Barriers to Delirium Assessment in the ICU

Many barriers exist to prevent effective assessment and management of delirium, but several of these are due to a lack of understanding or unfamiliarity with the condition and the assessment tools as well as lack of medical... read more

Barriers to Delirium Assessment in the ICU

Oral Antibiotics Preferred for Pediatric Pneumonia

Children with complicated pneumonia should be discharged from the hospital with oral instead of intravenous (IV) antibiotics when possible, according to a new study. The results showed no significant differences in treatment... read more

Oral Antibiotics Preferred for Pediatric Pneumonia

Aerosol Delivery During Invasive Mechanical Ventilation

Lung deposition was lower than 20% of nominal dose delivered with nebulizers and mostly occurred in proximal airways. Further studies are needed to link substantial concentrations of antibiotics in infected pulmonary fluids... read more

Aerosol Delivery During Invasive Mechanical Ventilation

Can this patient be safely weaned from RRT?

The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently. However, there is limited information and few recommendations... read more

Can this patient be safely weaned from RRT?

Active Noise Control Headphones to Reduce Patient’s Exposure to ICU Noise

The use of active noise cancellation, as delivered by noise-cancelling headphones, is associated with a significant reduction in noise exposure in our model of noise exposure in a cardiac ICU. This is the first study to look... read more

Active Noise Control Headphones to Reduce Patient’s Exposure to ICU Noise

Opioid use to worse outcomes in C. difficile

A study presented at the World Congress of Gastroenterology found that patients being prescribed opioids who also have Clostridium difficile infections (CDIs) have higher peak white blood cell counts, higher creatinine elevations,... read more

Opioid use to worse outcomes in C. difficile

Early Oseltamivir Therapy Improves the Outcome in Critically Ill with Influenza

This real-life study emphasizes oseltamivir efficacy on in-hospital outcome when administrated within 2 days of the onset of symptoms. Even if physicians' awareness of the influenza disease has been undeniably enhanced... read more

Early Oseltamivir Therapy Improves the Outcome in Critically Ill with Influenza

Humanizing the Treatment of Hyperactive Delirium in the Last Days of Life

When patients with advanced cancer near the end of their life, it is important for physicians, nurses, and other health care personnel to respect and dignify the dying process of the patient. This requires a shift in focus... read more

Humanizing the Treatment of Hyperactive Delirium in the Last Days of Life

Sound and Light Levels Are Similarly Disruptive in ICU and non-ICU Wards

Quieter, non-ICU wards have as many SLCs as ICUs do, which has implications for quality improvement measurements. Efforts to further reduce average noise levels might be counterproductive. Light levels in the hospital (ICU... read more

Sound and Light Levels Are Similarly Disruptive in ICU and non-ICU Wards

2B4-Mediated Coinhibition of CD4+ T Cells Underlies Mortality in Experimental Sepsis

Sepsis is a leading cause of death in the United States, but the mechanisms underlying sepsis-induced immune dysregulation remain poorly understood. 2B4 (CD244, SLAM4) is a cosignaling molecule expressed predominantly on... read more

2B4-Mediated Coinhibition of CD4+ T Cells Underlies Mortality in Experimental Sepsis

Rapid Retriage of Critically Injured Trauma Patients

Critically injured patients presenting to nontrauma hospitals require timely transfer to trauma centers; however, the transfer process varies and differences in outcomes for patients from trauma centers are unknown. We evaluated... read more

Rapid Retriage of Critically Injured Trauma Patients

Acute Kidney Injury Is Risk Factor for Delirium and Coma

For critically ill adults, acute kidney injury is a risk factor for delirium and coma. Stage 2 acute kidney injury was associated with increased risk of delirium and coma (odds ratios, 1.55 and 2.04, respectively), as was... read more

Acute Kidney Injury Is Risk Factor for Delirium and Coma

Does Early Mobilization Reduce Time in the Surgical ICU?

Is early mobilization in the surgical intensive care unit (ICU) beneficial? Here is a multicenter, randomized, controlled trial in five university hospitals, where they recruited a total of 200 patients.... read more

Does Early Mobilization Reduce Time in the Surgical ICU?

Oestrogen Inhibition Reverses PAH and Associated Metabolic Defects

Increased oestrogen is a strong epidemiological risk factor for development of pulmonary arterial hypertension (PAH) in patients, associated with metabolic defects. In addition, oestrogens drive penetrance in mice carrying... read more

Oestrogen Inhibition Reverses PAH and Associated Metabolic Defects

Should Transfusions Be Matched by Sex?

In the first large study to look at how blood transfusions from previously pregnant women affect recipients' health, researchers discovered men under 50 were 1.5 times more likely to die in the three years following a transfusion... read more

Should Transfusions Be Matched by Sex?

Risk of AKI After Intravenous Contrast Media Administration

In the largest well-controlled study of acute kidney injury (AKI) following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury. Rates of acute... read more

Risk of AKI After Intravenous Contrast Media Administration

Understanding Patient Outcomes After ARDS

We identified four post-ARDS outcome subtypes that were predicted by sex, ethnicity, pre-ARDS smoking status and other baseline factors. These subtypes may help develop tailored rehabilitation strategies, including investigation... read more

Understanding Patient Outcomes After ARDS

A Better Way to Detect Sepsis in Kids in the ED

We have been interested in this question for a long time here at CHOP and have done several interventions over the past several years to try to improve our ability to recognize children with septic shock. When we started... read more

A Better Way to Detect Sepsis in Kids in the ED