Tag: study

Upvote Story 6
Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU length of stay (LOS) for survivors up to 9 days, and extra costs. Many studies have reported decreased VAP rates associated with the use of bundles of preventive measures. Fewer studies have reported compliance with... Read More | Comment
Upvote Story 12
Survivors of intensive care are known to be at increased risk of developing longer-term psychopathology issues. We present a large UK multicentre study assessing the anxiety, depression and post-traumatic stress disorder (PTSD) caseness in the first year following discharge from an intensive care unit (ICU). Over half of those who respond to postal questionnaire following treatment on ICU in the UK reported significant symptoms of... Read More | Comment
Upvote Story 4
As little as 30 minutes of exposure to anesthetic and sedative agents may adversely affect the developing brain. Safe, humane management of critically ill infants requires the use of sedative agents, often for prolonged periods. Infants with respiratory diagnoses having non-invasive ventilation without sedation (Group C) or intubation and ventilation with sedation (Group S) were identified by chart review. It is not possible to randomise... Read More | Comment
Upvote Story 9
Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. Our prospective study showed that sepsis management in Japan was characterized by a high compliance rate for the 3-h... Read More | Comment
Upvote Story 8
Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR). Patients with sepsis admitted to an ICU from a hospital ward experienced greater mortality than... 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
Plasma endostatin shows a useful value for predicting failure to recover from acute kidney injury (AKI). The predictive ability can be greatly improved when endostatin is combined with the Sequential Organ Failure Assessment (SOFA) score and AKI classification. Seventy-six of 198 (38.4%) patients failed to recover from AKI onset, with 41 in the derivation cohort and 35 in the validation cohort. Compared with NGAL and... Read More | Comment
Upvote Story 5
Researchers conducted a review of the effects of corticosteroids given in addition to antibiotics to children with septic arthritis. Evidence was sought until April 2018. After searching for all relevant studies, reviewers found two studies with 149 children. These studies were conducted in hospitalized children with a normal immune system between the ages of three months and 18 years living in Costa Rica and Israel.... Read More | Comment
Upvote Story 4
Patients with ulcerative colitis who discontinue 5-aminosalicylate therapy once they begin anti-TNF therapy do not appear at great risk for adverse clinical events, according to research published in Gut. Researchers analyzed data from 3,589 patients with UC taken from two national cohorts: the United States Truven MarketScan health claims database and the Danish health registers. They included patients who started taking anti-TNF after having been... Read More | Comment
Upvote Story 5
Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of a multicenter retrospective cohort study in 1,809 adults in cardiac ICUs. Patients were treated either to a blood glucose target of 80-110 mg/dL or 90-140 mg/dL, based on the clinician’s preference, but using a... Read More | Comment
Upvote Story 5
In this large observational series, there was no association between paralytic choice and first-pass rapid sequence intubation success or peri-intubation adverse events. There were 2,275 rapid sequence intubations facilitated by succinylcholine and 1,800 by rocuronium. Patients receiving succinylcholine were younger and more likely to undergo intubation with video laryngoscopy and by more experienced providers. First-pass intubation success rate was 87.0% with succinylcholine versus 87.5% with... Read More | Comment
Upvote Story 6
In a single centre UK HEMS study, in patients with suspected traumatic hemorrhage who received a PRBC transfusion there was an observed, but non-significant, reduction in mortality at 6 h and 28 days, also reflected in a massive transfusion subgroup. Patients receiving pre-hospital PRBC were significantly less likely to require an in-hospital major transfusion. Further adequately powered multi-centre prospective research is required to establish the optimum strategy... Read More | Comment
Upvote Story 13
The highest burden of incidence and total costs occurred in the lowest severity sepsis cohort population. Sepsis cases not diagnosed until after admission, and those with increasing severity had a higher economic burden and mortality on a case-by-case basis. Methods to improve early identification of sepsis may provide opportunities for reducing the severity and economic burden of sepsis in the United States. The final study... Read More | Comment
Upvote Story 4
In acutely ill adults, high-quality evidence shows that liberal oxygen therapy increases mortality without improving other patient-important outcomes. Supplemental oxygen might become unfavourable above an SpO2 range of 94-96%. These results support the conservative administration of oxygen therapy. 25 randomised controlled trials enrolled 16 037 patients with sepsis, critical illness, stroke, trauma, myocardial infarction, or cardiac arrest, and patients who had emergency surgery. Compared with a... 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 8
A new study has validated potential biomarkers for a sepsis-triage model to distinguish sepsis patients requiring care in the pediatric intensive care unit (PICU) from sepsis identified in the pediatric emergency department (PED) that does not require ICU admission. The study, led by Beata Mickiewicz and colleagues from the University of Calgary and University of Alberta, took serum and plasma samples from children aged 1-23... Read More | Comment
Upvote Story 6
Studies evaluating exercise and nutrition interventions before elective major surgery in adults are producing encouraging early results, but definitive clinical evidence is currently very limited. Future research should focus on refining interventions, exploring mechanism, and evaluating the interactions between therapies and large-scale clinical effectiveness studies. Read More | Comment
Upvote Story 7
Symptoms of post-traumatic stress, anxiety and depression assessed 1 week after ICU stay correlate with 3-month psychological outcome. The HADS and PTSS-10 may be useful aids to identify ICU survivors at high risk for clinically significant symptoms of post-traumatic stress, anxiety and depression 3 months post ICU stay. Eighty-two patients returned the follow-up questionnaires. We found correlation between early and late scores and reasonable predictive... Read More | Comment
Upvote Story 5
Based on study of more than 28,000 TJA patients, presurgical ABO blood group testing looks like an inexpensive way to identify patents at increased risk for symptomatic postoperative VTE. Prophylaxis regimens can dramatically lower the chances of a patient developing venous thromboembolism (VTE), one of the most serious complications of total hip (THA) and knee arthroplasty (TKA). The challenge lies in choosing and balancing the... 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