Tag: ICU
Monitoring ICU Performance-impact of a Novel Individualised Performance Scorecard in Critical Care Medicine
Patients admitted to a critical care medicine (CCM) environment, including an intensive care unit (ICU), are susceptible to harm and significant resource utilisation. Therefore, a strategy to optimise provider performance... read more
Enteral vs Parenteral Nutrition in Critical Care Requiring Mechanical Ventilation
Enteral feeding was not superior to parenteral feeding for early nutritional support in critically ill patients receiving mechanical ventilation and vasopressor support for shock, according to the results of a study published... read more
Prospective Evaluation of a Multifaceted Intervention to Improve Outcomes in Intensive Care
Studies comprehensively assessing interventions to improve team communication and to engage patients and care partners in ICUs are lacking. This study examines the effectiveness of a patient-centered care and engagement program... read more
Factors Associated with Life-Sustaining Treatment Restriction in the ICU
Few previous studies have investigated associations between clinical variables available after 24 hours in the ICU and decisions to restrict life-sustaining treatment. The aim of this study was to identify factors associated... read more
The ADRENAL Trial: Steroids in Septic Shock
Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular looked at lower dose hydrocortisone (200mg/day)... read more
Enabling Machine Learning in Critical Care
Critical care units are home to some of the most sophisticated patient technology within hospitals. In parallel, the field of machine learning is advancing rapidly and increasingly touching our lives. To facilitate the adoption... read more
Barriers and Facilitators to Early Rehabilitation in Mechanically Ventilated Patients
Using a theoretically driven approach, this study identified important barriers and facilitators to early rehabilitation in ICU patients. In particular, the domains of social influences and behavioral regulation were not... read more
Defining Sepsis on the Wards: Comparing Two Sepsis Definitions
Sepsis is defined as a dysregulated host response to infection, resulting in acute organ dysfunction. Although the condition has been thoroughly studied in the intensive care unit (ICU), accurate data collection outside of... read more
How Patient Stories Can Improve Intensive Care
Opportunities to share stories about care, in settings away from the hospital, serve to bridge the gap between the experiences of patients and those of doctors and nurses. The 21st century re-orientation of health care towards... read more
Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults
This individually titrated supplemental PN strategy applied over 7 days significantly increased energy delivery when compared to usual care delivery. Clinical and functional outcomes were similar between the two patient groups.... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients
In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more
An attenuated rate of leg muscle protein depletion and leg free amino acid efflux over time is seen in ICU long-stayers
In critically ill patients with sustained organ failure and in need of a prolonged ICU stay, the initial high rate of skeletal muscle protein depletion was attenuated over time. The distinction between the acute phase and... read more
Evaluation of early administration of simvastatin in the prevention and treatment of delirium in critically ill patients undergoing mechanical ventilation
Delirium in critically ill patients is associated with poor clinical outcomes. Neuroinflammation might be an important mechanism in the pathogenesis of delirium, and since simvastatin has anti-inflammatory properties it might... read more
Dexmedetomidine Prevents AKI After Adult Cardiac Surgery
Perioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery may reduce the incidence of postoperative AKI. Future trials are needed to determine the dose and timing of dexmedetomidine in improving... read more
What Is PICS and How Does it Affect Patients and Families
Every year, about 6 million people are admitted to intensive care units with a life-threatening illness. As medical technology advances, more people survive conditions that once would have been fatal. However, about half... read more
Pressure on NHS Intensive Care at Highest Level Since 2010 Swine Flu Pandemic
Pressures in intensive care units are at their highest level since the 2010 swine flu pandemic,with wards regularly having no spare beds, senior doctors have warned. Figures reported by the NHS this winter show that two-thirds... read more
The Case of the Relative Insufficiency
When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more
Adjunctive Glucocorticoid Therapy in Patients with Septic Shock
Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. We randomly assigned patients with septic shock who were undergoing... read more
Should We Manage All Septic Patients Based on a Single Definition?
It is indisputable from the biological and clinical perspectives that not all cases of sepsis are the same. On the contrary, most have great many differences, that is, different portals of entry, clinical manifestations,... read more
ECMO for Severe Middle East Respiratory Syndrome Coronavirus
Extracorporeal membrane oxygenation (ECMO) use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue... read more
Train Of Four Monitoring
A peripheral nerve stimulator, also called the "train of four", is used to assess nerve function in patients receiving neuromuscular blocking agents (AKA paralytic medications). It is commonly seen used in critical care... read more
