Tag: ICU
Dealing with missing delirium assessments in prospective clinical studies of the critically ill
For longitudinal data where a summary exposure is of interest, we recommend practitioners adopting the passive imputation strategy. Simulations show that all methods performed comparably when the proportion of missingness... read more
Optimizing the Timing of RRT in AKI
The optimal timing of renal replacement therapy (RRT) in critically ill patients with acute kidney injury (AKI) has been much debated. Over the past five years several studies have provided new guidance for evidence-based... read more
RRT in Critically Ill Patients with AKI
Recent evidence has shown that pre-emptive or earlier renal-replacement therapy (RRT) in patients with severe acute kidney injury (AKI) and no urgent indications does not confer clinical benefit. By default, this would imply... read more
The Relationship of Delirium, Sedation, Dementia, and Acquired Weakness
The advent of modern critical care medicine has revolutionized care of the critically ill patient in the last 50 years. The Society of Critical Care Medicine (was formed in recognition of the challenges and need for specialized... read more
Point-of-Care Transcranial Doppler by Intensivists
In the unconscious patient, there is a diagnostic void between the neurologic physical exam, and more invasive, costly and potentially harmful investigations. Transcranial color-coded sonography and two-dimensional transcranial... read more
A Systematic Review of the Incidence and Outcomes of In-Hospital Cardiac Arrests in Patients with COVID-19
Approximately, one in 20 patients hospitalized with coronavirus disease 2019 received resuscitation for an in-hospital cardiac arrest. Hospital survival after in-hospital cardiac arrest within the ICU was higher than non-ICU... read more
Delirium and long term cognition in critically ill patients
Delirium, a form of acute brain dysfunction, is very common in the critically ill adult patient population. Although its pathophysiology is poorly understood, multiple factors associated with delirium have been identified,... read more
What the Flecainide is going on here?
A 54-year-old woman is brought to the emergency department for palpitations. In triage she has a heart rate of 120 bpm, BP 143/89, SpO2 99%. Shortly after being roomed, she begins to complain of worsening symptoms and looks... read more
Health Systems Successfully Leverage Tele-ICU During Pandemic and Intend to Continue
Help during the pandemic for overwhelmed, overworked intensive care unit (ICU) nurses at some health systems came in the form of experienced tele-ICU nurses working remotely to support on-site colleagues as they cared for... read more
Lactate = LactHATE
Like many others who attended SMACC earlier this year I returned home dazed and confused about the significance of lactate in the septic patient. So like any good (aspiring to be) evidence-based medicine practitioner,... read more
Do team and task performance improve after training situation awareness?
This intervention study shows that a 2-h education in situation awareness improved parts of team performance in an acute care situation. Team leadership and task management improved in the intervention group, which may indicate... read more
Tocilizumab Use May Be Associated with a Short-term Mortality Benefit
For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required. Its benefits may also lie in reducing the... read more
Why and How to Open ICU to Family Visits During the Pandemic
Since the lockdown because of the pandemic, family members have been prohibited from visiting their loved ones in hospital. While it is clearly complicated to implement protocols for the admission of family members, we believe... read more
Higher Level of Mobilization Improves Health Status
In critically ill survivors, achieving higher levels of mobilization, but not increasing the number of active mobilization sessions, improved health status 6 months after ICU admission. The dosage of mobilization in ICU... read more
NIV After Early Extubation Reduces Total Days Spent on i-MV
Patients recovering from an episode of hypoxemic acute respiratory failure (hARF) may benefit from a weaning strategy based on early extubation followed by immediate noninvasive ventilation (NIV) application. Compared... read more
Risk of Clinical Severity by Age and Race/Ethnicity Among Adults Hospitalized for COVID-19
Older adults and people from certain racial and ethnic groups are disproportionately represented in coronavirus disease 2019 (COVID-19) hospitalizations and deaths. Using data from the Premier Healthcare Database on 181,813... read more
Case Files Critical Care (LANGE Case Files)
Experience with clinical cases is key to mastering the art and science of medicine and ultimately to providing patients with competent clinical care. Case Files: Critical Care provides 42 true-to-life cases that illustrate... read more
Managing Patients With Short-Term Mechanical Circulatory Support
The use of mechanical circulatory support for patients presenting with cardiogenic shock is rapidly increasing. Currently, there is only limited and conflicting evidence available regarding the role of the Impella (a microaxial,... read more
Norepinephrine Dosing Error Associated with Multiple Health System Vulnerabilities
Vasopressors are commonly used in the treatment of shock to support blood pressure, cardiac output, and end-organ perfusion. These agents are associated with risk of serious adverse effects including ischemia (e.g. stroke,... read more
Major Trauma Definition Using Different Revisions of the Abbreviated Injury Scale
Injury Severity Score (ISS) 08 ≥ 11 and ISS 15 ≥ 12 perform similarly to a threshold ISS 98 ≥ 16 for in-hospital mortality and ICU admission. This confirms studies evaluating mapped datasets, and is the... read more
Variation in Pediatric Palliative Care Allocation Among Critically Ill Children in the United States
Palliative care consultation for critically ill children in the United States is low. Palliative care utilization is increasing but considerable variation exists across institutions, suggesting inequity in palliative care... read more
Safety profile of enhanced thromboprophylaxis strategies for critically ill COVID-19 patients
In a cohort of critically ill patients with a high prevalence of thromboembolic events, ET was associated with reduced ICU mortality without an increased burden of haemorrhagic complications. This study suggests ET strategies... read more
