Operation Timing and 30-Day Mortality After Elective General Surgery
Elective general surgery appears to be comparably safe at any time of the workday, any day of the workweek, and in any month of the year. The binary outcomes of 32,001 elective general surgical patients at the Cleveland Clinic... read more
Timing of Renal Support and Outcome of Septic Shock and ARDS
Early RRT initiation strategy was not associated with any improvement of 60-day mortality in patients with severe acute kidney injury and septic shock or Acute Respiratory Distress Syndrome (ARDS). Unnecessary and potentially... read more
Increasing the Number of Medical Emergency Calls Does Not Improve Hospital Mortality
With adjustment for patient factors, illness, and comorbidities, increased emergency calling rates were not associated with reduced in-hospital mortality. Efforts to increase calling rates do not seem warranted. We studied... read more
The Checklist Manifesto: How to Get Things Right
We train longer, specialize more, use ever-advancing technologies, and still we fail. Atul Gawande makes a compelling argument that we can do better, using the simplest of methods: the checklist. In riveting stories, he reveals... read more
Health-related Outcomes of Critically Ill Patients With and Without Sepsis
Critically ill patients with sepsis have higher healthcare resource use and costs but similar survival and HRQoL compared to matched patients without sepsis. We conducted a primary propensity score matched analysis of patients... read more
Foleys Aren’t Fun: Patient Study Shows Catheter Risks
A new study puts large-scale evidence behind what many hospital patients already know: Having a urinary catheter may help empty the bladder, but it can hurt, lead to urinary tract infections, or cause other issues in the... read more
Treatment of Acute Non-Anion Gap Metabolic Acidosis
Acute non-anion gap metabolic acidosis is now recognized to be as a common cause of metabolic acidosis, particularly in the ICU. Further examination of its impact on cellular function and clinical outcome are needed. Most... read more
The Intensive Care Medicine Research Agenda in Nutrition and Metabolism
Priorities for clinical research in the field of nutritional management of critically ill patients were suggested, with the prospect that different nutritional interventions targeted to the appropriate patient population... read more
Nephrology Secrets
Recently released, Nephrology Secrets, features the highly regarded "Secrets Series" popular question-and-answer format that also includes lists, tables, and an easy-to-read style – making reference and review quick, easy,... read more
Evaluation of a strategy for enrolling the families of critically ill patients in research using limited human resources
Family members were recruited for more than one third of eligible patients, and >90% of approached consented to participate. There are important demographic differences between patients with vs without an enrolled family... read more
Presenting Symptoms Independently Predict Mortality in Septic Shock
More than one third of patients with septic shock presented to the emergency department with vague symptoms that were not specific to infection. These patients had delayed antibiotic administration and higher risk of mortality... read more
Collective Quality Improvement in the Pediatric Cardiology Acute Care Unit
Collaborative quality improvement and learning networks have amended healthcare quality and value across specialities. Motivated by these successes, the Pediatric Acute Care Cardiology Collaborative (PAC3) was founded in... read more
Immunotherapy for Sepsis: A Good Idea or Another Dead End?
THE treatment of sepsis remains an intractable problem in critical care. It has been called the “graveyard”1 for pharmaceutical companies in recognition of dozens of negative clinical trials; this reflects multiple distinct... read more
Decatecholaminisation during sepsis
While necessary and life-saving in the early fight or flight reaction to any insult, prolonged adrenergic stress is detrimental and contributes to organ dysfunction. In the largest trial to date, Morelli et al. enrolled septic... read more
Survival outcomes after prolonged ICU length of stay among trauma patients: The evidence for never giving up
Prolonged intensive care unit length of stay (ICU-LOS) is associated with high mortality for medical and surgical patients. Existing literature suggests that this may not be true for trauma patients.The results reveal that... read more
Bacterial protein structure could aid development of new antibiotics
Bacterial cells have an added layer of protection, called the cell wall, that animal cells don't. Assembling this tough armor entails multiple steps, some of which are targeted by antibiotics like penicillin and vancomycin.... read more
Warfarin Nonadherence: What Factors Lead Patients with Afib to Discontinue?
Patients with atrial fibrillation (AF) frequently discontinue their warfarin therapy, and a recently-published study offers insight into factors that may contribute to nonadherence. The report, released in JAMA Cardiology,... read more
Peer Support in Critical Care
Peer support appeared to reduce psychologic morbidity and increase social support. The evidence for peer support in critically ill populations is limited. There is a need for well-designed and rigorously reported research... read more
The Impact of Enhanced Critical Care Training and 24/7 (Tele‐ICU) Support on Medicare Spending and Postdischarge Utilization Patterns
Innovations in workforce training and technology specific to the ICU may be useful in addressing the shortage of intensivist physicians, yielding benefits to patients and payers. Implementation of the advanced practice provider... read more
The Value of 24/7 In-House ICU Staffing 24/7 Intensivist in the ICU
Staffing of high-volume, high-intensity ICUs with 24 × 7 intensivist coverage facilitates the system changes, which allow ICU teams to provide 24 × 7 critical care.... read more
Beyond Bleeps and Alarms: Live Music by the Bedside in the ICU
Live music by the bedside is an additional, simple and inexpensive factor in the open ICU, aiming at reducing the incidence of delirium and transform the critical care setting into a more familiar and domestic environment.... read more
The 11th Pitfall: Thiamine Deficiency
Thiamine deficiency may occur in critically ill patients in case of increased glucose metabolism (i.e., in septic states or post-surgical phases), sudden or aggressive nutrition delivery to malnourished patients (refeeding... read more
