Prolonged acute and post-acute care recovery of physical function in survivors of acute respiratory failure

The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Patients who require prolonged admission... read more

Prolonged acute and post-acute care recovery of physical function in survivors of acute respiratory failure

Effects of High-Flow Nasal Cannula on the Work of Breathing in Patients Recovering From ARF

High-flow nasal cannula, when set at 60 L/min, significantly reduces the indexes of respiratory effort in adult patients recovering from acute respiratory failure (ARF). This effect is associated with an improvement in... read more

Effects of High-Flow Nasal Cannula on the Work of Breathing in Patients Recovering From ARF

Prospective Assessment of the Feasibility of a Trial of Low Tidal Volume Ventilation for Patients with Acute Respiratory Failure

Use of initial tidal volumes less than 8 ml/kg PBW is common at hospitals participating in the NHLBI PETAL Network. After considering the size and budgetary requirement for a cluster-randomized trial of LTVV vs. usual care... read more

Prospective Assessment of the Feasibility of a Trial of Low Tidal Volume Ventilation for Patients with Acute Respiratory Failure

Remodeling ICU Care

A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both... read more

Remodeling ICU Care

Carbonic anhydrase inhibitors in patients with respiratory failure and metabolic alkalosis

In patients with respiratory failure and metabolic alkalosis, carbonic anhydrase inhibitor therapy may have favorable effects on blood gas parameters. In mechanically ventilated patients, carbonic anhydrase inhibitor therapy... read more

Carbonic anhydrase inhibitors in patients with respiratory failure and metabolic alkalosis

Sedation and Mobilization during Venovenous Extracorporeal Membrane Oxygenation for ARF

The majority of respondents reported targeting moderate to deep sedation following cannulation, with the use of sedative and opioid infusions. There is considerable variability surrounding early physical therapy and mobilization... read more

Sedation and Mobilization during Venovenous Extracorporeal Membrane Oxygenation for ARF

Antipsychotic Prescribing Patterns During and After Critical Illness

In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly... read more

Antipsychotic Prescribing Patterns During and After Critical Illness

Noninvasive Ventilation in Patients With ARF and Do-Not-Intubate and Comfort-Measures-Only Orders

A large proportion of patients with do-not-intubate orders who received noninvasive ventilation survived to hospital discharge and at 1 year, with limited data showing no decrease in quality of life in survivors. Provision... read more

Noninvasive Ventilation in Patients With ARF and Do-Not-Intubate and Comfort-Measures-Only Orders

Medications and RRT: We Know How to Dose, Right?

Dr. Fraser, MD, speaks with Bruce A. Mueller, PharmD, FCCP, FASN, about his talk presented at the 47th Critical Care Congress in San Antonio, Texas, entitled "Artificial Kidney Meets Mechanical Lung: Comanaging the Patient... read more

Should We Manage All Septic Patients Based on a Single Definition?

It is indisputable from the biological and clinical perspectives that not all cases of sepsis are the same. On the contrary, most have great many differences, that is, different portals of entry, clinical manifestations,... read more

Should We Manage All Septic Patients Based on a Single Definition?

Delayed Intubation Linked to Poor Outcome

The optimal timing of endotracheal intubation in critically ill patients requiring invasive mechanical ventilation remains undefined. A new analysis of the large, prospective Intensive Care Over Nations (ICON) database compares... read more

Delayed Intubation Linked to Poor Outcome

Choosing the Appropriate Configuration and Cannulation Strategies for ECMO

Extracorporeal membrane oxygenation (ECMO) is becoming a common procedure to support patients with severe cardio-circulatory or respiratory failure as well as in case of combined compromise of the two systems. Deciding which... read more

Choosing the Appropriate Configuration and Cannulation Strategies for ECMO

Acute Hypoxemic Respiratory Failure in Immunocompromised Patients

In immunocompromised patients with acute hypoxemic respiratory failure (ARF), initial management aims primarily to avoid invasive mechanical ventilation (IMV). HFNC has an effect on intubation but not on mortality rates.... read more

Acute Hypoxemic Respiratory Failure in Immunocompromised Patients

Initial Nutritional Management During NIV and Outcomes

Patients starting noninvasive ventilation (NIV) to treat acute respiratory failure are often unable to eat and therefore remain in the fasting state or receive nutritional support. Nearly three-fifths of patients receiving... read more

Initial Nutritional Management During NIV and Outcomes

Perspectives of Survivors, Families and Researchers on Key Outcomes for Research in ARF

There is heterogeneity among the outcomes evaluated in studies of survivors of acute respiratory failure (ARF). Patient, family and researcher groups supported inclusion of outcome domains that fit within the PICS framework.... read more

Perspectives of Survivors, Families and Researchers on Key Outcomes for Research in ARF

Core Outcome Measures for Clinical Research in ARF Survivors

This Core Outcome Measurement Set is recommended for use in all clinical research evaluating acute respiratory failure (ARF) survivors after hospital discharge. In the future, researchers should evaluate measures for outcomes... read more

Core Outcome Measures for Clinical Research in ARF Survivors

Focus on Ventilation and Airway Management in the ICU

Airway and ventilation management are particularly challenging in the intensive care unit (ICU), and are associated with high morbidity and mortality. Figure summarizes some of the more recent findings from the literature.... read more

Focus on Ventilation and Airway Management in the ICU

Potentially modifiable factors contributing to sepsis-associated encephalopathy

Acute renal failure and common metabolic disturbances represent potentially modifiable factors contributing to sepsis-associated encephalopathy. However, a true causal relationship has yet to be demonstrated. Our study confirms... read more

Potentially modifiable factors contributing to sepsis-associated encephalopathy

Improving Long-Term Outcomes Research for ARF

Alison Turnbull, DVM, MPH, PhD discusses the heterogeneity in outcome measures in our field and the need for a Core Outcome Measurement Set (COMS) to standardize reporting of important outcomes. As part of the consensus process,... read more

Improving Long-Term Outcomes Research for ARF

Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls

A three-year-old male presents with mom for seven days of fever, diarrhea, and decreased activity. When you walk into the room, you note a listless-appearing boy with pallor. His eyes appear sunken. He is tachycardic, tachypneic,... read more

Hemolytic Uremic Syndrome (HUS): Pearls and Pitfalls

Critical care ultrasonography in acute respiratory failure

CCUS combining CCE and chest ultrasonography rapidly provides valuable information in patients presenting with ARF. A pragmatic and systematic applied protocol may first evaluate how aerated is the lung and whether there... read more

Critical care ultrasonography in acute respiratory failure