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In a prospective study of the actual oral nutritional intake of patients with respiratory failure in the first week following extubation, average intake failed to exceed 50% of daily requirements on all seven days.
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In this before-after study in a surgical ICU, addition to the daily physician worksheet of a red box requiring the checking of "yes" or "no" to continued need for central venous and urinary catheters was associated with a significant reduction in the duration of catheterization.
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The presence of cerebral complications of infective endocarditis (IE) can affect diagnostic and treatment decisions. Thus, this group from Paris, France, evaluated whether early cerebral MRI would affect the diagnosis and management of hospitalized patients suspected of having IE.
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Bilateral absence of N20 responses in the setting of therapeutic hypothermia does not preclude neurologic recovery in comatose survivors of cardiac arrest.
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Asymptomatic pulmonary embolism is quite common among patients with deep venous thrombosis. In many instances in these patients, the pulmonary emboli are located within the central pulmonary arteries.
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This randomized, multicenter trial showed no differences in 28-day mortality in patients with shock who received either norepinephrine or dopamine, but did reveal a higher incidence of arrhythmia in the dopamine-treated group.
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In this large retrospective cohort study of more than 100,000 patients in 112 hospitals, after correction for illness severity and other factors, daily rounds by a multidisciplinary care team were associated with lower mortality in the ICU, regardless of whether an intensivist model of physician staffing was in use.
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The risk of relapse after effective therapy with plasma exchange for thrombotic thrombocytopenic purpura (TTP) has not been well-characterized. Among 376 patients with an initial episode of TTP treated with plasma exchange, overall survival was around 68%, with a survival of 78% among the subset with idiopathic TTP. Survival did not differ on those having a low (< 10%) ADAMTS13 level. Relapse was greater for those with a low ADAMTS13 level at the time of presentation.
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In a prospective, observational study, > 50% of patients identified and treated for severe sepsis in the emergency department (ED) had negative cultures; 18% of patients had a noninfectious diagnosis that mimicked sepsis.
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This two-phase, prospective, multicenter study demonstrated that implementation of an intubation management protocol reduced the incidence of severe hypoxemia and cardiovascular collapse during endotracheal intubation when compared to standard practice, but did not improve other patient outcomes such as ICU mortality or duration of mechanical ventilation.