A systematic review of evidence-informed practices for patient care rounds in the ICU. Critical care medicine, Vol. 41(8), p.2015-29.
Lane, D., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/A_Systematic_Review_of_Evidence_Informed_Practices.23.aspx
Patient care rounds are a key mechanism by which healthcare providers communicate and make patient care decisions in the ICU but no synthesis of best practices for rounds currently exists. Therefore, we systematically reviewed the evidence for facilitators and barriers to patient care rounds in the ICU.
Thursday, 18 July 2013
Body mass index is associated with hospital mortality in critically ill patients
Body mass index is associated with hospital mortality in critically ill patients: An observational cohort study. Critical care medicine, August 2013, Vol. 41(8), p.1878-83.
Pickkers, P., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Body_Mass_Index_Is_Associated_With_Hospital.7.aspx
Obesity is associated with a variety of diseases, which results in a decreased overall life expectancy. Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox. Conflicting results for critically ill patients are reported. Therefore, we wished to investigate the association of body mass index and hospital mortality in critically ill patients.
Pickkers, P., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Body_Mass_Index_Is_Associated_With_Hospital.7.aspx
Obesity is associated with a variety of diseases, which results in a decreased overall life expectancy. Nevertheless, some studies suggest that being overweight may reduce hospital mortality of certain patient groups, referred to as obesity paradox. Conflicting results for critically ill patients are reported. Therefore, we wished to investigate the association of body mass index and hospital mortality in critically ill patients.
Surviving intensive care
Surviving intensive care: A systematic review of healthcare resource use after hospital discharge. Critical care medicine, August 2013, Vol. 41(8), p.1832-43.
Lone, N.I., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Surviving_Intensive_Care___A_Systematic_Review_of.2.aspx
Intensive care survivors continue to experience significant morbidity following acute hospital discharge, but healthcare costs associated with this ongoing morbidity are poorly described. As the demand for intensive care increases, understanding the magnitude of post-acute hospital healthcare costs is of increasing relevance to clinicians and healthcare planners. We undertook a systematic review of the literature reporting major healthcare resource use by intensive care survivors following discharge from the hospital and identified factors associated with increased resource use.
Lone, N.I., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Surviving_Intensive_Care___A_Systematic_Review_of.2.aspx
Intensive care survivors continue to experience significant morbidity following acute hospital discharge, but healthcare costs associated with this ongoing morbidity are poorly described. As the demand for intensive care increases, understanding the magnitude of post-acute hospital healthcare costs is of increasing relevance to clinicians and healthcare planners. We undertook a systematic review of the literature reporting major healthcare resource use by intensive care survivors following discharge from the hospital and identified factors associated with increased resource use.
Fever in adult ICUs
Fever in adult ICUs: An interrupted time series analysis. Critical care medicine, August 2013, Vol. 41(8), p.1863-69.
Niven, D.J., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Fever_in_Adult_ICUs___An_Interrupted_Time_Series.5.aspx
Fever is common and associated with increased mortality among patients admitted to adult ICUs, yet recent literature suggests that the incidence of fever may be decreasing. The objective of this study was to determine whether the incidence of fever in adult ICUs changed over time and the factors responsible for the observed change.
Niven, D.J., et al.
http://journals.lww.com/ccmjournal/Abstract/2013/08000/Fever_in_Adult_ICUs___An_Interrupted_Time_Series.5.aspx
Fever is common and associated with increased mortality among patients admitted to adult ICUs, yet recent literature suggests that the incidence of fever may be decreasing. The objective of this study was to determine whether the incidence of fever in adult ICUs changed over time and the factors responsible for the observed change.
Therapeutic hypothermia: is it effective for non-VF/VT cardiac arrest?
Therapeutic hypothermia: is it effective for non-VF/VT cardiac arrest? Critical care, March 2013, 17: 215
Sandroni, C., et al.
http://ccforum.com/content/pdf/cc12524.pdf
Sudden cardiac death represents a major health problem. In adults, the prevalence of out-of-hospital cardiac arrest (OHCA) attended by the emergency medical services (EMS) ranges from 52 to 112 per 100,000 person-years in developed countries, whereas the prevalence of adult in-hospital cardiac arrest (IHCA) ranges from 1 to 5 per 1,000 patient admissions. Mortality from cardiac arrest exceeds 90 % in OHCA
and 70 % in most studies on IHCA. Patients who have a shock able rhythm, i.e., ventricular fibrillation
(VF) or pulseless ventricular tachycardia (VT), on initial electrocardiogram (EKG) have a consistently higher
survival than those whose initial cardiac rhythm is nonshockable, i.e., asystole or pulseless electrical activity
(PEA).
