Critical Care Archives
A pleural adherence score derived from thoracic ultrasound at 24 hours post-talc administration is predictive of long-term pleurodesis success in patients with symptomatic malignant pleural effusion.
Hospital readmission was also more likely in individuals whose first spontaneous pneumothorax occurred after 2008 compared with before 2008.
No decrease in duration vs placebo in patients with hypoactive or hyperactive delirium in ICU.
Remimazolam was safe and effective for achieving moderate sedation in patients undergoing flexible bronchoscopy.
Antibiotic treatment started sooner in individuals with sepsis treated with advanced life support who did not have hypotension.
After high flow nasal cannula oxygen therapy, 15% of patients had to be intubated and mechanically ventilated, but the majority stepped down to regular oxygen therapy.
Vasopressor requirement, transfusions, neurologic dysfunction, coagulopathy, and acute respiratory distress syndrome were related to higher mortality after multivariate analysis.
Previous antibiotic use and mechanical invasive ventilation were risk factors for multidrug-resistant pathogens in hospital-associated or ventilator-associated pneumonia.
Alcohol abuse, fluid and electrolyte abnormalities, and pulmonary circulation disorders increased the risk for noninvasive ventilation in a COPD exacerbation.
Vitamin C was associated with lower mortality rates, shorter lengths of ICU stay, and shorter durations of vasopressor use in patients with sepsis.
Supraglottic airway resuscitation likely more or just as effective as endotracheal intubation for out-of-hospital cardiac arrest
In a randomized controlled trial, supraglottic airway resuscitation was associated with marginally better neurological outcomes and 72-hour survival compared with endotracheal intubation in patients with out-of-hospital cardiac arrests.
The recommendations include enhancing recognition of potential errors, increasing teamwork, and patient-centeredness.
Oxygen saturation at induction and acute hypoxemic respiratory failure were the risk factors most strongly associated with lower oxygen saturation.
The use of a supraglottic airway device compared with tracheal intubation did not result in a favorable functional outcome in patients with out-of-hospital cardiac arrest.
Although preterm infants had abnormal tidal breathing measurements, significant differences were not found to be associated with postdischarge respiratory disease.
Influenza proved to be an independent risk factor for invasive pulmonary aspergillosis.
The clinical prediction tool that uses confusion, uremia, elevated respiratory rate, and hypotension in community-acquired pneumonia demonstrated an association with ICU admittance.
Compassion and communication for both patients and families are among the most important factors involved in providing end-of-life care.
Spontaneous pleurodesis was achieved more frequently in the daily drainage group than in the symptom-guided drainage group.
However, completing individual bundle elements in that timeframe does not reduce pediatric mortality.
Lower and higher oxygen saturation targets result in equal but contrasting outcomes for extremely preterm infants
In this meta-analysis, there was no significant difference between lower and higher oxygen saturation targets on a primary composite of mortality or major disability at a corrected age of 18-24 months for infants born extremely preterm.
Lactate clearance improved in patients who presented with septic shock who were given thiamine within 24 hours of hospital admission.
Indwelling pleural catheters can be used safely but with caution as a bridge to transplant or as palliative care.
Overall outcomes of hospital mortality, unit mortality, and reintubation were similar between patients who were still on vasoactive infusions and those who were not.
Reducing the number of computers in surgical intensive care units reduced barriers to communication.
The Pediatric Index Pulmonary Hypertension Intensive Care Mortality model was compared with the Pediatric Risk of Mortality 2 and 3 models to determine the best model for predicting mortality.
ICU telemedicine was associated with a reduction in interhospital transfers in patients with respiratory and gastrointestinal diagnoses.
ICU and hospital mortality were lower for patients with cancer vs those without cancer.
In patients with end-stage interstitial lung disease, there was a higher rate of survival to transplantation with venoarterial extracorporeal membrane oxygenation.
Risk for death from sepsis was higher at hospitals with the lowest volume of immunosuppressed patients with sepsis.
Systematic early lactate measurements speed antibiotic administration and improve outcomes in patients with sepsis.
Increased circulating immature granulocytes at the acute phase of sepsis are linked to clinical worsening, especially when associated with T-cell lymphopenia.
In patients with very severe acute respiratory distress syndrome, 60-day mortality was not significantly lower with venovenous extracorporeal membrane oxygenation than with conventional treatment.
Liberal supplemental oxygen therapy in acutely ill patients increased mortality during hospitalization, at 30 days, and at longest follow-up.
In patients with acute respiratory failure, high-flow nasal cannula and conventional oxygen therapy provided similar benefits.
