Tag: diagnostics
A 10-Year Longitudinal Analysis of Protocol-Based Sepsis Management
This 10-year single-center retrospective cohort showed that the use of PB management of severe sepsis and septic shock was associated with a decreased hospital mortality for patients. This mortality benefit was preserved... read more
ED Management of Smoke Inhalation Injury in Adults
When treating patients who have suffered injury in a fire, managing their airway is as critical as treating their burns. Following on the February 2018 issue on Thermal Burns, this issue reviews strategies for diagnosing... read more
Echocardiographic Assessment of Pulmonary Artery Occlusion Pressure in Ventilated Patients
TEE accurately predicts invasive PAOP ≤ 18 mmHg in ventilated patients. This further increases its diagnostic value in patients with suspected acute lung injury/acute respiratory distress syndrome. During two consecutive... read more
Clinical Assessment of Critically Ill Patients by Whole-body Ultrasonography
Critical care ultrasonography (CCUS) is increasingly advocated and used, and is defined as point-of-care image acquisition, interpretation and clinical application, all performed by the critical care clinician, and directed... read more
Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis
A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration... read more
Causes and Consequences of Optimistic Expectations About Prognosis by Surrogate Decision-Makers in ICUs
This multicenter study shows that optimistic expectations about prognosis are prevalent among surrogates of patients with advanced critical illness, arise both from misunderstandings by surrogates and from surrogates holding... read more
Comparison of Diagnostic Accuracy Among Procalcitonin, C-reactive protein, and Interleukin 6 for Blood Culture Positivity in General ICU Patients
Despite various technological advances, it still usually takes at least 24 to 48 h to obtain a blood culture result. The subsequent delays in diagnosis and treatment of infection can negatively impact care in the intensive... read more
Identification of Subclasses of Sepsis that Showed Different Clinical Outcomes and Responses to Amount of Fluid Resuscitation
Sepsis is a heterogeneous disease and identification of its subclasses may facilitate and optimize clinical management. This study aimed to identify subclasses of sepsis and its responses to different amounts of fluid resuscitation.... read more
Department-Based ICU Improves Patient Survival Rates
A new Michigan Medicine study found that implementing a dedicated emergency medicine department-based intensive care unit improved patient survival rates and lowered inpatient intensive care unit (ICU) admissions. In the... read more
Measuring Cardiac Output at the Bedside
The purpose of this review is to review the importance of cardiac output (CO) or stroke volume (SV) measurement and to discuss the various methods (devices) used in determination of CO. Bedside cardiac output measurement... read more
Predictive Utility of DNI in Patients with MOF After Severe Traumatic Injury
Post-injury multiple organ failure (MOF) is the result of a systemic uncontrolled inflammatory response and it is the one of leading cause of late post-injury mortality. Delta neutrophil index (DNI) may serve useful marker... read more
Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults
Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill... read more
Translational Simulation: Not “Where?” But “Why?” A Functional View of In SITU Simulation
Healthcare simulation has been widely adopted for health professional education at all stages of training and practice and across cognitive, procedural, communication and teamwork domains. Recent enthusiasm for in situ simulation—delivered... read more
Oliguria and AKI in Critically Ill Children
Nearly one in five critically ill children with acute kidney injury (AKI) do not experience increase in serum creatinine. These acute kidney injury events, which are only identified by urine output criteria, are associated... read more
Why Most Diagnostic Procedures Aren’t Beneficial
We often assume that diagnostic procedures will help patients. A lot of training goes into learning how to do these procedures. Procedures are dramatic. We like performing them. Patients are impressed, perceiving that we... read more
Updates and Controversies in the Early Management of Sepsis and Septic Shock
For patients in the ED who are suspected of having sepsis, swift, effective management is vital to improving outcomes. This issue reviews the latest evidence on the diagnosis and treatment of sepsis and septic shock: ... read more
Indications and Outcomes of Extracorporeal Life Support in Trauma Patients
Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered... read more
Time to Add a Fifth Pillar to Bedside Physical Examination
Inspection, palpation, percussion, and auscultation have been the 4 pillars of clinical bedside medicine. Although these basic methods of physical examination have served us well, traditional bedside examination, for a number... read more
Effect of Occupancy on Critically Ill Admissions
Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients. The volume of ICU admissions from the ED has increased around 50% from 2001-2009. Hospitals struggle with this... read more
Considerations in the Diagnosis of Idiopathic Pulmonary Fibrosis
The clinical practice guideline on diagnosis of idiopathic pulmonary fibrosis (IPF) by Raghu and colleagues has been helpful in addressing the complexities of radiological and pathological features in diagnosing IPF. The... read more
Procalcitonin Reduces Antibiotic Use with No Negative Outcomes
The elderly patient presenting to the ED with nonspecific symptoms remains a diagnostic and therapeutic challenge. Often, these patients arrive with general complaints ranging from altered mental status to weakness, subjective... read more
