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The first sitting of the CICM General Fellowship exam for 2012 is drawing near. Here are a few topics being debated in various intensive care medicine fora that may be worth giving some thought to during your preparation … |
1) Fluid/Volume balance in critically ill patients:
Morbidity and mortality outcomes
- Read Acute kidney injury: how can we facilitate recovery? Neil J. Glassford and Rinaldo Bellomo, Current Opinion in Critical Care 2011, 17:562–568 (Available via the CICM online journals)
- Read the FEAST trial (Maitland K, Kiguli S, OpokaRO, et al. for the FEAST Trial Group: “Mortality after fluid bolus in African children with severe infection”. N Engl J Med 2011; 364:2483–2495. Vodcast available via the Intensive Care Network discussion forum: topic heading = ) and editorial review (Hilton AK, Bellomo R. “Totem and taboo: fluids in sepsis.” Crit Care 2011; 15:164–166.)
- CHEST is on schedule and has recruited 7000 patient encounters to date
- Have an opinion on the implications of chasing numbers with fluid boluses and the concept of “some is good, more must be better”
- Consider the potential for association versus causality
2) Oxygen therapy in critically ill patients
- Similar to fluid therapy, some is good, more may not always be better, particularly in areas such as neurological outcome following successful management of out of hospital cardiac arrest (OHCA)
- Read the ANZ Resus Council guidelines on the use of O2 in arrythmia resuscitation.
- Recently published in the Intensive Care Medicine journal: Eastwood, Bellomo, Bailey, Taori, D. Pilcher, Young, Beasley – Paper – Intensive Care Med (2012) 38: 91 -98 – “Arterial oxygen tension and mortality in mechanically ventilated patients”
3) Australian research
- Jan 2012 – EPO-TBI is currently recruiting in Australia and New Zealand. Examining the potential for benefit by using erythropoietin in traumatic brain injury.
- The CytoFab study is currently recruiting in Australia and New Zealand. The use of a sepsis modulator in severe sepsis and its effect on outcomes.
- Nephro-Protect is currently recruiting in Australia and New Zealand. The use of Synthamin in reducing the incidence of AKI and the need for CRRT in critically ill patients.
- The Refeeding Project is currently recruiting in Australia and New Zealand. Protocolised treatment of hypophosphataemia in critically ill patients receiving nutritional support.
- The PREDICT trial has completed data collection and is currently analysing results. It is due to present preliminary findings at the upcoming Noosa CTG meeting
If you have any other Hot Topics that you feel your colleagues should be aware of, send them in and we’ll post them up for all to see.
Good luck out there
