Objective surveillance definitions for ventilator-associated pneumonia. Critical care medicine, Dec. 2012, Vol. 40(12), p.3154-61.
Klompas, M., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Objective_surveillance_definitions_for.6.aspx
The subjectivity and complexity of surveillance definitions for ventilator-associated pneumonia preclude meaningful internal or external benchmarking and therefore hamper quality improvement initiatives for ventilated patients. We explored the feasibility of creating objective surveillance definitions for ventilator-associated pneumonia.
Monday, 17 December 2012
Pulmonary embolism in mechanically ventilated patients requiring computed tomography
Pulmonary embolism in mechanically ventilated patients requiring computed tomography: Prevalence, risk factors and outcome. Critical care medicine, Dec. 2012, Vol. 40(12), p.3202-08.
Minet, C., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Pulmonary_embolism_in_mechanically_ventilated.12.aspx
In mechanically ventilated patients who needed a computed tomography, pulmonary embolism was more common than expected. Patients diagnosed with pulmonary embolism were all treated with therapeutic anticoagulation, and their intensive care unit or hospital mortality was not impacted by the pulmonary embolism occurrence.
Minet, C., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Pulmonary_embolism_in_mechanically_ventilated.12.aspx
In mechanically ventilated patients who needed a computed tomography, pulmonary embolism was more common than expected. Patients diagnosed with pulmonary embolism were all treated with therapeutic anticoagulation, and their intensive care unit or hospital mortality was not impacted by the pulmonary embolism occurrence.
Effects of the neurological wake-up test on clinical examination, intracranial pressure, brain metabolism and brain tissue oxygenation in severely brain-injured patients
Effects of the neurological wake-up test on clinical examination, intracranial pressure, brain metabolism and brain tissue oxygenation in severely brain-injured patients. Critical care, Nov. 2012, 16: R22.
Helbok, R., et al.
http://ccforum.com/content/16/6/R226/abstract
Daily interruption of sedation (IS) has been implemented in 30- 40% of intensive care units worldwide and may improve outcome in medical intensive care patients. Little is known about the benefit of IS in acutely brain-injured patients.
Helbok, R., et al.
http://ccforum.com/content/16/6/R226/abstract
Daily interruption of sedation (IS) has been implemented in 30- 40% of intensive care units worldwide and may improve outcome in medical intensive care patients. Little is known about the benefit of IS in acutely brain-injured patients.
Feasibility of a sedation wake-up trial and spontaneous breathing trial in critically ill trauma patients
Feasibility of a sedation wake-up trial and spontaneous breathing trial in critically ill patients: A secondary analysis. Intensive & critical care nursing, Feb., 2013, Vol. 29(1), p.20-27.
Fiqueroa-Ramos, M.I., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000523/abstract?rss=yes
To determine the feasibility of conducting a sedation wake-up trial plus a spontaneous breathing trial in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients’ physiological responses; and to maintain patient safety.
Fiqueroa-Ramos, M.I., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000523/abstract?rss=yes
To determine the feasibility of conducting a sedation wake-up trial plus a spontaneous breathing trial in critically ill trauma patients based on the ability to implement the combined intervention; to measure and describe patients’ physiological responses; and to maintain patient safety.
Impact of a preventive programme on the occurrence of incidents during the transport of critically ill patients
Impact of a preventive programme on the occurrence of incidents during the transport of critically ill patients. Intensive & critical care nursing, Feb. 2013, Vol. 29(1), p.9-19.
Berube, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000742/abstract?rss=yes
Incidents related to transport of critically ill patients have been extensively reported. The objective of this study was to determine the effect of an interdisciplinary preventive programme used by all intensive care unit team members involved in patients’ transport on the rate of these incidents.
Berube, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000742/abstract?rss=yes
Incidents related to transport of critically ill patients have been extensively reported. The objective of this study was to determine the effect of an interdisciplinary preventive programme used by all intensive care unit team members involved in patients’ transport on the rate of these incidents.
Participation and support in intensive care as experienced by close relatives of patients
Participation and support in intensive care as experienced by close relatives of patients: A phenomenological study. Intensive and critical care nursing, Feb. 2013, Vol. 29(1), p.1-8.
Blom, H., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(12)00048-1/abstract
Participation with and support from health-care professionals are important for the relatives’ well-being and their ability to contribute to the patients’ care. Health-care professionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.
Blom, H., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(12)00048-1/abstract
Participation with and support from health-care professionals are important for the relatives’ well-being and their ability to contribute to the patients’ care. Health-care professionals, especially critical care nurses, need to create an atmosphere that invites relatives to participate in the care provided at an ICU.
Safety and efficacy of the Abcde bundle in critically-ill patients receiving mechanical ventilation
Safety and efficacy of the Abcde bundle in critically-ill patients receiving mechanical ventilation. Critical care medicine, oral abstract session.
Balas, M., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12001/1___Safety_and_Efficacy_of_the_Abcde_Bundle_in.4.aspx
There is strong, recent, convincing evidence that delirium, immobility, sedation, and ventilator management are closely interrelated. The purpose of this study was to evaluate the efficacy and safety of the ABCDE bundle in critically-ill patients receiving mechanical ventilation.
Balas, M., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12001/1___Safety_and_Efficacy_of_the_Abcde_Bundle_in.4.aspx
There is strong, recent, convincing evidence that delirium, immobility, sedation, and ventilator management are closely interrelated. The purpose of this study was to evaluate the efficacy and safety of the ABCDE bundle in critically-ill patients receiving mechanical ventilation.
Give enteral nutrition a chance in the critically ill
Give enteral nutrition a chance in the critically ill. BMJ 2012; 345:e8387.
http://www.bmj.com/highwire/filestream/619732/field_highwire_article_pdf/0/bmj.e8387
Intensive care specialists are still debating the best way to meet the complex nutritional needs of critically ill adults. International guidelines recommend enteral nutrition first but diverge on what to do when this is not enough.
http://www.bmj.com/highwire/filestream/619732/field_highwire_article_pdf/0/bmj.e8387
Intensive care specialists are still debating the best way to meet the complex nutritional needs of critically ill adults. International guidelines recommend enteral nutrition first but diverge on what to do when this is not enough.
Thursday, 22 November 2012
Weighing risks and benefits of stress ulcer prophylaxis in critically ill patients
Weighing risks and benefits of stress ulcer prophylaxis in critically ill patients. Critical care, Oct 2012, Vol. 16(5): 322.
Chanpura, T. & Yende, S.
http://ccforum.com/content/16/5/322
Recent observational studies suggest that bleeding from stress ulceration is extremely uncommon in intensive care unit patients. Furthermore, the risk of bleeding may not be altered by the use of acid suppressive therapy. Early enteral tube feeding (initiated within 48 h of intensive care unit admission) may account for this observation. Stress ulcer prophylaxis may, however, increase the risk of hospital-acquired pneumonia and Clostridia difficile infection.
Chanpura, T. & Yende, S.
http://ccforum.com/content/16/5/322
Recent observational studies suggest that bleeding from stress ulceration is extremely uncommon in intensive care unit patients. Furthermore, the risk of bleeding may not be altered by the use of acid suppressive therapy. Early enteral tube feeding (initiated within 48 h of intensive care unit admission) may account for this observation. Stress ulcer prophylaxis may, however, increase the risk of hospital-acquired pneumonia and Clostridia difficile infection.
Outcome of ICU patients with Clostridium difficile infection
Outcome of ICU patients with Clostridium difficile infection. Critical care, Nov. 2012, Vol. 16(6): R215.
Zahar, J-R., et al.
http://ccforum.com/content/16/6/R215/abstract
As data from Clostridium difficile infection in the intensive care unit are still scarce, our objectives were to assess the morbidity and mortality of ICU-acquired CDI.
Zahar, J-R., et al.
http://ccforum.com/content/16/6/R215/abstract
As data from Clostridium difficile infection in the intensive care unit are still scarce, our objectives were to assess the morbidity and mortality of ICU-acquired CDI.
Examining the positive effects of exercise in intubated adults in ICU
Examining the positive effects of exercise in intubated adults in ICU: A prospective repeated measures clinical study. Intensive & critical care nursing, Dec. 2012, Vol. 28(6), p.307-318.
Winkelman, C., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(12)00028-6/abstract
Determining the optimal timing and progression of mobility exercise has the potential to affect functional recovery of critically ill adults. This study compared standard care with care delivered using a mobility protocol.
Winkelman, C., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(12)00028-6/abstract
Determining the optimal timing and progression of mobility exercise has the potential to affect functional recovery of critically ill adults. This study compared standard care with care delivered using a mobility protocol.
Non-invasive mechanical ventilation in hematology patients
Non-invasive mechanical ventilation in hematology patients: Let's agree on several things first. Critical care 2012, 16:175.
Dnull, S., et al.
