Recent Critical Care News

Upvote Story 4
Shared decision making occurs when patients and clinicians reach a formulation about the presenting problem and discuss how to manage it. If there are several reasonable alternatives, the alternatives should be explicitly compared, using evidence about relevant harms and benefits. Such decisions should be informed by knowledge about the patients’ condition, about the evidence applicable to it, and the patient’s goals and preferences. Eliciting patients’... Read More | Comment
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Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). In a large, global observational study of patients with AHRF,... Read More | Comment
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The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic stenosis in the high-risk mixed surgical and medical critically ill pediatric cohort using high-volume, low-pressure cuffed endotracheal tube policy has not yet been described. We report no single case of acquired subglottic stenosis... Read More | Comment
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Social media is changing the ways that patients interact with healthcare providers and the healthcare system. It is increasingly common for patients to use information technology to gain access to information and control their own healthcare. Increased access to the Internet and mobile communication will bring public health information to many more people, more quickly and directly than at any time in history. Social media... Read More | Comment
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Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information on baseline health. To determine the impact of frailty on the outcome of critically ill patients, we performed a systematic review and meta-analysis comparing clinical outcomes in frail and non-frail patients admitted to ICU.... Read More | Comment
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Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring sedation remains unclear. Nocturnal administration of low-dose dexmedetomidine in critically ill adults reduces the incidence of delirium during the ICU stay; patient-reported sleep quality appears unchanged. Nocturnal dexmedetomidine was associated with a greater proportion of... Read More | Comment
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Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased capillary permeability. Endothelial injury during shock may lead to ACE defects, which in turn may cause an increase in vasodilatory mediators that are normally metabolized by ACE and a relative or absolute decrease in ANG-2. These... Read More | Comment
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In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly increased the odds of discharge with an antipsychotic prescription, a practice that should be examined carefully during medication reconciliation since these drugs carry “black box warnings” regarding long-term use. After excluding 18 patients due... Read More | Comment
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There is great variability in end-of-life care and the legal context may interfere with decisions on limitation of medical treatment. In Brazil, end-of-life care was initially regulated in 2006, but legal controversies still continue. Even though physicians do not need authorization from the Judiciary system to act, those controversies may cause uncertainty regarding seemingly competing professional duties (caring for patients’ best interests versus maintenance of... Read More | Comment
Upvote Story 15
It seems like every week there’s another publicized instance of our impending replacement by artificial intelligence. Big Data, they say, is going to free us of the cognitive burdens of complex thought while maximizing healthcare outcomes. This latest entry is the “AI Clinician”, which has been created as a demonstration for the treatment of sepsis. Or, rather more narrowly, the AI Clinician tries to prescribe... Read More | Comment
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Delirium is a confused mental state that includes changes in awareness, thinking, judgment, sleeping patterns, and behavior. It can affect patients of any age but is more common among older adults who experience major illness or have a major surgery. More than half of patients who are given mechanical ventilation in the intensive care unit (ICU) experience delirium. Antipsychotic medications have been used to treat... Read More | Comment
Upvote Story 11
Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism. Advanced age may necessitate novel therapeutic strategies to promote multisystem organ recovery and improve survival after sepsis. The cohort included 173 patients with severe sepsis (n = 93; 53.8%) or septic shock (n = 80; 46.2%), with a... Read More | Comment
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This article explores the potential role of nutrition and EMS in maintaining muscle health in critical illness. Within this article, we will evaluate fundamental concepts of muscle wasting and evaluate the effects of EMS, as well as the effects of nutrition therapy on muscle health and the clinical and functional outcomes in critically ill patients. We will also highlight current research gaps in order to... Read More | Comment
Upvote Story 5
What do doctors and religious leaders have in common? At least a couple of big things: individuals in both professions engage with people at some of the most critical moments in their lives and require a high degree of empathy to truly succeed in all of their endeavors. Last year, I worked with the Rev. Professor Jane Shaw, at the time Stanford’s Dean of Religious... Read More | Comment
Upvote Story 4
Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients. Of 410 patients receiving PT in the medical ICU, 22 (5% of all patients; male, 64%; median age, 52 years) had 42 PT treatments with video games (median [interquartile range]... Read More | Comment