Tag: ICU
Does Head of Bed Elevation During Intubation Improve Patient Oriented Outcomes?
To date the study that has shown the biggest benefit to HOB elevation is the 2016 study performed by Khandelwal and colleagues in a teaching hospital system in Seattle, WA. 528 patients managed by anesthesiologists... read more
Reduced Level of Arousal on Hospital Admission
Reduced level of arousal on hospital admission may be a strong predictor of in-hospital mortality. Most evidence was of low quality. Reduced level of arousal is highly specific to delirium, better formal detection of hypoactive... read more
Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients
In this updated systematic review, we were able to refute a relative change of 20% of mortality. The occurrence of GI bleeding was reduced, but we lack firm evidence for a reduction in clinically important GI bleeding. The... read more
Core Outcome Measures for Critical Care Ventilation Trials
The main objective for this study was to obtain international consensus on a set of core outcome measures that should be recorded in all clinical trials of interventions intended to modify the duration of ventilation for... read more
TPTD Techniques in the Hemodynamically Unstable Patient
Transpulmonary thermodilution (TPTD) devices invasively measure not only cardiac output but also several other hemodynamic variables estimating cardiac preload, cardiac preload, systolic function, the lung oedema and systolic... read more
Risk Factors for Avoidable Transfer to a Pediatric Trauma Center Among Patients Age Two Years and Older
Among injured children age two years and older, those with minor head injuries were at greatest risk for avoidable transfer. Many were transferred because of a perceived need for evaluation by a pediatric neurosurgeon. Future... read more
Worse outcomes with video laryngoscopy in ICU
When used in intensive care units, video laryngoscopy did not improve the chances of successful intubation on the first try, compared with direct laryngoscopy, and was associated with a significantly higher risk of severe... read more
Terlipressin for Septic Shock Patients
Catecholamines are commonly used in septic shock but face limitations of their hypo-responsiveness and adverse events due to high dose. Terlipressin is a synthetic vasopressin analog with greater selectivity for the V1-receptor.... read more
Age and Decisions to Limit Life Support for Patients with ALI
The purpose of this study was to estimate the association between patient age and the rate of new limitations in the use of life support, independent of daily organ dysfunction status, following acute lung injury (ALI) onset. 490... read more
Emergency Department Hyperoxia Associated with Increased Mortality in Mechanically Ventilated Patients
Emergency Department exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation... read more
Moving Vulnerable Patients Around Hospital Can Increase Infections
Researchers at Overlook Medical Center released a report stating that transporting patients increases the risk of hospital-acquired infections. The study focused on ICU patients being treated for strokes, aneurysm ruptures... read more
qSOFA Performance Score as Prognostic Tool in Infected Patients Outside the ICU
A positive qSOFA score had high specificity outside the ICU in early detection of in-hospital mortality, acute organ dysfunction, and ICU admission, but low sensitivity may have limitations as a predictive tool for adverse... read more
Ideas for Future Intensive Care
Progress toward determining the true worth of ongoing practices or value of recent innovations can be glacially slow when we insist on following the conventional stepwise scientific pathway. Moreover, a widely accepted but... read more
Detection of Brain Activation in Unresponsive Patients with Acute Brain Injury
A dissociation between the absence of behavioral responses to motor commands and the evidence of brain activation in response to these commands in EEG recordings was found in 15% of patients in a consecutive series of patients... read more
Effect of an ICU Diary on PTSD Symptoms Among Patients Receiving Mechanical Ventilation
Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms. Among 657 patients who were randomized completed the trial. At 3 months, significant... read more
Sedatives in Neurocritical Care
Extrapolating the findings from studies in the general ICU population suggests to reserve deep continuous sedation in the neuro-ICU for specific indications. Although an improved understanding of cerebral physiological changes... read more
Peripherally Inserted Central Catheters in the ICU
A retrospective study of adult medical patients in 52 hospitals. 27,289 patients with peripherally inserted central catheters placed during hospitalization. Peripherally inserted central catheter use in the ICU is highly... read more
Acute Kidney Injury in Postoperative Shock
Is hyperoncotic albumin administration an unrecognized resuscitation risk factor? The use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for... read more
ICU Patients May Understand Verbal Commands After Acute Brain Injury
A New England Journal of Medicine study shows 1 in 6 clinically unresponsive ICU patients show electroencephalography (EEG) patterns of brain activity when spoken to soon after acute brain injury. A dissociation between the... read more
Factors Nurses in the ICU Consider When Making Decisions About Patient Mobility
Nurses are often responsible for mobilizing patients, but how they overcome barriers and make decisions to mobilize patients in the intensive care unit (ICU) is not understood. Deciding to mobilize patients in the ICU... read more
Early Mobilization on CRRT is Safe and May Improve Filter Life
Despite studies demonstrating benefit, patients with femoral vascular catheters placed for continuous renal replacement therapy (CRRT) are frequently restricted from mobilization. No researchers have reported filter pressures... read more
A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU
Over the last decades, the incidence of healthcare-associated infections (HAI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) involved in poor outcomes has dramatically increased worldwide.... read more