Acute respiratory failure is a dreaded and life-threatening event that represents the main reason for ICU admission. Respiratory events occur in up to 50% of hematology patients, including one-half of those admitted to the ICU. Mortality from acute respiratory failure in hematology patients depends on the patient's general status, acute respiratory failure etiology, need for mechanical ventilation and associated organ dysfunction. Non-invasive mechanical ventilation is clearly beneficial for chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. These benefits are based mainly on the avoidance of invasive mechanical ventilation complications. Non-invasive mechanical has also been recommended in hematology patients with acute respiratory failure but its real benefits remain unclear in these settings. There is growing concern about the safety of non-invasive mechanical ventilation to treat hypoxemic acute respiratory failure overall, but also in hematology patients. Prophylactic non-invasive mechanical ventilation in patients with acute respiratory failure but not respiratory distress seems to be effective in hematology patients with a reduced rate of intubation. However, curative non-invasive mechanical ventilation should be restricted to those patients with isolated respiratory failure, with fast improvement of respiratory distress under non-invasive mechanical ventilation, and with rapid switch to intubation to avoid deleterious delays in optimal invasive mechanical ventilation.
Dnull, S., et al.
Acute respiratory failure is a dreaded and life-threatening event that represents the main reason for ICU admission. Respiratory events occur in up to 50% of hematology patients, including one-half of those admitted to the ICU. Mortality from acute respiratory failure in hematology patients depends on the patient's general status, acute respiratory failure etiology, need for mechanical ventilation and associated organ dysfunction. Non-invasive mechanical ventilation is clearly beneficial for chronic obstructive pulmonary disease exacerbation and cardiogenic pulmonary edema. These benefits are based mainly on the avoidance of invasive mechanical ventilation complications. Non-invasive mechanical has also been recommended in hematology patients with acute respiratory failure but its real benefits remain unclear in these settings. There is growing concern about the safety of non-invasive mechanical ventilation to treat hypoxemic acute respiratory failure overall, but also in hematology patients. Prophylactic non-invasive mechanical ventilation in patients with acute respiratory failure but not respiratory distress seems to be effective in hematology patients with a reduced rate of intubation. However, curative non-invasive mechanical ventilation should be restricted to those patients with isolated respiratory failure, with fast improvement of respiratory distress under non-invasive mechanical ventilation, and with rapid switch to intubation to avoid deleterious delays in optimal invasive mechanical ventilation.
Effects of etomidate on complications related to intubation and on mortality in septic shock patients treated with hydrocortisone
Effects of etomidate on complications related to intubation and on mortality in septic shock patients treated with hydrocortisone: a propensity score analysis. Critical care, November 2012, Vol. 16(6): R224.
Jung, B., et al.
http://ccforum.com/content/16/6/R224/abstract
Endotracheal intubation in the intensive care unit is associated with a high incidence of complications. Etomidate use is debated in septic shock because it increases the risk of critical illness-related corticosteroid insufficiency, which may impact outcome. We hypothesized that hydrocortisone, administered in all septic shock in our intensive care unit, and may counteract some negative effects of etomidate. The aim of our study was to compare septic shock patients who received etomidate vs another induction drug both on the short-term safety and the long-term outcomes.
Jung, B., et al.
http://ccforum.com/content/16/6/R224/abstract
Endotracheal intubation in the intensive care unit is associated with a high incidence of complications. Etomidate use is debated in septic shock because it increases the risk of critical illness-related corticosteroid insufficiency, which may impact outcome. We hypothesized that hydrocortisone, administered in all septic shock in our intensive care unit, and may counteract some negative effects of etomidate. The aim of our study was to compare septic shock patients who received etomidate vs another induction drug both on the short-term safety and the long-term outcomes.
Probiotics in the critically ill
Probiotics in the critically ill: A systematic review of the randomized trial evidence. Critical care medicine, December 2012, Vol. 40(12), p.3290-3302.
Petrof, E.O., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Probiotics_in_the_critically_ill___A_systematic.22.aspx
Critical illness results in changes to the microbiology of the gastrointestinal tract, leading to a loss of commensal flora and an overgrowth of potentially pathogenic bacteria. Administering certain strains of live bacteria (probiotics) to critically ill patients may restore balance to the microbiota and have positive effects on immune function and gastrointestinal structure and function. The purpose of this systematic review was to evaluate the effect of probiotics in critically ill patients on clinical outcomes.
Petrof, E.O., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Probiotics_in_the_critically_ill___A_systematic.22.aspx
Critical illness results in changes to the microbiology of the gastrointestinal tract, leading to a loss of commensal flora and an overgrowth of potentially pathogenic bacteria. Administering certain strains of live bacteria (probiotics) to critically ill patients may restore balance to the microbiota and have positive effects on immune function and gastrointestinal structure and function. The purpose of this systematic review was to evaluate the effect of probiotics in critically ill patients on clinical outcomes.
Effects of norepinephrine on mean systemic pressure and venous return in human septic shock
Effects of norepinephrine on mean systemic pressure and venous return in human septic shock. Critical care medicine, December 2012, Vol. 40(12), p.3146-53.
Persichini, R., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Effects_of_norepinephrine_on_mean_systemic.5.aspx
Norepinephrine exerts venoconstriction that could increase both the mean systemic pressure and the resistance to venous return, but this has not yet been investigated in human septic shock. We examined the relative importance of both effects and the resulting effect on venous return when decreasing the dose of norepinephrine.
Persichini, R., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Effects_of_norepinephrine_on_mean_systemic.5.aspx
Norepinephrine exerts venoconstriction that could increase both the mean systemic pressure and the resistance to venous return, but this has not yet been investigated in human septic shock. We examined the relative importance of both effects and the resulting effect on venous return when decreasing the dose of norepinephrine.
The stress response and critical illness
The stress response and critical illness: A review. Critical care medicine, December 2012, Vol. 40(12), p.3283-89.
Cuesta, J. & Singer, M.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/The_stress_response_and_critical_illness___A.21.aspx
Objectives: To describe different paradigms that define the stress response, and to postulate how stress is implicated in the pathophysiology of critical illness.
Cuesta, J. & Singer, M.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/The_stress_response_and_critical_illness___A.21.aspx
Objectives: To describe different paradigms that define the stress response, and to postulate how stress is implicated in the pathophysiology of critical illness.
Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients
Guidelines for the use of an insulin infusion for the management of hyperglycemia in critically ill patients.
Critical care medicine, December 2012, Vol. 40(12), p.3251-76.
Jacobi, J., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Guidelines_for_the_use_of_an_insulin_infusion_for.19.aspx
Objective: To evaluate the literature and identify important aspects of insulin therapy that facilitate safe and effective infusion therapy for a defined glycemic end point.
Critical care medicine, December 2012, Vol. 40(12), p.3251-76.
Jacobi, J., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/12000/Guidelines_for_the_use_of_an_insulin_infusion_for.19.aspx
Objective: To evaluate the literature and identify important aspects of insulin therapy that facilitate safe and effective infusion therapy for a defined glycemic end point.
Antibiotic subscription patterns in the empirical therapy of severe sepsis
Antibiotic subscription patterns in the empirical therapy of severe sepsis: combination of antimicrobials with different mechanisms of action reduces mortality. Critical care, November 2012, Vol. 12(6): R223.
Diaz-Martin, A., et al.
http://ccforum.com/content/16/6/R223/abstract
Although early institution of adequate antimicrobial therapy is life-saving in septic patients, optimal antimicrobial strategy has not been established. Moreover, the benefit of combination therapy over monotherapy remains to be determined. Our aims are to describe patterns of empirical antimicrobial therapy in severe sepsis, assessing the impact of combination therapy including antimicrobials with different mechanisms of action on mortality.
Diaz-Martin, A., et al.
http://ccforum.com/content/16/6/R223/abstract
Although early institution of adequate antimicrobial therapy is life-saving in septic patients, optimal antimicrobial strategy has not been established. Moreover, the benefit of combination therapy over monotherapy remains to be determined. Our aims are to describe patterns of empirical antimicrobial therapy in severe sepsis, assessing the impact of combination therapy including antimicrobials with different mechanisms of action on mortality.
Intensive care in low income countries
Intensive care in low income countries: A critical need. N Engl J Med 2012; 367:1974-1976
Firth, P. & Ttendo, S.
http://www.nejm.org/doi/full/10.1056/NEJMp1204957
Mbarara is a small town in the rural southwest of Uganda, one of the poorest countries in the world. The per capita income in this equatorial East African nation is less than $4 a day, and one third of the population lives below the poverty line. When the Ugandan government and foreign donors recently committed to upgrading Mbarara Hospital's aging infrastructure, the hospital steering committee identified the expansion of the intensive care unit (ICU) as a critical objective.
Firth, P. & Ttendo, S.
http://www.nejm.org/doi/full/10.1056/NEJMp1204957
Mbarara is a small town in the rural southwest of Uganda, one of the poorest countries in the world. The per capita income in this equatorial East African nation is less than $4 a day, and one third of the population lives below the poverty line. When the Ugandan government and foreign donors recently committed to upgrading Mbarara Hospital's aging infrastructure, the hospital steering committee identified the expansion of the intensive care unit (ICU) as a critical objective.
