Tag: recommendation
An Ethical Claim for Providing Medical Recommendations in PICU
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one... read more
SSEP Retains its Value as Predictor of Poor Outcome Following Cardiac Arrest in the Era of Therapeutic Hypothermia
The absence of the somatosensory evoked potential (SSEP) N20 cortical wave remains one of the most reliable early prognostic tools for identifying unfavorable neurologic outcome in the evaluation of patients with severe anoxic-ischemic... read more
Procalcitonin-Guided Use of Antibiotics for Lower Respiratory Tract Infection
The provision of procalcitonin assay results, along with instructions on their interpretation, to emergency department and hospital-based clinicians did not result in less use of antibiotics than did usual care among patients... read more
How to Optimize the Use of Blood Cultures for the Diagnosis of Bloodstream Infections?
Bloodstream infection (BSI) is a major cause of death in developed countries and the detection of microorganisms is essential in managing patients. Despite major progress has been made to improve identification of microorganisms,... read more
Practical Management of Invasive Candidiasis in Critically Ill Patients
The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their... read more
Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years
The addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world... read more
Antibiotics for Sepsis – Finding the Equilibrium
Sepsis is medicine’s last remaining preserve for unrestrained antibiotic prescribing. The Surviving Sepsis Campaign guidelines recommend empirical broad-spectrum therapy within one hour of triage for both sepsis and septic... read more
To transfuse or not transfuse: an intensive appraisal of red blood cell transfusions in the ICU
A restrictive transfusion threshold is recommended in nearly all critically ill patients. This is at least noninferior to more liberal transfusion practice; in addition, a restrictive threshold has shown improved outcomes... read more
European Guideline on Managing Post-traumatic Bleeding: 5th Edition
An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more
Threshold Analysis as an Alternative to GRADE for Assessing Confidence in Guideline Recommendations Based on Network Meta-analyses
Guideline development requires the synthesis of evidence on several treatments of interest, typically by using network meta-analysis (NMA). Because treatment effects may be estimated imprecisely or be based on evidence lacking... read more
Improved Guideline Adherence and Reduced Brain Dysfunction After a Multicenter Multifaceted Implementation of ICU Delirium Guidelines in 3,930 Patients
This large pre-post implementation study of delirium-oriented measures based on the 2013 Pain, Agitation, and Delirium guidelines showed improved health professionals’ adherence to delirium guidelines and reduced brain... read more
Recommendations on the Use of Ultrasound Guidance for Adult Thoracentesis
The use of ultrasound guidance for thoracentesis has been associated with increased success rates and decreased complication rates. Ultrasound can be used to estimate the pleural fluid volume, characterize the effusion as... read more
Reassessing the death risk related to probiotics in critically ill patients
Probiotics prove to be a very useful weapon to reduce infections in critically ill patients, although strong recommendation in support of their use cannot be drawn yet. Reassessing the risk ratio with the meta-analytic software... read more
Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations
Significant gaps exist between CDC recommendations to improve antibiotic use and antibiotic practices during the newborn period. There is wide variation in point prevalence AURs. Three-quarters of infants who received antibiotics... read more
Top 10 Tips for New Interns to Survive and Thrive the ICU Rotation
Graduating residents moving on and new interns, fresh out of medical school with their clean and crisp long white coats, moving in. Out with the old, in with the new! The ICU rotation for medicine residents and medical students... read more
Oxygen Therapy for Acutely Ill Medical Patients
It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation. A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases... read more
Adjunct and Rescue Therapies for Refractory Hypoxemia
Prone position, inhaled nitric oxide, high frequency oscillation, extra corporeal life support. The mortality of severe acute respiratory distress syndrome (ARDS), defined with a PaO2/FiO2 ratio of 100 mmHg... read more
