Tag: recommendation
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
Diagnosis and Treatment of Clostridium difficile Infection
Clostridium difficile infection (CDI) is less common than antibiotic-associated diarrhea and irritable bowel syndrome. There is significant concern about overdiagnosis and subsequent overtreatment of CDI with increasing use... read more
Barriers to implementing expert safety recommendations for early mobilization in ICU during mechanical ventilation
Early mobilization in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilized. An expert... read more
Do We Know Enough to Recommend Corticosteroids in ARDS?
We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more
Petition to Retire the Surviving Sepsis Campaign Guidelines
Concern regarding the Surviving Sepsis Campaign (SSC) guidelines dates back to their inception. Guideline development was sponsored by Eli Lilly and Edwards Life Sciences as part of a commercial marketing campaign. Throughout... read more
Evidence-based Recommendations on the Use of Intravenous Lipid Emulsion Therapy in Poisoning
Although intravenous lipid emulsion (ILE) was first used to treat life-threatening local anesthetic (LA) toxicity, its use has expanded to include both non-local anesthetic (non-LA) poisoning and less severe manifestations... read more
Cardiac Output Monitoring: Throw it Out… or Keep it?
In critical care units, the shelf for cardiac output (CO) monitoring devices fills up with ever more innovative systems. Are these techniques useful, or are they expensive and irrelevant gadgets? There are arguments to defend... read more
Outcomes of Ethics Consultations in Adult ICUs
Our review identified outcome-based assessment as the predominant measure used to report effectiveness of clinical ethics consultation consultations. In particular, clinical ethics consultation decreased ICU length of stay... read more
Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway
Perioperative malnutrition has proven to be challenging to define, diagnose, and treat. Despite these challenges, it is well known that suboptimal nutritional status is a strong independent predictor of poor postoperative... read more
Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery
The primary driver of length of stay after bowel surgery, particularly colorectal surgery, is the time to return of gastrointestinal (GI) function. Traditionally, delayed GI recovery was thought to be a routine and unavoidable... read more
Your plumber offers a money-back guarantee. Should your doctor?
One recommendation is that patients shouldn't have to pay for their care if they experience certain avoidable complications up to 90 days after surgery. A participating hospital would guarantee its work, or patients would... read more
Recommendations for a Standardized Pulmonary Function Report
The American Thoracic Society committee on Proficiency Standards for Pulmonary Function Laboratories has recognized the need for a standardized reporting format for pulmonary function tests. Although prior documents have... read more
