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In the second in our series of F1000Prime most influential articles we present the top-ranking articles in Critical Care & Emergency Medicine in 2013 and speak to a global influencer in the field.

The top-ranking – clinical-practice changing – article, a randomized controlled trial, found that anesthesiologists should use a lung-protective ventilation strategy in intermediate-risk and high-risk patients undergoing major abdominal surgery. The Intraoperative Protective Ventilation in Abdominal Surgery (IMPROVE) study was published in New England Journal of Medicine in August 2013.

The most influential article published in a specialist journal explored the impact of bispectral index (BIS)-guided anesthesia on postoperative cognitive dysfunction (POCD). Awarding the article 3 stars, the highest possible rating, Dr Jean Charchaflieh, Yale University School of Medicine, wrote: “This excellent article provides the promise of the role of a simple clinical intervention to produce significant clinical effect on an important clinical problem.”

After compiling the list we spoke to F1000Prime’s Head of Faculty for Critical Care & Emergency Medicine, Prof Jean-Louis Vincent (pictured). He said: “In 2013 in Critical Care & Emergency Medicine we saw significant advances in respiratory management as well as in monitoring of high risk surgical patients to minimize the risks of postoperative complications. These articles identified by F1000Prime reflect many of these important developments in our field. By identifying articles such as the IMPROVE trial soon after publication F1000Prime is helping to bring important research – such as papers that change clinical practice – to the attention of intensivists and policy-makers who need reliable information quickly.”

Jean-Louis is Professor of Intensive Care, Université Libre de Bruxelles and the Head of the Department of Intensive Care, Erasme University Hospital (University of Brussels), Editor-in-Chief of the journal Critical Care and President of the World Federation of Societies of Intensive and Critical Care Medicine. He has also, for 34 successive years, organized the International Symposium on Intensive Care and Emergency Medicine, which is held every March in Brussels. This symposium, which gathers around 6,000 participants, has become one of the largest meetings in the field. You can follow discussion at this year’s conference, which starts today, on twitter, #ISICEM2014

Keep reading to see recommendations of the top 10 articles in 2013.

Top 5 overall

1. [F1000Prime score: 20]
A trial of intraoperative low-tidal-volume ventilation in abdominal surgery.
N Engl J Med. 2013 Aug 1; 369(5):428-37
A multicenter randomized controlled trial strongly supports the use of lung-protective ventilation in abdominal surgery.

2. [F1000Prime score: 19]
Combination antifungal therapy for cryptococcal meningitis.
N Engl J Med. 2013 Apr 4; 368(14):1291-302
A combination regimen is shown to improve survival for patients with cryptococcal meningitis.

3. [F1000Prime score: 17]
Transfusion strategies for acute upper gastrointestinal bleeding.
N Engl J Med. 2013 Jan 3; 368(1):11-21
A practice-changing study on blood transfusion supports lowering the hemoglobin threshold in patients with acute gastrointestinal bleeding.

4. [F1000Prime score: 16]
Targeted temperature management at 33°C versus 36°C after cardiac arrest.
N Engl J Med. 2013 Dec 5; 369(23):2197-206
A critique of ‘therapeutic hypothermia’ comes in the form of this ‘definitive’ trial, which suggests that fever avoidance is more beneficial than cooling after cardiac arrest.

5. [F1000Prime score: 15]
Prone positioning in severe acute respiratory distress syndrome.
N Engl J Med. 2013 Jun 6; 368(23):2159-68
Acute respiratory distress syndrome patients demonstrate significantly better survival with prone positioning during ventilation support.

Top 5 Hidden Jewels

1. [F1000Prime score: 14]
BIS-guided anesthesia decreases postoperative delirium and cognitive decline.
J Neurosurg Anesthesiol. 2013 Jan; 25(1):33-42
A clinical trial of elderly patients demonstrates decreased postoperative delirium when using bispectral index-guided anesthesia.

2. [F1000Prime score: 9]
Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials.
Anesthesiology. 2013 Jul; 119(1):178-90
A meta-analysis of randomized trials suggests magnesium could help reduce reliance on opiates after surgery.

3. [F1000Prime score: 8]
New strategy of α- and γ-tocopherol to prevent contrast-induced acute kidney injury in chronic kidney disease patients undergoing elective coronary procedures.
Nephrol Dial Transplant. 2013 Feb; 28(2):337-44
An “interesting and well-conducted” trial supports a new strategy of using vitamin E to prevent contrast nephropathy in CKD patients.

4. [ F1000Prime score: 7]
Prophylactic perioperative sodium bicarbonate to prevent acute kidney injury following open heart surgery: a multicenter double-blinded randomized controlled trial.
PLoS Med. 2013 Apr; 10(4):e1001426
Acute kidney injury could be prevented after heart surgery by use of perioperative sodium bicarbonate, as demonstrated in this phase II trial.

5. [F1000Prime score: 7]
Intraperitoneal nebulization of ropivacaine for pain control after laparoscopic cholecystectomy: A double-blind, randomized, placebo-controlled trial.
Br J Anaesth. 2013 Jan 4
A trial on postoperative pain after laproscopic surgery shows promising results for nebulized Ropivacaine, which could also reduce morphine requirements.

Every article recommendation in the Top 10 is free to read from the links in this blog. See this blog for information of how these lists are calculated and this blog for information on how Hidden Jewels are calculated.