Tag: ICU
Chasing Mortality Endpoints is a Fool’s Errand
"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more
Dopamine Antagonists in ICU Delirium
Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia
Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more
Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients
In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality,... read more
Decontamination of Oral or Digestive Tract for Patients in the ICU
The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more
Rudeness in Medical Settings Could Kill Patients
A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more
Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria
The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children... read more
Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical ICU
We instituted several interventions in our trauma and surgical ICU aimed at improving communication and teamwork between RNs and MDs. Informal feedback indicated greater satisfaction among RNs and MDs with the working environment.... read more
Adjunct and Rescue Therapies for Refractory Hypoxemia
Prone position, inhaled nitric oxide, high frequency oscillation, extra corporeal life support. The mortality of severe acute respiratory distress syndrome (ARDS), deļ¬ned with a PaO2/FiO2 ratio of 100 mmHg... read more
Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics
This issue of Critical Care Clinics focuses on Mechanical Ventilation and Ventricular Assist Devices, with topics including: Targeted management approach to cardiogenic shock; Prevention and treatment of right heart failure... read more
When ICU Delirium Leads To Symptoms Of Dementia After Discharge
Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia,... read more
Navigating Medical Emergencies – An interactive guide to patient management
This free eBook presents emergent clinical situations and the core tasks required of healthcare professionals needing to recognize, navigate and safely manage them. It's really about how to perform the ABCs while protecting... read more
ESPEN Guideline on Clinical Nutrition in the ICU
Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk,... read more