Name: Relias Media
Price range: $

The Disruptive Effects of Tablet Readers on Sleep Patterns

The use of light-emitting tablet devices prior to bedtime negatively impacts sleep patterns through disturbances in circadian rhythms.

Corticosteroids in Severe Community-Acquired Pneumonia: The Controversy Continues

Treatment failure in hospitalized patients with severe community-acquired pneumonia (CAP) is associated with an excessive inflammatory response and worse outcomes. Torres and colleagues sought to determine the effect of corticosteroids in patients with severe CAP and a significant inflammatory response. In this multicenter, randomized, double-blind, placebo-controlled trial, 120 severe CAP patients with C-reactive protein (CRP) levels >150 mg/L were randomized to receive either an IV methylprednisolone bolus of 0.5 mg/kg every 12 hours or placebo. Treatment began within 36 hours of hospital admission and lasted for 5 days. Severe CAP was defined as two out of the three minor criteria independently associated with severity including PaO₂ /FiO₂ < 250, multilobar involvement, and systolic blood pressure < 90 mmHg, or one out of two major criteria, including a requirement for mechanical ventilation or septic shock.¹ Risk class V for the Pneumonia Severity Index was also considered severe CAP.² The primary outcome was early or late treatment failure. Early treatment failure was defined as the development of shock, need for mechanical ventilation not present at baseline, or death within 72 hours of treatment. Late treatment failure was defined as radiographic progression, persistence of severe respiratory failure, development of shock, need for invasive mechanical ventilation not present at baseline, or death between 72 hours and 120 hours after treatment.

Neuromuscular Blockade and Successful Endotracheal Intubation

Previous studies have shown the utility of neuromuscular blocking agents for endotracheal intubation in the operating room and emergency department. However, airway management in the ICU often involves unplanned, emergent intubations under suboptimal conditions. This study asked whether NMBAs improved first attempt success of intubations in the ICU. Additionally, these authors asked whether succinylcholine or rocuronium improved first attempt success and the effects of NMBA on intubations using video laryngoscopy.

Does Functional Ability Prior to an ICU Admission Influence Outcomes in Older Adults?

The impact of an older person’s functional status prior to experiencing hospitalization for a critical illness is difficult to determine. Given that ICU admission is generally an unplanned event, obtaining prospective evaluations of function prior to a critical illness or injury is almost impossible. Most evidence to date has utilized proxy reports for a patient’s functional status to determine what, if any, pre-ICU disability may have on an older adult’s outcomes after hospitalization for a critical illness or injury.

Assessment, Prevention, and Treatment of Delirium in the ICU

A review of the latest Society of Critical Care Medicine clinical practice guidelines.

Endovascular Intracranial Clot Extraction Benefits Are Confirmed in Two More Clinical Trials

On April 17, 2015, the New England Journal of Medicine published the results of two randomized clinical trials of endovascular stent-retriever clot extraction for ischemic stroke, simultaneous with their presentation at the European Stroke Conference. These two studies, added to those presented and published at the International Stroke Conference in February, bring the total number of studies to five that have shown dramatic benefits of this therapy in appropriately selected patients with acute ischemic stroke.

Hypothermia after Acute Traumatic Brain Injury Revisited

Hypothermia therapy is effective after severe traumatic brain injury for patients ages 50 years and younger. However, mortality was increased in patients treated with hypothermia who had diffuse injury with swelling on CT.

Is Early MRI Warranted for Back Pain in the Elderly?

In an analysis of a large dataset from several large integrated health care systems of patients older than 65 years of age with new-onset low back pain, early spine imaging did not alter management or outcomes, but added considerable cost to their care.

Does Traumatic Brain Injury Cause Sleep Disruption?

In a well-designed animal model of traumatic brain injury, a sleep disorder was induced that resembles, in many ways, what is observed in spontaneous human narcolepsy.

Relationship Between Brain MRI Biomarkers and Cognition

In a prospective, longitudinal, cohort study of an asymptomatic, multi-ethnic Dallas community, brain MRI biomarkers measuring volume were associated with cognitive functions, as measured by the Montreal Cognitive Assessment.

Articles Tagged With: