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.
Monday, 8 October 2012
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.
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