Physical therapy for the critically ill in the ICU

Physical therapy for the critically ill in the ICU: A systematic review and meta-analysis. Critical care medicine, June 2013, Vol. 41(6), p.1543-54.

Kayambu, G., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/06000/Physical_Therapy_for_the_Critically_Ill_in_the.19.aspx

The purpose of this systematic review was to review the evidence base for exercise in critically ill patients.

Physical rehabilitation of the critically ill trauma patient in the ICU

Physical rehabilitation of the critically ill trauma patient in the ICU. Critical care medicine, July 2013, Vol. 41(7), p. 1790-1801.

Engels, P.T., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/07000/Physical_Rehabilitation_of_the_Critically_Ill.24.aspx

Objectives: To review the existing evidence for early mobilization of the critically ill patients in the ICU with polytrauma; provide intensivists with an introduction to the biomechanics, physiology, and nomenclature of injuries; summarize the evidence for early mobilization in each anatomic area; and provide recommendations for the mobilization of these patients.

Do windows or natural views affect outcomes or costs among patients in ICUs?

Do windows or natural views affect outcomes or costs among patients in ICUs?  Critical care medicine, July 2013, Vol. 41(7), p.1645-55.

Kohn, R., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/07000/Do_Windows_or_Natural_Views_Affect_Outcomes_or.7.aspx

Objective: To determine whether potential exposure to natural light via windows or to more pleasing views through windows affects outcomes or costs among critically ill patients.

Fever in adult ICUs

Fever in adult ICUs: An interrupted time series analysis. Critical care medicine, Aug 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.

Evaluating pain, sedation and delirium in the neurologically critically ill

Evaluating pain, sedation and delirium in the neurologically critically ill - feasibility and reliability of standardized tools: A multi-institutional study.  Critical care medicine, Aug 2013, Vol. 41(8), 2002-07.

Yu, A., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/08000/Evaluating_Pain,_Sedation,_and_Delirium_in_the.21.aspx

Objectives: To assess the feasibility and reliability of systematic evaluations of analgesia, sedation level, and delirium features in the neurologically critically ill and to determine whether delirium features are linked to clinical outcomes in this population.

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, Aug 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.

Clostridium difficile infection

Clostridium difficile infection: A multicenter study of epidemiology and outcomes in mechanically ventilated patients. Critical care medicine, Aug 2013, Vol. 41(8), p.1968-75.

Micek, S.T., et al.

Clostridium difficile is a leading cause of hospital-associated infection in the United States. The purpose of this study is to assess the prevalence of C. difficile infection among mechanically ventilated patients within the ICUs of three academic hospitals and secondarily describe the influence of C. difficile infection on the outcomes of these patients.

Atypical sleep in ventilated patients

Atypical sleep in ventilated patients: Empirical electroencephalography findings and the path towards revised ICU sleep scoring criteria. Critical care medicine Aug 2013, Vol. 41(8), 1958-67.

Watson, P.L., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/08000/Atypical_Sleep_in_Ventilated_Patients___Empirical.16.aspx

Standard sleep scoring criteria may be unreliable when applied to critically ill patients. We sought to quantify typical and atypical polysomnographic findings in critically ill patients and to begin development and reliability testing of methodology to characterize the atypical polysomnographic tracings that confound standard sleep scoring criteria.

Safety of intrahospital transport in ventilated critically ill patients

Safety of intrahospital transport in ventilated critically ill patients: A multicenter cohort study. Critical care medicine, Aug 2013, Vol. 41(8), p.1919-28.

Schwebel, C., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/08000/Safety_of_Intrahospital_Transport_in_Ventilated.12.aspx

Objective: To describe intrahospital transport complications in critically ill patients receiving invasive mechanical ventilation.

Usefulness of combined bedside lung ultrasound and echocardiography to assess weaning failure from mechanical ventilation

Usefulness of combined bedside lung ultrasound and echocardiography to assess weaning failure from mechanical ventilation: A suggestive case.  Critical care medicine, Aug 2013, Vol. 41(8) [online case report]

Mongodi, S., et al.

http://journals.lww.com/ccmjournal/Abstract/2013/08000/Usefulness_of_Combined_Bedside_Lung_Ultrasound_and.50.aspx

Recognition of the cardiac origin of weaning failure is a crucial issue for successful discontinuation of mechanical ventilation. Bedside lung ultrasound and echocardiography have shown a potential in predicting weaning failure. Objective of this report was to describe the case of a patient repeatedly failing to wean from mechanical ventilation, where the combined use of lung ultrasound and echocardiography during a spontaneous breathing trial uncovered an unexpected cause of the failure.

Therapeutic drug monitoring of Amikacin in septic patients

Therapeutic drug monitoring of Amikacin in septic patients. Critical care, July 2013, 17: R165.

Duszynska, W., et al.

http://ccforum.com/content/17/4/R165/abstract

Use of higher than standard doses of amikacin (AMK) has been proposed during sepsis, especially to treat less susceptible bacterial strains. However, few data are available on drug concentrations during prolonged therapy and on potential adverse events related to this strategy.

Routine use of Staphylococcus aureus rapid diagnostic test in patients with suspected ventilator-associated pneumonia

Routine use of Staphylococcus aureus rapid diagnostic test in patients with suspected ventilator-associated pneumonia. Critical care, Aug 2013, 17 R:170.

Leone, M., et al.

http://ccforum.com/content/17/4/R170/abstract

In patients with ventilator-associated pneumonia (VAP), administration of an appropriate empirical antimicrobial treatment is associated with improved outcomes, leading to the prescription of broad-spectrum antibiotics including drugs active against methicillin resistant Staphylococcus aureus (MRSA). In order to avoid the overuse of antibiotics, the present study aimed to evaluate the technical characteristics of a rapid diagnostic test (Cepheid Xpert assay) in patients with suspected VAP.

Screening and risk factors of exocrine pancreatic insufficiency in critically ill adult patients

Screening and risk factors of exocrine pancreatic insufficiency in critically ill adult patients receiving enteral nutrition. Critical care, Aug 2013, 17 R171.

Wang, S., et al.

http://ccforum.com/content/17/4/R171/abstract

Malnutrition is a frequent problem associated with detrimental clinical outcomes in critically ill patients. To avoid malnutrition, most studies focus on the prevention of inadequate nutrition delivery, whereas little attention is paid to the potential role of exocrine pancreatic insufficiency (EPI). We therefore aim to evaluate the prevalence of EPI and identify its potential risk factors in critically ill adult patients without pre-existing pancreatic diseases.

Critical care - an all-encompassing specialty

Critical care - an all-encompassing specialty. N Engl J Med, Aug 2013; 369:669-670.

Finfer, S. and Vincent J-L.

http://www.nejm.org/doi/full/10.1056/NEJMe1304035?af=R&rss=currentIssue

The August 29 issue of the NEJM will include the first in a series of review articles on critical care. Critical care is a young specialty that is generally considered to have developed from the successful use of invasive ventilation during the 1952 polio epidemic in Copenhagen. From these beginnings, critical care has spread to most countries in the world. In many developed societies, the number of critical care beds is increasing while total number of acute care hospital beds is decreasing; the proportion of acute care hospital beds that are intensive care unit beds is increasing substantially.