Factors Nurses in the ICU Consider When Making Decisions About Patient Mobility
Nurses are often responsible for mobilizing patients, but how they overcome barriers and make decisions to mobilize patients in the intensive care unit (ICU) is not understood. Deciding to mobilize patients in the ICU... read more
High-flow Oxygen Therapy for Treating Bronchiolitis in Infants
Bronchiolitis is the most common reason for hospitalization in infants worldwide. Current recommendations by the American Academy of Pediatrics are for supportive care including maintenance of hydration and oxygen support... read more
Airway Closure during Surgical Pneumoperitoneum in Obese Patients
In obese patients, complete airway closure is frequent during anesthesia and is worsened by Trendelenburg pneumoperitoneum, which increases airway opening pressure and alveolar pressure: besides preventing alveolar derecruitment,... read more
Randomized Controlled Trial of Health Coaching for Vulnerable Patients with COPD
These results help inform expectations regarding the limitations and benefits of health coaching for patients with Chronic Obstructive Pulmonary Disease (COPD). They may be useful to health policy experts in assessing the... read more
Early Mobilization on CRRT is Safe and May Improve Filter Life
Despite studies demonstrating benefit, patients with femoral vascular catheters placed for continuous renal replacement therapy (CRRT) are frequently restricted from mobilization. No researchers have reported filter pressures... read more
Vasopressors and Inotropes for Shock Syndromes
Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors' receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... read more
A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU
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.... read more
Procalcitonin-Guided Antimicrobial Therapy in Critical Care
Procalcitonin guidance for antibiotic cessation improves short-term mortality in ICU patients. Previous meta-analyses showed that procalcitonin-guided antimicrobial management, compared with standard care, resulted in less... read more
Transcutaneous CO2 vs. End-tidal CO2 in Neonates and Infants Undergoing Surgery
EtCO2 underestimates PvCO2 values in neonates and infants under general anesthesia. TcPCO2 closely approximates venous blood gas values, in both the NICU and non-NICU samples. We, therefore, conclude that tcPCO2 is a more... read more
Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy
Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more
Steroids in Septic Shock – Four Misconceptions and One Truth
The utility of steroids in sepsis has been debated passionately for decades. There is hope that steroids might improve mortality, but also fear that they could increase infectious complications. Practice varies widely. What... read more
The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection
Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more
Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults
Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill... read more
Poor Communication Between Physicians and Nurses Linked to Patient Catheter Issues
Communication is contextual, and improving physician-nurse communication about appropriate catheter use may require innovations that address the identified contextual barriers. Several barriers to communication between physicians... read more
Hospitals Delay Use Of New Antibiotics
According to a new study published in Diagnostic Microbiology and Infectious Disease, US hospitals on average waited more than a year to prescribe any of six new antibiotics approved by the US Food and Drug Administration... read more
Pain in the PICU: How and What Are We Doing?
Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units (PICU) experience pain and the practices being used to lessen pain. Critically... read more
Sepsis: Personalization vs. Protocolization?
The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more
Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them
A witty, irreverent tour of history's worst plagues―from the Antonine Plague, to leprosy, to polio―and a celebration of the heroes who fought them. In 1518, in a small town in Alsace, Frau Troffea began dancing and... read more
The Hospitalist Role in Treating Opioid Use Disorder
Opioid use disorder, like many of the other conditions we see, is a chronic relapsing remitting medical disease and a risk factor for premature mortality. When a patient with diabetes is admitted with cellulitis, we might... read more
Patients Identify Female Physicians as Doctors Less Than Male Physicians
Patients correctly identify female attending physicians as doctors significantly less frequently than they identify male attending physicians as doctors. Patients correctly identify male nurses as nurses significantly less... read more
Penn Finds a Way to Reduce ICU Doctor Burnout
Reducing the length of rotations in medical ICUs in half also reduces rates of physician burnout in half while additionally improving feelings of fulfillment, according to a new pilot study from Penn Medicine. The results... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
