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May 16, 2013

Concise Critical Appraisal

Glutamine and Antioxidants for Patients with Multiple Organ Failure

Education

Webcast Highlights Third Edition of SSC Guidelines

SCCM News

Wear Blue Tomorrow to Support Critical Care
SCCM Congratulates Members on Research Awards
Critical Connections Focuses on Sepsis Management
Apply for ANZICS New Fellowship Program
Glutamine and Antioxidants for Patients with Multiple Organ Failure

Critically ill patients are at risk for significant oxidative stress; however, several small analyses have proposed that supplementation with glutamine, with or without antioxidants, may improve survival. Heyland and colleagues from the Canadian Critical Care Trials Group conducted an international, multicenter study to test the hypothesis that 28-day mortality in critically ill adults would be reduced by supplementation with glutamine, with or without antioxidants. Results were published in a recent issue of The New England Journal of Medicine.

There were 1,223 patients randomized to one of four groups. Overall 28-day mortality was 29.8%. Patients who received glutamine had a trend towards worse mortality at 28 days compared to patients who did not receive glutamine (32.4% vs. 27.2%; adjusted odds ratio [AOR], 1.28; 95% confidence interval [CI], 1.00 to 1.64; P=0.05). The combination of glutamine with antioxidants made no significant difference in survival (AOR, 1.09; 95% CI, 0.86 to 1.40; P=0.48). In-hospital mortality and mortality at 6 months were significantly higher among patients who received glutamine; they also had increases in ICU length of stay, length of mechanical ventilation, and overall hospital length of stay. Antioxidant supplementation had no effect on secondary outcomes. The findings from this large, robust randomized study are in opposition to those of previous smaller studies. Read the full Concise Critical Appraisal.

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Wear Blue Tomorrow to Support Critical Care

Be sure to wear blue on Friday, May 17, to show your support forNational Critical Care Awareness and Recognition Month (NCCARM). There is still time to mark this year’s NCCARM, and the Society offers several simple ideas for recognition of the critical care team. Some teams choose to offer tours of the intensive care unit to other hospital staff, while others organize educational symposia or invite former patients and their families back to the unit. No matter how you choose to celebrate, we hope you post your NCCARM photos and stories to the SCCM Facebook page.

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SCCM Congratulates Members on Research Awards

The Patient Centered Outcomes Research Institute (PCORI) has approved 51 new awards, totaling $88.6 million over three years, to fund patient-centered comparative clinical effectiveness research projects under the first four areas of its National Priorities for Research and Research Agenda.  The Society of Critical Care Medicine congratulates the following members for their award-winning projects related to critical care:

  • Christopher Ethan Cox, MD, MPH – Improving Psychological Distress Among Critical Illness Survivors and Their Informal Caregivers
  • J. Randall Curtis, MD, MPH – Health System Intervention to Improve Communication About End-of-Life Care for Vulnerable Patients
  • Elliott R. Haut, MD – Preventing Venous Thromboembolism: Empowering Patients and Enabling Patient-Centered Care via Health Information Technology
  • Rebecca Aslakson, MD – Utilizing Advance Care Planning Videos to Empower Perioperative Cancer Patients and Families
  • Erik Paul Hess, MD, MS – Shared Decision Making in the Emergency Department: The Chest Pain Choice Trial; and Shared Decision Making in Parents of Children with Head Trauma: Head CT Choice
  • Debra Kay Moser, DNSc, RN – Reducing Health Disparities in Appalachians with Multiple Cardiovascular Disease Risk Factors
  • Rachel Berger, MD, MPH – Using the Electronic Medical Record to Improve Outcomes and Decrease Disparities in Screening for Child Physical Abuse

We congratulate these members for their dedication to evolving research and to the field of critical care medicine.

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Critical Connections Focuses on Sepsis Management

The April/May issue of Critical Connections focuses on managing sepsis in the intensive care unit, highlighting various strategies, from the use of early goal-directed therapy to implementing the Surviving Sepsis Campaign (SSC) guideline recommendations and bundles. Find the following articles:

  • Surviving Sepsis Campaign Enters Second Decade with Dynamic Plans
  • Rapid Identification of Sepsis: The Value of Screening Tools
  • Early Goal-Directed Therapy: Contemporary Care and Controversies
  • Ongoing Clinical Trials in Sepsis
  • Challenges in Pediatric Sepsis

The latest issue also features an article highlighting the growing concern over physician burnout and providing strategies for identifying the problem and improving performance.

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Apply for ANZICS New Fellowship Program

The Australian and New Zealand Intensive Care Society (ANZICS) has instituted a fellowship program, Intensive Care Global Rising Star Programme, in support of innovative and productive research. ANZICS will be awarding three travel fellowships for attending their 38th Annual Scientific Meeting, to be held October 25 to 27, 2013, in Hobart, Tasmania,  Australia. One fellowship will be awarded to a clinician/scientist from each of the following regions: America (USA, Canada and South America), Europe (including United Kingdom and Ireland) and Asia.

Award recipients will have the opportunity to present an overview of their past and ongoing research activities during a dedicated symposium. Travel expenses (to the value of $3,000), accommodation and registration costs for the recipients will be covered.

Applicants should have the following:

  • Medical degree and completed (or be in-training for) fellowship in intensive care medicine.
  • Age 45 years or younger, as of October 25, 2013.

Those interested in applying for this opportunity should fill out the online abstract submission form no later than May 31, 2013. Applicants will be notified by June 3, 2013.

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Webcast Highlights Third Edition of SSC Guidelines

Severe sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year, killing one in four (and often more), and increasing in incidence. Similar to polytrauma, acute myocardial infarction, or stroke, the speed and appropriateness of therapy administered in the initial hours after severe sepsis develops are likely to influence outcome.

During the Society of Critical Care Medicine’s (SCCM) webcast, What’s New in the Third Edition of the SSC Guidelines?, R. Phillip Dellinger, MD, MCCM, and Christa A. Schorr, RN, MSN, FCCM, will discuss the additions to the latest update of the Surviving Sepsis Campaign guidelines and the rationale for the changes. The webcast will be held Wednesday, May 29, from 1:00 p.m. to 2:00 p.m. Central Time.

Register online today. Registration is complimentary for all participants. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888. This event is part of SCCM’s newest webcast series, which outlines strategies for successful implementation of the SSC recommendations. Previous webcasts, now available free of charge, are available for download at www.survivingsepsis.org.

Programs are supported by the Gordon and Betty Moore Foundation:

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