Critical Care
Cohort Study | Maternal cardiac arrest: occurrence, survival, and influencing factors
6 Apr, 2023 | 12:59h | UTCCardiac Arrest During Delivery Hospitalization: A Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries:
Cardiac Arrest During Delivery Hospitalization – American College of Cardiology
Cardiac Arrest During Childbirth Is Rare, But Some Women Face Higher Risks – HealthDay
Commentary on Twitter
Study of pregnant women hospitalized during delivery found #CardiacArrest occurred in 1 in 9k deliveries, higher than other reported rates. More common in older or Black patients or persons w/ #Medicare or underlying conditions: https://t.co/ko1K7NFaPi. @CDCgov pic.twitter.com/23CxVi138k
— Annals of Int Med (@AnnalsofIM) March 15, 2023
Cohort Study | Multimodal prediction of favorable outcome after cardiac arrest
6 Apr, 2023 | 13:01h | UTC
ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia
5 Apr, 2023 | 13:45h | UTC
Commentary on Twitter
Management of severe community-acquired pneumonia: @EuroRespSoc @ESICM @ESCMID @ALATorax international guidelines
➡️ evidence-based recommendations for diagnosis, empirical treatment, ABTs
➡️ current knowledge gaps
➡️ recommendations for future research
?️ https://t.co/qhe1wlgN9t pic.twitter.com/LMNCbauYfs— Intensive Care Medicine (@yourICM) April 4, 2023
Review | Diagnosis and treatment of acute myocarditis
5 Apr, 2023 | 13:40h | UTCDiagnosis and Treatment of Acute Myocarditis: A Review – JAMA (free for a limited period)
RCT | Endovascular treatment vs. no treatment after 6-24h in ischemic stroke patients with collateral flow on CT angiography
5 Apr, 2023 | 13:38h | UTCEndovascular treatment versus no endovascular treatment after 6–24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial – The Lancet (link to abstract – $ for full-text)
SR | The effectiveness of the interventions to reduce sound levels in the ICU
5 Apr, 2023 | 13:19h | UTC
RCT | Comparable results in endovascular therapy using general anesthesia vs. procedural sedation for stroke treatment
4 Apr, 2023 | 13:45h | UTCOutcomes After Endovascular Therapy With Procedural Sedation vs General Anesthesia in Patients With Acute Ischemic Stroke: The AMETIS Randomized Clinical Trial – JAMA Neurology (free for a limited period)
See also: Visual Abstract
Related: M-A | General Anesthesia vs. to Non-GA in endovascular thrombectomy for ischemic stroke
Perspective | Create intensive care green teams, there is no time to waste
4 Apr, 2023 | 13:27h | UTCCreate intensive care green teams, there is no time to waste – Intensive Care Medicine
Commentary on Twitter
? #ICU green teams: form or join now, no time to waste!!
? how common are environmental sustainability teams?
? how to create a successful green team
? what could teams be doing?
? evidence for effectiveness
Free to read #FOAMcc on @yourICM
?️ https://t.co/SPDVv3xSwd pic.twitter.com/xVD4I5pOoz— Intensive Care Medicine (@yourICM) April 3, 2023
ICU Delirium | Bayesian analysis suggests high probabilities of benefits and low probabilities of harm with the use of haloperidol
3 Apr, 2023 | 13:43h | UTCHaloperidol vs. placebo for the treatment of delirium in ICU patients: a pre-planned, secondary Bayesian analysis of the AID–ICU trial – Intensive Care Medicine (free for a limited period)
Original article: RCT | Haloperidol for the treatment of delirium in ICU patients did not significantly improve outcomes.
