Tag: ICU

Peer Support in Critical Care

Peer support appeared to reduce psychologic morbidity and increase social support. The evidence for peer support in critically ill populations is limited. There is a need for well-designed and rigorously reported research... read more

The Impact of Enhanced Critical Care Training and 24/7 (Tele‐ICU) Support on Medicare Spending and Postdischarge Utilization Patterns

Innovations in workforce training and technology specific to the ICU may be useful in addressing the shortage of intensivist physicians, yielding benefits to patients and payers. Implementation of the advanced practice provider... read more

The Value of 24/7 In-House ICU Staffing 24/7 Intensivist in the ICU

Staffing of high-volume, high-intensity ICUs with 24 × 7 intensivist coverage facilitates the system changes, which allow ICU teams to provide 24 × 7 critical care.... read more

Beyond Bleeps and Alarms: Live Music by the Bedside in the ICU

Live music by the bedside is an additional, simple and inexpensive factor in the open ICU, aiming at reducing the incidence of delirium and transform the critical care setting into a more familiar and domestic environment.... read more

Acute Skeletal Muscle Wasting in Critical Illness

Among these critically ill patients, muscle wasting occurred early and rapidly during the first week of critical illness and was more severe among those with multiorgan failure compared with single organ failure. These findings... read more

Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features

Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil. The main objective is to evaluate the incidence and risk factors of pressure ulcers (PU) in adult... read more

Antibiotic Decisions in the ICU: A Dragon’s Tale

Medical decision-making about antibiotic use in critically ill patients is challenging and complex. The need for antibiotic stewardship requires judicious prescription and choice of antimicrobials, as the need for effective... read more

Practice Change From Intermittent Medication Boluses to Bolusing From a Continuous Infusion in Pediatric Critical Care

Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without... read more

Nine Reasons to Quit Using Normal Saline for Resuscitation

Saline vs. balanced solutions has been a topic of ongoing debate. Two fresh studies will illuminate this: the SMART and SALT-ED trials. This post summarizes current knowledge, beginning with physiology and working our way... read more

The Practice of Respect in the ICU

Although "respect" and "dignity" are intuitive concepts, little formal work has addressed their systematic application in the ICU setting. After convening a multidisciplinary group of relevant experts, we undertook a review... read more

Current efforts to fight sepsis aren’t working. We need a bolder approach

Thanks to antibiotics, vaccinations, and public health advances like modern sanitation, it's easy to think that Americans live largely free of the infectious diseases that once took such a toll. That’s partially right:... read more

The Fluid Debate: Balanced or Unbalanced

Consider using balanced fluids in your ED unless you are treating a patient at risk for cerebral edema, or a patient with a chloride responsive metabolic alkalosis, e.g. from gastric losses. Although the superiority of balanced... read more

Effects of Chlorhexidine Gluconate Oral Care on Hospital Mortality

Chlorhexidine oral care is widely used in critically and non-critically ill hospitalized patients to maintain oral health. We investigated the effect of chlorhexidine oral care on mortality in a general hospitalized population.... read more

The Relationship Between ICU Hypotension and In-hospital Mortality and Morbidity in Septic Patients

Current guidelines recommend maintaining a mean arterial pressure (MAP)≥ 65 mmHg in septic patients. However, the relationship between hypotension and major complications in septic patients remains unclear. We, therefore,... read more

Evaluating the Cost-Effectiveness of Proportional-Assist Ventilation Plus vs. Pressure Support Ventilation in the ICU in Two Countries

The published reductions in asynchrony and length of stay in the ICU with proportional assist ventilation (PAV ventilation by Medtronic) led to shorter time on ventilation, and reduced incidence of ventilator-associated pneumonia... read more

The Contemporary Timing of Trauma Deaths

In this study, the distribution of trauma deaths no longer appears to be trimodal. This may reflect advances in trauma and ICU care, and the widespread adaption of damage control principles. Early deaths, however, remains... read more

The Role of Speech and Language Therapy in Critical Care

The role of speech and language therapists (SLTs) in critical care can be unclear so this article sets out the scope of practice to increase awareness of the value of SLTs as part of the wider multidisciplinary team. Speech... read more

Measuring and Monitoring Lean Body Mass in Critical Illness

Methods to monitor lean body mass in the ICU are under constant development, improving upon bedside usability and offering new modalities to measure. This provides clinicians with valuable markers with which to identify patients... read more

Strategies for Intravenous Fluid Resuscitation in Trauma Patients

Fluids are drugs and should be managed as such. Appropriate early fluid resuscitation in trauma patients is a challenging task. Care should be taken in selecting both the type and volume to promote appropriate perfusion and... read more

Reducing diagnostic errors in the ICU

Diagnostic error occurs in 5-20 percent of physician-patient encounters, with a comparable prevalence among ICU admissions and patients who die in the intensive care unit (ICU). Further, diagnostic errors comprise 9-12 percent... read more

Abnormal Saline and the History of Intravenous Fluids

Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more

Early Interventions for the Prevention of Posttraumatic Stress Symptoms in Survivors of Critical Illness

Despite a paucity of high-quality clinical investigations, the preponderance of evidence to date suggests that 1) posttraumatic stress disorder among survivors of critical illness may be preventable and 2) early interventions... read more