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In this study of administrative data from patients admitted to 421 U.S. hospitals with acute chronic obstructive pulmonary disease (COPD) exacerbations, 41% received long-acting bronchodilators, which are not recommended in this setting. Comparison with patients who did not receive the long-acting agents showed no evidence for clinical or economic benefit from their use.
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Although studies in animals and preliminary reports in patients with ARDS suggested that statin administration might be beneficial in patients with the syndrome, this multicenter, double-blind clinical trial showed no benefit from simvastatin by any measure examined.
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Venous thromboembolism (VTE) is the third most common cardiovascular condition behind myocardial infarction and stroke, with an incidence rate of about one per 1000 person-years.1,2 Nearly 5% of the population will experience
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Using retrospective cohort data from a national survey of medical and mixed medical-surgical ICUs, this study found that nurse practitioner (NP)/physician assistant (PA) staffing was common and not associated with any differences in in-hospital mortality compared to ICUs without NP/PAs.
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Dehydration is an independent predictor of discharge outcome and admission cost in acute ischaemic stroke.
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Reintubation following unplanned extubation in critically ill post-operative patients is associated with increased hospital mortality.
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Examination of outcomes in 710,535 patients in relation to the timing of ICU discharge showed that being moved out to the ward between 1800 and 0600 hours was associated with increased risks of both in-hospital death and unplanned ICU readmission.
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As hospitals in the United States and other resource-intensive countries prepare for the care of patients with possible Ebola virus disease, the greatest impact on its clinical outcome and further spread will most likely come from the application of existing basic critical-care and infection-control principles.
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Intravascular catheters are an essential component of the practice of critical care medicine. These devices are used to deliver life-sustaining intravenous fluids, antibiotics, parenteral nutrition, blood, and blood products, and to monitor the hemodynamic status of critically ill patients.
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Health care providers are understandably concerned about the legal climate in which they live, observes Marshall B. Kapp, JD, MPH, professor in the department of community health at Wright State University School of Medicine in Dayton, Ohio. But ICU physicians can rest easier than many. Even though malpractice cases abound, the reality is that very few medical malpractice claims or other adverse legal actions happen due to thoughtful decisions to withhold or withdraw treatment for dying patients in the ICU.