Commentary on Twitter
Haloperidol vs placebo in acutely admitted, adult #ICU pts with #delirium? With IV haloperidol 2.5 mg × 3 daily & as needed doses up to max 20 mg daily:
➡️ high probabilities of benefits
➡️ low probabilities of harm for primary & most secondary outcomes
?️ https://t.co/iNRVVozlRJ pic.twitter.com/NJbhvxxdYx— Intensive Care Medicine (@yourICM) March 27, 2023
Review | Prolonged intermittent kidney replacement therapy
3 Apr, 2023 | 13:39h | UTCProlonged Intermittent Kidney Replacement Therapy – Clinical Journal of the American Society of Nephrology (free for a limited period)
Commentary on Twitter
Kidney replacement therapy (KRT) is a vital, supportive treatment for patients with critical illness and severe AKI. This Review discusses the option of prolonged intermittent KRT in the management of patients with kidney failure in the ICU https://t.co/jPHVLRnoqJ@VijayanMD pic.twitter.com/4oWJ6IDR4C
— CJASN (@CJASN) September 30, 2022
Review | Acute respiratory distress syndrome, mechanical ventilation, and inhalation injury in burn patients
3 Apr, 2023 | 13:38h | UTC
Update | Optimal oxygen and mean arterial blood pressure targets after cardiac arrest
31 Mar, 2023 | 13:41h | UTC
Commentary on Twitter
O2/MAP after CA? NO clear benefit from deviating from
?MAP >65-70 mmHg, if impaired ?autoregulation as high as 85-90
? PaO2 75-97 mmHg; more liberal O2 may be best if reliable monitoring difficult (ie transport or in ED)
More evidence needed (coming)
?️ https://t.co/ujsz09tDSJ pic.twitter.com/fft8Q1turt— Intensive Care Medicine (@yourICM) March 21, 2023
M-A | Incidence and prognostic role of pleural effusion in patients with pulmonary embolism
31 Mar, 2023 | 13:40h | UTC
Palliative care in the intensive care unit: not just end-of-life care
31 Mar, 2023 | 13:21h | UTCPalliative Care in the Intensive Care Unit: Not Just End-of-life Care – Intensive Care Research
ICU Burnout Crisis | Meta-analysis reveals over 40% prevalence in medical professionals
30 Mar, 2023 | 14:30h | UTCHigh-level burnout in physicians and nurses working in adult ICUs: a systematic review and meta-analysis – Intensive Care Medicine (if the link is paywalled, try this one)
Related:
AAP Clinical Report | Physician health and wellness.
M-A | Physicians suffering burnout are twice as likely to be involved in patient safety incidents.
Systematic Review | Predictors of burnout among healthcare providers.
Physician Well-being 2.0: Where Are We and Where Are We Going? – Mayo Clinic Proceedings
Assessment of Risk Factors for Suicide Among US Health Care Professionals
Beyond Burnout: Docs Decry ‘Moral Injury’ From Financial Pressures of Health Care
Hospital administration response to physician stress and burnout – Journal of Hospital Practice
Opinion: It’s Time to Talk About Physician Burnout and Moral Injury
Systematic Review: Effect of Organization-Directed Workplace Interventions on Physician Burnout
The 3 Causes Of Physician Burnout (And Why There’s No Simple Solution) – Forbes
Physician Burnout: A Global Crisis
The Burnout Crisis in American Medicine – The Atlantic
Physician burnout costs up to $17B a year, task force says – HealthcareDive
Systematic Review: Prevalence of Burnout Among Physicians
Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction
Commentary on Twitter
High-level burnout in adult ICUs physicians & nurses, SR/MA
➡️ prevalence > 40% in all #ICU HCWs, 41% physicians/44% nurses
➡️ #COVID19? ⬆️ burnout only in nurses
Preventive/therapeutic measures to improve well-being crucial as a consensual definitio.
