Web site designed and maintained by Chris Cairns  © SICS EBM Group 2004                                  

SICS EBMG Annual Report 

2005/06 

Since the last report in April 2005 the EBMG has had a productive 16 months. The number of reviews, and critically appraised papers (CATs) produced have continued to increase with over 70 paper reviews published on the groups website (www.sicsebm.org.uk). These are summarized in the list below. The papers reviewed have included both “classic” papers from the past and newly published evidence. The number of submissions to the group for publication in the near future remains healthy. 

The feedback from the joint meeting with the SICS CCTG in June of this year has been very positive. The trainee CAT presentations generated good debate as always. There were also excellent presentations from our guest EBM speakers from SIGN. 

There have been several new developments for the group this year: By popular demand we have created an EBM discussion forum through a yahoo discussion group. The main aims of the forum are to facilitate discussion / feedback on articles published on the website as well as other wider issues. If you would like to join the forum then please send a request to icu_ebm-subscribe@yahoogroups.co.uk or visit http://uk.groups.yahoo.com/group/icu_ebm/. We particularly hope to circulate comments on CATs from the original paper authors. 2006 has also seen the launch of a partnership between the ICS and the SICS EBMG. The SICS EBMG is now editing the CATs published in JICS. Hopefully some of you will have recognised the change to our format and the increase in CATs from north of the boarder. These CATs are also published on our web site. JICS will be publishing our updates as well as circulating them via the ICS e-letter. The feedback from the ICS membership has been encouraging. 

The website continues to perform well with over half a million hits in the last 12 months and healthy rankings when compared with other ICU EBM sites. 

The future: In the later half of 2006 there will be another significant web publication run. There are several reviews underway (METs/Outreach, SDD, Hypothermia II, Nutrition, NIV) and the joint EBM / Research meeting will be repeated in June 2007. As always the group welcomes any new submissions. Details of the group and the submission and review/editorial process can be found on the groups wed site. 

Dr Chris Cairns

Chair, SICS EBMG

New Reviews 

• Preventing Catheter-related Blood Stream Infection (36 Cats). By David Swann, Andrew Longmate & Chris Cairns

• Early tracheostomy: A review of the available evidence from a meta-analysis and its composite controlled studies. (6 CATS) By Richard Price, David Swann & Martin Hughes

 Updated Reviews

• EBM Reviews. Scottish Intensive Care Society EBM Group. Swann D. Using heat and moisture exchange filters reduces the incidence of ventilator-associated pneumonia. 2004. (Updated 2005, 2006).

• Tidal volume limitation and PEEP in Acute Lung Injury and Acute Respiratory Distress Syndrome. By Dr Brian Cuthbertson

New Critically Appraised Papers (28):

•  Kress JP, et al. Daily interruption of sedative infusions in critically ill patients undergoing mechanical ventilation. NEJM 2000; 342: 1471-1477. By Tim Geary

• Kress JP, et al. The long term psychological effects of daily sedative interruptions on critically ill patients. AJRCCM 2003; 168: 1457- 1461. By Tim Geary.

• Effect of Glucose-Insulin-Potassium Infusion on Mortality in Patients With Acute ST-Segment Elevation Myocardial Infarction The CREATE-ECLA Randomized Controlled Trial. JAMA. 2005;293:437-446. By Paul McConnell.

• Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control. Crit Care Med 2003; Vol 31(2): 359-366. By Ryan Moffat.

• M Holzer et al.: Hypothermia for neuroprotection after cardiac arrest: Systematic review and individual patient data meta-analysis, Critical Care Medicine 2005, Vol.33: 414-418. By Anja Beilharz.

• Phua J, et al. Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic abstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure. Int Care Med 2005; 31:533-539. By Alice Murray.

• Derek C Angus, et al. The effect of drotrecogin alfa (activated) on long-term survival after severe sepsis. Crit Care Med 2004;Vol 32; No 11: 2199-2206. By Caroline Hawe.

