Tag: ICU

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

Intraoperative Oxidative Stress Associated With Postoperative Delirium

Intraoperative oxidative stress is associated with postoperative delirium in ICU patients after cardiac surgery, a study has found. Researchers from Vanderbilt University Medical Center, in Nashville, Tenn., came to this... read more

Vitamin C and the Ethics of Borrowing data

I was recently amazed to be engaged in a Twitter kerfuffle which generated more than 10,000 Impressions within 24 hours. Passions were running high, libellous comments were being broadcast, and old friendships seemed to be... read more

Quantifying the Mortality Impact of Do-Not-Resuscitate Orders in the ICU

Do-not-resuscitate status is an independent risk factor for ICU mortality. This may reflect severity of illness not captured by other clinical factors, but the perceptions of the treating team related to do-not-resuscitate... read more

Perceptions of the Appropriateness of Care in California Adult ICUs

Increased demand for expensive intensive care unit (ICU) services may contribute to rising health-care costs. A focus on appropriate use may offer a clinically meaningful way of finding the balance. Thirty-eight percent of... read more

Clinical review: The ABC of weaning failure

About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing... read more

Milestones in Critical Care

Take a look back at some of Critical Care's milestones over the past 20 years. In the past 20 years, the journal has contributed to improving the care of critically ill patients by acquiring, discussing, distributing... read more

The Current State of Glycaemic Control Practice

Study involving intensivists from 90 ICUs in northwest Europe confirms significant variability in glycaemic control practices. The study confirmed that there are still controversies over what constitutes optimal glucose management... read more

Priority Levels in Intensive Care at an Academic Public Hospital

This prospective study of medical records determined the proportion of medical ICU patients in each priority group within a tertiary care academic public hospital. Critical care services can be life-saving, but many patients... read more

The ICM research agenda on ICU-acquired weakness

Intensive care unit (ICU)-acquired weakness (ICUAW) develops as a complication of critical illness and may represent the extreme end of a spectrum of weakness that begins with any serious illness regardless of care location.... read more