Tag: ICU
Procalcitonin-Guided Antimicrobial Therapy in Critical Care
Procalcitonin guidance for antibiotic cessation improves short-term mortality in ICU patients. Previous meta-analyses showed that procalcitonin-guided antimicrobial management, compared with standard care, resulted in less... read more
The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection
Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more
Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults
Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill... read more
Sepsis: Personalization vs. Protocolization?
The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
Essentials of Neuroanesthesia and Neurointensive Care
This updated second edition of Gupta and Gelb's Essentials of Neuroanesthesia and Neurointensive Care contains the ideal combination of updated information for the practitioner, presented in easy-to-digest short chapters.... read more
Pharmacotherapy in Neurointensive Care
Neurointensive care medicine has experienced great advancements and developments of neuromonitoring techniques, allowing a better comprehension of acute brain injury early phase pathological mechanisms and an overall improvement... read more
Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years
The addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world... read more
Gut Dysmotility in the ICU
Off-label metoclopramide and/or erythromycin administration are effective for upper gastrointestinal dysmotility but have adverse effects. Trials of alternative or novel promotility drugs have not demonstrated superiority... read more
How and Whom to Monitor for Seizures in an ICU
Prevalence of seizures detected by continuous electroencephalography was significantly higher than with routine electroencephalography. Prevalence was particularly high in post convulsive status epilepticus, CNS infection,... read more
I am a male nurse – so what?
For Brett Adamson, becoming a nurse was a gateway into helping the world’s most disadvantaged people. In 2005 Brett began working for the medical humanitarian aid organisation, Médecins Sans Frontières. That year was... read more
The Glutamine Debate in Surgery and Critical Care
Three recent meta-analyses have confirmed traditional glutamine (GLN)-supplemented (or "GLN-Complemented" – providing GLN for completeness of amino acid content) TPN is safe, reduces mortality and improves outcome in surgical... read more
Prevalence and outcome of heparin-induced thrombocytopenia diagnosed under veno-arterial extracorporeal membrane oxygenation
Prevalence of HIT among patients under VA‑ECMO is extremely low at 0.36% with an associated mortality rate of 33.3%, which appears to be in the same range as that observed in patients treated with VA‑ECMO without HIT.... read more
Defining Sepsis on the Wards
The aim of this study is to look at the prevalence (commonness) of sepsis across acute hospitals (hospitals with an emergency department) across Wales using the currently used and new definitions of sepsis. Sepsis is a major... read more
Psychological and Cognitive Impact of Critical Illness
Hot off the presses. Concise book on PICS, PICS-F and FICUS. Neuropsychiatric problems after critical illness are receiving increasing attention, particularly in the critical care medicine literature, but mental health and... read more
Impact of Hypophosphatemia on Outcome of Patients in ICU
Hypophosphatemia at admission is an independent risk factor for 28-day mortality in general ICU patients. The cohort included 946 patients with a median phosphate concentration of 0.77 mmol/L. Patients with hypophosphatemia... read more
Hypernatremia & Dehydration in the ICU
Hypernatremia is very common in the ICU. It often develops during ICU admission due to inadequate free water administration. Hypernatremia is not benign, it causes profound thirst, particularly among intubated patients, this... read more
Who May Benefit Most From Future Vitamin D Intervention Trials
High-dose vitamin D3 supplementation was associated with a reduction of 28-day mortality in a mixed population of critically ill adults with vitamin D deficiency when excluding patients who died or were discharged within... read more
Validation and Critical Evaluation of the Effective Arterial Elastance in Critically Ill Patients
In critically ill patients, effective arterial elastance may be reliably estimated at bedside. We support the use of this validated estimate of effective arterial elastance when coupled with an index of left ventricular contractility... read more
Acute Kidney Injury in Cirrhosis
Novel biomarkers may assist in identification of acute tubular necrosis and persistent/severe acute kidney injury (AKI). Norepinephrine has been suggested to be inferior to terlipressin, with additional research required.... read more
What influences critical care doctors in withdrawing life support for patients with brain injury?
Decisions to withdraw life support treatments in critically ill patients with severe brain injury are complicated, are based on many factors, and are usually made by critical care physicians and families in the intensive... read more
Withholding or Withdrawing of Life-sustaining Therapy in Older Adults Admitted to the ICU
The most important patient variables associated with the instigation of Life-sustaining Therapy (LST) limitation were acute admission, frailty, age, admission SOFA score and country. LST limitation was identified in 1356/5021... read more
