Tag: analysis

Upvote Story 6
This single-center retrospective analysis shows promising results with NEWS as a screening tool primarily because it can be done at triage and does not require any laboratory evaluation. This study adds to the current knowledge that qSOFA should not be used as a sepsis screening tool as it has poor sensitivity and moderate specificity for short-term mortality. While the methodology of this study is extensively... Read More | Comment
Upvote Story 4
A large proportion of Japanese patients on mechanical ventilation (MV) were treated in non-ICU settings. Analysis of administrative data indicated preliminary that hospital mortality rates in these patients were higher in non-ICU settings than in ICUs. Prospective analyses comparing non-ICU and ICU patients on MV by severity scoring are needed. Over the study period, 17,775 patients on MV were treated only in non-ICU settings, whereas... Read More | Comment
Upvote Story 8
Our study confirmed an association between higher driving pressure and higher mortality in mechanically ventilated patients with acute respiratory distress syndrome (ARDS). These findings suggest a possible range of driving pressure to be evaluated in clinical trials. Future research is needed to ascertain the benefit of ventilatory strategies targeting driving pressure in patients with acute respiratory distress syndrome. In the meta-analyses of four studies (3,252... Read More | Comment
Upvote Story 5
Current evidence does not support the use of non-pharmacological interventions in reducing incidence and duration of delirium in critically ill patients. Future research should consider well-designed and well-described multicomponent interventions and include adequately defined outcome measures. We identified 15 trials (2812 participants). Eleven trials reported incidence of delirium. Pooled data from four trials of bright light therapy showed no significant effect between groups (n = 829 participants,... Read More | Comment
Upvote Story 4
Patients with refractory status epilepticus (RSE) treated with continuous intravenous anesthetic drugs (cIVADs) may benefit from early initiation of such therapy. wWhen cIVADs are applied in RSE, prescribing them early may positively impact outcome, probably by shorter seizure duration and apparently mainly in those patients who do not have a severe RSE etiology dominating their prognosis. Fifty-three (68.8%) patients received cIVADs within the first 48... Read More | Comment
Upvote Story 5
In patients receiving palliative care, individualized management of delirium precipitants and supportive strategies result in lower scores and shorter duration of target distressing delirium symptoms than when risperidone or haloperidol are added. wo hundred forty-seven participants (mean [SD] age, 74.9 [9.8] years; 85 women [34.4%]; 218 with cancer [88.3%]) were included in intention-to-treat analysis (82 receiving risperidone, 81 receiving haloperidol, and 84 receiving placebo). Read More | Comment
Upvote Story 5
The use of therapeutic hypothermia decreased in a large US registry of patients with out-of-hospital cardiac arrest soon after the publication of a study supporting more lenient temperature thresholds. Concurrent with this change, overall survival of cardiac arrest among patients admitted to the hospital decreased, but survival was not explained by patient-level or hospital-level trends in the use of therapeutic hypothermia. These findings raise concern... Read More | Comment
Upvote Story 7
Although the impact of PCT guidance on total healthcare-related costs during the initial hospitalisation episode is likely negligible, the lower in-hospital mortality may lead to a non-significant increase in costs over a one-year time horizon. However, since uncertainty remains, it is recommended to investigate the long-term cost-effectiveness of PCT guidance, from a societal perspective, in different countries and settings. A trial-based analysis was performed to... Read More | Comment
Upvote Story 4
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
Upvote Story 9
Intravenous caffeine is able to accelerate emergence from isoflurane anesthesia in healthy males without any apparent adverse effects. All randomized participants were included in the analysis. The mean time to emergence with saline was 16.5 ± 3.9 (SD) min compared to 9.6 ± 5.1 (SD) min with caffeine (P = 0.002), a difference of 6.9 min (99% CI, 1.8 to 12), a 42% reduction. Participants emerged at a higher expired... Read More | Comment
Upvote Story 6
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
Upvote Story 6
A biomarker test based on the presence of two proteins in the blood appears to be suitable for ruling out significant intracranial injuries in patients with a history of mild traumatic brain injury (TBI) without the need for a CT head scan, according to data presented at the annual meeting of the American College of Emergency Physicians. A biomarker suitable for ruling out significant brain... Read More | Comment
Upvote Story 8
Severe traumatic brain injury is a clinically heterogeneous disease that can be accompanied by a range of neurologic impairment and a variety of injury patterns at presentation. This secondary analysis of prospectively collected data identifies several characteristics associated with outcome among children with severe traumatic brain injury. Future, larger trials are needed to better characterize phenotypes within this population. Baseline, clinical, and CT characteristics of... Read More | Comment
Upvote Story 7
It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation. A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases mortality for medical patients in hospital. Patients randomised to liberal oxygen therapy were more likely to die (risk ratio 1.21 (95% confidence interval 1.03 to 1.43)). The increase in mortality was highest... Read More | Comment
Upvote Story 13
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic hypothermia for patients with severe traumatic brain injury. Among 511 patients who were randomized, 500 provided ongoing consent (mean age, 34.5 years [SD, 13.4]; 402 men [80.2%]) and 466 completed the primary outcome... Read More | Comment
Upvote Story 8
A new meta-analysis reveals a positive correlation between incorporating vitamin C in the treatment of sepsis and favorable patient outcomes. Results of the meta-analysis showed a marked reduction in mortality and duration of vasopressor administration in the group with the use of vitamin C, despite varying degrees of statistical significance between the original studies included in this analysis. Sepsis is a severe condition with high... Read More | Comment
Upvote Story 4
Stressful by nature, the intensive care unit (ICU) inevitably faces conflicts due to immediate and cohesive action from physicians, nurses, respiratory therapists, and advanced practitioners. In an effort to help improve the ICU’s taxing environment, a team of investigators has created a conflict management education intervention, which was released at the 2018 CHEST Annual Meeting in San Antonio, TX. Specifically, the team focused on 4... Read More | Comment
Upvote Story 4
These results help inform expectations regarding the limitations and benefits of health coaching for patients with Chronic Obstructive Pulmonary Disease (COPD). They may be useful to health policy experts in assessing the potential value of reimbursement and incentives for health coaching-type activities for patients with chronic disease. Of 192 patients enrolled, 158 (82%) completed 9 months of follow-up. There were no significant differences between study... Read More | Comment
Upvote Story 9
Resuscitation teams at hospitals with high IHCA survival differ from non–top-performing hospitals. Our findings suggest core elements of successful resuscitation teams that are associated with better outcomes and form the basis for future work to improve in-hospital cardiac arrest (IHCA). Across 9 hospitals, we interviewed 158 individuals from multiple disciplines including physicians (17.1%), nurses (45.6%), other clinical staff (17.1%), and administration (20.3%). We identified 4... Read More | Comment
Upvote Story 5
Since the description in the 1970s of external positive end-expiratory pressure for acute respiratory distress syndrome (ARDS), the optimum level of external positive end-expiratory pressure remains unresolved. In the 1990s, the lower inflection point, an inspiratory phenomenon on the low-flow pressure–volume curve, was defined as the point above which external positive end-expiratory pressure should be set to ensure full opening of the lung, e.g., open... Read More | Comment