Sandroni, C., et al.
http://ccforum.com/content/pdf/cc12524.pdf
Sudden cardiac death represents a major health problem. In adults, the prevalence of out-of-hospital cardiac arrest (OHCA) attended by the emergency medical services (EMS) ranges from 52 to 112 per 100,000 person-years in developed countries, whereas the prevalence of adult in-hospital cardiac arrest (IHCA) ranges from 1 to 5 per 1,000 patient admissions. Mortality from cardiac arrest exceeds 90 % in OHCA
and 70 % in most studies on IHCA. Patients who have a shock able rhythm, i.e., ventricular fibrillation
(VF) or pulseless ventricular tachycardia (VT), on initial electrocardiogram (EKG) have a consistently higher
survival than those whose initial cardiac rhythm is nonshockable, i.e., asystole or pulseless electrical activity
(PEA).
Assessment of volume responsiveness during mechanical ventilation
Assessment of volume responsiveness during mechanical ventilation: recent advances. Critical care, March 2013, R:217
Monnet, X. and Teboul, J-L.
http://ccforum.com/content/pdf/cc12526.pdf
Predicting which patients with acute circulatory failure will respond to fluid by a significant increase in cardiac output is a daily challenge, in particular in the setting of the intensive care unit (ICU). This challenge has become even more crucial because evidence is growing that administering excessive amounts of fluid is a risk factor in critically ill patients, in particular in patients with lung injury.
Monnet, X. and Teboul, J-L.
http://ccforum.com/content/pdf/cc12526.pdf
Predicting which patients with acute circulatory failure will respond to fluid by a significant increase in cardiac output is a daily challenge, in particular in the setting of the intensive care unit (ICU). This challenge has become even more crucial because evidence is growing that administering excessive amounts of fluid is a risk factor in critically ill patients, in particular in patients with lung injury.
Patient monitoring alarms in the ICU and in the operating room
Patient monitoring alarms in the ICU and in the operating room. Critical care, March 2013, 17: R216
Schmid, F., et al.
http://ccforum.com/content/pdf/cc12525.pdf
In complex fields of work like aviation, mining, anesthesiology, and intensive care medicine – and here
particularly with regard to monitoring of vital functions – alarms are ubiquitous and have been the subject of
medical, technical, and psychological research for decades. Monitoring of vital functions and function
of life-support devices is essential for critically ill patients, although real evidence based data are missing.
Schmid, F., et al.
http://ccforum.com/content/pdf/cc12525.pdf
In complex fields of work like aviation, mining, anesthesiology, and intensive care medicine – and here
particularly with regard to monitoring of vital functions – alarms are ubiquitous and have been the subject of
medical, technical, and psychological research for decades. Monitoring of vital functions and function
of life-support devices is essential for critically ill patients, although real evidence based data are missing.
An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors
An exploration of social and economic outcome and associated health-related quality of life after critical illness in general intensive care unit survivors: A 12-month follow-up study. Critical care, May 2013, R:100
Griffiths, J., et al.
http://ccforum.com/content/pdf/cc12745.pdf
The socio-economic impact of critical illnesses on patients and their families in Europe has yet to be
determined. The aim of this exploratory study was to estimate changes in family circumstances, social and
economic stability, care requirements and access to health services for patients during their first 12 months after ICU discharge.
Griffiths, J., et al.
http://ccforum.com/content/pdf/cc12745.pdf
The socio-economic impact of critical illnesses on patients and their families in Europe has yet to be
determined. The aim of this exploratory study was to estimate changes in family circumstances, social and
economic stability, care requirements and access to health services for patients during their first 12 months after ICU discharge.
Cardiac ischemia in patients with septic shock randomized to vasopressin or narepinephrine
Cardiac ischemia in patients with septic shock randomized to vasopressin or norepinephrine. Critical care, June 2013, 17:R117
Mehta, S., et al.
http://ccforum.com/content/pdf/cc12789.pdf
Cardiac ischemia occurs frequently in critically ill patients, and is associated with increased mortality. Given that most critically ill patients cannot communicate symptoms, the diagnosis of cardiac ischemia can be challenging and necessitates that clinicians rely on cardiac biomarkers and electrocardiograms (ECGs). Patients receiving vasopressors may be at even higher risk of cardiac ischemia than other patients because of coronary artery vasoconstriction, increased systemic vasoconstriction-induced afterload, or catecholamine-driven increases in myocardial oxygen demand.
Mehta, S., et al.
http://ccforum.com/content/pdf/cc12789.pdf
Cardiac ischemia occurs frequently in critically ill patients, and is associated with increased mortality. Given that most critically ill patients cannot communicate symptoms, the diagnosis of cardiac ischemia can be challenging and necessitates that clinicians rely on cardiac biomarkers and electrocardiograms (ECGs). Patients receiving vasopressors may be at even higher risk of cardiac ischemia than other patients because of coronary artery vasoconstriction, increased systemic vasoconstriction-induced afterload, or catecholamine-driven increases in myocardial oxygen demand.