Using end of life care pathways for the last hours or days of life
Using end of life care pathways for the last hours or days of life. BMJ 2012; 345: e7718
Boyd, K. & Murray, S.
http://www.bmj.com/highwire/filestream/614798/field_highwire_article_pdf/0/bmj.e7718
There is international consensus about the importance of achieving a “good death” that is comfortable, dignified, and person centred.1 But controversy persists about the benefits and hazards of using an integrated care pathway to support the care of people who are expected to die soon. National end of life care programmes, in the United Kingdom and internationally, endorse tools designed to improve standards of care for people dying in the community, care homes, and hospitals
Boyd, K. & Murray, S.
http://www.bmj.com/highwire/filestream/614798/field_highwire_article_pdf/0/bmj.e7718
There is international consensus about the importance of achieving a “good death” that is comfortable, dignified, and person centred.1 But controversy persists about the benefits and hazards of using an integrated care pathway to support the care of people who are expected to die soon. National end of life care programmes, in the United Kingdom and internationally, endorse tools designed to improve standards of care for people dying in the community, care homes, and hospitals
Monday, 8 October 2012
Treatment of four psychiatric emergencies in the intensive care unit
Treatment of four psychiatric emergencies in the intensive care unit. Critical care medicine, September 2012, Vol. 40(9), p.2662-70.
Sevransky, J.E., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/09000/Treatment_of_four_psychiatric_emergencies_in_the.17.aspx
To review the diagnosis and management of four selected psychiatric emergencies in the intensive care unit: agitated delirium, neuroleptic malignant syndrome, serotonin syndrome, and psychiatric medication overdose.
Sevransky, J.E., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/09000/Treatment_of_four_psychiatric_emergencies_in_the.17.aspx
To review the diagnosis and management of four selected psychiatric emergencies in the intensive care unit: agitated delirium, neuroleptic malignant syndrome, serotonin syndrome, and psychiatric medication overdose.
Association between systemic corticosteroids and outcomes of intensive care unit-acquired pneumonia
Association between systemic corticosteroids and outcomes of intensive care unit-acquired pneumonia. Critical care medicine, September 2012, Vol. 40(9), p.2552-61.
Ranzani, O.T., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/09000/Association_between_systemic_corticosteroids_and.2.aspx
The use of corticosteroids is frequent in critically-ill patients. However, little information is available on their effects in patients with intensive care unit–acquired pneumonia. We assessed patients’ characteristics, microbial etiology, inflammatory response, and outcomes of previous corticosteroid use in patients with intensive care unit–acquired pneumonia.
Ranzani, O.T., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/09000/Association_between_systemic_corticosteroids_and.2.aspx
The use of corticosteroids is frequent in critically-ill patients. However, little information is available on their effects in patients with intensive care unit–acquired pneumonia. We assessed patients’ characteristics, microbial etiology, inflammatory response, and outcomes of previous corticosteroid use in patients with intensive care unit–acquired pneumonia.
Time to effective antibiotic administration in adult patients with septic shock
Time to effective antibiotic administration in adult patients with septic shock: A descriptive analysis. Intensive and critical care nusing, Vol. 28(5), October 2012, p.288-93.
Kanji, Z. and Dumaresque, C.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000109/abstract?rss=yes
To determine the median time to antibiotic administration following the onset of septic shock at our institution as well as the appropriateness of empiric therapy, sources of delay in antibiotic administration and the effect of delays on survival.
Kanji, Z. and Dumaresque, C.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000109/abstract?rss=yes
To determine the median time to antibiotic administration following the onset of septic shock at our institution as well as the appropriateness of empiric therapy, sources of delay in antibiotic administration and the effect of delays on survival.
The sound environment in an ICU patient room
The sound environment in an ICU patient room: A content analysis of sound levels and patient experiences. Intensive and critical care nursing, Vol. 28(5), October 2012, p.269-79.
Johansson, L., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000377/abstract?rss=yes
This study had two aims: first to describe, using both descriptive statistics and quantitative content analysis, the noise environment in an ICU patient room over one day, a patient's physical status during the same day and early signs of ICU delirium; second, to describe, using qualitative content analysis, patients’ recall of the noise environment in the ICU patient room.
Johansson, L., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000377/abstract?rss=yes
This study had two aims: first to describe, using both descriptive statistics and quantitative content analysis, the noise environment in an ICU patient room over one day, a patient's physical status during the same day and early signs of ICU delirium; second, to describe, using qualitative content analysis, patients’ recall of the noise environment in the ICU patient room.
The visitor's regard of their need for support, comfort, information proximity and assurance in the intensive care unit
The visitor's regard of their need for support, comfort, information proximity and assurance in the intensive care unit. Intensive and critical care nursing, Vol. 28(5), October 2012, p.263-8.
Hoghaug, G., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339711001285/abstract?rss=yes
In a cross-sectional correlational design, data were collected from March 2008 to January 2009 at a university hospital in the city of Oslo, Norway. The Critical Care Family Needs Inventory was used to collect data on the participants’ perceived need for support, comfort, information, proximity and assurance.
Hoghaug, G., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339711001285/abstract?rss=yes
In a cross-sectional correlational design, data were collected from March 2008 to January 2009 at a university hospital in the city of Oslo, Norway. The Critical Care Family Needs Inventory was used to collect data on the participants’ perceived need for support, comfort, information, proximity and assurance.
Continual improvement in ventilator acquired pneumonia bundle compliance
Continual improvement in ventilator acquired pneumonia bundle compliance: A retrospective case matched review. Intensive and critical care nursing, Vol. 28(5), October 2012, p.255-62.
Beattie, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000080/abstract?rss=yes
This study aimed to describe the population of people who acquired ventilator acquired pneumonia and determine the feasibility of a larger scale study to assess the degree to which bundle compliance reduces or even eliminates, the risk of ventilator acquired pneumonia.
Beattie, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000080/abstract?rss=yes
This study aimed to describe the population of people who acquired ventilator acquired pneumonia and determine the feasibility of a larger scale study to assess the degree to which bundle compliance reduces or even eliminates, the risk of ventilator acquired pneumonia.
Previous prescription of B-blockers is associated with reduced mortality among patients hospitalized in intensive care units for sepsis
Previous prescription of B-blockers is associated with reduced mortality among patients hospitalized in intensive care units for sepsis. Critical care medicine, October 2012, Vol. 40(10), p.2768-72.
Macchia, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Previous_prescription_of___blockers_is_associated.4.aspx
Results from basic science and narrative reviews suggest a potential role of β-blockers in patients with sepsis. Although the hypothesis is physiologically appealing, it could be seen as clinically counterintuitive. We sought to assess whether patients previously prescribed chronic β-blocker therapy had a different mortality rate than those who did not receive treatment.
Macchia, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Previous_prescription_of___blockers_is_associated.4.aspx
Results from basic science and narrative reviews suggest a potential role of β-blockers in patients with sepsis. Although the hypothesis is physiologically appealing, it could be seen as clinically counterintuitive. We sought to assess whether patients previously prescribed chronic β-blocker therapy had a different mortality rate than those who did not receive treatment.
Diurnal sedative changes during intensive care
Diurnal sedative changes during intensive care: Impact on liberation from mechanical ventilation and delirium. Critical care medicine, October 2012, Vol. 40(10), p.2788-96.
Seymour, C.W., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Diurnal_sedative_changes_during_intensive_care__.7.aspx
To determine whether benzodiazepine and propofol doses are increased at night and whether daytime and nighttime sedative doses are associated with delirium, coma, and delayed liberation from mechanical ventilation.
Seymour, C.W., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Diurnal_sedative_changes_during_intensive_care__.7.aspx
To determine whether benzodiazepine and propofol doses are increased at night and whether daytime and nighttime sedative doses are associated with delirium, coma, and delayed liberation from mechanical ventilation.
Challenge of assessing symptoms in seriously ill intensive care unit patients
Challenge of assessing symptoms in seriously ill intensive care unit patients: Can proxy reporters help? Critical care medicine, October 2012, Vol. 40(10), p.2760-67.
Puntillo, K.A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Challenge_of_assessing_symptoms_in_seriously_ill.3.aspx
Determine levels of agreement among intensive care unit patients and their family members, nurses, and physicians (proxies) regarding patients’ symptoms and compare levels of mean intensity (i.e., the magnitude of a symptom sensation) and distress (i.e., the degree of emotionality that a symptom engenders) of symptoms among patients and proxy reporters.
Puntillo, K.A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/10000/Challenge_of_assessing_symptoms_in_seriously_ill.3.aspx
Determine levels of agreement among intensive care unit patients and their family members, nurses, and physicians (proxies) regarding patients’ symptoms and compare levels of mean intensity (i.e., the magnitude of a symptom sensation) and distress (i.e., the degree of emotionality that a symptom engenders) of symptoms among patients and proxy reporters.
