Story Category: Intensive Care

Upvote Story 4
The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%) were female; median age, 56 years (interquartile range, 41-67 years); 922 (14%) were discharged directly home, with significant variation found between hospitals (range, 4.4%-44.0%). The primary outcome was readmission... Read More | Comment
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Despite having a powerful effect on restoring spontaneous circulation after out-of-hospital cardiac arrest, epinephrine produced only a small absolute increase in survival with no increase in favorable functional recovery as compared with placebo. We now must ponder whether additional treatments after a return of spontaneous circulation could improve functional recovery, whether drug use should differ on the basis of cardiac rhythm, and whether lower doses... Read More | Comment
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If peripheral perfusion-targeted resuscitation improves 28-day mortality, this could lead to simplified algorithms, assessing almost in real-time the reperfusion process, and pursuing more physiologically sound objectives. At the end, it might prevent the risk of over-resuscitation and lead to a better utilization of intensive care unit resources. ANDROMEDA-SHOCK is a randomized controlled trial which aims to determine if a peripheral perfusion-targeted resuscitation is associated with... Read More | Comment
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Angiotensin receptor blockers were associated with lower rates of sepsis and mortality than angiotensin-converting enzyme inhibitors in the patients with chronic obstructive pulmonary disease. The similar findings were also noted in subgroup analysis. The primary outcome was sepsis, and the secondary outcome was death. The occurrence rate of sepsis was 3.67 per 100 person-years for the patients receiving angiotensin-converting enzyme inhibitors and 2.87 per 100... Read More | Comment
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This book describes the techniques, strategies, and drugs that have been demonstrated by multicenter randomized trials to influence survival in critically ill patients, defined as those who have acute failure of at least one organ, due to either a pathological condition or a medical intervention, and require intensive care treatment. Each chapter focuses on a specific procedure, device, or drug. The scope is accordingly wide,... Read More | Comment
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With the approval and release of angiotensin II, a new vasoactive agent is now available to utilize in these patients. Overall, the treatment for vasodilatory shock should not be a one-size fits all approach and should be individualized to each patient. A multimodal approach, integrating angiotensin II as a noncatecholamine option should be considered for patients presenting with this disease state. The Angiotensin II for... Read More | Comment
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Decisions to limit therapy (DTLT) are routine for ICU physicians. Although breaking bad news is one of the most difficult tasks clinicians face, ongoing communication is even more crucial as families (not necessary following a legal or genetic definition) of critically ill patients have heightened communication needs. Supporting families during the process of shared decision-making from the pursuit of cure/recovery to the pursuit of comfort/freedom... Read More | Comment
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Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score for in-hospital mortality for cardiogenic shock patients who received VA-ECMO after isolated CABG. The REMEMBER score might help clinicians at bedside to predict in-hospital mortality for patients receiving VA-ECMO after isolated CABG for refractory cardiogenic... Read More | Comment
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Guideline adherence to an expert panel predefined care set in brain death (DBD) donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation and documentation of guidelines. A total of 296 patients were included. Thirty-five of 67 KIs had a high level of adherence congruent to a high expert panel rating of importance. Nineteen of 67 KIs... Read More | Comment
Upvote Story 6
ICU doctors are often required to analyse large volumes of complex, heterogeneous data to make life-critical decisions. Artificial Intelligence (AI), if used effectively, could reduce this burden by transforming data into more actionable information. We can use AI to predict adverse outcomes before they happen, better manage highly complex situations, and ultimately allow clinicians to spend less time analyzing data and more time harnessing their... Read More | Comment
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In 2014, the Canadian Task Force on Preventive Health Care recommended against the prostate-specific antigen (PSA) test used to screen for prostate cancer in healthy men, concluding that it results in substantial harms via biopsies and surgeries that can lead to infections, impotence or urinary incontinence, and does not save men’s lives. “Amazingly, despite thousands and thousands of patients included in randomized controlled trials, there... Read More | Comment
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Work in intensive care is dynamic and often requires swift decision-making to achieve the best patient outcome. This book serves as a practical guide for professionals working in this demanding area of medicine. It reviews diagnostic options as well as strengths and weaknesses of imaging techniques in clinical scenarios familiar to most ICU clinicians. The concise format allows rapid access to key information. Imaging the... Read More | Comment
Upvote Story 7
It is well established that the Arts have a clear contribution to make in the delivery of an improved healthcare experience for patients, service users and staff. Southmead Hospital (part of North Bristol NHS Trust) has a very active arts programme – Fresh Arts, who have introduced a range of creative interventions including sculpture, music, exhibitions and craft activities, which all help make the hospital... Read More | Comment
Upvote Story 4
If you’re involved in the care of critically unwell patients then you will frequently encounter patients who are shocked. The European Society of Intensive Care Medicine defines shock as; “Life-threatening, generalized form of acute circulatory failure associated with inadequate oxygen utilization by the cells. It is a state in which the circulation is unable to deliver sufficient oxygen to meet the demands of the tissues,... Read More | Comment
Upvote Story 7
Glycaemic Control in the EU. Following on from the poster we presented at the Intensive Care Society. We asked Sphere Medical's own Dr Gavin Troughton to present at our launch event. In the below video he goes into more detail on the poster study.  "A comparative survey of glycaemic control practice in the UK, Germany and BeNeLux". The study confirmed that there are still controversies over... Read More | Comment