Continuous on-line glucose measurement by microdialysis in a central vein
Continuous on-line glucose measurement by microdialysis in a central vein. A pilot study. Critical care, May 2013, 17:R87
Blixt, C., et al.
http://ccforum.com/content/17/3/R87
Tight glucose control in the ICU has been proven difficult with an increased risk for hypoglycaemic episodes. Also the variability of glucose may have an impact on morbidity. An accurate and feasible on-line/continuous measurement is therefore desired. In this study a central vein catheter with a microdialysis membrane in combination with an on-line analyzer for continuous monitoring of circulating glucose and lactate by the central route was tested.
Blixt, C., et al.
http://ccforum.com/content/17/3/R87
Tight glucose control in the ICU has been proven difficult with an increased risk for hypoglycaemic episodes. Also the variability of glucose may have an impact on morbidity. An accurate and feasible on-line/continuous measurement is therefore desired. In this study a central vein catheter with a microdialysis membrane in combination with an on-line analyzer for continuous monitoring of circulating glucose and lactate by the central route was tested.
Monday, 15 July 2013
Patient photographs - a landmark for the ICU staff: A descriptive study
Patient photographs - a landmark for the ICU staff. A descriptive study. Intensive and critical care nursing, August 2013, Vol. 29(4), p.193-201.
Andersson, M., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(13)00037-2/abstract
The purpose of this study was to investigate ICU staff's perceptions of photographs displayed at the bedsides of unconscious patients and whether profession, years in ICU and work status had any influence on these perceptions.
Andersson, M., et al.
http://www.intensivecriticalcarenursing.com/article/S0964-3397(13)00037-2/abstract
The purpose of this study was to investigate ICU staff's perceptions of photographs displayed at the bedsides of unconscious patients and whether profession, years in ICU and work status had any influence on these perceptions.
Cognitive stimulation in ICU patients: should we pay more attention?
Cognitive stimulation in ICU patients: should we pay more attention? Critical care 2013, 17: 158
Turon, M., et al.
http://ccforum.com/content/pdf/cc12719.pdf
Advances in ICUs have raised survival rates, but they have highlighted the need to reduce the morbidity of ICU patients and improve their short- and long-term functional outcomes. Frequently these patients, especially with acute respiratory distress syndrome, present neurocognitive impairments that extend beyond their acute phase and hospital stay and lead to significant deficits in quality of life.
Turon, M., et al.
http://ccforum.com/content/pdf/cc12719.pdf
Advances in ICUs have raised survival rates, but they have highlighted the need to reduce the morbidity of ICU patients and improve their short- and long-term functional outcomes. Frequently these patients, especially with acute respiratory distress syndrome, present neurocognitive impairments that extend beyond their acute phase and hospital stay and lead to significant deficits in quality of life.
Do we need to innovate in critical care practice?
Do we need to innovate in critical care practice? Critical care 2013, 17: 166
Blanch, L., et al.
http://ccforum.com/content/pdf/cc12769.pdf
Clinical work and continuous investigation have improved the outcome of critically ill patients over time. Nowadays, innovation pulled by demand and translational research projects of excellence will constitute new opportunities for clinicians to improve care and provide economic incentives to be returned to the patient, institutions, and society.
Blanch, L., et al.
http://ccforum.com/content/pdf/cc12769.pdf
Clinical work and continuous investigation have improved the outcome of critically ill patients over time. Nowadays, innovation pulled by demand and translational research projects of excellence will constitute new opportunities for clinicians to improve care and provide economic incentives to be returned to the patient, institutions, and society.
Early alterations of B cells in patients with septic shock: another piece in the complex puzzle of the immune response in sepsis
Early alterations of B cells in patients with septic shock: another piece in the complex puzzle of the immune response to sepsis. Critical care, 2013, 17: 162
Girardis, M. and Cossarizza, A.
[No link available]
Impairment of the inflammatory-immune response is currently accepted as a hallmark of severe sepsis even in the early stages of the disease. In this context, the alterations of the circulating B-lymphocytes have never been described in detail. The study by Monserrat and colleagues in the previous issue of Critical Care indicated that, in patients with septic shock, the B-cell compartment is early and deeply altered with different patterns in subset distribution and activation between survivors and non-survivors.
Girardis, M. and Cossarizza, A.
[No link available]
Impairment of the inflammatory-immune response is currently accepted as a hallmark of severe sepsis even in the early stages of the disease. In this context, the alterations of the circulating B-lymphocytes have never been described in detail. The study by Monserrat and colleagues in the previous issue of Critical Care indicated that, in patients with septic shock, the B-cell compartment is early and deeply altered with different patterns in subset distribution and activation between survivors and non-survivors.
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