It may be more lung protective to use the lower of either measured or predicted body weight when targeting tidal volume for mechanically ventilated children.
A randomized clinical trial evaluated whether premedication with propofol reduced the frequency of prolonged desaturation during neonatal nasotracheal intubation compared with the combination of a rapid-onset short-acting opioid and a muscle relaxant.
The SeptiCyteTM LAB may be an effective complementary diagnostic tool to clinical assessment of critically ill adult patients in discriminating between sepsis and noninfectious systemic inflammation syndrome.
An indwelling pleural catheter and administration of talc may have a higher odds of achieving pleurodesis compared with an indwelling pleural catheter alone in individuals with malignant pleural effusions.
Palliative care consultation was linked to a reduction in hospital costs for hospitalized adults with serious illness, such as COPD.
Survival at 6 months was significantly associated with acute respiratory failure and history of COPD.
Balanced crystalloids decreases adverse kidney events compared to saline among critically ill patients: The SMART trial
Use of balanced crystalloids (lactated Ringers or Plasma-Lyte A) was associated with a significant reduction in acute kidney injury events compared with normal saline among intensive care unit (ICU) patients. Use of balanced crystalloids was also associated with lower though nonsignificant in-hospital mortality at 30-days after admission.
In patients with insulin-treated diabetes and sepsis, increased highest glucose levels and glycemic variability have a significant illness severity-adjusted association with decreasing in-hospital mortality.
The risk for death in patients with community-acquired pneumonia who were given mechanical ventilation does not seem to be affected by the presence of acute respiratory distress syndrome.
Sedative-associated, hypoxic, and septic delirium were predictive of long-term cognitive impairment in patients with a critical illness related to acute respiratory failure, shock, or both.
A higher percentage of critically ill patients in the intensive care unit who were given nocturnal dexmedetomidine remained delirium free compared with placebo.
High-flow oxygen therapy may be more effective in preventing care escalation in infants with bronchiolitis compared with standard oxygen therapy.
Prophylactic haloperidol did not reduce delirium incidence, delirium-free days, duration of mechanical ventilation, or hospital length of stay in patients in the intensive care unit.
Patients with septic shock in the intensive care unit undergoing mechanical ventilation and managed with adjunctive continuous hydrocortisone infusion did not have a lower 90-day mortality compared with placebo.
A routine chest radiograph after ultrasound-guided central venous catheter insertion is now considered costly and unnecessary.
On-demand nebulization of acetylcysteine with salbutamol did not result in an inferior number of ventilator-free days compared with routine nebulization.
A revisit to the emergency department within 30 days of a previous visit predicted poor outcomes in elderly adults.
A study sought to determine whether bag-mask ventilation was noninferior to endotracheal intubation as initial airway management during advanced cardiac life support during out-of-hospital cardiac arrest.
Prophylactic haloperidol does not improve survival at 28 days compared with placebo in critically ill adults
An overall higher mortality rate was associated with pediatric acute respiratory distress syndrome ARDS management with PEEP levels lower than those recommended by the ARDS Network PEEP/FiO2 protocol.
Off-label use of inhaled nitric oxide is not associated with reduced mortality in neonates born at 22 to 29 weeks'gestation with RDS.
Researchers conducted an anonymous survey of medical trainees with a case vignette to determine attitudes regarding palliative care for chronic obstructive pulmonary disease.
Invasive mechanical ventilation in patients with severe community-acquired pneumonia appeared to increase their mortality risk.
Enteral nutritional support was not clinically superior to parenteral nutritional support in critically ill patients receiving mechanical ventilation.
Adults with cardiac arrest have better outcomes with continuous compressions with asynchronous ventilations or compression-to-ventilation ratios of 30:2.
A randomized trial sought to determine whether the use of titrated positive end-expiratory pressure influenced the 28-day mortality risk in patients with acute respiratory distress syndrome.
The European Respiratory Society and American Thoracic Society have released updated guidelines on the use of noninvasive ventilation for acute respiratory failure.
A low tidal volume ventilation strategy in patients with acute respiratory distress syndrome demonstrated a trend toward improved mortality.
Extended pharmacologic thromboprophylaxis seems to be safe and effective for patients getting liver surgery.
Transesophageal echocardiography can be used safely and effectively by critical care fellows to assess and manage cardiopulmonary failure when transthoracic echocardiography fails to provide adequate views.
Incidence of delirium and coma were not prevented with early initiation of simvastatin in patients on mechanical ventilation.