Tag: intensive care

In this section, we highlight the key high-impact studies, updates, and analyses published in medicine during the past week. Prevalence of Antimicrobial Use in US Acute Care Hospitals, May-September 2011 Inappropriate and excessive use of antimicrobial drugs in hospitals contributes to increased bacterial resistance and adverse events in patients, but it...
1. Off-hours admissions to the pediatric intensive care unit (PICU) were less likely to be elective, had a higher risk of mortality using the Pediatric Index of Mortality 2 (PIM2), and had higher observed ICU mortality.  2. Off-hours admission to the PICU was associated with lower odds of mortality compared...
1. Selective decontamination of the digestive tract (SDD) was associated with a lower prevalence of antibiotic-resistant gram-negative bacteria in the rectum compared to selective oropharyngeal decontamination (SOD). 2. There were no differences in ICU lengths of stay or day-28 mortality between the two groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Prophylactic...
1. Vitamin D supplementation did not change length of ICU or hospital stay among individuals with vitamin D deficiency in this randomized controlled study. 2. The risk of hospital mortality was lower among individuals receiving vitamin D replacement, but there was no mortality benefit at 6 months. Evidence Rating Level: 1...
1. Central line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonias (VAPs) fell significantly among neonatal intensive care units between 2007 and 2012. 2. During the same time period, CLABSIs and VAPs also fell significantly among pediatric intensive care units; however, there was no significant change in catheter-associated urinary tract infections (CAUTIs). Evidence...
1. High protein enteral nutrition enriched with immune-modulating nutrients (IMHP) did not reduce infections in mechanically ventilated adults compared to high protein enteral nutrition (HP). 2. Compared to the HP group, a higher 6-month mortality rate was observed in IMHP group.  Evidence Rating: 1 (Excellent)  Study Rundown: Critically ill patients in the intensive...
Image: PD 1. Among children admitted to 1 of 10 medical centers for diabetic ketoacidosis management, elevated serum urea nitrogen concentrations and low partial pressures of carbon dioxide were associated with significant increases in risk of developing cerebral edema.  2. Lack of pronounced serum sodium rise and use of bicarbonate for...
Image: PD 1. Conscious, intubated patients in the intensive care unit frequently experience significant anxiety, which can affect their clinical condition and often requires significant sedative use. 2. In the present study, patient-directed music therapy reduces both anxiety and sedative administration in conscious, intubated patients.   Evidence Rating Level: 1 (Excellent)  Study Rundown: In...
Classics Series, Landmark Trials in Medicine
1. Intensive glycemic control in critically ill patients significantly increases 90-day mortality when compared to conventional glycemic control. 2. The incidence of severe hypoglycemia was significantly higher in patients receiving intensive glycemic control. Original Date of Publication: March 26, 2009 Study Rundown: In the intensive care unit (ICU), hyperglycemia is a common problem...