An observational study to determine the effect of delayed admission to the ICU
An observational study to determine the effect of delayed admission to the intensive care unit on patient outcome. Critical Care 2012, 16:R173.
O'Callaghan, D.J.P., et al.
http://ccforum.com/content/16/5/R173/abstract
Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem but the effect on patient outcome is not fully known. A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and temporary management within the operating theatre suite on patient outcome.
O'Callaghan, D.J.P., et al.
http://ccforum.com/content/16/5/R173/abstract
Delayed patient admission to the intensive care unit (ICU) due to lack of bed availability is a common problem but the effect on patient outcome is not fully known. A retrospective study was performed using departmental computerised records to determine the effect of delayed ICU admission and temporary management within the operating theatre suite on patient outcome.
Effect of non-clinical inter-hospital critical care unit transfer of critically ill patients
Effect of non-clinical inter-hospital critical care unit transfer of critically ill patients: a propensity-matched cohort analysis. Critical Care 2012, 16:R179.
http://ccforum.com/content/16/5/R179/abstract
Barratt, H., et al.
No matter how well resourced, individual hospitals cannot expect to meet all peaks in demand for adult general critical care. However, previous analyses suggest that patients transferred for non-clinical reasons have worse outcomes than those who are not transferred, but these studies were underpowered and hampered by residual case mix differences.
http://ccforum.com/content/16/5/R179/abstract
Barratt, H., et al.
No matter how well resourced, individual hospitals cannot expect to meet all peaks in demand for adult general critical care. However, previous analyses suggest that patients transferred for non-clinical reasons have worse outcomes than those who are not transferred, but these studies were underpowered and hampered by residual case mix differences.
Impaired cerebrovascular autoregulation in patients with severe sepsis
Impaired cerebrovascular autoregulation in patients with severe sepsis and sepsis-associated delirium. Critical Care 2012, 16:R181.
Schramm, P., et al.
http://ccforum.com/content/16/5/R181/abstract
Sepsis-associated delirium (SAD) increases morbidity in septic patients and, therefore, factors contributing to SAD should be further characterized. One possible mechanism might be the impairment of cerebrovascular autoregulation (AR) by sepsis, leading to cerebral hypo- or hyperperfusion in these haemodynamically unstable patients.
Schramm, P., et al.
http://ccforum.com/content/16/5/R181/abstract
Sepsis-associated delirium (SAD) increases morbidity in septic patients and, therefore, factors contributing to SAD should be further characterized. One possible mechanism might be the impairment of cerebrovascular autoregulation (AR) by sepsis, leading to cerebral hypo- or hyperperfusion in these haemodynamically unstable patients.
Identification of sepsis subtypes in critically ill adults
Identification of sepsis subtypes in critically ill adults using gene expression profiling. Critical Care 2012, 16:R183.
Maslove, D.M., et al.
Sepsis is a syndromic illness that has traditionally been defined by a set of broad, highly sensitive clinical parameters. As a result, numerous distinct pathophysiologic states may meet diagnostic criteria for sepsis, leading to syndrome heterogeneity. The existence of biologically distinct sepsis subtypes may in part explain the lack of actionable evidence from clinical trials of sepsis therapies.
Maslove, D.M., et al.
Sepsis is a syndromic illness that has traditionally been defined by a set of broad, highly sensitive clinical parameters. As a result, numerous distinct pathophysiologic states may meet diagnostic criteria for sepsis, leading to syndrome heterogeneity. The existence of biologically distinct sepsis subtypes may in part explain the lack of actionable evidence from clinical trials of sepsis therapies.
-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients
-3 fatty acid-enriched parenteral nutrition regimens in elective surgical and ICU patients: a meta-analysis.
Critical Care 2012, 16:R184.
Pradelli, L., et al.
http://ccforum.com/content/16/5/R184/abstract
Previous studies and a meta-analysis in surgical patients indicate that supplementing parenteral nutrition regimens with n-3 polyunsaturated fatty acids (PUFAs), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with improved laboratory and clinical outcomes in the setting of hyper-inflammatory conditions.
Critical Care 2012, 16:R184.
Pradelli, L., et al.
http://ccforum.com/content/16/5/R184/abstract
Previous studies and a meta-analysis in surgical patients indicate that supplementing parenteral nutrition regimens with n-3 polyunsaturated fatty acids (PUFAs), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with improved laboratory and clinical outcomes in the setting of hyper-inflammatory conditions.
Prevention and management of neutropenic sepsis
Prevention and management of neutropenic sepsis in patients with cancer: summary of NICE guidance. BMJ 2012; 345: e5368.
Phillips, R., et al.
http://www.bmj.com/highwire/filestream/603550/field_highwire_article_pdf/0/bmj.e5368
Neutropenic sepsis is a potentially fatal complication of treatment for cancer, with mortality rates of 2-21%.
An investigation by the National Confidential Enquiry into Patient Outcome and Death and a follow-up report by the National Chemotherapy Advisory Group highlighted problems in the management of neutropenic sepsis in adults receiving chemotherapy.
Phillips, R., et al.
http://www.bmj.com/highwire/filestream/603550/field_highwire_article_pdf/0/bmj.e5368
Neutropenic sepsis is a potentially fatal complication of treatment for cancer, with mortality rates of 2-21%.
An investigation by the National Confidential Enquiry into Patient Outcome and Death and a follow-up report by the National Chemotherapy Advisory Group highlighted problems in the management of neutropenic sepsis in adults receiving chemotherapy.
Variations in collecting date on central line infections
Variations in collecting date on central line infections. BMJ 2012; 345: e6377.
Limb, M.
http://www.bmj.com/content/345/bmj.e6377.pdf%2Bhtml
Researchers have found huge variability in the way English hospitals collect, record, and report rates of central line infections in seriously ill patients. They say their findings “sound a warning” about the NHS’s
ability to measure safety in healthcare and compare hospitals’ performance on infections accurately.
Limb, M.
http://www.bmj.com/content/345/bmj.e6377.pdf%2Bhtml
Researchers have found huge variability in the way English hospitals collect, record, and report rates of central line infections in seriously ill patients. They say their findings “sound a warning” about the NHS’s
ability to measure safety in healthcare and compare hospitals’ performance on infections accurately.
Doctors leaders, charities and hospices back Liverpool Care Pathway
Doctors leaders, charities and hospices back Liverpool Care Pathway. BMJ 2012; 345: e6654.
Kmietowicz, Z.
http://www.bmj.com/content/345/bmj.e6654.pdf%2Bhtml
A group of 20 organisations has issued a consensus statement backing the Liverpool Care Pathway for the Dying Patient and reiterating that the care is not about ending life but about delivering excellent end of life care.
Kmietowicz, Z.
http://www.bmj.com/content/345/bmj.e6654.pdf%2Bhtml
A group of 20 organisations has issued a consensus statement backing the Liverpool Care Pathway for the Dying Patient and reiterating that the care is not about ending life but about delivering excellent end of life care.
Tuesday, 4 September 2012
Risk factors and outcomes for prolonged versus brief fever
Risk factors and outcomes for prolonged versus brief fever: a prospective cohort study. Critical care, August 2012, 16(4): R150
Seguin, P., et al.
http://ccforum.com/content/16/4/R150/abstract
Prolonged fever occurs with infectious and noninfectious diseases but is poorly studied in intensive care units. The aims of this prospective multicenter noninterventional study were to determine the incidence and etiologies of prolonged fever in critically ill patients and compare outcomes for prolonged fever and short-lasting fever.
Seguin, P., et al.
http://ccforum.com/content/16/4/R150/abstract
Prolonged fever occurs with infectious and noninfectious diseases but is poorly studied in intensive care units. The aims of this prospective multicenter noninterventional study were to determine the incidence and etiologies of prolonged fever in critically ill patients and compare outcomes for prolonged fever and short-lasting fever.
Diacerhein attenuates the inflammatory response and improves survival in a model of severe sepsis
Diacerhein attenuates the inflammatory response and improves survival in a model of severe sepsis. Critical care, August 2012, 16(4): R158
Calisto, K.L., et al.
http://ccforum.com/content/16/4/R158/abstract
Hyperglycemia and insulin resistance has been associated with a worse outcome in sepsis. Although tight glycaemic control through insulin therapy has been shown to reduce morbidity and mortality rates, the effect of intensive insulin therapy in patients with severe sepsis is controversial because of the increased risk of serious adverse events related to hypoglycemia.
Calisto, K.L., et al.
http://ccforum.com/content/16/4/R158/abstract
Hyperglycemia and insulin resistance has been associated with a worse outcome in sepsis. Although tight glycaemic control through insulin therapy has been shown to reduce morbidity and mortality rates, the effect of intensive insulin therapy in patients with severe sepsis is controversial because of the increased risk of serious adverse events related to hypoglycemia.
