medication Shortages includes information on the shortage’s impact in intensive care units, including suggested management strategies, pharmacotherapeutic considerations, and safety concerns. The recommendations are based on a combination of current evidence, clinical experience from multiple clinicians, and the need for conservation during these shortages.

Visit www.sccm.org/currentissues to access all Drug Shortage Alerts, including those addressing:

  • Intravenous Sodium Bicarbonate
  • Web Resources
  • Intravenous Loop Diuretics
  • General Considerations

John Lewin, MBA, PharmD, and other members of the Drug Shortage Task Force discuss safe and consistent management of drug shortages as well as on additional resources and strategies.

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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. 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 unit  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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Hamilton Medical – Reduced time on the ventilator with ASV

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