Antipsychotic Drugs are Not Useful to Reduce Symptoms of Delirium
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... read more
Surviving Critical Illness: What Is Next?
This consensus-based framework for PT after hospital discharge aims to improve long-term outcomes for survivors of critical illness. Physical therapists should seek close collaboration with the multidisciplinary team... read more
Transfusions Stuck in an Endless Cycle of Denial
Each publication from Maitland, et al., gives us a glimpse of a greater medical truth, but our view is obstructed by questions about external validity. This group published the landmark FEAST trial that questioned the... read more
Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy
There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more
MODS on Day 1 is a Major Source of Mortality in the PICU
Multiple Organ Dysfunction Syndrome (MODS) present on Day 1 of admission continues to be a major source of morbidity and mortality in the PICU, but risk of poor neurologic outcome may be improved. Further research is... read more
Assessment of Microcirculation in Cardiogenic Shock
The parameter most frequently used to detect tissue malperfusion is serum lactate. Novel, noninvasive methods to quantify microvascular perfusion have the potential to guide treatment in terms of optimizing organ perfusion... read more
Post-ICU Clinics and Peer Support Groups to Reduce PICS
Kyle B. Enfield, MD, and Kimberley J. Haines, PhD, BHSc, discuss implementing post-ICU clinics and peer support groups following critical illness to help reduce the burden of post-intensive care syndrome (PICS). Dr. Haines... read more
Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents
Clinically Relevant Bleeding (CRB) is common in critically ill adolescents who are at high risk of venous thromboembolism (VTE). Admission after trauma or surgery can be used to stratify the risk of CRB in this population.... read more
Circulating Gasdermin-D in Critically Ill Patients
This is the first study to demonstrate that the active form of GSDM-D is found exclusively in the circulation of septic critically ill patients raising its potential as an agent of dysregulated immunity in systemic infection.... read more
Feeding Should be Individualized in the Critically Ill Patients
Although energy expenditure can now be measured, we miss indicators of early endogenous energy production and of protein needs. A pragmatic ramping up of extrinsic energy provision by nutrition support reduces the risk of... read more
CytoSorb Associated with Decreased Observed vs. Expected 28-day All-cause Mortality in ICU Patients with Septic Shock
CytoSorb was associated with a decreased observed versus expected 28-day all-cause mortality. By IPTW analysis, intervention with CytoSorb may be associated with a decreased all-cause mortality at 28 days compared to CRRT... read more
Blood Grouping Identifies Patients at Risk for Developing Venous Thromboembolism
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... read more
Prehabilitation and Nutritional Support to Improve Perioperative Outcomes
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... read more
Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients
Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation, when the reasons for intubation... read more
Palliative Care in the Emergency Department As Seen By Providers and Users
This study provides insights into targets for changes in Italian Emergency Departments. Room for improvement relates to training for healthcare professionals on palliative care, the development of a shared care pathway for... read more
Evidence-Based Practice of Palliative Medicine
Evidence-Based Practice of Palliative Medicine is the only book that uses a practical, question-and-answer approach to address evidence-based decision making in palliative medicine. Dr. Nathan E. Goldstein and Dr. R.... read more
Early Enteral Nutrition Associated with Improved Clinical Outcomes in Critically Ill Children
In critically ill children with hyperglycemia requiring inotropic support and/or mechanical ventilation, early enteral nutrition was independently associated with better clinical outcomes. Of 608 eligible subjects, 331... read more
Palliative Care Nursing: Quality Care to the End of Life
This fourth edition of a comprehensive text/reference that has been valued by students, educators, and practicing nurses for many years, Palliative Care Nursing continues to reflect the fundamental hospice and palliative... read more
Vitamin C for Sepsis Suffers a Setback. Or a Step-Forward. It’s Complicated
The CITRIS-ALI study found no difference in primary outcomes among patients with sepsis treated with vitamin C versus placebo. But there was a difference in a secondary outcome - overall mortality. When it comes to sepsis... read more
Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients
Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status. 72 patients were included in the initial group and 72... read more
Effect Sizes in Ongoing Randomized Controlled Critical Care Trials
For some of the largest ongoing critical care trials, many clinicians regard prior probabilities as low and consider that plausible effects on absolute mortality are less than 5%. Further work is needed to determine whether... read more
20 Percent of Patients Hospitalized for Cardiac Arrest Readmitted Within a Month
This cohort study found increased rates of readmission among patients who survived cardiac arrest. Early follow-up with health care professionals may enable timely management of both cardiac and general medical conditions... read more
