Tag: ICU

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

Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy

There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more

Post-ICU Clinics and Peer Support Groups to Reduce PICS

Kyle B. Enfield, MD, and Kimberley J. Haines, PhD, BHSc, discuss implementing post-ICU clinics and peer support groups following critical illness to help reduce the burden of post-intensive care syndrome (PICS). Dr. Haines... read more

Circulating Gasdermin-D in Critically Ill Patients

This is the first study to demonstrate that the active form of GSDM-D is found exclusively in the circulation of septic critically ill patients raising its potential as an agent of dysregulated immunity in systemic infection.... read more

Feeding Should be Individualized in the Critically Ill Patients

Although energy expenditure can now be measured, we miss indicators of early endogenous energy production and of protein needs. A pragmatic ramping up of extrinsic energy provision by nutrition support reduces the risk of... read more

Early Enteral Nutrition Associated with Improved Clinical Outcomes in Critically Ill Children

In critically ill children with hyperglycemia requiring inotropic support and/or mechanical ventilation, early enteral nutrition was independently associated with better clinical outcomes. Of 608 eligible subjects, 331... read more

Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients

Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status. 72 patients were included in the initial group and 72... read more

Driving Pressure Is Associated with Outcome during Assisted Ventilation in ARDS

In patients with Acute Respiratory Distress Syndrome (ARDS), plateau pressure, driving pressure, and respiratory system compliance can be measured during assisted ventilation, and both higher driving pressure and lower compliance... read more

Cognitive Outcomes After Critical Illness

Persistent cognitive impairment is a major complication of critical illness. Our knowledge of this problem remains incomplete. Collaborative research is indispensable to improve our understanding of this disabling sequel... read more