Critical Care Alert – January 1, 2018

January 1, 2018

• Crystalloid Resuscitation in Sepsis and Septic Shock: The Earlier, the Better

  Although the most recent Surviving Sepsis Campaign guidelines authorized completion of 30 mL/kg of IV crystalloid within three hours of the recognition of sepsis and septic shock, there remains controversy regarding the benefits and harms of early, aggressive crystalloids, especially in specific patient populations.

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• Implementing Noninvasive Ventilation: If You Build It, They Will Come

  Hospitals that have been highly effective in implementing noninvasive ventilation as front-line therapy for acute exacerbation of chronic obstructive pulmonary disease recognized that a combination of allied health autonomy, interdisciplinary teamwork, and devoting sufficient resources are essential features for success.

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• More ICU Care Does Not Equal Better Survival for Elderly Patients

  Using a systematic strategy for promoting ICU admission for elderly patients resulted in a higher ICU admission rate but the strategy produced no effect on six-month mortality.

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• Urine Output: The New Vital Sign?

  An analysis of a large ICU database showed that hourly monitoring of urine output was associated with improved detection of acute kidney injury (AKI) and lower 30-day mortality in patients with AKI.

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