Dying as a Pathway to Death in Sepsis
Mortality from sepsis remains high, with at least 270,000 deaths annually in the United States and more than 5 million deaths worldwide. Despite increasing understanding of the pathophysiology of sepsis, outside of targeted... read more
Music Helps Prevent Delirium in Elderly Critical Care Patients
A randomized controlled trial demonstrates that music intervention to prevent delirium among older patients is one of few strategies that provide support in a critical care setting. This study builds on non-pharmacologic... read more
Can Better Teamwork in the ICU Save Lives?
Effective teamwork is the goal of any workplace. But few settings offer higher stakes than the fast-paced, life-or-death environment of a hospital intensive care unit (ICU). Team collaboration in ICUs is an area ripe for... read more
Travel Times Affect Neurocritical Care Unit Nurse Staffing Levels
For specialist nurses on neurocritical care units, accompanying patients for imaging scans and other procedures has a major impact on nurse staffing ratios, reports a study in the Journal of Neuroscience Nursing. Over 30... read more
Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?
Acute kidney injury (AKI) is a common complication of critical illness and is associated with significant morbidity, mortality, and financial cost. Sepsis is the leading association of acute kidney injury in the intensive... read more
Giving plasma in helicopters, before hospital, may save trauma patients
Giving plasma to trauma victims during air transport, rather than waiting until arrival at the hospital, saved lives, according to the results of a study that involved patients treated aboard MetroHealth Medical Center's... read more
Functional Recovery in Critically Ill Children, the “WeeCover” Multicenter Study
This study provides new information regarding functional outcomes and the factors that influence meaningful aspects of functioning in critically ill children. Identifying patients at greatest risk and modifiable targets for... read more
NIH Researchers Discover Highly Infectious Vehicle for Transmission of Viruses Among Humans
Researchers have found that a group of viruses that cause severe stomach illness — including the one famous for widespread outbreaks on cruise ships — get transmitted to humans through membrane-cloaked "virus clusters"... read more
Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms
This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound,... read more
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock
Effective antimicrobial administration within the first hour of documented hypotension was associated with increased survival to hospital discharge in adult patients with septic shock. Despite a progressive increase in mortality... read more
Delirium, Frailty, and Mortality: Interactions in a Prospective Study of Hospitalized Older People
Although delirium and frailty contribute to mortality, the overall impact of delirium on admission appears to be greater at lower levels of frailty. In contrast to the hypothesis that there is a bimodal distribution for mortality,... read more
Association of Inferior Vena Cava Filter Placement for Venous Thromboembolic Disease and a Contraindication to Anticoagulation With 30-Day Mortality
After adjustment for immortal time bias, Inferior Vena Cava (IVC) filter placement was associated with increased 30-day mortality in patients with venous thromboembolic disease (VTE) and a contraindication to anticoagulation.... read more
Expectations of Recovery: ICU Anecdotes
Most of us believe we know our loved ones' wishes. You may know what your father's favorite meal is or what he enjoys doing on a Sunday afternoon. But do you know if he would want a feeding tube if he can’t eat? These kinds... read more
Timing of Infectious Disease Clinical Rotation Is Associated With Infectious Disease Fellowship Application
During a 7-year period, those interns randomly assigned to rotate on ID in the first 6 months of their intern year were more likely to become future ID applicants. This supports prior self-reported survey data that early... read more
Research Optimizes Comprehensive Medication Management: Defines the Patient Care Process of CMM
The Patient Care Process for Delivering Comprehensive Medication Management (CMM) provides a common definition of comprehensive medication management (CMM) and common language to describe the patient care process for delivering... read more
Technology in the ICU, An Issue of Critical Care Nursing Clinics of North America
Dr. Wung is addressing an important component of critical care nursing: the role of technology in patient care. She has assembled top authors to provide current clinical information in the following areas: Sensory overload... read more
Lies, Damned Lies, and Sepsis Bundles
The Surviving Sepsis Campaign recently released an update to the bundles of care it recommends for "sepsis" patients. You may have heard of the three-hour bundle, which essentially means that you do a bunch of stuff (lactate,... read more
Out-of-hours Discharge from ICU, In-hospital Mortality and ICU Readmission Rates
Out-of-hours discharge from an ICU is strongly associated with both in-hospital death and ICU readmission. These effects persisted across all definitions of “out of hours” and across healthcare systems in different geographical... read more
Moving Albumin Into the Small Volume Resuscitation Era
Physicians have an intense 70-year history of enthusiasm, skepticism, fear, and reconciliation with albumin products since their market introduction in the late 1940s. Despite its cumbersome production method and costs, albumin... read more
Ultrasound Non-invasive Measurement of Intracranial Pressure in Neurointensive Care
Of the studied ultrasound nICP methods, ONSD is the best estimator of Intracranial Pressure (ICP). The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique... read more
The Untapped Potential of Patient and Family Engagement in the Organization of Critical Care
There is growing interest in patient and family participation in critical care - not just as part of the bedside, but as part of educational and management organization and infrastructure. This offers tremendous opportunities... read more
Oxygenate, Ventilate, Do No Harm
Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more
