Critical care at the end of life: a population-level cohort study of cost and outcomes

Critical care at the end of life: a population-level cohort study of cost and outcomes

Despite the high cost associated with ICU use at the end of life, very little is known at a population level about the characteristics of users and their end of life experience. In this study, our goal was to characterize... read more

ICU Medicine Is a Team Sport

ICU Medicine Is a Team Sport

I am incredibly fortunate to work on a multidisciplinary team every day. The team includes respiratory therapists, nurses, nutritionists, attending physicians (APs), and advanced practice providers (APPs) (nurse practitioners... read more

ICU Admission for the Very Elderly: A Cost Analysis

ICU Admission for the Very Elderly: A Cost Analysis

Considering the poor clinical outcomes, and that many intensive care unit (ICU) admissions may be undesired by very elderly patients (aged 80 or older), ICU costs in this population are substantial, according to a new study... read more

Integration of Single-Center Data-Driven Vital Sign Parameters into a Modified Pediatric Early Warning System

Integration of Single-Center Data-Driven Vital Sign Parameters into a Modified Pediatric Early Warning System

Pediatric early warning systems using expert-derived vital sign parameters demonstrate limited sensitivity and specificity in identifying deterioration. We hypothesized that modified tools using data-driven vital sign parameters... read more

Facilitators and Barriers of Hand Hygiene

Facilitators and Barriers of Hand Hygiene

What keeps ICU nurses from washing their hands? And why do some overcome the barriers? Although there are many papers on hand hygiene, this new one in American Journal of Infection Control caught my eye. In this study 3,260... read more

Assessment of Post-ICU Functional Outcome

Assessment of Post-ICU Functional Outcome

Poor functional status is common after critical illness, and can adversely impact intensive care unit (ICU) survivors’ abilities to live independently. Instrumental activities of daily living (IADL), which encompass complex... read more

Prediction of Survival and Functional Outcomes After ICU Admission

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

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

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?

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

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

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

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

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

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?

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