Tag: guidelines
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
New Guidelines for Hospital-acquired Pneumonia/Ventilator-associated Pneumonia
American and European guidelines have many areas of common agreement such as limiting antibiotic duration. Both guidelines were in favor of a close clinical assessment. Neither recommended a regular use of biomarkers but... read more
Antibiotic Treatment of Hospital-acquired Pneumonia
Although more prospective therapy trials of Hospital-acquired Pneumonia (HAP) are needed, based on currently available data, it is possible to use an approach that provides appropriate therapy without the overuse of broad-spectrum... read more
Should We Stop Trending Lactate in Septic Shock?
There may be a tendency to cement guideline recommendations into our collective minds as inalienable and sacrosanct – as if carved onto stone tablets and brought down to us from the heights of Mount Sinai. Thoughtful medicine,... read more
Implementing Early Mobilization in the ICU
The use of a quality improvement appraisal tool can help identify high quality projects when planning a similar mobility program. Even though projects were conducted in a variety of intensive care unit settings, and implementation... read more
Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients
This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more
Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis
The use of ultrasound guidance for thoracentesis has been associated with increased success rates and decreased complication rates. Ultrasound can be used to estimate the pleural fluid volume, characterize the effusion as... read more
Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF
Echocardiography is increasingly recommended for the diagnosis and assessment of patients with severe cardiac disease, including acute heart failure (AHF). Echocardiography and LUS can assist in the rapid assessment of patients... read more
Adherence to Guidelines for the Management of Donors After Brain Death
Guideline adherence to an expert panel predefined care set in brain death (DBD) donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation... read more
Delirium in Critical Illness: Haloperidol vs Ziprasidone?
Delirium is defined as an acute disorder of consciousness which can occur in up to 80% of mechanically ventilated ICU patients. This acute cognitive dysfunction is associated with prolonged hospital stay, increased mortality,... read more
Antithrombotic Therapy for Venous Thromboembolic Disease
This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians' 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE). The estimated annual incidence of VTE, defined... read more
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals
The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more
Oxygen Therapy for Acutely Ill Medical Patients
It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation. A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases... read more
Conflicts of interest disclosure forms and management in critical care clinical practice guidelines
The current conflicts of interest (COIs) disclosure forms of selected professional societies provide more attention to financial disclosures and COIs and less attention to detecting and managing intellectual COIs, while rarely... 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
Update on Perioperative Acute Kidney Injury
Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a... read more
Sepsis: Learn the Signs and Document
Writing in the MJA, researchers have reported the findings of a prospective cohort study comparing estimates of the incidence and mortality of sepsis using clinical diagnosis or the Australian and New Zealand Intensive Care... read more
High Flow Nasal Oxygen for Acute Bronchiolitis?
Since bronchiolitis is a clinical diagnosis, there is no test, including viral testing and radiography, which rules it in or out (Schuh et al 2007). Sadly, despite multiple guidelines (NICE, AAP, CPS), there has also been... read more
