Tag: therapy
Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients
In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective... read more
Comparison of Diagnostic Accuracy Among Procalcitonin, C-reactive protein, and Interleukin 6 for Blood Culture Positivity in General ICU Patients
Despite various technological advances, it still usually takes at least 24 to 48 h to obtain a blood culture result. The subsequent delays in diagnosis and treatment of infection can negatively impact care in the intensive... read more
Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients
Procalcitonin-guided (PCT) antibiotic therapy fails to decrease the mortality or length of stay (LOS) of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce... read more
Balanced Crystalloids vs. Saline in Critically Ill Adults
Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal... read more
A Compression Method to Reduce Fluid Balance of Septic Shock Patients
This article presents a close look at the Corporeal Compression at the Onset of Septic shock (COCOONs). Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There... read more
Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation
The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more
Effective Goal-Directed Therapy in TBI Patients May Improve Outcomes
The purpose of this study was to estimate the impact of goal-directed therapy on outcome after traumatic brain injury (TBI). Goal-directed therapy was applied to standardize care in patients with moderate to severe traumatic... read more
High-flow Oxygen Therapy for Treating Bronchiolitis in Infants
Bronchiolitis is the most common reason for hospitalization in infants worldwide. Current recommendations by the American Academy of Pediatrics are for supportive care including maintenance of hydration and oxygen support... 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
Withholding or Withdrawing of Life-sustaining Therapy in Older Adults Admitted to the ICU
The most important patient variables associated with the instigation of Life-sustaining Therapy (LST) limitation were acute admission, frailty, age, admission SOFA score and country. LST limitation was identified in 1356/5021... read more
Early Protocolized Versus Usual Care Rehabilitation for Pediatric Neurocritical Care Patients
A protocol for early personalized rehabilitation by physical therapy, occupational therapy, and speech and language therapy in pediatric neurocritical care patients could be safely implemented and led to more ICU-based treatment... read more
Antibiotics for Sepsis
Antibiotics for Sepsis - Does Each Hour Really Count? Or is it Incestuous Amplification? - by Prof Mervyn Singer "Each hour's delay in initiating antibiotics costs lives" is a doctrine that has attained quasi religious status.... read more
A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients
Hemodynamic therapy aimed at achieving supranormal values for the cardiac index or normal values for mixed venous oxygen saturation does not reduce morbidity or mortality among critically ill patients. A total of 10,726 patients... read more
Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With ARF
Among critically ill immunocompromised patients with acute respiratory failure (ARF), high-flow oxygen therapy did not significantly decrease day-28 mortality compared with standard oxygen therapy. Of 778 randomized patients... read more
Angiotensin II For Septic Shock Treatment
Angiotensin II has been studied for many years and has consistently shown to increase MAP. This medication adds a new mechanism of action to the vasopressor arsenal that is already used for septic shock. Angiotensin II should... read more
Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients
A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more
Neuromuscular Blockade for ARDS Was No Help, In Supine Patients
Continuous neuromuscular blockade for severe ARDS became common practice after the ACURASYS trial showed it reduced mortality by an absolute 9%. A larger trial, ROSE, now finds no benefit of the therapy over usual care, but... read more
How Should ECMO Initiation and Withdrawal Decisions Be Shared?
Extracorporeal membrane oxygenation (ECMO) is a new technology used to rescue patients with severe circulatory or respiratory failure and help bridge them to recovery or to definitive therapies like device implantation or... read more
Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock
In this study, administration of high-dose ascorbic acid significantly decreased the requirement for vasopressor's dose and duration in surgical critically ill patients with septic shock. Several mechanisms including anti-oxidant,... read more
High-flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure
In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant... read more
Continuous RRT – Understanding Circuit Hemodynamics to Improve Therapy Adequacy
The utilization of continuous renal replacement therapy (CRRT) increases throughout the world. Technological improvements have made its administration easier and safer. However, CRRT remains associated with numerous pitfalls... read more
Hospital Variation in RRT for Sepsis in the United States
Use of renal replacement therapy (RRT) in sepsis varied widely among nationally sampled hospitals without associated differences in mortality. Improving renal replacement standards for the initiation of therapy for sepsis... read more
