Critical Care
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Communication Facilitators Potentially Can Improve Care for the Sickest ICU Patients
Highly trained communication facilitators who counseled families and met with physicians and nurses were shown to decrease symptoms of depression in family members at six months and decreased ICU length of stay without affecting mortality.
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Delaying Intubation in Severe Alcohol Withdrawal
Delaying intubation until aspiration or cardiopulmonary decompensation did not affect mortality but increased the incidence of pneumonia and length of stay.
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Patients Rarely Sleep in the ICU
Understanding the mechanisms of sleep deprivation in the ICU may help clinicians modify some of these factors to promote better quality sleep.
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Intracerebral Hemorrhages Associated with Non-vitamin K Oral Anticoagulants Appear to Be Smaller than Those Associated with Warfarin
Intracerebral hemorrhage is the most dangerous complication of treatment with oral anticoagulants, and this complication carries a high mortality. Because of the increasing prevalence of atrial fibrillation in the elderly population, and the increasing use of oral anticoagulants, the overall prevalence of intracerebral hemorrhage is increasing.
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Optimal Antiplatelet Therapy for Secondary Prevention of Ischemic Stroke
Patients presenting with acute ischemic stroke are often taking aspirin on a regular basis for prevention of cardiovascular disease. The optimal antiplatelet therapy for secondary prevention has been uncertain in this setting.
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Use of CNMs and Hospitalists
SYNOPSIS: A study assessing the effects of instituting a model of certified nurse midwife with MD laborist backup on a private patient population showed a decrease in cesarean section rate and an increase in vaginal birth after cesarean delivery rate without any change in combined neonatal outcome.
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Prognostic Value of Coronary Calcium on Standard Chest CT Scans
SYNOPSIS: Coronary calcium scan on standard CT scans performed for other indications is of equivalent prognostic value to that seen on ECG-gated coronary studies and should be included in radiology test reports.
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The Current Outlook for Cardiac Tamponade
SYNOPSIS: In the modern era, cardiac tamponade is most commonly caused by malignancies with poor prognosis. As compared to older literature, iatrogenic causes have increased, most resulting from complications of percutaneous coronary intervention.
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The Best Rate Control Agent for Sepsis and Atrial Fibrillation
Sepsis and atrial fibrillation are common in the ICU, and the presence of both together is not a rare occurrence. Here's how to handle them.
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Are Nighttime Extubations in the ICU Safe?
Compared to daytime extubations, ICU patients who undergo planned extubation at night do not experience higher likelihood of reintubation, increased length of stay, or increased mortality.