This article reviews noteworthy investigations and society recommendations published in 2023 relevant to the care of critically ill cardiothoracic surgical patients. We reviewed 3,214 articles to identify 18 publications that add to the existing literature across a variety of topics including resuscitation, nutrition, antibiotic management, extracorporeal membrane oxygenation (ECMO), neurologic care following cardiac arrest, coagulopathy and transfusion, steroids in pulmonary infections, and updated guidelines in the management of acute respiratory distress syndrome (ARDS).
DünserMWHasibederWR. Sympathetic overstimulation during critical illness: adverse effects of adrenergic stress. J Intensive Care Med. 2009;24(5):293-316.
2.
RudigerASingerM. Mechanisms of sepsis-induced cardiac dysfunction. Crit Care Med. 2007;35(6):1599-1608.
3.
AcklandGLYaoSTRudigerA, et al.Cardioprotection, attenuated systemic inflammation, and survival benefit of beta1-adrenoceptor blockade in severe sepsis in rats. Crit Care Med. 2010;38(2):388-394.
4.
Ibrahim-ZadaIRheePGomezCTWellerJFrieseRS. Inhibition of sepsis-induced inflammatory response by β1-adrenergic antagonists. J Trauma Acute Care Surg. 2014;76(2):320-327; discussion 327-8.
5.
ZhangJChenCLiuYYangYYangXYangJ. Benefits of esmolol in adults with sepsis and septic shock: an updated meta-analysis of randomized controlled trials. Medicine (Baltimore). 2022;101(27):e29820.
6.
WhitehouseTHossainAPerkinsGD, et al.Landiolol and organ failure in patients with septic shock: the STRESS-L randomized clinical trial. JAMA. 2023;330(17):1641-1652.
7.
SingerMDeutschmanCSSeymourCW, et al.The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-810.
8.
ProCESS InvestigatorsYealyDMKellumJA, et al.A randomized trial of protocol-based care for early septic shock. N Engl J Med. 2014;370(18):1683-1693.
9.
EvansLRhodesAAlhazzaniW, et al.Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Crit Care Med. 2021;49(11):e1063-e1143.
10.
SelfWHSemlerMWBellomoR, et al.Liberal versus restrictive intravenous fluid therapy for early septic shock: rationale for a randomized trial. Ann Emerg Med. 2018;72(4):457-466.
11.
MeyhoffTSHjortrupPBWetterslevJ, et al.Restriction of intravenous fluid in ICU patients with septic shock. N Engl J Med. 2022;386(26):2459-2470.
12.
National Heart Lung and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials NetworkShapiroNIDouglasIS, et al.Early restrictive or liberal fluid management for sepsis-induced hypotension. N Engl J Med. 2023;388(6):499-510.
13.
HeylandDKPatelJCompherC, et al.The effect of higher protein dosing in critically ill patients with high nutritional risk (EFFORT Protein): an international, multicentre, pragmatic, registry-based randomised trial. Lancet. 2023;401(10376):568-576.
14.
CompherCBinghamALMcCallM, et al.Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for parenteral and enteral nutrition. JPEN J Parenter Enteral Nutr. 2022;46(1):12-41.
15.
GunstJDebaveyeYGüizaF, et al.Tight blood-glucose control without early parenteral nutrition in the ICU. N Engl J Med. 2023;389(13):1180-1190.
16.
KrinsleyJSEgiMKissA, et al.Diabetic status and the relation of the three domains of glycemic control to mortality in critically ill patients: an international multicenter cohort study. Crit Care. 2013;17(2):R37.
17.
Van HerpeTMesottenDWoutersPJ, et al.LOGIC-insulin algorithm-guided versus nurse-directed blood glucose control during critical illness: the LOGIC-1 single-center, randomized, controlled clinical trial. Diabetes Care. 2013;36(2):188-194.
18.
DuboisJVan HerpeTvan HooijdonkRT, et al.Software-guided versus nurse-directed blood glucose control in critically ill patients: the LOGIC-2 multicenter randomized controlled clinical trial. Crit Care. 2017;21(1):212.
