Lack of Association of High Backrest With Sacral Tissue Changes in Adults Receiving Mechanical Ventilation

Although higher backrest elevation may be a theoretical risk for integrity of sacral tissues, few data support use of high backrest elevation. Level of backrest elevation is not associated with changes in tissue integrity.... read more

Critical Burn Patients in the ED/ICU

Dr. Djogovic completed training in Emergency Medicine and Critical Care Medicine from 1999-2005, and is currently employed at the University of Alberta Hospital as an Emergency Physician, and as an Intensivist in the General... read more

Noninvasive Ventilation in Patients With 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

Survival and Safety Outcomes of ICU Patients Discharged Directly Home

Recruited discharged directly to home patients experienced very good 8-week postdischarge outcomes with 0% mortality and a low rate of ICU readmission (1%) or ward readmission (4%), but not an insignificant rate of emergency... read more

Too Much SALT on the ICU?

There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients in... read more

Association Between Continuous Hyperosmolar Therapy and Survival in Patients with TBI

Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared... read more

The Life Cycle of Intensive Care Survivors

I started the Intensive care follow-up clinic to try to make sense of my work with critical patients and get feedback from their physical recovery. Over time, I verified that the patients presented not only physical effects,... read more

Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium

The use of the delirium prevention protocol seems to result in improvement of several delirium outcome measures. Prophylactic treatment with low dose haloperidol in critically ill patients with a high risk of delirium likely... read more

Critical Care Pharmacists and Medication Management in an ICU Recovery Center

Many patients experience complications following critical illness; these are now widely referred to as post-intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known... read more

Comparison of Self-Reported and Behavioral Pain Assessment Tools in Critically Ill Patients

Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this... read more

Pressure Injuries and Sedation: Are they related?

Critically ill patients inherently have most of the risk factors for the development of pressure injuries. One of the key factors is immobility, which is very frequent in ICUs. This lack of mobility is enhanced by the administration... read more

The Safety of a Novel Early Mobilization Protocol Conducted by ICU Physicians

There are numerous barriers to early mobilization (EM) in a resource-limited intensive care unit (ICU) without a specialized team or an EM culture, regarding patient stability while critically ill or in the presence of medical... read more

What Role Do Dogs Play in ICUs?

Dr. Megan Hosey PhD speaks about how dogs in the ICU can help lessen patients' pain & make them more hopeful. Getting people out of bed in intensive care units, even when they're being mechanically ventilated, is associated... read more

Are We Using IV Bags Properly?

In the months since Hurricane Maria, my hospital has dealt with an IV bag shortage. It turns out that might not be such a bad thing. Among the collateral damage of Hurricane Maria’s havoc on Puerto Rico is the shutdown... read more

Incidence of NV-HAP in the United States

Because nonventilator hospital-acquired pneumonia (NV-HAP) is understudied, our purpose was to determine the incidence, overall burden, and level of documented pneumonia preventive interventions of NV-HAP in 24 U.S. hospitals.... read more

Finding the Best Strategy to Improve Weaning Outcomes

Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Strategies to improve weaning outcomes... read more

Clinicians’ Perceptions of Rationales for Rehabilitative Exercise in a Critical Care Setting

Rehabilitative exercise for critically ill patients may have many benefits; however, it is unknown what intensive care unit (ICU) clinicians perceive to be important rationale for the implementation of rehabilitative exercise... read more

The hospital of tomorrow in 10 points

Technology has advanced rapidly in recent years and is continuing to do so, with associated changes in multiple areas, including hospital structure and function. Here we describe in 10 points our vision of some of the ways... read more

Decision-making on withholding or withdrawing life-support in the ICU

Many critically ill patients who die will do so after a decision has been made to withhold/withdraw life-sustaining therapy. Our objective was to document the characteristics of intensive care unit (ICU) patients with a decision... read more

Get Ready for a Massive Influx of Untriaged Patients

When a mass casualty incident occurs, emergency physicians are quickly thrust onto the front lines. That is precisely what happened on October 1st at Sunrise Emergency Department in Las Vegas the night Stephen Paddock opened... read more

Comparison of European ICU patients in 2012 (ICON) versus 2002 (SOAP)

Over the 10‑year period between 2002 and 2012, the proportion of patients with sepsis admitted to European ICUs remained relatively stable, but the severity of disease increased. In multilevel analysis, the odds of ICU... read more

Effect of a Multifaceted Performance Feedback Strategy on Length of Stay Compared With Benchmark Reports Alone

In the context of ICUs participating in a national registry, applying a multifaceted activating performance feedback strategy did not lead to better patient outcomes than only receiving periodical registry reports. The extent... read more