Outcomes of Ethics Consultations in Adult ICUs

Our review identified outcome-based assessment as the predominant measure used to report effectiveness of clinical ethics consultation consultations. In particular, clinical ethics consultation decreased ICU length of stay... read more

The Utility of ICU Readmission as a Quality Indicator and the Effect of Selection

Intensive care readmission rates are used to signal quality, yet it is unclear whether they represent poor quality in the transition of care from the ICU to the ward, patient factors, or differences in survival of the initial... read more

Mastering Intensive Care – Making an Excellent Start to an Intensive Care Career

What are the biggest challenges when beginning as a fully-fledged intensive care clinician? How do you best use your senior colleagues when your experience bank is still small? What can you do to help achieve gender equity... read more

The Effect of a Quality Improvement Intervention on Perceived Sleep Quality and Cognition in the ICU

An ICU-wide quality improvement intervention to improve sleep and delirium is feasible and associated with significant improvements in perceived nighttime noise, incidence of delirium/coma, and daily delirium/coma-free status.... read more

Physician Genders and the Likelihood of ICU Admission in Hospital with Restricted ICU Bed Capacity

Despite the evidence that the patient gender is an important component in the intensive care unit (ICU) admission decision, the role of physician gender and the interaction between the two remain unclear. We demonstrated... read more

Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients

ICU admission decisions for critically ill emergency department patients are affected by medical ICU bed availability, though higher emergency department volume and other ICU occupancy did not play a role. Prolonged emergency... read more

Moral distress and its contribution to the development of burnout syndrome among critical care providers

Correlation between moral distress and burnout was assessed among all intensive care unit (ICU) and the step–down unit (SDU) providers (physicians, nurses, nurse technicians and respiratory therapists). Researchers reported... read more

Effect of Nocturnal Sound Reduction on the Incidence of Delirium in ICU Patients

The incidence of delirium in ICU patients was significantly reduced after implementation of a nocturnal sound-reduction protocol. However, reported sleep quality did not improve. A significant difference in slope in the percentage... read more

Antipsychotics for Prevention and Treatment of Delirium

Delirium is a common, complex and costly condition in older adults. Every year, over 7 million hospitalized Americans suffer from delirium. A recent systematic review found that 31% of critical care patients have delirium,... read more

ICU Physiology in 1000 Words: Venous Doppler & Volume Tolerance

With the birth of "fluid responsiveness" physiology, there has been a slow and solemn drumbeat ushering the central venous pressure (CVP) up the squeaking planks of the hemodynamic gallows. Despite this, a few years ago... read more

Bedside Limited Echocardiography by the Emergency Physician Is Accurate During Evaluation of the Critically Ill Patient

Our study suggests that PEP sonographers are capable of obtaining images that permit accurate assessment of LVF and IVC volume. BLEEP can be performed with focused training and oversight by a pediatric cardiologist. We conducted... read more

My ICU Patient Lived. Is That Enough?

As many as one in three patients sick enough to require a ventilator might develop symptoms of post-traumatic stress disorder. Anxiety and depression are equally common, if not more so. Others survive critical illness but... read more

The Washington Manual of Critical Care

Prepared by residents and faculty at the Washington University School of Medicine, this pocket manual contains easy-to-read algorithms for the management of more than 80 medical and surgical problems arising in the intensive... read more

The Washington Manual of Critical Care

Transfers From ICU to Hospital Ward

Little is known about documentation during transitions of patient care between clinical specialties. Therefore, we examined the focus, structure and purpose of physician progress notes for patients transferred from the intensive... read more

Stress Ulcer Prophylaxis in ICU Patients Receiving Enteral Nutrition

Our results suggested that in patients receiving enteral feeding, pharmacologic SUP is not beneficial and combined interventions may even increase the risk of nosocomial pneumonia. We searched PubMed, Embase, and the Cochrane... read more

The Overlooked Danger of Delirium in Hospitals

The condition, once known as "ICU psychosis," disproportionately affects seniors and those who have been heavily sedated—and the delusions can last long after they're discharged. Patients treated in intensive-care units... read more

Do We Need New Trials of Procalcitonin-Guided Antibiotic Therapy?

Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect... read more

Lower ARDS Mortality at High-Volume Intensive Care Units

For patients with acute respiratory distress syndrome (ARDS), mortality is lower in high-volume intensive care units (ICUs), according to a study presented at the annual meeting of the American Thoracic Society. The researchers... read more

AI Can Predict Sepsis to Save Lives

Emory University researchers have created a "Sepsis Expert" algorithm that works in real time to predict the onset of sepsis, the deadly condition that often takes hold in healthcare settings. Banking on information from... read more

Risk Factors for Ventilator-Associated Events in a PICU

There is an association between ventilator-associated condition and infection-related ventilator-associated complication in critically ill children with acute kidney injury, ventilatory support, and neuromuscular blockade.... read more

Early Application of APRV May Reduce the Duration of Mechanical Ventilation in ARDS

Compared with LTV, early application of airway pressure release ventilation (APRV) in patients with ARDS improved oxygenation and respiratory system compliance, decreased Pplat and reduced the duration of both mechanical... read more

Differences in Impact of Definitional Elements on Mortality Precludes International Comparisons of Sepsis Epidemiology

Within a sepsis cohort, we illustrate case-mix heterogeneity using definitional elements (infection source and organ dysfunction). In the context of improving outcomes, we illustrate differential secular trends in impact... read more