Tag: ICU
Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses
Guideline development requires the synthesis of evidence on several treatments of interest, typically by using network meta-analysis (NMA). Because treatment effects may be estimated imprecisely or be based on evidence lacking... read more
Dysphagia in the ICU: Epidemiology, Mechanisms, and Clinical Management
In the light of the fact that the clinical consequences of ICU-acquired dysphagia (e.g., aspiration-induced pneumonitis/pneumonia) can often be observed on ICUs, more data on underlying mechanisms and/or risk factors seems... read more
Thromboelastography Predicts Thromboembolism in Critically Ill Coagulopathic Patients
Critically ill patients with deranged conventional coagulation tests are often perceived to have an increased bleeding risk. Whether anticoagulant prophylaxis for these patients should be withheld is contentious. This study... read more
Letting the Patient Decide: A Case Report of Self-Administered Sedation During Mechanical Ventilation
It is common for critical care nurses to administer sedative medications to patients receiving mechanical ventilation. Although patient-controlled analgesia is frequently used in practice to promote effective self-management... read more
Tele-ICU Leads to Overall Reduction in ICU Mortality
A new systematic review and meta-analysis has found that implementation of tele-ICU services was associated with an overall reduction in ICU mortality. Furthermore, in subgroup analysis, the pooled odds ratio for ICU mortality... read more
Increased Hospital-Based Physical Rehabilitation and Information Provision After ICU Discharge
Post-ICU hospital-based rehabilitation, including increased physical and nutritional therapy plus information provision, did not improve physical recovery or HRQOL, but improved patient satisfaction with many aspects of recovery.... read more
Extravascular Lung Water as a Target for Intensive Care
Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary edema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and heart failure. In addition, EVLW has a prognostic... read more
Critical Care Pearls: Basics for Critical Patient Care and Board Review
Critical Care Pearls for medical professionals involved in taking care of critically ill patients. An excellent resource for board review written by Dr. Iqbal Ratnani and Dr. Salim Surani. Dr. Iqbal Ratnani, MD, FCCP, FCCM... read more
A Non-Antibiotic Approach for Treating or Preventing Sepsis
Researchers at the Royal College of Surgeons in Ireland (RCSI) have tested a compound called cilengitide in a preclinical trial. The drug goes by the brand name InnovoSep. Researchers discover the drug has the potential to... read more
Hospital-acquired Infections – Adding Process Metrics
So far, we've only been looking at metrics that are really big and important. This is certainly a good place to start. To move beyond this, I'd like to introduce the concept of Outcome vs Process Metrics. Outcome Metrics... read more
Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation
In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more
ICU Survivors Have a Substantial Higher Risk of Developing New Chronic Conditions Compared to a Population-Based Control Group
ICU patients have more chronic conditions during the year before ICU admission compared with a population-based control group and a five times higher odds on developing one or more new chronic conditions compared with the... read more
Telemedicine Reduces ICU Mortality Rate at Valley Health
During the first year of tele-ICU at Valley Health, the technology helped save 125 lives, achieve a 35 to 44 percent reduction in ICU mortality rate, reduce ICU length of stay by 34 percent, reduce the sepsis mortality rate,... read more
Psychology Consultation Patterns in a Medical ICU
Intensive care unit (ICU) survivors frequently experience long-lasting mental health, cognitive, and physiologic challenges. Psychologists have a role in providing interventions to reduce patient distress during critical... read more
Intrathoracic Pressure Regulation Therapy Applied to Ventilated Patients for Treatment of Compromised Cerebral Perfusion from Brain Injury
These data support the notion that active intrathoracic pressure regulation, in this limited evaluation, can successfully augment cerebral perfusion by lowering intracranial pressure and increasing mean arterial pressure... read more
Association of ICU Delirium with Sleep Disturbance and Functional Disability After Critical Illness
After adjusting for important covariates, total days of MICU delirium were significantly associated with increased post-discharge sleep disturbance. Delirium incidence showed a trend toward association with increased functional... read more
Mobilization is Feasible in Intensive Care Patients Receiving Vasoactive Therapy
In our ICU, patients mobilized on approximately one-third of vasoactive days. Clinicians should anticipate a higher risk of hypotension during mobilization in patients receiving vasoactive therapy, which may require transient... read more
Identifying Barriers to Nurse-Facilitated Patient Mobility in the ICU
Nurses have limited time for additional clinical activities but may miss potentially important opportunities for facilitating patient mobility during existing patient care. The proposed method is feasible and helpful in empirically... read more
Physician-Level Variation in Outcomes of Mechanically Ventilated Patients
Physicians are increasingly being held accountable for patient outcomes. Yet their specific contribution to the outcomes remains uncertain. Intensivists independently contribute to outcomes of Medicare patients who undergo... read more
Age- and Gender-related Peculiarities of Patients with Delirium in the Cardiac ICU
Our investigation presented a number of associated peculiarities related to gender and age. It was shown that delirium is a severe complication that more often affects men amongst patients < 65 years old and more frequently... read more
How Should We Relate to Unreasonable Families in the ICU?
Most families have never suffered through a loved one experiencing prolonged critical illness and respiratory failure (defined as ventilator dependence for weeks, usually with a tracheostomy). But each year, more do. An estimated... read more
The CAM-ICU-7 Delirium Severity Scale: A Novel Delirium Severity Instrument for Use in the ICU
The CAM-ICU-7 delirium severity scale is a valid, reliable, and practical delirium severity measure among ICU patients that can be easily calculated and is associated with meaningful clinical outcomes. This practical tool... read more
