Tag: ICU
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
Critical Care Study Guide: Text and Review
Critical care medicine is a dynamic and exciting arena where complex pathophysiologic states require extensive knowledge and up-to-date clinical information. An extensive knowledge of basic pathophysiology, as well as awareness... read more
Impact of Weekly Case-based Tele-education on Quality of Care in a Limited Resource Medical ICU
Limited critical care subspecialty training and experience is available in many low- and middle-income countries, creating barriers to the delivery of evidence-based critical care. We hypothesized that a structured tele-education... read more
Artificial Liver Support in Acute and Acute-on-Chronic Liver Failure
Liver support systems such as MARS and TPE may temporarily improve systemic hemodynamics and the degree of encephalopathy. However, TPE is the only procedure that improves survival in patients with ALF. The role of TPE in... read more
It Is Important to Talk About Death
Changes to the rules on organ donation will "reframe" the way people talk about death, a top critical care doctor said today. Dr Matt Morgan said the introduction of "deemed consent" in Wales almost four years ago – a similar... read more
A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients
Hemodynamic therapy aimed at achieving supranormal values for the cardiac index or normal values for mixed venous oxygen saturation does not reduce morbidity or mortality among critically ill patients. A total of 10,726 patients... read more
Association of Age With Short-term and Long-term Mortality Among Patients Discharged From ICUs in France
Results of this study suggest that aging was associated with an increased risk of mortality in the 3 years after hospital discharge that included an ICU admission, with a sharp increase in those 80 years and older. However,... read more
The Rise of the Healthcare Administrator
Here's some food for thought: The number of physicians in the United States grew 150 percent between 1975 and 2010, roughly in keeping with population growth, while the number of healthcare administrators increased 3,200... read more
Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in ICU Patients Without ARDS
In patients in the Intensive Care Unit (ICU) without acute respiratory distress syndrome (ARDS) who were expected not to be extubated within 24 hours of randomization, a low tidal volume strategy did not result in a greater... read more
