Tag: ICU
Competing and Conflicting Interests in the Care of Critically Ill Patients
Medical professionals are expected to prioritize patient interests, and most patients trust physicians to act in their best interest. However, a single patient is never a physician's sole concern. The competing interests... read more
Snapshots of Hemodynamics
This new edition reviews recent developments in genetics and molecular biology and new noninvasive measurement techniques that have enabled vast improvements in the measurement and understanding of cardiovascular hemodynamics.... read more
Fluid Resuscitation: Evidence-based Solutions?
Intravenous (IV) fluid prescribing is one of the commonest tasks carried out by junior doctors. I still remember around this time last year when I was fresh out of medical school and had just been let loose on the wards,... read more
Biomarkers and Clinical Scores to Identify Patient Populations at Risk of Delayed Antibiotic Administration or Intensive Care Admission
Patients with low severity signs of infection but high MR-proADM concentrations had an increased likelihood of subsequent disease progression, delayed antibiotic administration or ICU admission. Appropriate triage decisions... read more
Urgent Intubation without Neuromuscular Blocking Agents and the Risk of Tracheostomy
Neuromuscular blocking agents play a significant role in improving the success rate for urgent intubation, although there is limited evidence about the effect on subsequent outcomes, such as the incidence of tracheostomy.... read more
Hyperoxia in the Critically Ill
Critically ill patients come to the ED all the time and it is almost reflexive to liberally administer oxygen in these acutely ill patients. Many providers may consider supplemental oxygen a harmless and potentially beneficial... read more
When Patients Die in the ICU, Should Their Family Be Allowed to Watch?
In most ICUs, it's standard practice to send relatives out of the room when a patient codes, but a growing body of research—and one doctor's personal experience—suggests relatives should be allowed to witness the medical... read more
Critical: Science and Stories From the Brink of Human Life
Following in the wake of hugely successful medical memoirs such as Do No Harm and Fragile Lives, Critical is an intelligent, compelling and profoundly insightful journey into the world of intensive care medicine and the lives... read more
How To Prevent Brain-Sapping Delirium In The ICU
After an overwhelming infection sent O'Burke into five-organ failure, he also developed ICU delirium, perhaps related to heavy sedation. An ICU protocol developed at Vanderbilt University Medical Center found that getting... read more
Use of Levosimendan in ICU Settings
Levosimendan has been demonstrated to have potential utility in a range of critical illness scenarios. It must be acknowledged, however, that in each sphere of application, the evidence is incomplete or indicative rather... read more
Should fecal microbial transplantation be used in the ICU?
FMT has become an attractive option to mitigate multiple organ dysfunction in the ICU. This article discusses the physiology, rationale, early experience, and expectations for such therapy in the critically ill patient. The... read more
Long-term Cognitive Impairment and Delirium in ICU
ICU delirium was positively associated with impaired information processing speed and executive functioning at six-months post-discharge for this cohort. Testing for cognitive impairment with RBANS and TMT should be considered... read more
The Effect of Early Mobilization in Critically Ill Patients
This study indicated that early mobilization was effective in preventing the occurrence of ICU-AW, shortening the length of ICU and hospital stay, and improving the functional mobility. However, it had no effect on the ICU... read more
Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm
Among patients with coma who had been resuscitated from cardiac arrest with nonshockable rhythm, moderate therapeutic hypothermia at 33°C for 24 hours led to a higher percentage of patients who survived with a favorable... read more
Early Prognostication of Neurological Outcome by HRV in Adults with Out-of-Hospital Sudden Cardiac Arrest
The present data indicate that heart rate variability (HRV) analysis could be useful for early prognostication for comatose patients during hypothermic TTM within 24 h after ROSC. The value of HRV as a prognosticator... read more
ICU Admission Source as a Predictor of Mortality for Patients With Sepsis
Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients... read more
Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination
Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU... read more
First Portable MRI Scanner for Neuro ICU
Health technology incubator Hyperfine Research and the Yale School of Medicine are testing out a first-of-its-kind, portable MRI scanner in the neuro intensive care unit (ICU). The point-of-care system, designed by Hyperfine,... read more
Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?
Generally, the bundle was deemed acceptable and deliverable. However, like any complex intervention, component adaptations will be required depending on resources available to the ICU; in particular, involvement of pharmacists... read more
Effect of Organisational Factors on the Variation in Incidence of Delirium in ICU Patients
The mean incidence of delirium in the ICU was 29%. The organisational factors found including methods of delirium assessment, screening frequency, and hospital type were not related to the reported ICU delirium incidence. A... read more
Surviving Critical Illness: What Is Next?
This consensus-based framework for PT after hospital discharge aims to improve long-term outcomes for survivors of critical illness. Physical therapists should seek close collaboration with the multidisciplinary team... read more
Transfusions Stuck in an Endless Cycle of Denial
Each publication from Maitland, et al., gives us a glimpse of a greater medical truth, but our view is obstructed by questions about external validity. This group published the landmark FEAST trial that questioned the... read more
