Tag: mortality
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
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
Importance of Second Antibiotic Doses in ED Sepsis Patients
Most studies evaluating early antibiotic administration in sepsis patients focus on timing of the first dose. We highlight many of these studies in our recent review article on Appropriate Antibiotic Therapy in Emergency... read more
Is Fever the Normal Temperature of Sepsis
We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated.... read more
Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock
Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more
TBI Outcomes in an LMIC Tertiary Care Centre and Performance of Trauma Scores
This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery.... read more
Diagnostic Stewardship for Healthcare-Associated Infections
Healthcare-associated infections (HAIs) are associated with increased morbidity and mortality, prolonged hospital stays, and unnecessary cost. The financial stakes of HAIs for hospitals were underscored in 2008 when the Centers... read more
What is the Role of Benchmarking for Intensive Care?
Although the evaluation of a single intensive care unit (ICU) over time can produce insightful results, self-reflection can lead to excessive optimism or criticism. Benchmarking against other ICUs can provide ICU staff and... read more
When Do Confounding by Indication and Inadequate Risk Adjustment Bias Critical Care Studies?
In critical care observational studies, when clinicians administer different treatments to sicker patients, any treatment comparisons will be confounded by differences in severity of illness between patients. We sought to... read more
Social Determinants of Health: A Missing Link in Emergency Medicine Training
The health of a population depends upon several factors, including disease, public health initiatives, and the social determinants of health (SDH). These factors often converge in the emergency department (ED) where the impact... read more
Effect of a National Standard for Deteriorating Patients on Intensive Care Admissions Due to Cardiac Arrest in Australia
The main objective of this study is to assess whether a national standard for improving care of deteriorating patients affected ICU admissions following cardiac arrests from hospital wards. Introducing a national standard... read more
Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products
This study is the first to identify and document a statistically significant variability in the chloride concentration of available 5% albumin products. This study has also informed a pilot randomized controlled trial examining... read more
Six-month Outcome of Immunocompromised Severe ARDS Patients Rescued by ECMO
Recently diagnosed immunodeficiency is associated with a much better prognosis in ECMO-treated severe ARDS. However, low 6-month survival of our large cohort of immunocompromised patients supports restricting ECMO to patients... read more
Age of Red Cells for Transfusion and Outcomes in Critically Ill Adults
The age of transfused red cells did not affect 90-day mortality among critically ill adults. In an international, multicenter, randomized, double-blind trial, we assigned critically ill adults to receive either the freshest... read more
Enhancing Recovery From Sepsis
Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. In the... read more
Serum Lactate Upon Emergency Department Arrival as Predictor of 30-day In-Hospital Mortality
Despite of numerous evidences that elevated serum lactate levels were associated with unfavorable outcomes, there have been no study demonstrated an optimal cutoff of serum lactate in unselected patients. This study was aimed... read more
Development of Dementia in Patients with Femoral Neck Fracture Who Experience Postoperative Delirium
It remains unclear to what extent postoperative delirium (POD) affects the incidence of dementia in hip fracture patients, and the methods used to detect delirium and dementia require validation. The aim of this study was... read more
Delay Within the 3-Hour Surviving Sepsis Campaign Guideline on Mortality for Patients With Severe Sepsis and Septic Shock
The guideline recommendations showed that shorter delays indicates better outcomes. There was no evidence that 3 hours is safe; even very short delays adversely impact outcomes. Findings demonstrated a new approach to incorporate... read more
Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction
Effect of Individualized vs Standard Blood Pressure Management Strategies on Postoperative Organ Dysfunction Among High-Risk Patients Undergoing Major Surgery. Among patients predominantly undergoing abdominal surgery who... read more
Severity of Illness Scores May Misclassify Critically Ill Obese Patients
Severity of illness scores rest on the assumption that patients have normal physiologic values at baseline and that patients with similar severity of illness scores have the same degree of deviation from their usual state.... read more
Early Identification of Acute Respiratory Distress Disorder in the Absence of Positive Pressure Ventilation
Almost all patients with pulmonary bilateral infiltrates and a PaO2/FIO2 less than or equal to 300 mm Hg under standard oxygen fulfilled the acute respiratory distress syndrome criteria under noninvasive ventilation within... read more