The Role of Physiotherapy in Enhanced Recovery After Surgery in the ICU

Enhanced recovery after surgery (ERAS) is an evidence-based, multimodal approach to optimising patient outcomes following surgery. The role of physiotherapy within ERAS and intensive care units (ICU) is important. Patients... read more

When Antibiotic Treatment Fails

What to do when antimicrobial treatment fails and when and how to define it? These are three very common questions arising when clinicians use antibiotics. Categorization of responders and non-responders early in the course... read more

Ultrasound-guided Mechanical Ventilation

Point-of-care ultrasound (POCUS) is now a tool used worldwide, integrating clinical assessment of the critically ill. In this review, we focus on lung, diaphragm and cardiac ultrasound in the management of the mechanically... read more

Translational Evidence for Two Distinct Patterns of Neuroaxonal Injury in Sepsis

Ischemic and diffuse neuroaxonal injury to the brain in experimental sepsis, human postmortem brains, and in vivo MRI suggest these two distinct lesion types to be relevant. Future studies should be focused on body fluid... read more

Delirium in Hospitalized Older Adults

Delirium, an acute confusional state, is common among hospitalized elders and is associated with poor outcomes. All patients with delirium should be evaluated for reversible causes. Behavioral disturbances should be managed... read more

Barriers to Delirium Assessment in the ICU

Many barriers exist to prevent effective assessment and management of delirium, but several of these are due to a lack of understanding or unfamiliarity with the condition and the assessment tools as well as lack of medical... read more

Oral Antibiotics Preferred for Pediatric Pneumonia

Children with complicated pneumonia should be discharged from the hospital with oral instead of intravenous (IV) antibiotics when possible, according to a new study. The results showed no significant differences in treatment... read more

Severe AKI in Young ICU Patients Predicts Higher Mortality

Acute kidney injury (AKI) among critically ill children and young adults is common and is associated with higher mortality risk and other poor outcomes The condition also is associated with greater use of renal-replacement... read more

Aerosol Delivery During Invasive Mechanical Ventilation

Lung deposition was lower than 20% of nominal dose delivered with nebulizers and mostly occurred in proximal airways. Further studies are needed to link substantial concentrations of antibiotics in infected pulmonary fluids... read more

Can this patient be safely weaned from RRT?

The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently. However, there is limited information and few recommendations... read more

Active Noise Control Headphones to Reduce Patient’s Exposure to ICU Noise

The use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look... read more

ICU Telemedicine Program Financial Outcomes

The ability of properly modified ICU telemedicine programs to increase case volume and access to high-quality critical care with improved annual direct contribution margins suggests that there is a financial argument to encourage... read more

Robot aims to zap out ICU infections

Hospital workers are constantly cleaning rooms to avoid Hospital Acquired Infections at Hunterdon Medical Center, but now a robot will be working to do the dirty work. In July, the hospital purchased a $100,000 Xenex... read more

Opioid use to worse outcomes in C. difficile

A study presented at the World Congress of Gastroenterology found that patients being prescribed opioids who also have Clostridium difficile infections (CDIs) have higher peak white blood cell counts, higher creatinine elevations,... read more

Levosimendan in high-risk patients undergoing cardiac surgery

Levosimendan reduces mortality in patients with preoperative severely reduced LVEF but does not affect overall mortality. Levosimendan reduces the need for RRT after high-risk cardiac surgery. Six RCTs were included in the... read more

Early Oseltamivir Therapy Improves the Outcome in Critically Ill with Influenza

This real-life study emphasizes oseltamivir efficacy on in-hospital outcome when administrated within 2 days of the onset of symptoms. Even if physicians' awareness of the influenza disease has been undeniably enhanced... read more

Humanizing the Treatment of Hyperactive Delirium in the Last Days of Life

When patients with advanced cancer near the end of their life, it is important for physicians, nurses, and other health care personnel to respect and dignify the dying process of the patient. This requires a shift in focus... read more

Sound and Light Levels Are Similarly Disruptive in ICU and non-ICU Wards

Quieter, non-ICU wards have as many SLCs as ICUs do, which has implications for quality improvement measurements. Efforts to further reduce average noise levels might be counterproductive. Light levels in the hospital (ICU... read more

2B4-Mediated Coinhibition of CD4+ T Cells Underlies Mortality in Experimental Sepsis

Sepsis is a leading cause of death in the United States, but the mechanisms underlying sepsis-induced immune dysregulation remain poorly understood. 2B4 (CD244, SLAM4) is a cosignaling molecule expressed predominantly on... read more

Preventing the misuse of ICU visiting hours to reduce inequities

Family participation in healthcare serves to improve outcomes across a broad spectrum of conditions. Current guidelines recommend open family presence in the intensive care unit (ICU) while citing evidence of its safety.... read more

Rapid Retriage of Critically Injured Trauma Patients

Critically injured patients presenting to nontrauma hospitals require timely transfer to trauma centers; however, the transfer process varies and differences in outcomes for patients from trauma centers are unknown. We evaluated... read more

Acute Kidney Injury Is Risk Factor for Delirium and Coma

For critically ill adults, acute kidney injury is a risk factor for delirium and coma. Stage 2 acute kidney injury was associated with increased risk of delirium and coma (odds ratios, 1.55 and 2.04, respectively), as was... read more