Tag: ICU

Prediction of Survival and Functional Outcomes After ICU Admission

This study assesses the 6-month discriminative accuracy of patient mortality and functional outcome predictions made by intensive care unit (ICU) physicians and nurses at the time of ICU admission. Intensive care unit physicians'... read more

Diagnostic Value of Procalcitonin on Early Postoperative Infection After Pediatric Cardiac Surgery

Procalcitonin was more accurate than C-reactive protein and WBC to predict early postoperative infection, but the diagnostic properties of procalcitonin could not be observed during the first 3 postoperative days due to the... read more

Reflections on the ICU Liberation ABCDEF Bundle Improvement Collaborative

Ludwig Lin, MD, speaks with Brenda Pun, DNP, RN, ACNP, about the ICU Liberation ABCDEF Bundle Improvement Collaborative. Dr. Pun reflects upon Collaborative work, including origins and logistics of the project, team training... read more

How to Ensure Your Medical Wishes Are Followed if You’re Critically Ill and Incapacitated

It happens every day in the intensive care units of hospitals throughout the country: Physicians ask the loved ones of someone kept alive by a ventilator and other medical devices whether the patient would want to live hooked... read more

Video vs direct laryngoscopy in the ICU: are we asking the right question?

Endotracheal intubation in the operating room (OR) and the ICU are different procedures, but this is not always recognized. The ICU patient should be evaluated as a physiologically difficult airway, in contrast to the traditional... read more

Early EEG for outcome prediction of postanoxic coma

We recently showed that electroencephalography (EEG) patterns within the first 24 hours robustly contribute to multimodal prediction of poor or good neurological outcome of comatose patients after cardiac arrest. Here, we... read more

Using Clinically Accessible Tools to Measure Sound Levels and Sleep Disruption in the ICU

Ambient sound was measured for 1 minute using an application downloaded to a personal mobile device. Bedside nurses also recorded the total time and number of awakening for each patient overnight. Across a large number of... read more

Neuro ICU Early Mobilization Protocol

Researchers in the U.S. have developed a multidisciplinary Neuro Early Mobilization Protocol for complex patients in the neuroscience intensive care unit (NSICU). Developing an evidence-based protocol with inter-professional... read more

Interprofessional Survey of Perceived Barriers and Facilitators to Early Mobilization of Critically Ill Patients in Montreal, Canada

Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the... read more

Diagnostic work-up and specific causes of acute kidney injury

Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting... read more

We're Bad at Death. Can We Talk?

Despite growing recognition that more care isn't necessarily better care, particularly at the end of life, many Americans still receive an enormous dose of medicine in their final days. On average, patients make 29 visits... read more

Reduction In Blood Gas Time To Result In ICU

A recent time and motion study by University Hospital Southampton NHS Foundation Trust has demonstrated a 1.5 minute (>20%) reduction in time to blood gas results when using the Proxima bedside blood gas monitoring system... read more

I was confident in my patient’s care. Then my senior doctor overruled me

When a resident and an attending physician disagree, the attending has the right to overrule the resident. But both should talk openly about the issue. During one 28-hour call shift, I took care of a critically ill man in... read more

Admission to the ICU is Associated With Changes in the Oral Mycobiome

A prospective exploratory study was conducted to characterize the oral mycobiome at baseline and determine whether changes occur after admission to the intensive care unit (ICU). We found that ICU admission is associated... read more

Early Palliative Care in Advanced Illness

As the on-call pulmonary critical care fellow, I listened to a family member plead with me to "do right by Mama." The emergency department team consulted me for possible intensive care unit (ICU) admission on a... read more

The Confusion Assessment Method for the ICU-7 Delirium Severity Scale

Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments... read more

Pricey Technology Is Keeping People Alive Who Don’t Want to Live

As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial,... read more

Family Responses to Prognostic Information in Chronic Critical Illness

Prognostic disclosure by skilled clinician communicators evokes a repertoire of responses from surrogates for the chronically critically ill. Recognition of these response patterns may help all clinicians better communicate... read more

The association of sleep quality, delirium, and sedation status with daily participation in physical therapy in the ICU

Poor sleep is common in the ICU setting and may represent a modifiable risk factor for patient participation in ICU-based physical therapy (PT) interventions. This study evaluates the association of perceived sleep quality,... read more

Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient

Dr. Todd Fraser, MD, speaks with Michael J. Murray, MD, PhD, FCCM, FCCP, about the article, "Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient," published in Critical Care... read more

THRIVE Developments

The THRIVE initiative is proud to announce the selection of 10 institutions to a new Post Intensive Care Unit (ICU) Clinic Collaborative. The purpose of the THRIVE Post ICU Clinic Collaborative is to build an international... read more

Relative Bradycardia in Patients With Septic Shock Requiring

Relative bradycardia in patients with septic shock is associated with lower mortality, even after adjustment for confounding. Our data support expanded investigation into whether inducing relative bradycardia will benefit... read more