As a direct result of critical illness and its management, ICU patients and their caregivers are vulnerable to communication breakdown and associated adverse sequelae. Nurses are the most frequent communication partners to critically ill patients during the period in which they are unable to speak. However, nurses do not typically receive training in specialised communication assessment or techniques to use with nonspeaking patients.
Billings has proposed that any potentially conscious and imminently dying patient who is undergoing withdrawal of ventilator support should be offered general anesthesia to fully protect against suffering. Here we examine whether his proposal is compatible with the doctrine of double effect, a philosophical construct that is generally in accord with the legal requirements for palliative care in the United States.
The family response to critical illness includes development of adverse psychological outcomes such as anxiety, acute stress disorder, posttraumatic stress, depression, and complicated grief. This cluster of complications from exposure to critical care is now entitled postintensive care syndrome–family.
Masseter tissue oxygen saturation predicts normal central venous oxygen saturation during early goal-directed therapy and predicts mortality in patients with severe sepsis. Critical care medicine, Feb 2012, Vol. 40(23), p. 435-440.
Energy deficit and length of hospital stay can be reduced by a two-step quality improvement of nutrition therapy: The intensive care unit dietitian can make the difference. Critical care medicine, Feb 2012, Vol. 40(2), p. 412-419.
Critically ill patients are at high risk of malnutrition. Insufficient nutritional support still remains a widespread problem despite guidelines. The aim of this study was to measure the clinical impact of a two-step interdisciplinary quality nutrition program.