Impact of surveillance of hospital-acquired infections on the incidence of ventilator-associated pneumonia in intensive care units
Impact of surveillance of hospital-acquired infections on the incidence of ventilator-associated pneumonia in intensive care units: a quasi-experimental study. Critical Care, August 2012; 16(4): R161.
Benet, T., et al.
http://ccforum.com/content/16/4/R161/abstract
The preventive impact of hospital-acquired infection (HAI) surveillance is difficult to assess. Our objective was to investigate the effect of HAI surveillance disruption on ventilator-associated pneumonia (VAP) incidence.
Benet, T., et al.
http://ccforum.com/content/16/4/R161/abstract
The preventive impact of hospital-acquired infection (HAI) surveillance is difficult to assess. Our objective was to investigate the effect of HAI surveillance disruption on ventilator-associated pneumonia (VAP) incidence.
Acute kidney injury patients have worse long-term outcomes
Acute kidney injury patients have worse long-term outcomes especially in the immediate post-ICU period. Critical care, August 2012, 16(4): 148.
Hoste, E.A.J. and De Corte, W.
http://ccforum.com/content/16/4/148/abstract
AKI is associated with worse outcome n the acute phase of acute illness, but also in the chronic phase. In a recent large Danish study, 1-year mortality was lower in AKI patients compared to non-AKI patients [1]. Mortality was most important during the first 50 days after ICU admission, while after 2 months the survival curves were similar in AKI and non-AKI patients.
Hoste, E.A.J. and De Corte, W.
http://ccforum.com/content/16/4/148/abstract
AKI is associated with worse outcome n the acute phase of acute illness, but also in the chronic phase. In a recent large Danish study, 1-year mortality was lower in AKI patients compared to non-AKI patients [1]. Mortality was most important during the first 50 days after ICU admission, while after 2 months the survival curves were similar in AKI and non-AKI patients.
Serious adverse effects associated with the use of rituximab
Serious adverse effects associated with the use of rituximab: a critical care perspective. Critical care, August 2012; 16(4):231.
Kasi, P.M., et al.
http://ccforum.com/content/16/4/231/abstract
The purpose of this review is to focus on the severe complications associated with the use of rituximab that require critical care. Management and prevention strategies for the most common complications are also discussed along with some examples of its uses within the critical care setting.
Kasi, P.M., et al.
http://ccforum.com/content/16/4/231/abstract
The purpose of this review is to focus on the severe complications associated with the use of rituximab that require critical care. Management and prevention strategies for the most common complications are also discussed along with some examples of its uses within the critical care setting.
An evaluation of the impact of antibiotic stewardship in reducing the use of high-risk antibiotics
An evaluation of the impact of antibiotic stewardship in reducing the use of high-risk antibiotics and its effect on the incidence of Clostridium difficile infection in hospital settings. J.Antimicrob. Chemother., Aug 2012 [epub]
Aldeyab, M.A., et al.
http://www.ncbi.nlm.nih.gov/pubmed/22899806?dopt=Abstract
To evaluate the impact of a high-risk antibiotic stewardship programme on reducing antibiotic use and on hospital Clostridium difficile infection (CDI) incidence rates. A secondary objective was to present the possible utility of time-series analysis as an antibiotic risk classification tool.
Aldeyab, M.A., et al.
http://www.ncbi.nlm.nih.gov/pubmed/22899806?dopt=Abstract
To evaluate the impact of a high-risk antibiotic stewardship programme on reducing antibiotic use and on hospital Clostridium difficile infection (CDI) incidence rates. A secondary objective was to present the possible utility of time-series analysis as an antibiotic risk classification tool.
Thursday, 16 August 2012
Neuro--ventilatory efficiency and extubation readiness in critically ill patients
Neuro--ventilatory efficiency and extubation readiness in critically ill patients. Critical care, July 2012, 16: R143.
Liu, L., et al.
http://ccforum.com/content/16/4/R143/abstract
Based on the hypothesis that weaning failure from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation.
Liu, L., et al.
http://ccforum.com/content/16/4/R143/abstract
Based on the hypothesis that weaning failure from mechanical ventilation is caused by respiratory demand exceeding the capacity of the respiratory muscles, we evaluated whether extubation failure could be characterized by increased respiratory drive and impaired efficiency to generate inspiratory pressure and ventilation.
Depressive symptoms in spouses of older patients with severe sepsis
Depressive symptoms in spouses of older patients with severe sepsis. Critical care medicine, August 2012, Vol. 40(8), p.2335-41.
Davydow, D., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Depressive_symptoms_in_spouses_of_older_patients.10.aspx
Objective: To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse’s presepsis history, whether this risk differs by sex, and is associated with a sepsis patient’s disability after hospitalization.
Davydow, D., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Depressive_symptoms_in_spouses_of_older_patients.10.aspx
Objective: To examine whether spouses of patients with severe sepsis are at increased risk for depression independent of the spouse’s presepsis history, whether this risk differs by sex, and is associated with a sepsis patient’s disability after hospitalization.
Light and the outcome of the critically ill
Light and the outcome of the critically ill: an observational cohort study. Critical care, July 2012, 16: R132.
Castro, R.A., et al.
http://ccforum.com/content/16/4/R132/abstract
Light before and during acute illness has been associated with both benefit and harm in animal models and small human studies. Our objective was to determine the associations of light duration (photoperiod) and intensity (insolation) before and during critical illness with hospital mortality in ICU patients. Based on the 'winter immunoenhancement' theory, we tested the hypothesis that a shorter photoperiod before critical illness is associated with improved survival.
Castro, R.A., et al.
http://ccforum.com/content/16/4/R132/abstract
Light before and during acute illness has been associated with both benefit and harm in animal models and small human studies. Our objective was to determine the associations of light duration (photoperiod) and intensity (insolation) before and during critical illness with hospital mortality in ICU patients. Based on the 'winter immunoenhancement' theory, we tested the hypothesis that a shorter photoperiod before critical illness is associated with improved survival.
Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation
Development and pilot testing of a decision aid for surrogates of patients with prolonged mechanical ventilation. Critical care medicine, August 2012, Vol. 40(8), p.2327-34.
Cox, C.E., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Development_and_pilot_testing_of_a_decision_aid.9.aspx
Shared decision making is inadequate in intensive care units. Decision aids can improve decision making quality, though their role in an intensive care units setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation.
Cox, C.E., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Development_and_pilot_testing_of_a_decision_aid.9.aspx
Shared decision making is inadequate in intensive care units. Decision aids can improve decision making quality, though their role in an intensive care units setting is unclear. We aimed to develop and pilot test a decision aid for shared decision makers of patients undergoing prolonged mechanical ventilation.
Identifying family members who may struggle in the role of surrogate decision maker
Identifying family members who may struggle in the role of surrogate decision maker. Critical care medicine, August 2012, Vol. 40(8), p.2281-86.
Majesko, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Identifying_family_members_who_may_struggle_in_the.2.aspx
Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties.
Majesko, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/08000/Identifying_family_members_who_may_struggle_in_the.2.aspx
Although acting as a surrogate decision maker can be highly distressing for some family members of intensive care unit patients, little is known about whether there are modifiable risk factors for the occurrence of such difficulties.
Do earplugs stop noise driving critical care patients into delirium?
Do earplugs stop noise driving critical care patients into delirium? Critical care, July 2012, 16: 139.
Mills, G.H. and Bourne, R.S.
http://ccforum.com/content/16/4/139/abstract
Quality sleep is a problem for the critically ill who are cared for in an environment where interventions night and day are common, staff members are constantly present in relatively high numbers, and treatment is accompanied by a range of changing warning tones and alarms and lights. These critical care units are generally designed without a focus on patient comfort, sleep, and rest and often lack access to appropriate natural daylight. To add to this problem, critical illness, particularly sepsis, disrupts circadian rhythms and sleep patterns, and disruption of circadian rhythms, in turn, impairs immunity and contributes to delirium.
Mills, G.H. and Bourne, R.S.
http://ccforum.com/content/16/4/139/abstract
Quality sleep is a problem for the critically ill who are cared for in an environment where interventions night and day are common, staff members are constantly present in relatively high numbers, and treatment is accompanied by a range of changing warning tones and alarms and lights. These critical care units are generally designed without a focus on patient comfort, sleep, and rest and often lack access to appropriate natural daylight. To add to this problem, critical illness, particularly sepsis, disrupts circadian rhythms and sleep patterns, and disruption of circadian rhythms, in turn, impairs immunity and contributes to delirium.
Critical care nurses' judgement of pain status
Critical care nurses' judgement of pain status: A case study design. Intensive & critical care nursing, August 2012, Vol.28(4), p.215-23.
Connor, L.O.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000055/abstract?rss=yes
In the performance of their professional activities, critical care nurses routinely make important judgements based on uncertain, fallible and inter-substitutable data. It is anticipated that this study will make visible the strategy by which critical care nurses use and combine multiple fallible cues, of which little is known, to reach a judgement about the pain status of the ventilated patient after coronary artery bypass graft (CABG) surgery.
