Targeted Temperature Management at 33 vs. 36 Degrees
Comatose, adult out-of-hospital cardiac arrest patients treated during the targeted temperature management 33°C period had higher odds of neurologically intact survival to hospital discharge compared with those treated during... read more
First ICU Certified in Humanization (H-ICU)
250 ICUs around the world that have performed the self-assessment, the baseline compliance referred is between 40 and 60%. For more than a year, the team of the ICU of Valdemoro distributed the pending good practices and... read more
Ventilation Rates and Pediatric In-Hospital Cardiac Arrest Survival Outcomes
In this multicenter cohort, ventilation rates exceeding guidelines were common. Among the range of rates delivered, higher rates were associated with improved survival to hospital discharge. Arterial blood pressure and... read more
Nonoperative Management of Splenic Injury of Patients with Reduced Consciousness is Safe and Feasible in Well-equipped Institutions
This study shows that NOM for blunt splenic trauma is a viable treatment modality in well-equipped institutions, regardless of the patients mental status. However, the presence of neurologic impairment is associated with... read more
Distance Between the Tips of Central Venous Catheters Does Not Depend on Same or Opposite Site Access
Central venous catheters (CVCs) are routinely required in the intensive care unit (ICU) for infusion of drugs, often concurrently with central venous dialysis catheters (CVDCs) for renal replacement therapy (RRT). Increased... read more
Mechanical Ventilation in Patients with Acute Ischemic Stroke
Although there are no specific data regarding the effect of respiratory management on stroke patients' outcomes, specific ventilator strategies in this population could potentially improve neurologic outcome and prevent respiratory... read more
Ultrasound-based Clinical Profiles for Predicting the Risk of Intradialytic Hypotension in Critically Ill Patients on Intermittent Dialysis
In critically ill patients on intermittent hemodialysis, the absence of hypervolemia as assessed by lung and vena cava ultrasound predisposes to intradialytic hypotension and suggests alternative techniques of hemodialysis... read more
Pain Response to Open Label Placebo in Induced Acute Pain in Healthy Adult Males
Open label placebos might play a role in multimodal analgesic concepts. Pain ratings (median, first to third quartile) were 21% lower during placebo treatment compared to no treatment, 4.0 (3.2 to 4.9) versus 5.1 (4.7... read more
Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support
Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention... read more
An assessment of repeat computed tomography utilization in the emergency department in the setting of blunt trauma
Two CT scans performed during blunt trauma encounters demonstrated mixed benefit and were associated with an increased hospital LOS. Additionally, IV contrast was associated with lower rates of AKI. Of 5787 patient encounters,... read more
TAPSE Has Superior Predictive Value vs. RV/LV Ratio in Normotensive Patients with Acute Pulmonary Embolism
Right ventricular dysfunction (RVD) is an indicator of poor prognosis in normotensive patients with acute pulmonary embolism (APE). The aim of this study was to compare right ventricular (RV)/left ventricular (LV) ratio measured... read more
Nonconvulsive Status Epilepticus
The only comprehensive source of information on this frequently misdiagnosed problem, with information critical for physicians, ER and ICU doctors, and psychiatrists. An under-recognized condition that can potentially... read more
Nonconvulsive Status Epilepticus: Overlooked and Undertreated
Nonconvulsive status epilepticus (NCSE) is characterized by persistent change in mental status from baseline lasting more than 5 minutes, generally with epileptiform activity seen on EEG monitoring and subtle or no motor... read more
Preoperative Risk and the Association between Hypotension and Postoperative AKI
Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative... read more
Timing of Tracheostomy in Pediatric Patients
In children on mechanical ventilation, early tracheostomy may improve important medical outcomes. However, our data demonstrate the urgent need for high-quality, randomized controlled trials in the pediatric population. Data... read more
No Reason to Choose Tramadol over Morphine
Tramadol is an opioid, but it does not bind directly to opioid receptors (or it binds so weakly that it might as well not bind at all). Its opioid action is the result of the metabolite O-desmethyltramadol, which means... read more
Impact of Rewarming Rate on the Mortality of Patients with Accidental Hypothermia
In this study, we found that overall, in-hospital mortality rates increase with each 0.5 °C/h decrease in rewarming rate (RR). However, judging from the results of subgroup analyses, the safest RR might differ according... read more
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
5-year Study Shows Predominance of Non-Device-Associated Pneumonia
Among more than 160,000 patients admitted to University of North Carolina hospitals during a recent 5-year period, non-device-associated, or ND, pneumonia was implicated in three of every four nosocomial pneumonia cases,... read more
Critical Pediatric Heart Deaths Drop by 24% at Hospitals With Cardiac ICUs
Major complications fall by 12%, time on a ventilator declines by 13% among children in the cardiac ICU at PC4 hospitals As a pediatric cardiology fellow nearly a decade ago, Michael Gaies remembers asking hospital colleagues... read more
Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions
Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic... read more
Incidence of Bloodstream Infections, Length of Hospital Stay, and Survival in Patients With Recurrent CDI Treated With Fecal Microbiota Transplantation or Antibiotics
In a propensity score–matched cohort, patients with recurrent Clostridioides difficile Infection (CDI) treated with fecal microbiota transplantation (FMT) were less likely to develop primary bloodstream infection (BSI). Of... read more
