Critical Care
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Growing Movement Toward More Family Participation in ICUs
Family satisfaction scores increased after ICUs implemented family-centered care initiatives as part of the Society of Critical Care Medicine’s Family Engagement Collaborative.
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Family Members Encouraged to Offer More Care for Loved Ones in ICU
Researchers provide guidance to worried family members who may not know how to act in the intimidating ICU setting.
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Dexamethasone for COVID-19 Inpatients Requiring Oxygen
Dexamethasone administration is associated with reduced 28-day mortality in oxygen-requiring COVID-19 patients, including those receiving mechanical ventilation.
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Pediatric Sedation: A Comprehensive Review
Painful procedures are common in the acute care setting, and failing to mange a child’s anxiety and pain may have long-term consequences. Being familiar with a diversity of non-pharmacologic and pharmacologic alternatives is critical.
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Considerations and Concerns with Vitamin C in Sepsis and Septic Shock
Sepsis remains a major healthcare problem associated with significant morbidity and mortality. Roles for hydrocortisone, ascorbic acid (vitamin C), and thiamine (HAT therapy) as potential adjuvants remain controversial.
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ORANGES and ACTS Trials: No Mortality Benefit with Ascorbic Acid, Thiamine, and Hydrocortisone in Septic Shock Patients
Two double-blinded, placebo-controlled, randomized trials involving 337 patients (ORANGES, n = 137; ACTS, n = 200) with sepsis and septic shock have shown that administration of ascorbic acid, thiamine, and hydrocortisone did not reduce organ dysfunction or improve overall mortality. However, both trials showed that this combination therapy was effective in reducing the time to achieve shock resolution or shock-free days.
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Sepsis Outcomes Improve, But Not at Minority-Serving Hospitals
ICU deaths declined 2% steadily annually at non-minority hospitals, according to a recent report. This was not true of minority-serving hospitals. Those hospitals also reported longer lengths of stay and more critical illness than non-minority hospitals.
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ICU Nurses Feel Marginalized During Ethical Conflicts
A pair of researchers analyzed open-ended responses from a survey with ICU nurses, and identified three themes.
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End-of-Life Experience Varies Depending on Geographical Region
Investigators were surprised by the striking degree to which the use of hospitalization and hospice varied across the United States, even among large metropolitan areas.
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Race Disparities Identified in End-of-Life Care
Minority patients receive more aggressive end-of-life interventions than white patients, according to the authors of a recent study. The answer has to do, in part, with the history of maltreatment of vulnerable populations. Some minority patients, or their family members, have been the recipients of substandard medical care.