Connor, L.O.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000055/abstract?rss=yes
In the performance of their professional activities, critical care nurses routinely make important judgements based on uncertain, fallible and inter-substitutable data. It is anticipated that this study will make visible the strategy by which critical care nurses use and combine multiple fallible cues, of which little is known, to reach a judgement about the pain status of the ventilated patient after coronary artery bypass graft (CABG) surgery.
How can nurses facilitate patient's transitions from intensive care?
How can nurses facilitate patient's transitions from intensive care? Intensive & critical care nursing, August 2012, Vol. 28(4), p.224-233.
Haggstrom, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000031/abstract?rss=yes
Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process.
Haggstrom, M., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000031/abstract?rss=yes
Intensive care patients often experience feelings of powerlessness and vulnerability when being transferred from an intensive care unit to a general ward. The aim of this study was to develop a grounded theory of nurses care for patients in the ICU transitional care process.
End of life in intensive care
End of life in intensive care: Is transfer home an alternative? Intensive & critical care nursing, August 2012, Vol. 28(4), p.234-241.
Tellett, L., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000079/abstract?rss=yes
The past decade has witnessed an increased focus on improving the quality of end of life care internationally. This has resulted in the development of specific health policy work streams to support patient choice and improve standards of care and patient experience. One concept well explored in areas outside of critical care is that of home care at the end of life. This paper seeks to challenge assumptions and practices about the options for transferring the critically ill patient home at end of life.
Tellett, L., et al.
http://www.intensivecriticalcarenursing.com/article/PIIS0964339712000079/abstract?rss=yes
The past decade has witnessed an increased focus on improving the quality of end of life care internationally. This has resulted in the development of specific health policy work streams to support patient choice and improve standards of care and patient experience. One concept well explored in areas outside of critical care is that of home care at the end of life. This paper seeks to challenge assumptions and practices about the options for transferring the critically ill patient home at end of life.
Tuesday, 10 July 2012
Should lower respiratory tract excretions from intensive care patients be systematically screened for influenza?
Should lower respiratory tract excretions from intensive care patients be systematically screened for influenza virus during the influenza season? Critical care 2012, Vol. 16: R104
Munoz, P., et al.
http://ccforum.com/content/16/3/R104
Influenza is easily overlooked in intensive care units (ICUs), particularly in patients with alternative causes of respiratory failure or in those who acquire influenza during their ICU stay.
Munoz, P., et al.
http://ccforum.com/content/16/3/R104
Influenza is easily overlooked in intensive care units (ICUs), particularly in patients with alternative causes of respiratory failure or in those who acquire influenza during their ICU stay.
The determinants of hospital mortality among patients with septic shock
The determinants of hospital mortality among patients with septic shock receiving appropriate initial antibiotic treatment. Critical care medicine, July 2012, Vol. 40(7), p.2016-21.
Labelle, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/The_determinants_of_hospital_mortality_among.2.aspx
Labelle, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/The_determinants_of_hospital_mortality_among.2.aspx
To identify the determinants of hospital mortality among patients with septic shock receiving appropriate initial antibiotic treatment. A retrospective cohort study of hospitalized patients with blood culture positive septic shock (January 2002–December 2007).
Impact of an intensive care unit diary on psychological distress in patients and relatives
Impact of an intensive care unit diary on psychological distress in patients and relatives. Critical care medicine, July 2012, Vol. 40(7), p.2033-2040.
Garrouste-Orgeas, M., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/Impact_of_an_intensive_care_unit_diary_on.4.aspx
Garrouste-Orgeas, M., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/Impact_of_an_intensive_care_unit_diary_on.4.aspx
To assess the impact of an intensive care unit diary on the psychological well-being of patients and relatives 3 and 12 months after intensive care unit discharge. Prospective single-center study with an intervention period between two control periods.
The top-cited clinical research articles on sepsis
The top-cited clinical research articles on sepsis: a bibliometric analysis. Critical care 2012, Vol. 16: R110.
Tao, T., et al.
http://ccforum.com/content/16/3/R110/abstract
A comprehensive list of citation classics in sepsis was generated by searching the database of Web of Science-Expanded (1970 to present) using keywords "sepsis" or "septic shock". The top 50 cited clinical research papers were retrieved by reading the abstract or full text if needed. Each eligible article was reviewed for basic information, including countries of origin, article types, journals, authors and funding sources.
Tao, T., et al.
http://ccforum.com/content/16/3/R110/abstract
A comprehensive list of citation classics in sepsis was generated by searching the database of Web of Science-Expanded (1970 to present) using keywords "sepsis" or "septic shock". The top 50 cited clinical research papers were retrieved by reading the abstract or full text if needed. Each eligible article was reviewed for basic information, including countries of origin, article types, journals, authors and funding sources.
Down but not out: myocardial depression in sepsis
Down but not out: myocardial depression in sepsis. Critical care 2012, Vol. 16: 132.
McClean, A.S.
Myocardial depression in septic patients is well recognized yet still poorly understood. The prognostic significance in terms of overall mortality when it is identified, remains in dispute. Parameters of left ventricular function measured by tissue Doppler imaging may assist in resolving whether dysfunction identified early in the course of sepsis is a good prognostic sign.
McClean, A.S.
Myocardial depression in septic patients is well recognized yet still poorly understood. The prognostic significance in terms of overall mortality when it is identified, remains in dispute. Parameters of left ventricular function measured by tissue Doppler imaging may assist in resolving whether dysfunction identified early in the course of sepsis is a good prognostic sign.
Should heparin-binding protein levels be routinely monitored in patients with severe sepsis and septic shock?
Should heparin-binding protein levels be routinely monitored in patients with severe sepsis and septic shock? Critical care, 2012, Vol. 16: 133
Mnull, H. and Onull, B.
Heparin-binding protein (HBP), also known as azurocidin, has multiple functions in the inflammatory process, especially during severe infections. Beside its antimicrobial properties, HBP may induce vascular leakage leading to extravascular efflux, which is an important pathophysiologic event in the development of septic shock.
Mnull, H. and Onull, B.
Heparin-binding protein (HBP), also known as azurocidin, has multiple functions in the inflammatory process, especially during severe infections. Beside its antimicrobial properties, HBP may induce vascular leakage leading to extravascular efflux, which is an important pathophysiologic event in the development of septic shock.
The relationship between delirium duration, white matter integrity and cognitive impairment in intensive care unit survivors
The relationship between delirium duration, white matter integrity and cognitive impairment in intensive care unit survivors as determined by diffusion tensor imaging. Critical care medicine, Vol. 40(7), p.2182-9.
Morandi, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/The_relationship_between_delirium_duration,_white.23.aspx
Evidence is emerging that delirium duration is a predictor of long-term cognitive impairment in intensive care unit survivors. Relationships between 1) delirium duration and brain white matter integrity, and 2) white matter integrity and long-term cognitive impairment are poorly understood and could be explored using magnetic resonance imaging.
Morandi, A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/07000/The_relationship_between_delirium_duration,_white.23.aspx
Evidence is emerging that delirium duration is a predictor of long-term cognitive impairment in intensive care unit survivors. Relationships between 1) delirium duration and brain white matter integrity, and 2) white matter integrity and long-term cognitive impairment are poorly understood and could be explored using magnetic resonance imaging.
A prospective analysis of lymphocyte phenotype and function over the course of acute sepsis
A prospective analysis of lymphocyte phenotype and function over the course of acute sepsis. Critical care 2012, Vol. 16: R112.
Boomer, J.S., et al.
http://ccforum.com/content/16/3/R112/abstract
Severe sepsis is characterized by an initial hyper-inflammatory response that may progress to an immune-suppressed state associated with increased susceptibility to nosocomial infection. Analysis of samples obtained from patients that died of sepsis has identified expression of specific inhibitory receptors expressed on lymphocytes that are associated with cell exhaustion. The objective of this study was to prospectively determine the pattern of expression of these receptors and immune cell function in patients with acute sepsis.
Boomer, J.S., et al.
http://ccforum.com/content/16/3/R112/abstract
Severe sepsis is characterized by an initial hyper-inflammatory response that may progress to an immune-suppressed state associated with increased susceptibility to nosocomial infection. Analysis of samples obtained from patients that died of sepsis has identified expression of specific inhibitory receptors expressed on lymphocytes that are associated with cell exhaustion. The objective of this study was to prospectively determine the pattern of expression of these receptors and immune cell function in patients with acute sepsis.
The confusion assessment method for the Intensive Care Unit
The confusion assessment method for the Intensive Care Unit and intensive care delirium screening checklist for the diagnosis of delirium. Critical care 2012, Vol. 16: R115.
Gusmao-Flores, D., et al.
http://ccforum.com/content/16/4/R115/abstract
Delirium is a frequent form of acute brain dysfunction in critically ill patients, and several detection tools for it have been developed for use in the Intensive Care Unit (ICU). The objective of this study is to evaluate the current evidence on the accuracy of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium in critically ill patients.
