Tag: study

Upvote Story 11
Over the last decades, the incidence of healthcare-associated infections (HAI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) involved in poor outcomes has dramatically increased worldwide. This has been explained by the high prevalence of ESBL-PE community carriage and the increasing trend in consumption of antibiotics such as third-generation cephalosporins (3GC). In particular, previous studies have suggested that the high biliary elimination of ceftriaxone (CRO) could increase... Read More | Comment
Upvote Story 5
Rehabilitative exercise for critically ill patients may have many benefits; however, it is unknown what intensive care unit (ICU) clinicians perceive to be important rationale for the implementation of rehabilitative exercise in critical care settings. Any shortcoming in implementation of rehabilitation exercise is unlikely attributable to a lack of perceived importance by nursing, medical or physiotherapy clinicians who are the most likely clinicians to influence... Read More | Comment
Upvote Story 6
External laryngeal manipulation during direct laryngoscopy was associated with lower initial tracheal intubation attempt success in critically ill children, even after adjusting for underlying differences in patient factors and provider levels. The indiscriminate use of external laryngeal manipulation cannot be recommended. Propensity score–matched analysis was performed to evaluate the association between external laryngeal manipulation and initial attempt success while adjusting for underlying differences in patient... Read More | Comment
Upvote Story 15
Multicenter Meta-Analysis Reveals Sepsis Patients can be Risk Stratified at the Time of Diagnosis Demonstrating Potential to Improve Critical Care Medicine on a Global Scale. For this study, the team identified a large collection of both public and privately-held gene expression data from clinical sepsis studies at the time of diagnosis to study molecular changes in immune cells, also known as leukocytes. The patients were... Read More | Comment
Upvote Story 6
This cohort study uses data from the Get With The Guidelines-Resuscitation registry to investigate the association between tracheal intubation during adult in-hospital cardiac arrest and survival to hospital discharge. In a study of 86 628 adults with in-hospital cardiac arrest using a propensity-matched cohort, tracheal intubation within the first 15 minutes was associated with a significantly lower likelihood of survival to hospital discharge compared with not... Read More | Comment
Upvote Story 18
Over the 10‑year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU mortality were lower in our 2012 cohort compared to our 2002 cohort, particularly in patients with sepsis. We compared the 3147 patients from the SOAP study with the 4852 patients from... Read More | Comment
Upvote Story 6
There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion for airway disruption and compression. For patients with facial trauma, control of the airway may be significantly impacted by edema, bleeding, inability to clear secretions, loss of bony support,... Read More | Comment
Upvote Story 11
Delirium is a disorder of decreased ability to focus, sustain or shift attention, change in cognition and or perception. The main objective was to evaluate the diagnostic accuracy of Confusion Assessment Method for the ICU (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC) among the nursing and medical staff in a multidisciplinary ICU. In our mixed ICU population, CAM-ICU remained more sensitive than ICDSC. Though... Read More | Comment
Upvote Story 11
A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study. While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low. Over the study period, 6723 patients were screened in 141 ICUs from 20... Read More | Comment
Upvote Story 5
This study assesses trends and risk factors of ventilator-associated pneumonia (VAP) according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. Ventilator-associated pneumonia incidence is lower but did not decrease over time in very old patients compared with young patients. Overall and multidrug-resistant organism–related ventilator-associated pneumonia incidence rates were expressed per 1,000 intubation days at risk. Age was stratified into... Read More | Comment
Upvote Story 8
Clinical care review is the process of retrospectively examining potential errors or gaps in medical care, aiming for future practice improvement. The objective of our systematic review is to identify the current state of care review reported in peer-reviewed publications and to identify domains that contribute to successful systems of care review. While guidelines for some aspects of care review exist and have gained traction,... Read More | Comment
Upvote Story 8
We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. We identified 22 trials on use of a pre-procedure check-list (1 study), pre-oxygenation or apneic oxygenation (6 studies), sedatives (3 studies), neuromuscular blocking agents (1 study), patient positioning (1 study), video laryngoscopy (9 studies), and... Read More | Comment
Upvote Story 7
This is the first study reporting distributions of continuously measured physiologic variables and trends in their behavior according to admission diagnosis in critically ill children. Differences detected between and within diagnostic groups may aid in earlier recognition of outliers as well as allowing refinement of patient monitoring strategies. Distributions at admission are dependent on patient age and admission diagnosis (p < 10–6). Heart rate decreases... Read More | Comment
Upvote Story 22
ICU patients are high risk of developing thrombotic complications such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Indeed, due to the hypercoagulative state typical for many forms of critical illness associated with risk factors as prolonged immobilization or the use of intravascular devices, ICU patients are at higher risk for thrombotic complications. Read More | Comment
Upvote Story 12
Real-time monitoring of cerebral oxygenation and function during cardiac arrest resuscitation is feasible. Although voltage suppression is the commonest electroencephalography pattern, other distinct patterns exist that may correlate with the quality of cerebral resuscitation and oxygen delivery. In total, 428 electroencephalography images from 16 subjects were gathered; 40.7% (n = 174/428) were artifactual, therefore 59.3% (n = 254/428) were interpretable. All 16 subjects had interpretable... Read More | Comment
Upvote Story 6
Ceftazidime-avibactam was noninferior to meropenem for nosocomial pneumonia including ventilator-associated pneumonia (VAP) from gram-negative organisms, results from the REPROVE trial demonstrated. Nosocomial or hospital-acquired pneumonia is a common hospital-acquired infection associated with increased cost and mortality. Further, nosocomial pneumonia is associated with gram-negative pathogens such as Pseudomonas aeruginosa and Enterobacteriaceae that may carry extended-spectrum beta-lactamases and carbapenemase, thereby limiting the treatment options. Read More | Comment
Upvote Story 5
Most deaths in acute respiratory distress syndrome (ARDS) patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies have an effect on overall survival. We examined death in the ICU from individual causes. Overall ICU mortality was 38.8% (95% CI, 35.4–42.3). Causes of acute respiratory distress syndrome modified the risk of... Read More | Comment
Upvote Story 10
As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. Despite the cessation of medications for continuous sedation, delirium persisted for the majority of patients and was associated with worse outcomes, which attests to... Read More | Comment
Upvote Story 8
Post Intensive Care Syndrome in pediatrics (PICS-p) will help illuminate the phenomena of surviving childhood critical illness and guide outcomes measurement in the field. Empirical studies are now required to validate and refine this framework, and to subsequently develop a set of core outcomes for this population. With explication of Post Intensive Care Syndrome in pediatrics, the discipline of pediatric critical care will then be... Read More | Comment
Upvote Story 4
Lung ultrasound (LUS) has emerged as an effective and accurate goal-directed diagnostic tool that can be applied in real time for the bedside assessment of patients with respiratory symptoms and signs. Lung ultrasound has definite and easily recognized findings and has been shown to outperform physical examination and chest radiography for the diagnosis and monitoring of many pulmonary and pleural conditions. In this article, we... Read More | Comment