Long-Term Mortality and Hospital Resource Use in ICU Patients With Alcohol-Related Liver Disease

ICU patients with alcohol-related liver disease have higher 5-year mortality and emergency readmission rates than ICU patients with other severe comorbidities and matched general ICU patients. These data can contribute to... read more

Antibiotic Treatment of Hospital-acquired Pneumonia

Although more prospective therapy trials of Hospital-acquired Pneumonia (HAP) are needed, based on currently available data, it is possible to use an approach that provides appropriate therapy without the overuse of broad-spectrum... read more

Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery

Among older patients undergoing cardiac surgery, postoperative scheduled IV acetaminophen, combined with IV propofol or dexmedetomidine, reduced in-hospital delirium vs placebo. Additional research, including comparison of... read more

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Among the 401... read more

Implementing Early Mobilization in the ICU

The use of a quality improvement appraisal tool can help identify high quality projects when planning a similar mobility program. Even though projects were conducted in a variety of intensive care unit settings, and implementation... read more

The Clinical Impacts and Risk Factors for Non-central Line-associated Bloodstream Infection in 5046 ICU Patients

Most of the previous studies focused on central line-associated bloodstream infection (CLABSI), while non-central line-associated bloodstream infection (N-CLABSI) was poorly studied. This study was performed to investigate... read more

Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients

This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more

Did I Start the Opioid Epidemic?

Prescription opioid abuse is at epidemic levels. Opioids diverted from friends and family members who have legitimate prescriptions are a major source of abused prescription opioids. Nurses are vital to any effort to combat... read more

Design and Implementation of a Pediatric ICU Acuity Scoring Tool as Clinical Decision Support

Pediatric in-hospital cardiac arrest most commonly occurs in the pediatric intensive care unit (PICU) and is frequently preceded by early warning signs of clinical deterioration. In this study, we describe the implementation... read more

Antibiotic timing in Severe Sepsis

Severe sepsis is a time dependent condition and this study builds on previous literature which supports that early identification and treatment of sepsis with antibiotics decreases mortality. Retrospective analysis of a large... read more

Fever Control in Critically Ill Adults

One potential way to protect patients from the physiological demands that are a consequence of fever is to aim to prevent fever and to treat it assiduously when it occurs. Our findings do not support the hypothesis that more... read more

Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics

Guest Editor Dane Nichols, MD, has assembled a panel of experts focusing on Hemodynamic Support in Septic Shock. Topics include: Oxygen Delivery and Consumption: A Macro-Circulatory Perspective; Mean Arterial Pressure: Therapeutic... read more

Optimizing Hemodynamic Support in Severe Sepsis and Septic Shock, An Issue of Critical Care Clinics

ICU Utilization for Patients With Acute Exacerbation of COPD Receiving Noninvasive Ventilation

There is wide variability in the rate of ICU utilization for noninvasive ventilation across hospitals. Chronic obstructive pulmonary disease (COPD) patients receiving noninvasive ventilation had similar in-hospital mortality... read more

Why Do Bleeding Trauma Patients Die?

It is important that we recognize that we have seen a reduction in the number of deaths from trauma. That's a great thing of course, but we should not be complacent. It's also worth looking at where and how patients die.... read more

Neuro ICU Nurse Tips for Newbies

This episode discusses a few diseases processes that are typically seen by the neuro ICU nurse as well as a neuro floor. We chat about subdural hematomas, epidural hematomas, seizures, brain tumors, and diffuse axonal injury.... read more

DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require time-consuming, error-prone calculations using static variable thresholds. These methods do not... read more

Prehospital Intravenous Fentanyl Administered by Ambulance Personnel

Prehospital acute pain is a frequent symptom that is often inadequately managed. The concerns of opioid induced side effects are well-founded. To ensure patient safety, ambulance personnel are therefore provided with treatment... read more

Reducing Catheter-associated Urinary Tract Infections in the ICU

Patients in the ICU are at higher risk for catheter-associated urinary tract infection (CAUTI) due to more frequent use of catheters and lower threshold for obtaining urine cultures. This review provides a summary of CAUTI... read more

ICU May Be Overused for Some COPD, Acute MI, HF Patients

For patients with COPD, heart failure and myocardial infarction, who are not critically ill, a stay in the ICU may be no more beneficial than staying on a ward, according to an analysis just published in the Annals of the... read more

The effects of performance status one week before hospital admission on the outcomes of critically ill patients

PS impairment was associated with worse outcomes independently of other markers of chronic health status, particularly for patients in the medium range of severity of illness. PS impairment was moderate in 17.3 % and severe... read more

Hypertriglyceridemic pancreatitis: Can we defuse the bomb?

Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more

Ultrasound-guided Pleural Effusion Drainage With a Small Catheter Using the Single-step Trocar or Modified Seldinger Technique

Ultrasound-guided pleural effusion drainage by catheter insertion is a safe and effective procedure. The success rate is low when the effusion is loculated and septated. Both the trocar and the modified Seldinger techniques... read more