19.
QianETCaseyJDWrightA, et al.Cefepime vs Piperacillin-tazobactam in adults hospitalized with acute infection: the ACORN randomized clinical trial. JAMA. 2023;330(16):1557-1567.
20.
BushKBradfordPA. β-Lactams and β-Lactamase inhibitors: an overview. Cold Spring Harb Perspect Med. 2016;6(8):a025247.
21.
CottaMODulhuntyJMRobertsJAMyburghJLipmanJ. Should β-lactam antibiotics be administered by continuous infusion in critically ill patients? A survey of Australia and New Zealand intensive care unit doctors and pharmacists. Int J Antimicrob Agents. 2016;47(6):436-438.
22.
MontiGBradicNMarzaroliM, et al.Continuous vs intermittent meropenem administration in critically ill patients with sepsis: the MERCY randomized clinical trial. JAMA. 2023;330(2):141-151.
23.
BrunnerSGuentherSPWLackermairK, et al.Extracorporeal life support in cardiogenic shock complicating acute myocardial infarction. J Am Coll Cardiol. 2019;73(18):2355-2357.
24.
OuweneelDMSchotborghJVLimpensJ, et al.Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis. Intensive Care Med. 2016;42(12):1922-1934.
25.
BecherPMSchrageBSinningCR, et al.Venoarterial extracorporeal membrane oxygenation for cardiopulmonary support. Circulation. 2018;138(20):2298-2300.
26.
ThieleHZeymerUAkinI, et al.Extracorporeal life support in infarct-related cardiogenic shock. N Engl J Med. 2023;389(14):1286-1297.
27.
OstadalPRokytaRKarasekJ, et al.Extracorporeal membrane oxygenation in the therapy of cardiogenic shock: results of the ECMO-CS randomized clinical trial. Circulation. 2023;147(6):454-464.
28.
NaiduSSBaranDAJentzerJC, et al.SCAI SHOCK stage classification expert consensus update: a review and incorporation of validation studies: this statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021. J Am Coll Cardiol. 2022;79(9):933-946.
29.
BelohlavekJSmalcovaJRobD, et al.Effect of intra-arrest transport, extracorporeal cardiopulmonary resuscitation, and immediate invasive assessment and treatment on functional neurologic outcome in refractory out-of-hospital cardiac arrest: a randomized clinical trial. JAMA. 2022;327(8):737-747.
30.
YannopoulosDBartosJRaveendranG, et al.Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trial. Lancet. 2020;396(10265):1807-1816.
31.
SuvereinMMDelnoijTSRLorussoR, et al.Early extracorporeal CPR for refractory out-of-hospital cardiac arrest. N Engl J Med. 2023;388(4):299-309.
32.
VaahersaloJBendelSReinikainenM, et al.Arterial blood gas tensions after resuscitation from out-of-hospital cardiac arrest: associations with long-term neurologic outcome. Crit Care Med. 2014;42(6):1463-1470.
33.
PanchalARBartosJACabañasJG, et al.Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S366-s468.
34.
EastwoodGNicholADHodgsonC, et al.Mild hypercapnia or normocapnia after out-of-hospital cardiac arrest. N Engl J Med. 2023;389(1):45-57.
35.
SchmidtHKjaergaardJHassagerC, et al.Oxygen targets in comatose survivors of cardiac arrest. N Engl J Med. 2022;387(16):1467-1476.
36.
RajajeeVMuehlschlegelSWartenbergKE, et al.Guidelines for neuroprognostication in comatose adult survivors of cardiac arrest. Neurocrit Care. 2023;38(3):533-563.
37.
OhSHParkKNChoiSP, et al.Prognostic value of somatosensory evoked potential in cardiac arrest patients without withdrawal of life-sustaining therapy. Resuscitation. 2020;150:154-161.
