Category Archives: Pulmonary and Critical Care
This small trial of 150 patients with sepsis and tachycardia found those randomized to an esmolol infusion (with heart rate goals 80-94) had significantly lower mortality than those in the control group (49% versus 81% at 28 days) (abstract).
In this cohort of ICU patients, 3/4 developed ICU delirium; at 3 months 40% had cognition scores 1.5 SD below the mean, and 25% were 2 SD below the mean. By 12 months, ~1/3 had scores similar to mild traumatic … Continue reading
In this trial of patients with in-hospital cardiac arrest, they were randomized to vasopressin-steroid-epi combo or epi alone; those in the combination group had significantly higher chance of survival to discharge with good neurologic outcomes (21%) versus the epi group … Continue reading
This single center study found ~20% of patients in the ICU were deemed to be receiving futile care at some point, which accounted for ~7% of all ICU days. Of those deemed futile, 6 month mortality was 85%; those still … Continue reading
In this trial of intubated critically ill patients, they were randomized to IV haldol (2.5mg IV q8) or placebo for a maximum of 14 days, and delirium was assessed by the CAM-ICU. There were no differences between the groups in … Continue reading
This simple evidence-based bundle reduced post operative pneumonia and reintubations (I:Incentive spirometry; C:Coughing-deep breathing; O:Oral care; U:Understanding from the patient-family; G:Getting out of bed at least tid; H:Head of bed >30 degrees) (abstract).
The large multi-center ICU trial randomized ICUs to 1 of 3 strategies: MRSA screening/isolation, MRSA screening/isolation/decolonization, or global decolonization (5 days BID nasal mupiricin and daily chlorhexidine bathing). The hazard ratios for MRSA isolates in the 3 groups were 0.92, … Continue reading
This trial found no difference in patient outcomes (mortality or LOS) if admitted during a time of 24/7 intensivist coverage, or during a time with only daytime intensivist coverage (with home call at night) in a medical ICU. This study … Continue reading
This trial of patients with severe ARDS randomized them to prone (at least 16 hours a day) or supine positioning. Those in the prone position had significantly lower 28 day mortality (16% vs 33%), and 90 day mortality (24% vs … Continue reading
This study of patients intubated in the ICU randomized them to patient-initiated/directed music, noise canceling headsets, or usual care. Those in the music group had significantly lower anxiety scores and use of sedatives compared to usual care. Those in the … Continue reading