Gusmao-Flores, D., et al.
http://ccforum.com/content/16/4/R115/abstract
Delirium is a frequent form of acute brain dysfunction in critically ill patients, and several detection tools for it have been developed for use in the Intensive Care Unit (ICU). The objective of this study is to evaluate the current evidence on the accuracy of the Confusion Assessment Method for Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) for the diagnosis of delirium in critically ill patients.
Early and simple detection of diastolic dysfunction during weaning from mechanical ventilation
Early and simple detection of diastolic dysfunction during weaning from mechanical ventilation. Critical care, July 2012, Vol. 16: 137.
Gnull, V.
Weaning from mechanical ventilation imposes additional work on the cardiovascular system and can provoke or unmask left ventricular diastolic dysfunction with consecutive pulmonary edema or systolic dysfunction with inadequate increase of cardiac output and unsuccessful weaning. Echocardiography, which is increasingly used for hemodynamic assessment of critically ill patients, allows differentiation between systolic and diastolic failure. For various reasons, transthoracic echocardiographic assessment was limited to patients with good echo visibility and to those with sinus rhythm without excessive tachycardia. In these patients, often selected after unsuccessful weaning, echocardiographic findings were predictive for weaning failure of cardiac origin. In some studies, patients with various degrees of systolic dysfunction were included, making evaluation of the diastolic dysfunction to the weaning failure even more difficult.
Gnull, V.
Weaning from mechanical ventilation imposes additional work on the cardiovascular system and can provoke or unmask left ventricular diastolic dysfunction with consecutive pulmonary edema or systolic dysfunction with inadequate increase of cardiac output and unsuccessful weaning. Echocardiography, which is increasingly used for hemodynamic assessment of critically ill patients, allows differentiation between systolic and diastolic failure. For various reasons, transthoracic echocardiographic assessment was limited to patients with good echo visibility and to those with sinus rhythm without excessive tachycardia. In these patients, often selected after unsuccessful weaning, echocardiographic findings were predictive for weaning failure of cardiac origin. In some studies, patients with various degrees of systolic dysfunction were included, making evaluation of the diastolic dysfunction to the weaning failure even more difficult.
Thursday, 10 May 2012
Antibiotic strategies in severe nosocomial sepsis
Antibiotic strategies in severe nosocomial sepsis: why do we not de-escalate more often? Critical care medicine, May 2012, Vol. 40(5), p.1404-09.
Heenen, S., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Antibiotic_strategies_in_severe_nosocomial_sepsis_.2.aspx
We reviewed all episodes of severe sepsis treated over a 1-yr period in the department of intensive care. Antimicrobial therapy was considered as appropriate when the antimicrobial had in vitro activity against the causative microorganisms.
Heenen, S., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Antibiotic_strategies_in_severe_nosocomial_sepsis_.2.aspx
We reviewed all episodes of severe sepsis treated over a 1-yr period in the department of intensive care. Antimicrobial therapy was considered as appropriate when the antimicrobial had in vitro activity against the causative microorganisms.
Evaluating the use of recombinant human activated protein C in adult severe sepsis
Evaluating the use of recombinant human activated protein C in adult severe sepsis: results of the surviving sepsis campaign. Critical care medicine, May 2012, Vol. 40(5), p.1417-1426.
Casserly, B., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Evaluating_the_use_of_recombinant_human_activated.4.aspx
The Surviving Sepsis Campaign developed guidelines for the administration of recombinant human activated protein C in adult severe sepsis. However, it is not clear how these impacted clinical practice or patient outcome.
Casserly, B., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Evaluating_the_use_of_recombinant_human_activated.4.aspx
The Surviving Sepsis Campaign developed guidelines for the administration of recombinant human activated protein C in adult severe sepsis. However, it is not clear how these impacted clinical practice or patient outcome.
Active surveillance cultures of methicillin-resistant Staphylococcus aureus as a tool to predict methicillin-resistant S.aureus ventilator-associated pneumonia
Active surveillance cultures of methicillin-resistant Staphylococcus aureus as a tool to predict methicillin-resistant S.aureus ventilator-associated pneumonia. Critical care medicine, May 2012, Vol. 40(5), p.1437-1442.
Chan, J.D., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Active_surveillance_cultures_of.6.aspx
Ventilator-associated pneumonia is one of the most common infections in the intensive care unit and methicillin-resistant Staphylococcus aureus has emerged as a common cause of ventilator-associated pneumonia. We sought to study the performance characteristics of once weekly active surveillance culture of methicillin-resistant S. aureuscolonization in predicting the development of methicillin-resistant S. aureus ventilator-associated pneumonia.
Chan, J.D., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/05000/Active_surveillance_cultures_of.6.aspx
Ventilator-associated pneumonia is one of the most common infections in the intensive care unit and methicillin-resistant Staphylococcus aureus has emerged as a common cause of ventilator-associated pneumonia. We sought to study the performance characteristics of once weekly active surveillance culture of methicillin-resistant S. aureuscolonization in predicting the development of methicillin-resistant S. aureus ventilator-associated pneumonia.
The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock
The prognostic value of left ventricular systolic function measured by tissue Doppler imaging in septic shock. Critical care, 2012, 16, R71.
Weng, L., et al.
http://ccforum.com/content/16/3/R71/abstract
Left ventricular (LV) dysfunction is common in septic shock. Its association with clinical outcome is still controversial. Tissue Doppler imaging (TDI) is a useful tool to quantify LV function, however, few knowledge is available about the prognostic value of these TDI variables in septic shock. Therefore, we performed this prospective study to determine the role of TDI variables in septic shock.
Weng, L., et al.
http://ccforum.com/content/16/3/R71/abstract
Left ventricular (LV) dysfunction is common in septic shock. Its association with clinical outcome is still controversial. Tissue Doppler imaging (TDI) is a useful tool to quantify LV function, however, few knowledge is available about the prognostic value of these TDI variables in septic shock. Therefore, we performed this prospective study to determine the role of TDI variables in septic shock.
The effect of earplugs during the night on the onset of delirium and sleep perception
The effect of earplugs during the night on the onset of delirium and sleep perception: a randomized controlled trial in intensive care patients. Critical care, 2012, 16, R73.
Van Rompaey, B., et al.
http://ccforum.com/content/16/3/R73/abstract
This study hypothesised that a sound reduction during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, does the use of earplugs during the night improve the quality of sleep in the ICU?
Van Rompaey, B., et al.
http://ccforum.com/content/16/3/R73/abstract
This study hypothesised that a sound reduction during the night using earplugs could be beneficial in the prevention of intensive care delirium. Two research questions were formulated. First, does the use of earplugs during the night reduce the onset of delirium or confusion in the ICU? Second, does the use of earplugs during the night improve the quality of sleep in the ICU?
Brain natriuretic peptide for prediction of mortality in patients with sepsis
Brain natriurectic peptide for prediction of mortality in patients with sepsis: a systematic review and meta-analysis. Critical care, 2012, 16, R74.
Wang, F., et al.
http://ccforum.com/content/16/3/R74/abstract
Early identification of septic patients at high risk of dying remains a challenge. The prognostic role of brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) in septic patients remains controversial. The purpose of this systematic review and meta-analysis was to investigate the value of elevated BNP or NT-proBNP in predicting mortality in septic patients.
Wang, F., et al.
http://ccforum.com/content/16/3/R74/abstract
Early identification of septic patients at high risk of dying remains a challenge. The prognostic role of brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) in septic patients remains controversial. The purpose of this systematic review and meta-analysis was to investigate the value of elevated BNP or NT-proBNP in predicting mortality in septic patients.
Higher vs lower fluid volume for septic shock
Higher vs lower fluid volume for septic shock: clinical characteristics and outcome in unselected patients in a prospective, multicenter cohort. Critical care, 2012, 16, R76.
Smith, S.H. and Perner, A.
http://ccforum.com/content/16/3/R76/abstract
Patients with septic shock require fluid, but the optimum amount is unknown. Therefore we assessed patient characteristics and outcome associated to fluid volume in unselected patients with septic shock including those with three days of shock.
Smith, S.H. and Perner, A.
http://ccforum.com/content/16/3/R76/abstract
Patients with septic shock require fluid, but the optimum amount is unknown. Therefore we assessed patient characteristics and outcome associated to fluid volume in unselected patients with septic shock including those with three days of shock.
Effects of increasing compliance with minimal sedation on duration of mechanical ventilation
Effects of increasing compliance with minimal sedation on duration of mechanical ventilation: a quality improvement intervention. Critical care, 2012, 16: R78.
Amaral, A., et al.
http://ccforum.com/content/16/3/R78/abstract
In the past two decades, healthcare adopted industrial strategies for process measurement and control. In the industry model, care is taken to avoid minimal deviations from a standard. In healthcare there is scarce data to support that a similar strategy can lead to better outcomes. Briefly, when compliance is high, further attempts to improve uptake of a process are seldom made. Our intensive care unit (ICU) improved the compliance with minimizing sedation from a high baseline of 80.4% (95% CI: 66.9 to 90.2) to 96.2% (95% CI: 95.2 to 97.0) 12 months after a quality improvement initiative.