ZaramaVRevelo-NogueraJQuinteroJA, et al.Prophylactic platelet transfusion and risk of bleeding associated with ultrasound-guided central venous access in patients with severe thrombocytopenia. Acad Emerg Med. 2023;30(6):644-652.
40.
van de WeerdtEKBiemondBJZeerlederSS, et al.Prophylactic platelet transfusion prior to central venous catheter placement in patients with thrombocytopenia: study protocol for a randomised controlled trial. Trials. 2018;19(1):127.
41.
KaufmanRMDjulbegovicBGernsheimerT, et al.Platelet transfusion: a clinical practice guideline from the AABB. Ann Intern Med. 2015;162(3):205-213.
42.
EstcourtLJBirchallJAllardS, et al.Guidelines for the use of platelet transfusions. Br J Haematol. 2017;176(3):365-394.
43.
van BaarleFLFvan de WeerdtEKvan der VeldenWJFM, et al.Platelet transfusion before CVC placement in patients with thrombocytopenia. N Engl J Med. 2023;388(21):1956-1965.
44.
van BaarleFLFTishehAJhingoeriesinghSSVlaarAPJBiemondBJ. Contribution of coagulopathy on the risk of bleeding after central venous catheter placement in critically ill thrombocytopenic patients. Crit Care Explor. 2022;4(1):e0621.
45.
ZeidlerKArnKSennOSchanzUStussiG. Optimal preprocedural platelet transfusion threshold for central venous catheter insertions in patients with thrombocytopenia. Transfusion. 2011;51(11):2269-2276.
46.
McQuiltenZKWoodEMBaileyMCameronPACooperDJ. Fibrinogen is an independent predictor of mortality in major trauma patients: a five-year statewide cohort study. Injury. 2017;48(5):1074-1081.
47.
DavenportRCurryNFoxEE, et al.Early and empirical high-dose cryoprecipitate for hemorrhage after traumatic injury: the CRYOSTAT-2 randomized clinical trial. JAMA. 2023;330(19):1882-1891.
48.
CurryNRourkeCDavenportR, et al.Early cryoprecipitate for major haemorrhage in trauma: a randomised controlled feasibility trial. Br J Anaesth. 2015;115(1):76-83.
49.
HagemoJSStanworthSJuffermansNP, et al.Prevalence, predictors and outcome of hypofibrinogenaemia in trauma: a multicentre observational study. Crit Care. 2014;18(2):R52.
50.
CarsonJLStanworthSJDennisJA, et al.Transfusion thresholds for guiding red blood cell transfusion. Cochrane Database Syst Rev. 2021;12(12):Cd002042.
51.
WangYShiXWenMChenYZhangQ. Restrictive versus liberal blood transfusion in patients with coronary artery disease: a meta-analysis. Curr Med Res Opin. 2017;33(4):761-768.
52.
CarsonJLBrooksMMHébertPC, et al.Restrictive or liberal transfusion strategy in myocardial infarction and anemia. N Engl J Med. 2023;389(26):2446-2456.
53.
QadirNSahetyaSMunshiL, et al.An update on management of adult patients with acute respiratory distress syndrome: an official american thoracic society clinical practice guideline. Am J Respir Crit Care Med. 2024;209(1):24-36.
54.
DequinPFMezianiFQuenotJP, et al.Hydrocortisone in severe community-acquired pneumonia. N Engl J Med. 2023;388(21):1931-1941.
55.
EhrmannSBarbierFDemiselleJ, et al.Inhaled amikacin to prevent ventilator-associated pneumonia. N Engl J Med. 2023;389(22):2052-2062.
56.
GrasselliGCalfeeCSCamporotaL, et al.ESICM guidelines on acute respiratory distress syndrome: definition, phenotyping and respiratory support strategies. Intensive Care Med. 2023;49(7):727-759.
57.
AnnaneDPastoresSMRochwergB, et al.Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Intensive Care Med. 2017;43(12):1751-1763.
58.
FanEDel SorboLGoligherEC, et al.An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med. 2017;195(9):1253-1263.
