Interventions to improve the physical function of ICU survivors: A systematic review. Chest, 2013, Vol. 144(5), p.1469-80.
Calvo-Ayala, E., et al.
http://journal.publications.chestnet.org/article.aspx?articleid=1727081#Abstract
ICU admissions are ever increasing across the United States. Following critical illness, physical functioning (PF) may be impaired for up to 5 years. We performed a systematic review of randomized controlled trials evaluating the efficacy of interventions targeting PF among ICU survivors. The objective of this study was to identify effective interventions that improve long-term PF in ICU survivors.
Friday, 17 January 2014
Long-term cognitive impairment after critical illness
Long-term cognitive impairment after critical illness. New england journal of medicine 2013; 369:1306-1316.
Pandharipande, P.P., et al.
http://www.nejm.org/doi/full/10.1056/NEJMoa1301372
Survivors of critical illness often have a prolonged and disabling form of cognitive impairment that remains inadequately characterized. We enrolled adults with respiratory failure or shock in the medical or surgical intensive care unit (ICU), evaluated them for in-hospital delirium, and assessed global cognition and executive function 3 and 12 months after discharge with the use of the Repeatable Battery for the Assessment of Neuropsychological Status (population age-adjusted mean [±SD] score, 100±15, with lower values indicating worse global cognition) and the Trail Making Test, Part B (population age-, sex-, and education-adjusted mean score, 50±10, with lower scores indicating worse executive function).
Pandharipande, P.P., et al.
http://www.nejm.org/doi/full/10.1056/NEJMoa1301372
Survivors of critical illness often have a prolonged and disabling form of cognitive impairment that remains inadequately characterized. We enrolled adults with respiratory failure or shock in the medical or surgical intensive care unit (ICU), evaluated them for in-hospital delirium, and assessed global cognition and executive function 3 and 12 months after discharge with the use of the Repeatable Battery for the Assessment of Neuropsychological Status (population age-adjusted mean [±SD] score, 100±15, with lower values indicating worse global cognition) and the Trail Making Test, Part B (population age-, sex-, and education-adjusted mean score, 50±10, with lower scores indicating worse executive function).
Are the best patient outcomes achieved when ICU bundles are rigorously adhered to?
Point: Are the best patient outcomes achieved when ICU bundles are rigorously adhered to? Yes. Chest, 2013, Vol. 144(2), p.372-74.
Dellinger, R.P. and Townsend, S.R.
http://journal.publications.chestnet.org/article.aspx?articleid=1722640
CU bundles have emerged as important tools in addressing clinical health-care conditions with evidence-based medicine. An ICU bundle is a set of treatment goals (usually three to seven) that when grouped and achieved together over a finite time span are believed to promote optimum outcomes. The Institute for Healthcare Improvement (IHI) has been one of the main proponents of the bundle concept. Bundle-based care is based on evidence-based medicine. Bundles exist for the prevention of surgical site- and catheter-associated central line infections as well as for the prevention of urinary tract infections, weaning from ventilation, promotion of palliative care, treatment of sepsis, and prevention of pressure ulcers.
Dellinger, R.P. and Townsend, S.R.
http://journal.publications.chestnet.org/article.aspx?articleid=1722640
CU bundles have emerged as important tools in addressing clinical health-care conditions with evidence-based medicine. An ICU bundle is a set of treatment goals (usually three to seven) that when grouped and achieved together over a finite time span are believed to promote optimum outcomes. The Institute for Healthcare Improvement (IHI) has been one of the main proponents of the bundle concept. Bundle-based care is based on evidence-based medicine. Bundles exist for the prevention of surgical site- and catheter-associated central line infections as well as for the prevention of urinary tract infections, weaning from ventilation, promotion of palliative care, treatment of sepsis, and prevention of pressure ulcers.
Persistent fever in the ICU
Persistent fever in the ICU. Chest, Jan 2014, Vol. 145(1), p.158-165.
