ICU Patients May Understand Verbal Commands After Acute Brain Injury

A New England Journal of Medicine study shows 1 in 6 clinically unresponsive ICU patients show electroencephalography (EEG) patterns of brain activity when spoken to soon after acute brain injury. A dissociation between the... read more

Recognizing Acute Delirium as Part of Your Routine

The screening tool (RADAR) proved to be efficient, reliable, sensitive and very well accepted by nursing staff. Consequently, it becomes an appropriate new option for delirium screening among older adults, with or without... read more

Critical Illness and Cardiac Dysfunction in Anthracycline-Exposed Pediatric Oncology Patients

Children with cancer who received anthracyclines, especially at higher doses, and who develop cardiac dysfunction are at higher risk of critical illness, have higher rates of multiple organ dysfunction and higher rates of... read more

Factors Nurses in the ICU Consider When Making Decisions About Patient Mobility

Nurses are often responsible for mobilizing patients, but how they overcome barriers and make decisions to mobilize patients in the intensive care unit (ICU) is not understood. Deciding to mobilize patients in the ICU... read more

Airway Closure during Surgical Pneumoperitoneum in Obese Patients

In obese patients, complete airway closure is frequent during anesthesia and is worsened by Trendelenburg pneumoperitoneum, which increases airway opening pressure and alveolar pressure: besides preventing alveolar derecruitment,... read more

Randomized Controlled Trial of Health Coaching for Vulnerable Patients with COPD

These results help inform expectations regarding the limitations and benefits of health coaching for patients with Chronic Obstructive Pulmonary Disease (COPD). They may be useful to health policy experts in assessing the... read more

Early Mobilization on CRRT is Safe and May Improve Filter Life

Despite studies demonstrating benefit, patients with femoral vascular catheters placed for continuous renal replacement therapy (CRRT) are frequently restricted from mobilization. No researchers have reported filter pressures... read more

A hospital-wide intervention replacing ceftriaxone with cefotaxime to reduce rate of HAI in the ICU

Over the last decades, the incidence of healthcare-associated infections (HAI) caused by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) involved in poor outcomes has dramatically increased worldwide.... read more

Transcutaneous CO2 vs. End-tidal CO2 in Neonates and Infants Undergoing Surgery

EtCO2 underestimates PvCO2 values in neonates and infants under general anesthesia. TcPCO2 closely approximates venous blood gas values, in both the NICU and non-NICU samples. We, therefore, conclude that tcPCO2 is a more... read more

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more

Steroids in Septic Shock – Four Misconceptions and One Truth

The utility of steroids in sepsis has been debated passionately for decades. There is hope that steroids might improve mortality, but also fear that they could increase infectious complications. Practice varies widely. What... read more

Integrating host response and unbiased microbe detection for lower respiratory tract infection diagnosis in critically ill adults

Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill... read more

Hospitals Delay Use Of New Antibiotics

According to a new study published in Diagnostic Microbiology and Infectious Disease, US hospitals on average waited more than a year to prescribe any of six new antibiotics approved by the US Food and Drug Administration... read more

Pain in the PICU: How and What Are We Doing?

Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units (PICU) experience pain and the practices being used to lessen pain. Critically... read more

Sepsis: Personalization vs. Protocolization?

The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more

The Hospitalist Role in Treating Opioid Use Disorder

Opioid use disorder, like many of the other conditions we see, is a chronic relapsing remitting medical disease and a risk factor for premature mortality. When a patient with diabetes is admitted with cellulitis, we might... read more

Patients Identify Female Physicians as Doctors Less Than Male Physicians

Patients correctly identify female attending physicians as doctors significantly less frequently than they identify male attending physicians as doctors. Patients correctly identify male nurses as nurses significantly less... read more

Penn Finds a Way to Reduce ICU Doctor Burnout

Reducing the length of rotations in medical ICUs in half also reduces rates of physician burnout in half while additionally improving feelings of fulfillment, according to a new pilot study from Penn Medicine. The results... read more

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery

Intravenous lidocaine administered during and after cardiac surgery did not reduce postoperative cognitive decline at 6 weeks. Among the 420 allocated subjects who returned for 6-week follow-up, there was no difference in... 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

Gut Dysmotility in the ICU

Off-label metoclopramide and/or erythromycin administration are effective for upper gastrointestinal dysmotility but have adverse effects. Trials of alternative or novel promotility drugs have not demonstrated superiority... read more

How and Whom to Monitor for Seizures in an ICU

Prevalence of seizures detected by continuous electroencephalography was significantly higher than with routine electroencephalography. Prevalence was particularly high in post convulsive status epilepticus, CNS infection,... read more