The June/July issue of Critical Connections features review articles from the 42nd Critical Care Congress:
Claim CE credit by ordering the Congress Review at the SCCM store at www.sccm.org/congressreview13. There is no cost for this transaction.
The latest issue also offers a preview of the 43rd Critical Care Congress, to be held January 9 to 13, 2014, in San Francisco, California, USA. Check out our pre-Congress educational sessions, popular events and sightseeing activities, as well as information on hotels and travel.
The U.S. Food and Drug Administration (FDA) has found data that indicate an increased risk of mortality and renal injury requiring renal replacement therapy in critically ill adult patients treated with hydroxyethyl starch (HES) solutions. HES solutions are used for the treatment of hypovolemia when plasma volume expansion is indicated. After a public workshop, the FDA concluded that HES solutions should not be used in this patient population, and a Boxed Warning to include the risk of mortality and severe renal injury is warranted. In addition, the FDA reviewed a meta-analysis of studies conducted in patients undergoing open heart surgery in association with cardiopulmonary bypass and determined that an additional warning about excessive bleeding was needed in the Warnings and Precautions Section of the package insert. The FDA has created a list of recommendations for patients and healthcare providers to consider before use of HES solutions.
PDR Drug Alerts provides immediate, electronic delivery of safety information from the U.S. Food and Drug Administration. Society of Critical Care Medicine members can sign up to receive complimentary alerts as well as updates reflecting labeling changes.
Medications approved for adults often have additional uses in pediatric patients. Such is the case — as described by Wessel and colleagues — for clopidogrel, an agent that blocks the P2Y12 component of adenosine diphosphate (ADP) receptors on the surface of platelets. ADP receptors prevent the activation of the glycoprotein IIb/IIIa receptor complex, thereby reducing aggregation. Clopidogrel is used most commonly as a prophylactic antiplatelet therapy in adults with atherosclerotic cardiovascular disease, but is increasingly employed in the pediatric population, particularly in those with cardiac disease. Pediatric cardiovascular practitioners are using clopidogrel (along with the standard aspirin) to prevent the thrombosis of systemic-to-pulmonary-artery shunts in patients with complex cyanotic heart disease; however, the safety and efficacy of this practice have never been looked at prospectively. In the June 20 issue of The New England Journal of Medicine, investigators created a multicenter, event-driven trial to evaluate clopidogrel’s effect on infants.
A total of 906 subjects were enrolled, 467 in the clopidogrel group and 439 in the placebo group. The authors found that adding clopidogrel to conventional therapies (i.e., aspirin) did not affect mortality from any cause or shunt-thrombosis-related morbidity. Although no statistically significant differences were detected in total subjects with adverse events, the authors found more neurologic events in the clopidogrel group versus the placebo group. Read the full Concise Critical Appraisal.
The Society of Critical Care Medicine (SCCM) offers numerous awards that recognize dedication and contributions to the field in a variety of areas. Nominate yourself or a colleague, or recognize your entire intensive care unit (ICU) team. Most award recipients receive a complimentary registration to the 43rd Critical Care Congress. Apply for these opportunities by August 1, 2013.
Dr. Joseph and Rae Brown Award – Recognize an SCCM member who has advanced multiprofessional quality care at the regional or local level through exceptional leadership contributions that have furthered the vision and mission of chapters and/or affiliates.
Grenvik Family Award for Ethics – Acknowledge an SCCM member who has made significant contributions toward addressing ethical problems in critical care.
Norma J. Shoemaker Award for Critical Care Nursing Excellence – Recognize an SCCM nurse member who demonstrates excellence in clinical practice, education and/or administration in the field of critical care.
Barry A. Shapiro Memorial Award for Excellence in Critical Care Management – Nominate an SCCM member who has made significant contributions to the design and/or implementation of evidence-based practices that have improved clinical, operational or fiscal outcomes.
Family-Centered Care Innovation Award – Commend an intensive care unit team that has succeeded in instituting a novel approach to compassionate care and has a desire to share that innovation with other teams.
ICU Design Citation Applications Due August 15
Submit your application for the ICU Design Citation, which is co-sponsored by the Society of Critical Care Medicine, the American Association of Critical-Care Nurses, and the American Institute of Architects Academy on Architecture for Health. The award recognizes an operating critical care unit designed with attention to both functional and humanitarian issues.
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.
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.
The 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:
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 firstname.lastname@example.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:
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 email@example.com.
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.
Register for the Society of Critical Care Medicine’s (SCCM) Fundamentals of Critical Care Ultrasound and Advanced Ultrasound courses by Wednesday, June 19, 2013, to take advantage of discounted registration rates.
In the evaluation and treatment of acute illness and injury, every second makes a difference. Focused ultrasound examinations in the critical care setting have become an extension of the clinical assessment because of their rapid, precise detection capabilities. Assist in the immediate management of patients by learning or enhancing point-of-care ultrasound skills. Read more…
The deadline to receive early-bird rates for the Society of Critical Care Medicine’s (SCCM) Adult Multiprofessional Critical Care Board Review Course (MCCBRC) is Wednesday, June 19, 2013.
Led by an internationally recognized faculty, this four-and-a-half-day course will provide the most comprehensive review in the diagnosis, monitoring and management of critically ill patients. Attendees benefit by fulfilling continuing medical education requirements and gaining accurate assessments of their knowledge in critical care. The course also provides an excellent update for any critical care professional seeking the most current review of the field. Read more…
Registration is now open for the Society of Critical Care Medicine’s (SCCM) 43rd Critical Care Congress, to be held January 9 to 13, 2014, in San Francisco, California, USA.
The Society’s annual Congress is the largest multiprofessional critical care event of the year and the “City by the Bay” is the ideal setting to combine creative and inspirational ideas for the critical care field. This five-day event will provide outstanding networking opportunities and innovative learning experiences, highlighting the most up-to-date, evidence-based developments in critical care medicine. Read more…