Tag: ICU

Auditory Icon Alarms Are More Accurately and Quickly Identified than Current Standard Melodic Alarms in a Simulated Clinical Setting

Under our simulated conditions, anesthesia providers more correctly and quickly identified icon alarms than standard alarms. Subjects were more likely to perceive higher fatigue and task load when using current standard alarms... read more

A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest

In adults with out-of-hospital cardiac arrest, the use of epinephrine resulted in a significantly higher rate of 30-day survival than the use of placebo, but there was no significant between-group difference in the rate of... read more

Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis

Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular... read more

Over Half Of Patients And Families Hesitate To Raise ICU Safety Concerns

Imagine you're in the intensive care unit at the bedside of your loved one, and you think you see a medical mistake — a wrong pill, an unwashed hand. Do you speak up? Even if you're afraid that might annoy or alienate the... read more

Hemophagocytic Lymphohistiocytosis: Potentially Underdiagnosed in ICUs

Overall, 7 out of 9 patients (77.8%) suffering from aHLH remained undiagnosed. Awareness of this life-threatening syndrome, especially in ICUs, should be raised. The inclusion of ferritin into the admission lab panel for... read more

Barriers to implementing expert safety recommendations for early mobilization in ICU during mechanical ventilation

Early mobilization in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilized. An expert... read more

Noninvasive Ventilation in Patients With ARF and Do-Not-Intubate and Comfort-Measures-Only Orders

A large proportion of patients with do-not-intubate orders who received noninvasive ventilation survived to hospital discharge and at 1 year, with limited data showing no decrease in quality of life in survivors. Provision... read more

Dysphagia – A Common, Transient Symptom in Critical Illness Polyneuropathy

Dysphagia is frequent among patients with critical illness polyneuropathy treated in the ICU. Old age, chronic obstructive pulmonary disease, the mode of mechanical ventilation, the prevalence of tracheal tubes, and behavioral... read more

Why is trauma activation so expensive?

I can understand hospitals charging a fee for trauma activations to help recover some of the costs of having a trauma service. The staff may require some special training. Managing the service, collecting data, and other... read more

Trach Travails: Need-to-Know ED Tricks for Airway Emergencies in Tracheostomy Patients

The outside hospital emergency physician passed a bougie through the patient’s existing metal trach and exchanged the metal trach for a 6-0 endotracheal tube. After the exchange, the ETT cuff was inflated, and the patient... read more

ICU ventilators overused among advanced-dementia patients

Mechanical ventilation may be lifesaving, but in certain patient cases it may prolong suffering without a clear benefit. JAMA Internal Medicine published a study of 635,008 hospitalizations of nursing-home patients with advanced... read more

Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric ARDS Mortality

Patients with PARDS managed with lower PEEP relative to FiO2 than recommended by the ARDSNet model had higher mortality. Clinical trials targeting PEEP management in PARDS are needed. This was a multicenter, retrospective... read more

Sodium Bicarbonate Therapy for Patients with Severe Metabolic Acidaemia in the ICU

In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined... read more

Modes of Mechanical Ventilation Vary Between Hospitals and ICUs within a University Healthcare System

As evidence-based guidance to aid clinicians with mechanical ventilation mode selection is scant, we sought to characterize the epidemiology thereof within a university healthcare system and hypothesized that nonconforming... read more

Flexible Versus Restrictive Visiting Policies in ICUs

Flexible ICU visiting hours have the potential to reduce delirium and anxiety symptoms among patients and to improve family members' satisfaction. However, they may be associated with an increased risk of burnout among ICU... read more

Hospitalists Are the New Intensivists

Intensivists may get all the credit, but over 37,000 hospitalists provide much of the care for ICU patients in the U.S. According to a recent survey, they often do it without the presence or availability of intensivists for... read more

Increasing the Number of Medical Emergency Calls Does Not Improve Hospital Mortality

With adjustment for patient factors, illness, and comorbidities, increased emergency calling rates were not associated with reduced in-hospital mortality. Efforts to increase calling rates do not seem warranted. We studied... read more

Health-related Outcomes of Critically Ill Patients With and Without Sepsis

Critically ill patients with sepsis have higher healthcare resource use and costs but similar survival and HRQoL compared to matched patients without sepsis. We conducted a primary propensity score matched analysis of patients... read more

Treatment of Acute Non-Anion Gap Metabolic Acidosis

Acute non-anion gap metabolic acidosis is now recognized to be as a common cause of metabolic acidosis, particularly in the ICU. Further examination of its impact on cellular function and clinical outcome are needed. Most... read more

Evaluation of a strategy for enrolling the families of critically ill patients in research using limited human resources

Family members were recruited for more than one third of eligible patients, and >90% of approached consented to participate. There are important demographic differences between patients with vs without an enrolled family... read more

Collective Quality Improvement in the Pediatric Cardiology Acute Care Unit

Collaborative quality improvement and learning networks have amended healthcare quality and value across specialities. Motivated by these successes, the Pediatric Acute Care Cardiology Collaborative (PAC3) was founded in... read more

Survival outcomes after prolonged ICU length of stay among trauma patients: The evidence for never giving up

Prolonged intensive care unit length of stay (ICU-LOS) is associated with high mortality for medical and surgical patients. Existing literature suggests that this may not be true for trauma patients.The results reveal that... read more