Amaral, A., et al.
http://ccforum.com/content/16/3/R78/abstract
In the past two decades, healthcare adopted industrial strategies for process measurement and control. In the industry model, care is taken to avoid minimal deviations from a standard. In healthcare there is scarce data to support that a similar strategy can lead to better outcomes. Briefly, when compliance is high, further attempts to improve uptake of a process are seldom made. Our intensive care unit (ICU) improved the compliance with minimizing sedation from a high baseline of 80.4% (95% CI: 66.9 to 90.2) to 96.2% (95% CI: 95.2 to 97.0) 12 months after a quality improvement initiative.
Tuesday, 10 April 2012
Developing user-centred critical care discharge information
Developing user-centred critical care discharge information to support early critical illness rehabilitation using the Medical Research Council's complex interventions framework. Intensive and critical care nursing, April 2012, Vol. 28(2), p.123-131.
Bench, S.D., et al.
This paper reports on an intervention designed during an ongoing two phase project aimed at improving early critical illness rehabilitation. It focuses specifically on the justification for a newly developed critical care discharge information pack: ‘User Centred Critical Care Discharge Information Pack’ (UCCDIP). The intervention is described in detail and the chosen research methods are discussed.
Re-building life after ICU
Re-building life after ICU: A qualitative study of the patients' perspective. Intensive and critical care nursing, April 2012, Vol. 28(2), p.114-122.
Deacon, K.S.
Healthcare professionals in ICU, acute ward and community settings need to be aware of the broad array of physical and psychological challenges faced by patients who have been critically ill. Healthcare professionals need to ensure a holistic approach is implemented to coordinate and facilitate rehabilitation, to address identified patients’ needs.
Integrating a multidisciplinary mobility programme into intensive care practice
Integrating a multidisciplinary mobility programme into intensive care practice: A multicentre collaborative. Intensive and critical care nursing, April, 2012, Vol. 28(2), p.88-97.
Bassett, R.D., et al.
This multi-centre, ICU collaborative has shown that improvements in team culture, communication and resources can improve adoption of early mobility in ICU patients.
Move it or lose it?
Move it or lose it? A survey of the aims of treatment when using passive movements in intensive care. Intensive and critical care nursing, April 2012, Vol. 28(2), p.82-87.
Stockley, R.C., et al.
In ICU early mobilisation and rehabilitation are considered vital to restore function and may reduce the duration of ICU and inpatient stay. However, for patients to participate in mobility practice or bed exercises, they must be conscious. Passive movements could be considered as a very early form of mobilisation for intensive care patients who are sedated and ventilated and are widely used by United Kingdom physiotherapists.
Critical care rehabilitation and early mobilisation
Critical care rehabilitation and early mobilisation: An emerging standard of care. Intensive and critical care nursing, April 2012, Vol. 28(2), p. 55-57.
Grapp, M.J. & McFetridge, B.
Critical care rehabilitation across the trajectory of recovery, beginning in the critical care unit and ending with recovery to an optimal level of health is presently a major focus of health care and research. After discharge from the critical care unit, rehabilitation is often begun in earnest. Although the focus of critical care is appropriately on stabilisation and survival, rehabilitation must also be a major part of the plan of care during these initial stages of care.
Volume-limited versus pressure-limited hemodynamic management in septic and nonseptic shock
Volume-limited versus pressure-limited hemodynamic management in septic and nonseptic shock. Critical care medicine, April, 2012, Vol. 40(4), p.1177-1185.
Trof, R.J., et al.
Hemodynamic management guided by transpulmonary thermodilution vs. pulmonary artery catheter in shock did not affect ventilator-free days, lengths of stay, organ failures, and mortality of critically ill patients.
Lest we forget the endothelial glycocalyx in sepsis
Lest we forget the endothelial glycocalyx in sepsis. Critical Care 2012, 16, 121.
Burke-Gaffney, A.
Sepsis is the third largest cause of death in industrialised countries, but treatment remains largely supportive and effective therapeutic interventions are urgently needed. Disruption and dysfunction of the microvascular endothelium leading directly or indirectly to multiple organ failure are now recognised to underpin the pathophysiology of sepsis.
Noninvasive monitoring of blood pressure in the critically ill
Noninvasive monitoring of blood pressure in the critically ill: Reliability according to the cuff site (arm, thigh or ankle). Critical care medicine, april 2012, Vol. 40(4), p.1207-1213.
Lakhal, K., et al.
In the critically ill, blood pressure measurements mostly rely on automated oscillometric devices pending the intra-arterial catheter insertion or after its removal. If the arms are inaccessible, the cuff is placed at the ankle or the thigh, but this common practice has never been assessed.
Thursday, 16 February 2012
Development and validation of PRE-DELIRIC delirium prediction model for intensive care patients
Development and validation of PRE-DELIRIC delirium prediction model for intensive care patients: Observational multicentre study. BMJ 2012; 344: e420.
van den Boogaard, M., et al.
Objectives: To develop and validate a delirium prediction model for adult intensive care patients and determine its additional value compared with prediction by care givers.
Nurses' perceptions of communications training in the ICU
Nurses' perceptions of communications training in the ICU. Intensive and critical care nursing, 2012, 28, p.16-25.
Radtke, J.V., et al.
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.
The lived experiences of adult intensive care patients who were conscious during mechanical ventilation
The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: A phenomenological-hermeneutic study. Intensive and critical care nursing, 2012, 28, p.6-15.
Karlsson, V., et al.
The aim of this study was to illuminate the lived experience of patients who were conscious during mechanical ventilation in an intensive care unit.
Should patients receive general anaesthesia prior to extubation at the end of life?
Should patients receive general anaesthesia prior to extubation at the end of life? Critical care medicine, Feb 2012, Vol. 40(2), p. 631-633.
Truog, R.D., et al.
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.
Zero risk for central line-associated bloodstream infection. Are we there yet?
Zero risk for central line-associated bloodstream infection. Are we there yet? Critical care medicine, Feb 2012, Vol. 40(2), p. 388-393.
McLaws, M-L. and Burrell, A.R.
Objective: Identify the longest period a central line remains free from central line-associated bloodstream infection during an 18-month insertion-bundle project.
Family response to critical illness: Post-intensive care syndrome - family
Family response to critical illness: Post-intensive care syndrome - family. Critical care medicine, Feb. 2012, Vol. 40(2), p. 618-624.
Davidson, J.E., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/02000/Family_response_to_critical_illness__.34.aspx
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
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.
Gwenhael, C., et al.
This study aimed to investigate, in patients with severe sepsis, the correlation between central venous oxygen saturation and tissue oxygen saturation at different levels.
Energy deficit and length of hospital stay can be reduced by a two-step quality improvement of nutrition therapy
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.
Soguel, LRD, et al.
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.
Thursday, 12 January 2012
Prevention of ventilator-associated pneumonia or ventilator-associated complications
Prevention of ventilator-associated pneumonia or ventilator-associated compliations: A worthy, yet challenging goal. Critical care medicine, Jan 2012, Vol. 40(1), p.271-277.
Kollef, M.H.
http://journals.lww.com/ccmjournal/Abstract/2012/01000/Prevention_of_ventilator_associated_pneumonia_or.40.aspx
Ventilator-associated pneumonia is a difficult diagnosis to establish in the critically ill patient because of the presence of underlying cardiopulmonary disorders (e.g., pulmonary contusion, acute respiratory distress syndrome, atelectasis) and the nonspecific radiographic and clinical signs associated with this infection.
Kollef, M.H.
http://journals.lww.com/ccmjournal/Abstract/2012/01000/Prevention_of_ventilator_associated_pneumonia_or.40.aspx
Ventilator-associated pneumonia is a difficult diagnosis to establish in the critically ill patient because of the presence of underlying cardiopulmonary disorders (e.g., pulmonary contusion, acute respiratory distress syndrome, atelectasis) and the nonspecific radiographic and clinical signs associated with this infection.
The role of the medical emergency team in end-of-life care
The role of the medical emergency team in end-of-life care: A multicenter, prospective, observational study. Critical care medicine, Jan. 2012, Vol. 40(1), p.98-103.
Jones, D.A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/01000/The_role_of_the_medical_emergency_team_in.15.aspx
Objective: To investigate the role of medical emergency teams in end-of-life care planning. Design: One month prospective audit of medical emergency team calls. Setting: Seven university-affiliated hospitals in Australia, Canada, and Sweden.
Jones, D.A., et al.
http://journals.lww.com/ccmjournal/Abstract/2012/01000/The_role_of_the_medical_emergency_team_in.15.aspx
Objective: To investigate the role of medical emergency teams in end-of-life care planning. Design: One month prospective audit of medical emergency team calls. Setting: Seven university-affiliated hospitals in Australia, Canada, and Sweden.
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