Recent Critical Care News

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This case report shows that junctional rhythm can cause deterioration of SAM, LVOTO, and MR, and can lead to unstable hemodynamics in a patient with right ventricular failure after MVR. Atrial pacing can resolve SAM, LVOTO, and MR and can improve hemodynamics in a patient with unstable normal sinus rhythm. TEE in the ICU can play a pivotal role in clinical decision-making. Given that there... Read More | Comment
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Among patients with out-of-hospital cardiorespiratory arrest (OHCA), the use of BMV compared with ETI failed to demonstrate noninferiority or inferiority for survival with favorable 28-day neurological function, an inconclusive result. A determination of equivalence or superiority between these techniques requires further research. This study has several limitations. First, the presence of a physician in the ambulance team may make the results of this study less... Read More | Comment
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Pre-preparation of Preparation on Pre-hospital Emergency (PHEA) equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds;... Read More | Comment
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The finger cuff method provides a reasonable estimate of CO and blood pressure, which does not meet the criteria for clinical interchangeability with the currently used invasive devices. Finger cuff is an easy-to-use hemodynamic monitoring technique. Different devices are currently available, which provide continuous arterial blood pressure (Finapress), whereas only ClearSight (previously known as Nexfin; BMEYE) provides an estimate of CO. In most studies, the... Read More | Comment
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Hospitals are increasingly facing the challenge of cutting costs while also improving clinical outcomes. This is certainly true in the infectious disease sector, as unrecognized or ineffectively treated bacterial infections can lead to sepsis, which can be life-threatening. Sepsis is relatively common: each year in the United States, more than 1.6 million adults develop sepsis and approximately 270,000 people die from it. In fact, sepsis... Read More | Comment
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Statistically significant results in anesthesia and critical care randomized controlled trials are often fragile, and study conclusions are frequently affected by spin. Routine calculation of the Fragility Index in medical literature may allow for better understanding of trials and therefore enhance the quality of reporting. We identified 166 eligible randomized controlled trials with a median sample size of 207 patients (interquartile range, 109–497). The median... Read More | Comment
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A score derived from ventilator settings may help clinicians predict the timing of ventilator liberation in patients requiring prolonged mechanical ventilation. Of 372 patients, 72% were liberated from mechanical ventilation. The ventilator independence score measured on the day after tracheostomy placement had an area under the receiver operating characteristic curve value of 0.71 (95% CI, 0.65–0.76) for differentiating patients who were liberated within the next... Read More | Comment
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Researchers from MIT and Massachusetts General Hospital (MGH) have developed a predictive model that could guide clinicians in deciding when to give potentially life-saving drugs to patients being treated for sepsis in the emergency room. Early prediction could, among other things, prevent an unnecessary ICU stay for a patient that doesn’t need vasopressors, or start early preparation for the ICU for a patient that does.... Read More | Comment
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Something’s gone terribly wrong. Doctors are among the most technology-avid people in society; computerization has simplified tasks in many industries. Yet somehow we’ve reached a point where people in the medical profession actively, viscerally, volubly hate their computers. In recent years, it has become apparent that doctors have developed extraordinarily high burnout rates. In 2014, fifty-four per cent of physicians reported at least one of... Read More | Comment
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If the goal of the National Rifle Association (NRA) was to get doctors’ attention, the Tweet posted recently certainly did its job. The NRA editorial that accompanied the Tweet included the following statement: “some doctors’ collective hobby is opining on firearms policy.” Also, take a look at the accompanying photo, which includes a person in a white coat along with what appears to be an... Read More | Comment
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Among ICU nurses, an intervention that included education, role-play, and debriefing resulted in a lower prevalence of job strain at 6 months compared with nurses who did not undergo this program. Further research is needed to understand which components of the program may have contributed to this result and to evaluate whether this program is cost-effective. Among 198 ICU nurses who were randomized (95 aged... Read More | Comment
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The Health Information Technology for Economic and Clinical Health Act (HITECH), as part of the American Reinvestment & Recovery Act of 2009, was created to accelerate the pace of technology diffusion in the American healthcare system. The promulgation of this health policy led to the Meaningful Use incentive program – a $30 billion initiative to transform healthcare delivery in hospitals through the advanced implementation of... Read More | Comment
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PET-CT precisely detected the deep foci of infection about 48 hours prior to the diagnosis of sepsis. The cases reports suggested the use of this image technique in ICU for patients with sepsis of unknown origin. We admitted two critically ill patients for suspected sepsis and altered mental state. As all bacteriological samples were initially sterile, diagnostic workups in both patients led us to suspect... Read More | Comment
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When used in intensive care units, video laryngoscopy did not improve the chances of successful intubation on the first try, compared with direct laryngoscopy, and was associated with a significantly higher risk of severe life-threatening complications, researchers reported. The view during video laryngoscopy can also create a cognitive blind spot: laryngoscopists may fail to abort a laryngoscopy attempt in a timely manner because they have... Read More | Comment
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During a period of service reconfiguration, intensivists routinely rostered to work in one ICU worked in another of the hospital's four ICUs. "Home" intensivists were those who continued to work in their usual ICU; "visitor" intensivists were those who delivered care in an unfamiliar ICU. Patient data were obtained from electronic patient records to provide analysis on sex, age, admission Sequential Organ Failure Assessment score,... Read More | Comment