Tag: study

Upvote Story 6
In patients with sepsis, recovery by hospital discharge is associated with long-term survival similar to patients without AKI. Of the 1742 patients who survived to hospital discharge, stage 2–3 AKI occurred in 262 (15%), of which 111 (42.4%) recovered. Compared to recovered patients, patients without recovery were older (75 ±14 vs 69 ±15 years, p Read More | Comment
Upvote Story 5
In this multicenter cohort study, one or more post-intensive care syndrome problems were present in the majority of survivors, but co-occurring problems were present in only one out of four. Education was protective from post-intensive care syndrome problems and frailty predictive of the development of post-intensive care syndrome problems. Future studies are needed to understand better the heterogeneous subtypes of post-intensive care syndrome and to... Read More | Comment
Upvote Story 4
In nearly every intensive care unit (ICU) at every pediatric hospital across the country, physicians hold numerous care conferences with patients’ family members daily. Due to the challenging nature of many these conversations–covering anything from unexpected changes to care plans for critically ill children to whether it’s time to consider withdrawing life support–these talks tend to be highly emotional. That’s why physician empathy is especially... Read More | Comment
Upvote Story 7
Laryngeal injury from intubation is common in the ICU setting. Guidelines for laryngeal assessment and postextubation surveillance do not exist. A systematic approach to more robust investigations could increase knowledge of the association between particular injuries and corresponding functional impairments, improving understanding of both time course and prognosis for resolution of injury. Our findings identify targets for future research and highlight the long-known, but understudied,... Read More | Comment
Upvote Story 4
Time since symptom onset modifies the systemic inflammatory profile at Community-acquired Pneumonia (CAP) diagnosis. This information has relevant clinical implications for management, and it should be taken into account in the design of future clinical trials. In early presenters, CRP was significantly lower, whereas PCT, IL-6, and IL-8 were higher. Nonearly presenters showed significantly lower PCT, IL-6, and IL-8 levels. In the validation cohort, CRP... Read More | Comment
Upvote Story 9
Blocking the action of negative muscle regulators through the activin type II receptors with bimagrumab treatment safely increased skeletal muscle mass but did not improve functional capacity in patients with COPD and low muscle mass. We assessed changes in thigh muscle volume (TMV, cm3) as the primary endpoint along with 6-minute walk distance (6MWD, m), safety, and tolerability. Fifty-five (82.1%) patients completed the study. TMV... Read More | Comment
Upvote Story 4
The vicious circle of dyspnoea-inactivity has been proposed, but never validated empirically, to explain the clinical course of chronic obstructive pulmonary disease (COPD). We aimed to develop and validate externally a comprehensive vicious circle model. We identified nine vicious circle models for which SEMs confirmed most hypothesised paths but showed inappropriate fit. In the new model, airflow limitation, hyperinflation, dyspnoea, physical activity, exercise capacity and... Read More | Comment
Upvote Story 8
Deleterious hemodynamic effects of severe lactic acidosis are largely suggested by experimental data, although not fully confirmed by human studies. Pending the effectiveness of an etiological treatment, there is no efficient and validated symptomatic therapy at hand to correct a life-threatening metabolic acidosis. Upcoming research in this field should be focused on the optimal strategy to treat severe metabolic acidosis, including symptomatic therapy. Alkalinization with... Read More | Comment
Upvote Story 6
A randomized controlled trial demonstrates that music intervention to prevent delirium among older patients is one of few strategies that provide support in a critical care setting. This study builds on non-pharmacologic approaches for delirium prevention by addressing the pathophysiologic mechanisms that contribute to delirium; neurotransmitter imbalance, inflammation, and acute physiological stressors. Delirium is a neurobehavioral syndrome characterized by alterations in consciousness, attention, cognition and... Read More | Comment
Upvote Story 4
In our ICU, patients mobilized on approximately one-third of vasoactive days. Clinicians should anticipate a higher risk of hypotension during mobilization in patients receiving vasoactive therapy, which may require transient escalation of vasoactive therapy. In 119 patients undergoing vasoactive therapy on 371 cumulative vasoactive days, 195 mobilization episodes occurred (37.5% of vasoactive days). Low (76.8%) and moderate (13.7%) dose vasoactive therapies were associated with a... Read More | Comment
Upvote Story 6
Surgical site infections are significant contributors to health care–associated infections. Nursing interventions may help decrease the incidence of surgical site infections, particularly in regards to the management of post-surgical abdominal drains. This comprehensive guide, compiled from evidence-based practice literature, is intended for nurses to use to reduce surgical site infections secondary to post-surgical abdominal drains. This article focuses on drain management in intensive care unit... Read More | Comment
Upvote Story 7
Despite apparent consensus, lack of shared understanding of the rationale for an intervention may lead to divergent practice patterns and failure to implement standardized, evidence-based practice. There was wide consensus on the importance of daily interruptions of sedation, however practitioners usually performed sedation interruption for 1 of 5 distinct reasons: minimizing the dose of sedation, performing a neurologic exam, facilitating ventilator weaning, reducing ICU length... Read More | Comment
Upvote Story 7
For specialist nurses on neurocritical care units, accompanying patients for imaging scans and other procedures has a major impact on nurse staffing ratios, reports a study in the Journal of Neuroscience Nursing. Over 30 days, observations showed that neurocritical care nurses spent more than 226 hours traveling with patients. The main tests and procedures involved were computed tomography and magnetic resonance imaging scans and vascular... Read More | Comment
Upvote Story 4
In the primary analysis, limiting the level of sedation provided no significant benefit in reducing incident delirium. However, in a pre-specified subgroup analysis, lighter sedation levels benefitted reducing postoperative delirium for persons with a CCI of 0. Of 200 participants, the mean (SD) age was 82 (8) years, 146 (73%) were women, 194 (97%) were white, and the mean (SD) CCI was 1.5 (1.8). One... Read More | Comment
Upvote Story 9
This study provides new information regarding functional outcomes and the factors that influence meaningful aspects of functioning in critically ill children. Identifying patients at greatest risk and modifiable targets for improvement in PICU care guides us in developing strategies to improve functional outcomes and tailor to the rehabilitation needs of these patients and their families. The primary endpoint was functional outcome up to 6 months... Read More | Comment
Upvote Story 9
This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound, showed lung ultrasound to be clearly superior to chest radiograph in terms of sensitivity with similar specificity, thereby opting to be the first-line diagnostic tool in these patients. In the meta-analysis, we included 10 full-text... Read More | Comment
Upvote Story 12
Effective antimicrobial administration within the first hour of documented hypotension was associated with increased survival to hospital discharge in adult patients with septic shock. Despite a progressive increase in mortality rate with increasing delays, only 50% of septic shock patients received effective antimicrobial therapy within 6 hrs of documented hypotension. The main outcome measure was survival to hospital discharge. Among the 2,154 septic shock patients... Read More | Comment
Upvote Story 6
Although delirium and frailty contribute to mortality, the overall impact of delirium on admission appears to be greater at lower levels of frailty. In contrast to the hypothesis that there is a bimodal distribution for mortality, delirium appears to be particularly adverse when precipitated in fitter individuals. The sample consisted of 710 individuals. Both delirium and frailty were independently associated with increased mortality rates. We... Read More | Comment
Upvote Story 11
After adjustment for immortal time bias, Inferior Vena Cava (IVC) filter placement was associated with increased 30-day mortality in patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation. Randomized clinical trials are needed to determine the efficacy of IVC filter placement in patients with VTE and a contraindication to anticoagulation. Of 126 030 patients with VTE, 61 281 (48.6%) were male and the mean (SD)... Read More | Comment