• Plant PK. Owen JL. Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000 355(9219):1931-5. By Ewan Jack.

• Mayer SA, et al. Recombinant Activated Factor VII for Acute Intracerebral Hemorrhage. NEJM 2005: 352(8); 777 – 785. By Ewan Jack.

·        Spragg RG, et al, Effect of Recombinant Surfactant Protein C- based Surfactant on the Acute Respiratory Distress Syndrome Engl J Med 2004; 351:884-92. By Basu Bhadrajkumar.

·         Harvey S, Harrison DA, Singer M et al. Assessment of the clinical effectiveness of the pulmonary artery catheter; a randomised controlled trial. Lancet 2005; 366: 472- 477.By Brian Cuthbertson.

·         Abraham E, et al. Drotrecogin Alfa (Activated) for adults with severe sepsis and a low risk of death. New Engl J Med 2005;353:1332-41. By Paul Harrison & Chris Cairns

• Merit Study Investigators. Introduction of the medical emergency team (MET) system: a cluster randomised controlled trial. Lancet. 2005. 365: 2091-7. By Brian Cuthbertson

• Squadrone V, et al. Continuous Positive Airway Pressure for treatment of Postoperative Hypoxaemia: A Randomized Controlled Trial. JAMA Volume 293; Feb 2005 Page 589-595. By Pam Doherty

·         Esteban A, et al. Non-invasive Positive Pressure Ventilation for Respiratory Failure after extubation. New Engl J Med 2004;350:2452-69. by Pam Doherty

·         Effect of an Intensive Glucose Management Protocol on the Mortality of Critically Ill Patients: Mayo Clin Proc. August 2004: 79(8): 992-1000. by Paul McConnell.

·         Ferrer M, et al. Noninvasive Ventilation during Persistent Weaning Failure: A Randomized Controlled Trial. Am J Respiratory Crit Care Medicine Vol 168 pp 70-76 2003. by Pam Doherty.

• Busund R, et al. Plasmapheresis in severe sepsis and septic shock: prospective, randomised, controlled trial. Intensive Care Med (2002) 28:1434-1439. By Vaidyanathan Ramanathan.

• Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus 'nil by mouth' after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001; 323: 773-776. by Marcia McDougal.

• Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: A systematic review. Critical Care Medicine 2001 Vol. 29 No.12. 2264-2270. by Marcia McDougal.

• Van den Berghe G, et al. Intensive Insulin Therapy in The Medical ICU. N Engl J Med 2006;354:449-61. by Chris Cairns

• Pearse et al. Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial. Critical Care 2005, 9:R687-R693. by David Elliot

• Verheij J, et al. Effect of fluid loading with saline or colloids on pulmonary permeability, oedema and lung injury score after cardiac and major vascular surgery. Br J Anaesth 2006; 96 (1):21-30. by Rebecca Appelboam.

• Kruger P et al. Statin therapy is associated with fewer deaths in patients with bacteraemia. Intensive Care Med 2006; 32:75-79 by Niraj Niranjan

• Gershlick AH, Stephens-Lloyd A, Hughes S et al for the REACT Trial Investigators. Rescue angioplasty after failed thrombolytic therapy for acute myocardial infarction. N Engl J Med 2005; 353: 2758-68 by Stephen Harris

• The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Efficacy and Safety of Corticosteroids for Persistent Acute Respiratory Distress Syndrome. NEJM 2006; 354: 1671-1684 by Brian Cuthbertson.

• Martin GS, Moss M, Wheeler A, Mealer M, Morris J, Bernard G: A randomised, controlled trial of furosemide with or without albumin in hypoproteinaemic patients with acute lung injury. Crit Care Med. 2005; 33:1681-7 by David MacNair & Brian Cuthbertson

• John V. Peter, et al. Effect of non-invasive positive pressure ventilation ( NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. Lancet 2006; 367: 1155-63 by Brian Digby.