?️ https://t.co/kUcZ7P9iqz pic.twitter.com/owqC1W5yLu— Intensive Care Medicine (@yourICM) March 28, 2023
Review | Evaluation and management of hypernatremia in adults
30 Mar, 2023 | 14:20h | UTC
Update on the management of acute pancreatitis
30 Mar, 2023 | 14:10h | UTCUpdate on the management of acute pancreatitis – Current Opinion in Critical Care
Related:
Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis – New England Journal of Medicine
Acute Pancreatitis: Diagnosis and Treatment – Drugs
Evidence-Based Disposition of Acute Pancreatitis – emDocs
Pancreatitis – National Institute for Health and Care Excellence
Research: Endoscopic or Surgical Step-up Approach for Infected Necrotising Pancreatitis
Evidence-Based Approach to the Surgical Management of Acute Pancreatitis – The Surgery Journal
Brief Review | Acute mesenteric ischemia
30 Mar, 2023 | 13:44h | UTCAcute mesenteric ischaemia – British Journal of Surgery
M-A | Incidence of multiple organ failure in adult polytrauma patients
30 Mar, 2023 | 13:30h | UTC
M-A | Aggressive IV hydration may increase mortality risk in severe acute pancreatitis
29 Mar, 2023 | 13:26h | UTCSummary: This systematic review and meta-analysis investigated the outcomes of aggressive and non-aggressive intravenous hydration in patients with severe and non-severe acute pancreatitis (AP). The study included nine randomized controlled trials with a total of 953 participants.
The findings revealed that aggressive intravenous hydration significantly increased mortality risk in severe AP cases, and fluid-related complication risk in both severe and non-severe AP cases. However, the study has some limitations, as only one study with 249 participants was judged to have a low risk of bias in all domains, while the remaining eight studies had non-low risk of bias, raising concerns about the reliability of the findings.
Despite these concerns, the findings still suggest that more conservative intravenous fluid resuscitation protocols for AP may be preferable. Further research with more rigorous study designs is needed to provide robust evidence on the effectiveness of different intravenous hydration strategies in treating acute pancreatitis.
Review | Supplemental oxygen and noninvasive ventilation
29 Mar, 2023 | 13:18h | UTCSupplemental oxygen and noninvasive ventilation – European Respiratory Review
M-A | Effects of dexmedetomidine on postoperative sleep quality
29 Mar, 2023 | 13:17h | UTC
CDC report reveals escalating Candida auris transmission and resistance in the US
28 Mar, 2023 | 15:10h | UTCWorsening Spread of Candida auris in the United States, 2019 to 2021 – Annals of Internal Medicine
Commentaries:
CDC reports dramatic increase in US Candida auris cases – CIDRAP
An emerging fungal threat spread at an alarming rate in US health care facilities, study says – CNN
Related:
CDC Report: Transmission of pan-resistant Candida auris in health care facilities.
Case reports: Multidrug-resistant Candida auris infections in critically ill Covid-19 patients
Candida auris: A Review of Recommendations for Detection and Control in Healthcare Settings
Global Epidemiology of Emerging Candida Auris (reviews and commentaries on the subject)
The superbug Candida auris is giving rise to warnings — and big questions – STAT
Candida Auris – “A Mysterious Infection, Spanning the Globe in a Climate of Secrecy” (reviews and commentaries on the subject)
Commentary on Twitter
New Annals of Internal Medicine study finds cases of deadly fungus, Candida auris, rose drastically between 2019 and 2021. Increase included treatment resistant strains: https://t.co/J3SkmfWDr5 @CDCgov pic.twitter.com/ZJBRqMIOy1
— Annals of Int Med (@AnnalsofIM) March 21, 2023
Brief Review | Antifungal stewardship in critically ill patients
28 Mar, 2023 | 14:57h | UTCAntifungal stewardship in critically ill patients – Intensive Care Medicine (if the link is paywalled, try this one)
Commentary on Twitter
Antifungal stewardship in #ICU
? biomarkers
⬇️ de‑escalation
? other methods to improve AFs use
Empirical AFs commonly used (poor prognosis if inappropriate/delayed): AFS can ⬆️ performance measures/⬇️ AFs consumption, no negative impact on outcome
?️ https://t.co/eS9EJdjo2a pic.twitter.com/4FMV9NBndb— Intensive Care Medicine (@yourICM) March 24, 2023
Acute heart failure: diagnostic–therapeutic pathways and preventive strategies — a real-world clinician’s guide
28 Mar, 2023 | 14:45h | UTC