Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists
No significant impact of transitions of care observed between individual staff physicians on evidence-based processes of care for mechanically ventilated adult patients. However, transitions were associated with a lower likelihood... read more
Renal Function-Adjusted D-Dimer Levels in Critically Ill Patients With Suspected Thromboembolism
D-Dimer cutoff levels adjusted for renal dysfunction appear feasible and safe assessing thromboembolic disease in critically ill patients. Furthermore, adjusted D-dimer cutoff levels seem reliable in patients with acute kidney... read more
Study Suggests Benefits of Vitamin C for Severe Sepsis
More than 1.7 million Americans develop sepsis every year and incidence of the condition is on the rise. In severe cases, widespread inflammation leads to multiorgan failure and death. Results of a new study hold... read more
Is Intensive Care Becoming an Out-of-hours Acute Palliative Care Service?
First I will define what I conceive medicine to be. In general terms, it is to do away with the sufferings of the sick, to lessen the violence of their diseases, and to refuse to treat those who are overmastered by their... read more
Could the Furosemide Stress Test Clarify Resuscitative Goals?
Imagine that you admit a patient with septic shock. You resuscitate the patient as best you can with inopressors, fluids, and antibiotics. An adequate blood pressure is achieved. A reasonable amount of fluid is administered.... read more
Ventilator Management: Advanced Concepts In Critical Care
Mechanical ventilation is a broad subject that encompasses many factors that must be considered while providing overall resuscitation. It is not as easy as just entering in a rate and tidal volume and pushing start. Critical... read more
If we don’t start looking after our doctors there will be no one to care for our patients
"Would you choose medicine again?" I look into the eager faces of the sixth-formers I've been asked to speak to. Not for the first time, I hesitate before I answer. I love my job – it's a great privilege to be a Registrar... read more
Admissions Trends, Resource Use, and Risk-adjusted Hospital Mortality for Elderly Patients Admitted to ICUs
Over the past two decades, elderly patients have been more commonly admitted to ICU than can be explained solely by the demographic shift. Importantly, as with the wider population, outcomes in elderly patients admitted to... read more
Prognostication with Point-of-Care Echocardiography During Cardiac Arrest (ALS)
This topic was prioritized by the ALS Task Force based on the high prevalence of point-of-care echocardiography during cardiac arrest without recognizing the potential pitfalls for misinterpretation as an adjunct prognostic... read more
Early Psychological Screening of ICU Survivors
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... read more
Lower Glucose Targets Show Improved Mortality in Cardiac Patients
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... read more
Serum Lactate Level and Mortality in Metformin-associated Lactic Acidosis Requiring RRT
This study suggests that predialysis level of serum lactate level is an important marker of mortality in MALA patients requiring renal replacement therapy (RRT) with a linear dose-response relationship. To better evaluate... read more
Critical Care Opioids Impact in the 21st Century
Critical Care is impacted by opioids in multiple ways. Not only do they form the backbone of managing pain and sedation in the intensive care unit (ICU), the burgeoning opioid epidemic also feeds into opioid-related ICU admissions.... read more
Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia
The results of this study further support the importance of prompt appropriate antibiotic administration for patients with septic shock. Physicians should consider acting quickly to administer antibiotics with S. aureus... read more
Microcirculation Evolution in Patients on VA-ECMO for Refractory Cardiogenic Shock
Microcirculation is severely impaired in patients with refractory cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Inability to rapidly restore microcirculation during the first... read more
Modified Version of the ACC’s low-dose 4PCC Warfarin Reversal Option Achieves Similar Outcomes for Lowering INR
A modified version of the American College of Cardiology (ACC) low-dose four factor prothrombin complex concentrate (4PCC) option for warfarin reversal achieves similar outcomes for lowering International Normalized Ratio... read more
ICU Bouncebacks Associated with Worse Outcomes
ICU Bouncebacks (ICUBBs) are associated with worse outcomes and are disproportionately burdened by respiratory complications. These findings emphasize the importance of the TQIP Collaborative in identifying statewide... read more
Enteral Nutrition Can Be Given to Patients on Vasopressors
Most all recent studies show Enteral Nutrition (EN) can be delivered safely to patients on vasopressors. In fact, many studies show an outcome benefit of early EN (EEN) in ICU patients who are receiving vasopressors. It... read more
Early Prediction of Sepsis From Clinical Data
Diverse computational approaches predict the onset of sepsis several hours before clinical recognition, but generalizability to different hospital systems remains a challenge. A total of 104 groups from academia and industry... read more
Preoperative Vitamin D Concentration and Cardiac, Renal, and Infectious Morbidity after Noncardiac Surgery
Preoperative vitamin D was not associated with a composite of postoperative 30-day cardiac outcomes. However, there was a significant association between vitamin D deficiency and a composite of infectious complications and... read more
Holding Intubated Infants Well Tolerated and Safe
Critically ill infants who are old enough to move on their own but too young to cooperate with care instructions have been among the last to benefit from patient mobility initiatives. Results from a holding intervention... read more
Impact of a Progressive Mobility Program on the Functional Status, Respiratory and Muscular Systems of ICU Patients
Patients who participated in an ICU mobility program had better functional status at discharge from the ICU. The other benefits of the program included better performance in the mobility tests and improved maximum voluntary... read more
