Critical Care

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.

Thiamine Improves Lactate Clearance in Septic Shock

Thiamine Improves Lactate Clearance in Septic Shock

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Lactate clearance improved in patients who presented with septic shock who were given thiamine within 24 hours of hospital admission.

Indwelling Pleural Catheters an Option for Hepatic Hydrothorax Treatment

Indwelling Pleural Catheters an Option for Hepatic Hydrothorax Treatment

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Indwelling pleural catheters can be used safely but with caution as a bridge to transplant or as palliative care.

Extubation May Be Safe While on Vasoactive Infusions

Extubation May Be Safe While on Vasoactive Infusions

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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 Computers in Surgical ICU May Cut Communication Barriers

Reducing Computers in Surgical ICU May Cut Communication Barriers

Reducing the number of computers in surgical intensive care units reduced barriers to communication.

Prognostic Model for Mortality in Pediatric Pulmonary Hypertension

Prognostic Model for Mortality in Pediatric Pulmonary Hypertension

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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 Decreased Transfers to Other Acute Care Facilities

ICU Telemedicine Decreased Transfers to Other Acute Care Facilities

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ICU telemedicine was associated with a reduction in interhospital transfers in patients with respiratory and gastrointestinal diagnoses.

Initial Outcomes No Worse for Surgical ICU Patients With Cancer

Initial Outcomes No Worse for Surgical ICU Patients With Cancer

ICU and hospital mortality were lower for patients with cancer vs those without cancer.

Venoarterial ECMO Improves Survival to Transplant in Interstitial Lung Disease

Venoarterial ECMO Improves Survival to Transplant in Interstitial Lung Disease

In patients with end-stage interstitial lung disease, there was a higher rate of survival to transplantation with venoarterial extracorporeal membrane oxygenation.

Case Volume Affects Mortality for Immunosuppressed With Sepsis

Case Volume Affects Mortality for Immunosuppressed With Sepsis

Risk for death from sepsis was higher at hospitals with the lowest volume of immunosuppressed patients with sepsis.

Delaying Lactate Draws in Sepsis Increases In-Hospital Death Risk

Delaying Lactate Draws in Sepsis Increases In-Hospital Death Risk

Systematic early lactate measurements speed antibiotic administration and improve outcomes in patients with sepsis.

Early Flow Cytometry Predictive of Clinical Deterioration in Sepsis

Early Flow Cytometry Predictive of Clinical Deterioration in Sepsis

Increased circulating immature granulocytes at the acute phase of sepsis are linked to clinical worsening, especially when associated with T-cell lymphopenia.

60-Day Mortality Not Significantly Lower With ECMO in ARDS

60-Day Mortality Not Significantly Lower With ECMO in ARDS

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.

High-Flow Nasal Cannula vs Conventional Oxygen Therapy for Acute Respiratory Failure

High-Flow Nasal Cannula vs Conventional Oxygen Therapy for Acute Respiratory Failure

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In patients with acute respiratory failure, high-flow nasal cannula and conventional oxygen therapy provided similar benefits.

Mortality Increased With Liberal Oxygen Therapy in Acutely Ill Patients

Mortality Increased With Liberal Oxygen Therapy in Acutely Ill Patients

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Liberal supplemental oxygen therapy in acutely ill patients increased mortality during hospitalization, at 30 days, and at longest follow-up.

Use of Predicted vs Measured Body Weight for Targeting Tidal Volumes in Children

Use of Predicted vs Measured Body Weight for Targeting Tidal Volumes in Children

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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.

Does Propofol Prevent Prolonged Desaturation During Neonatal Intubation?

Does Propofol Prevent Prolonged Desaturation During Neonatal Intubation?

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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.

Molecular Laboratory Test Can Discriminate Sepsis From Noninfectious SIRS

Molecular Laboratory Test Can Discriminate Sepsis From Noninfectious SIRS

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.

Talc Via Pleural Catheter vs Indwelling Pleural Catheter Alone for Pleurodesis

Talc Via Pleural Catheter vs Indwelling Pleural Catheter Alone for Pleurodesis

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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 Consult Can Cut Hospital Costs in Seriously Ill

Palliative Care Consult Can Cut Hospital Costs in Seriously Ill

Palliative care consultation was linked to a reduction in hospital costs for hospitalized adults with serious illness, such as COPD.

Survival Predictors When Life Support Is Withheld in ICU

Survival Predictors When Life Support Is Withheld in ICU

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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.

Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis

Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis

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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.

Mortality in Mechanically Ventilated Community-Acquired Pneumonia With or Without ARDS

Mortality in Mechanically Ventilated Community-Acquired Pneumonia With or Without ARDS

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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.

Specific Delirium Phenotypes May Predict Long-Term Cognitive Impairment

Specific Delirium Phenotypes May Predict Long-Term Cognitive Impairment

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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.

Delirium in ICU Prevented With Nocturnal Administration of Dexmedetomidine

Delirium in ICU Prevented With Nocturnal Administration of Dexmedetomidine

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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 vs Standard Oxygen Therapy in Infants With Bronchiolitis

High-Flow vs Standard Oxygen Therapy in Infants With Bronchiolitis

High-flow oxygen therapy may be more effective in preventing care escalation in infants with bronchiolitis compared with standard oxygen therapy.

Prophylactic haloperidol not linked to improved survival in ICU patients: The REDUCE trial

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.

Adjunctive glucocorticoid therapy does not lower mortality in septic shock

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.

Routine Chest Radiography After US-Guided CVC Insertion Often Unnecessary

Routine Chest Radiography After US-Guided CVC Insertion Often Unnecessary

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A routine chest radiograph after ultrasound-guided central venous catheter insertion is now considered costly and unnecessary.

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