Rehman, T. and deBoisblanc, B.P.
http://journal.publications.chestnet.org/article.aspx?articleid=1793890
Disorders of elevated body temperature may be classified as either fever or hyperthermia. Fever is caused by a pyrogen-mediated upward adjustment of the hypothalamic thermostat; hyperthermia results from a loss of physiologic control of temperature regulation. Fever in the ICU can be due to infectious or noninfectious causes.
Rehman, T. and deBoisblanc, B.P.
http://journal.publications.chestnet.org/article.aspx?articleid=1793890
Disorders of elevated body temperature may be classified as either fever or hyperthermia. Fever is caused by a pyrogen-mediated upward adjustment of the hypothalamic thermostat; hyperthermia results from a loss of physiologic control of temperature regulation. Fever in the ICU can be due to infectious or noninfectious causes.
Survival of hemotological patients after discharge from the intensive care unit
Survival of hemotological patients after discharge from the intensive care unit: A prospective observational study. Critical care, 2013; 17 R:302
Bernal, T., et al.
http://ccforum.com/content/pdf/cc13172.pdf
Although the survival rates of hematological patients admitted to the ICU are improving,
little is known about the long-term outcome. Our objective was to identify factors related to
long-term outcome in hematological patients after ICU discharge.
Bernal, T., et al.
http://ccforum.com/content/pdf/cc13172.pdf
Although the survival rates of hematological patients admitted to the ICU are improving,
little is known about the long-term outcome. Our objective was to identify factors related to
long-term outcome in hematological patients after ICU discharge.
Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients
Low skeletal muscle area is a risk factor for mortality in mechanically ventilated critically ill patients. Critical care, 2014, 18: R12.
Weijs, P., et al.
http://ccforum.com/content/pdf/cc13189.pdf
Higher body mass index (BMI) is associated with lower mortality in mechanically ventilated
critically ill patients. However, it is yet unclear which body component is responsible for this
relationship.
Weijs, P., et al.
http://ccforum.com/content/pdf/cc13189.pdf
Higher body mass index (BMI) is associated with lower mortality in mechanically ventilated
critically ill patients. However, it is yet unclear which body component is responsible for this
relationship.
The effect of glutamine therapy on outcomes in critically ill patients
The effect of glutamine therapy on outcomes in critically ill patients: A meta-analysis of randomized controlled trials. Critical care, 2014, 18: R8.
Chen, Q-H, et al.
http://ccforum.com/content/pdf/cc13185.pdf
Glutamine supplementation is supposed to reduce mortality, nosocomial infections and length
of hospital stay in critically ill patients. However, the recently published reducing deaths due
to oxidative stress (REDOX) trials did not provide evidence supporting this. This study
investigated the impact of glutamine-supplemented nutrition on the outcomes of critically ill
patients using a meta-analysis.
Chen, Q-H, et al.
http://ccforum.com/content/pdf/cc13185.pdf
Glutamine supplementation is supposed to reduce mortality, nosocomial infections and length
of hospital stay in critically ill patients. However, the recently published reducing deaths due
to oxidative stress (REDOX) trials did not provide evidence supporting this. This study
investigated the impact of glutamine-supplemented nutrition on the outcomes of critically ill
patients using a meta-analysis.
End stage renal disease and outcome in a surgical intensive care unit
End stage renal disease and outcome in a surgical intensive care unit. Critical care, 2013, 17: R298.
Apel, M., et al.
http://ccforum.com/content/pdf/cc13167.pdf
End-stage renal disease (ESRD) is associated with an increased propensity for critical illness,
but whether ESRD is independently associated with a greater risk of death after major
surgical procedures is unclear.
Apel, M., et al.
http://ccforum.com/content/pdf/cc13167.pdf
End-stage renal disease (ESRD) is associated with an increased propensity for critical illness,
but whether ESRD is independently associated with a greater risk of death after major
surgical procedures is unclear.
