Tag: ICU

Key Enablers and Barriers for Improving ICU Outcomes

Several enablers and barriers to implementing ICU follow-up clinics and peer support groups should be taken into account and leveraged to improve ICU recovery. Among the most important enablers are motivated clinician leaders... read more

Sedation is Necessary to Minimize Patients’ Discomfort During Mechanical Ventilation

More than half of critical care nurses believe sedation is needed to minimize discomfort and distress among patients receiving mechanical ventilation, according to survey results published recently in the American Journal... read more

Platelet Function During ECMO in Adult Patients

Employing impedance aggregometry and flow cytometry, we found both impaired platelet aggregation and decreased platelet activation on day 1 of Extracorporeal Membrane Oxygenation (ECMO) support compared with healthy controls.... read more

Implementation of a Standardized Transfusion Protocol for Cardiac Patients Treated With Venoarterial ECMO Is Associated With Decreased Blood Component Utilization and May Improve Clinical Outcome

The data indicate that implementation of a standardized transfusion protocol, using more restrictive transfusion indications in cardiac ECMO patients, was associated with reduced blood product utilization, decreased complications,... read more

Mechanical Ventilation Management during ECMO for ARDS

Ultra-protective lung ventilation on ECMO was largely adopted across medium to high case-volume ECMO centers. In contrast with previous observations, mechanical ventilation settings during ECMO did not impact patients' prognosis... read more

Determinants of Health-Related Quality of Life After ICU

Preexisting comorbidity counts, but not severity of ICU illness, are strongly associated with health-related quality of life and physical symptoms in the year following critical illness. We prospectively collected data... read more

The Complex Kinetics of Blood Endocan During the Time Course of Sepsis and ARDS

This study highlights the kinetics of endocan in severe sepsis and acute respiratory distress syndrome (ARDS), thus helping to understand the apparently conflicting results observed in the literature. However, the interpretability... read more

Antipsychotics Not Helpful for Delirium in ICU

Delirium is a confused mental state that includes changes in awareness, thinking, judgment, sleeping patterns, and behavior. It can affect patients of any age but is more common among older adults who experience major illness... read more

Implementation Challenges in the ICU: The Why, Who and How of Daily Interruption of Sedation

Despite apparent consensus, lack of shared understanding of the rationale for an intervention may lead to divergent practice patterns and failure to implement standardized, evidence-based practice. There was wide consensus... read more

Early Mobilization Reduces Duration of Mechanical Ventilation and Intensive Care Unit Stay in Patients With ARF

The introduction of early mobilization for patients with mechanical ventilation (MV) in the ICU shortened MV durations and ICU stays. A multidisciplinary team that includes the patient's family can work together to improve... read more

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown. We primarily sought to determine the relationship between hypotension and a composite of myocardial... read more

Effect of a Nurse-Led Preventive Psychological Intervention on Symptoms of PTSD Among Critically Ill Patients

Among critically ill patients in the ICU, a nurse-led preventive, complex psychological intervention did not significantly reduce patient-reported Posttraumatic Stress Disorder (PTSD) symptom severity at 6 months. These findings... read more

Parenteral Anticoagulation Not Associated with Reduced Risk of Ischemic Stroke Among Patients with Atrial Fibrillation During Sepsis

Among patients with Atrial Fibrillation (AF) during sepsis, parenteral anticoagulation was not associated with reduced risk of ischemic stroke and was associated with higher bleeding rates. Of 113,511 patients hospitalized... read more

Beyond Ventilator-induced Diaphragm Dysfunction

Respiratory muscles are essential to ensure the vital function of breathing. The diaphragm is a unique respiratory muscle, because it contracts throughout the individual's life span without resting, not even during sleep.... 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

Sedation and Analgesia Impact On Long-term Cognitive Dysfunction in Critical Care Survivors

Deep sedation during stay in the Intensive Care Unit (ICU) may have deleterious effects upon the clinical and cognitive outcomes of critically ill patients undergoing mechanical ventilation. Over the last decade a vast... read more

Determinants of Citation Impact in Large Clinical Trials in Critical Care

Clinical trials conducted by investigator-led research groups are significantly more frequently cited than industry-led trials in critical care medicine. In addition, costs appear to be substantially lower with investigator-led... read more

Transfusion Practice in the ICU

This study shows a group of MICU physicians altered transfusion practice after the publication of the TRICC trial results and that, in the years following, transfusion practice has remained closer to the restrictive transfusion... read more

Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective... read more

Physical Function Impairment in Survivors of Critical Illness in an ICU Recovery Clinic

Physical function measurement in a recovery clinic is feasible and may inform subsequent morbidity and mortality. 36 patients were seen in clinic from July 2014 to June 2015; the median SPPB score was 5 (IQR 5). The... read more

Physical Rehabilitation in the ICU

Survivors of critical illness frequently experience poor physical outcomes, including persistent impairments in muscle strength, exercise capacity and physical function. In this article, we review these impairments and... 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