Other bulletins in this series include:

Breast Surgery

Wednesday 20 November 2013

ICU-acquired swallowing disorders

ICU-acquired swallowing disorders. Critical care medicine, Oct 2013, Vol. 41(10), p.2396-2405.

Macht, M., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/10000/ICU_Acquired_Swallowing_Disorders.16.aspx

Patients hospitalized in the ICU can frequently develop swallowing disorders, resulting in an inability to effectively transfer food, liquids, and pills from their mouth to stomach. The complications of these disorders can be devastating, including aspiration, reintubation, pneumonia, and a prolonged hospital length of stay. As a result, critical care practitioners should understand the optimal diagnostic strategies, proposed mechanisms, and downstream complications of these ICU-acquired swallowing disorders.

Epidemiology of critically ill patients in intensive care units

Epidemiology of critically ill patients in intensive care units: A population-based observational study. Critical care, Sept 2013, Vol. 17(5), R:212

Garland, A., et al.

http://ccforum.com/content/17/5/R212

Epidemiologic assessment of critically ill people in Intensive Care Units (ICUs) is needed to ensure the health care system can meet current and future needs. However, few such studies have been published.

Management of arterial lines and blood sampling in intensive care

Management of arterial lines and blood sampling in intensive care: A threat to patient safety. Anaesthesia, Nov 2013, Vol. 68(11), p.1114-19.

Leslie, R.A., et al.

http://onlinelibrary.wiley.com/doi/10.1111/anae.12389/full

In 2008, the UK National Patient Safety Agency (NPSA) made recommendations for safe arterial line management. Following a patient safety incident in our intensive care unit (ICU), we surveyed current practice in arterial line management and determined whether these recommendations had been adopted. 

Top 10 myths regarding sedation and delirium in the ICU

Top 10 myths regarding sedation and delirium in the ICU. Critical care medicine, Sept 2013, Vol. 41(9), p.S46-56.

Peitz, G.J., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/09001/Top_10_Myths_Regarding_Sedation_and_Delirium_in.5.aspx

The management of pain, agitation, and delirium in critically ill patients can be complicated by multiple factors. Decisions to administer opioids, sedatives, and antipsychotic medications are frequently driven by a desire to facilitate patients’ comfort and their tolerance of invasive procedures or other interventions within the ICU. 

Implementing the awakening and breathing coordination, delirium monitoring/management and early exercise/mobility bundle into everyday care

Implementing the awakening and breathing coordination, delirium monitoring/management and early exercise/mobility bundle into everyday care: Opportunities, challenges and lessons learned for implementing the ICU pain, agitation and delirium guidelines. Critical care medicine, Sept 2013, Vol. 41(9), p.S116-127.

Balas, M.C., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/09001/Implementing_the_Awakening_and_Breathing.10.aspx

The awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle is an evidence-based interprofessional multicomponent strategy for minimizing sedative exposure, reducing duration of mechanical ventilation, and managing ICU-acquired delirium and weakness. The purpose of this study was to identify facilitators and barriers to awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle adoption and to evaluate the extent to which bundle implementation was effective, sustainable, and conducive to dissemination.

The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis

The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: An analysis from a multicenter, prospective survey of severe sepsis. Critical care, Nov 2013, Vol. 17(6), R: 271.

Kushimoto, S., et al. 

http://ccforum.com/content/17/6/R271/abstract

Abnormal body temperatures (Tb) are frequently seen in patients with severe sepsis. However, the relationship between Tb abnormalities and the severity of disease is not clear. This study investigated the impact of Tb on disease severity and outcomes in patients with severe sepsis.

Making the GRADE

Making the GRADE: how useful are the new surviving sepsis campaign guidelines? Critical care, Nov 2013, Vol. 17(6), R328.

Vo, M. and Kahn, J.N.

http://ccforum.com/content/17/6/328

Updated guidelines are needed to guide physicians to care for patients with severe sepsis on the basis of recent advances.

Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia

Initial use of one or two antibiotics for critically ill patients with community-acquired pneumonia: Impact on survival and bacterial resistance. Critical care, Nov 2013, Vol. 17(6), R:267.

Adrie, C., et al.

http://ccforum.com/content/17/6/R265/abstract

Several guidelines recommend initial empirical treatment with two antibiotics instead of one to decrease mortality in community-acquired pneumonia (CAP) requiring intensive-care-unit (ICU) admission. We compared the impact on 60-day mortality of using one or two antibiotics. We also compared the rates of nosocomial pneumonia and multidrug-resistant bacteria.

Outcome and quality of life in patients with postoperative delirium during an ICU stay following major surgery

Outcome and quality of life in patients with postoperative delirium during and ICU stay following major surgery. Critical care, Oct 2013, Vol. 17(5), R257

Abelha, F.J., et al.

http://ccforum.com/content/17/5/R257/abstract

Delirium is an acute disturbance of consciousness and cognition that has been shown to be associated with poor outcomes, including increased mortality. We aimed to evaluate outcome after postoperative delirium in a cohort of surgical intensive care unit (SICU) patients.