Critical care transition programs and the risk of readmission or death after discharge from an ICU
Critical care transition programs and the risk of readmission or death after discharge from an ICU: A systematic review and meta-analysis. Critical care medicine, Jan 2014, Vol. 42(1), p.179-87.
Niven, D.J., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Critical_Care_Transition_Programs_and_the_Risk_of.21.aspx
To determine whether critical care transition programs reduce the risk of ICU readmission or death, when compared with standard care among adults who survived their incident ICU admission.
Niven, D.J., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Critical_Care_Transition_Programs_and_the_Risk_of.21.aspx
To determine whether critical care transition programs reduce the risk of ICU readmission or death, when compared with standard care among adults who survived their incident ICU admission.
Variation in diagnostic testing in ICUs
Variation in diagnostic testing in ICUs: A comparison of teaching and nonteaching hospitals in a regional system. Critical care medicine, Jan 2014, Vol. 42(1), p.9-16.
Spence, J., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Variation_in_Diagnostic_Testing_in_ICUs__A.2.aspx
To explore variation in the use of diagnostic testing in ICUs, with emphasis on differences between teaching and nonteaching ICUs.
Spence, J., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Variation_in_Diagnostic_Testing_in_ICUs__A.2.aspx
To explore variation in the use of diagnostic testing in ICUs, with emphasis on differences between teaching and nonteaching ICUs.
Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients
Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: A retrospective observational study. Critical care medicine, Jan 2014, Vol. 42(1), p.40-47.
O'Brien, D.D., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Intraoperative_Risk_Factors_Associated_With.6.aspx
The risk for pressure ulcers is rarely identified in the perioperative period, and the influence of this period on risk factors has not been as rigorously studied as the postoperative period. We hypothesized that intraoperative risk factors exist, which increase the likelihood of a postoperative new-onset pressure ulcer.
O'Brien, D.D., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Intraoperative_Risk_Factors_Associated_With.6.aspx
The risk for pressure ulcers is rarely identified in the perioperative period, and the influence of this period on risk factors has not been as rigorously studied as the postoperative period. We hypothesized that intraoperative risk factors exist, which increase the likelihood of a postoperative new-onset pressure ulcer.
Left ventricular assist device management in the ICU
Left ventricular assist device management in the ICU. Critical care medicine, Jan 2014, Vol. 42(1), p.158-68.
Pratt, A.K., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Left_Ventricular_Assist_Device_Management_in_the.19.aspx
To review left ventricular assist device physiology, initial postoperative management, common complications, trouble shooting and management of hypotension, and other common ICU problems.
Pratt, A.K., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Left_Ventricular_Assist_Device_Management_in_the.19.aspx
To review left ventricular assist device physiology, initial postoperative management, common complications, trouble shooting and management of hypotension, and other common ICU problems.
Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically-ventilated patients with severe sepsis
Treatment with neuromuscular blocking agents and the risk of in-hospital mortality among mechanically-ventilated patients with sever sepsis. Critical care medicine, Jan 2014, Vol. 42(1), p.90-96.
Steingrub, J.S., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Treatment_With_Neuromuscular_Blocking_Agents_and.12.aspx
Recent trials suggest that treatment with neuromuscular blocking agents may improve survival in patients requiring mechanical ventilation for acute respiratory distress syndrome. We examined the association between receipt of a neuromuscular blocking agent and in-hospital mortality among mechanically ventilated patients with severe sepsis.
Steingrub, J.S., et al.
http://journals.lww.com/ccmjournal/Abstract/2014/01000/Treatment_With_Neuromuscular_Blocking_Agents_and.12.aspx
Recent trials suggest that treatment with neuromuscular blocking agents may improve survival in patients requiring mechanical ventilation for acute respiratory distress syndrome. We examined the association between receipt of a neuromuscular blocking agent and in-hospital mortality among mechanically ventilated patients with severe sepsis.
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