Tag: ICU
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals
The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more
Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?
In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx... read more
The Impact of Frailty on ICU Outcomes
Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information... read more
Antipsychotic Prescribing Patterns During and After Critical Illness
In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly... read more
Differences in attitudes towards end-of-life care among intensivists, oncologists and prosecutors in Brazil
There is great variability in end-of-life care and the legal context may interfere with decisions on limitation of medical treatment. In Brazil, end-of-life care was initially regulated in 2006, but legal controversies still... read more
The Precogs Take On Sepsis
It seems like every week there’s another publicized instance of our impending replacement by artificial intelligence. Big Data, they say, is going to free us of the cognitive burdens of complex thought while maximizing... read more
The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients
Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism.... read more
Feasibility and observed safety of interactive video games for physical rehabilitation in the ICU
Novel use of interactive video games as part of routine PT in critically ill patients is feasible and appears safe in our case series. Video game therapy may complement existing rehabilitation techniques for ICU patients.... read more
Nurse intuition may play a role in critical-care outcomes
Nurse intuition doesn't sound scientific, but it could play a key role in critical-care outcomes, according to a small study published in DovePress. The researchers conducted a descriptive phenomenological study, interviewing... read more
Alfred ICU Intubation Checklist
Here is the Alfred ICU intubation checklist. We invite you to take it and adopt it whole, or, even better, to modify it to your own department's needs. We have spent considerable time and thought developing it, as well as... read more
PPIs do not increase risk for C. difficile infection in ICU
Proton pump inhibitors are not associated with an increased risk for Clostridium difficile infection in ICU patients, according to the results of a retrospective cohort study. PPI use was not associated with a significant... read more
Comparison of Two Lidocaine Administration Techniques on Perceived Pain From Bedside Procedures
Bedside procedures are exceedingly common. Data regarding the severity of procedural pain and strategies to mitigate it are important for the informed consent process and patient satisfaction. Overall, pain reported from... read more
Does Lactate Clearance Prognosticates Outcomes in ECMO Therapy
Changes in lactate levels after ECMO implantation is an important tool to assess effective circulatory support and it is found superior to single lactate measurements as a prognostic sign of mortality in our study. Based... read more
Never Underestimate the Simple Things We Do To Our Patients
In this compelling episode, Professor Paul Wischmeyer, shares some of his experiences as a patient in the ICU. Since he was 15 he has endured multiple hospitalizations and ICU stays for his inflammatory bowel disease. This... read more
Imaging platform captures hard-to-track bacterial lung infections in real time
Ahsan Akram and colleagues have created a fluorescent imaging probe that can quickly and accurately detect hard-to-trace Gram-negative bacteria (one of the major bacterial groups) in human lungs within minutes. Their first-in-human... read more
Proton-Pump Inhibitor Prophylaxis in the ICU
Critical illness can disrupt local and systemic mechanisms that protect against upper gastrointestinal bleeding, a condition that may be associated with increased mortality, particularly among patients receiving extracorporeal... read more
Chasing Mortality Endpoints is a Fool’s Errand
"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more
Dopamine Antagonists in ICU Delirium
Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia
Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more
Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients
In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality,... read more
Decontamination of Oral or Digestive Tract for Patients in the ICU
The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more
