2017 Dec - Are high nurse workload/staffing ratios associated with decreased survival in critically ill patients? A cohort study
Lee A, Cheung YSL, Joynt GM, Leung CCH, Wong WT, Gomersall CD.; Ann Intensive Care. 2017 Dec;7(1):46. doi: 10.1186/s13613-017-0269-2. Epub 2017 May 2.
BACKGROUND: Despite the central role of nurses in intensive care, a relationship between intensive care nurse workload/staffing ratios and survival has not been clearly established. We determined whether there is a threshold workload/staffing ratio above which the probability of hospital survival is reduced and then modeled the relationship between exposure to inadequate staffing at any stage of a patient's ICU stay and risk-adjusted hospital survival.
2017 Apr - Diagnostic accuracy of quantitative neuromuscular ultrasound for the diagnosis of intensive care unit-acquired weakness: a cross-sectional observational study
Witteveen E, Sommers J, Wieske L, Doorduin J, van Alfen N, Schultz MJ, van Schaik IN, Horn J, Verhamme C.; Ann Intensive Care. 2017 Dec;7(1):40. doi: 10.1186/s13613-017-0263-8. Epub 2017 Apr 5.
BACKGROUND: Neuromuscular ultrasound is a noninvasive investigation, which can be easily performed at the bedside on the ICU. A reduction in muscle thickness and increase in echo intensity over time have been described in ICU patients, but the relation to ICU-acquired weakness (ICU-AW) is unknown. We hypothesized that quantitative assessment of muscle and nerve parameters with ultrasound can differentiate between patients with and without ICU-AW. The aim of this cross-sectional study was to investigate the diagnostic accuracy of neuromuscular ultrasound for diagnosing ICU-AW.
2017 Apr - Earlier versus later initiation of renal replacement therapy among critically ill patients with acute kidney injury: a systematic review and meta-analysis of randomized controlled trials
Lai TS, Shiao CC, Wang JJ, Huang CT, Wu PC, Chueh E, Chueh SJ, Kashani K, Wu VC.; Ann Intensive Care. 2017 Dec;7(1):38. doi: 10.1186/s13613-017-0265-6. Epub 2017 Apr 5.
BACKGROUND: Although the optimal timing of initiation of renal replacement therapy (RRT) in critically ill patients with acute kidney injury has been extensively studied in the past, it is still unclear.
2017 May - A Multicenter, Randomized Trial of Ramped Position versus Sniffing Position during Endotracheal Intubation of Critically Ill Adults
Semler MW, Janz DR, Russell DW, Casey JD, Lentz RJ, Zouk AN, deBoisblanc BP, Santanilla JI, Khan YA, Joffe AM, Stigler WS, Rice TW; Check-UP Investigators.; Pragmatic Critical Care Research Group..; Chest. 2017 May 6. pii: S0012-3692(17)30881-4.
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room.
2017 May - Decision-making on withholding or withdrawing life-support in the ICU: A worldwide perspective
Lobo SM, Barros de Simoni FH, Jakob SM, Estella A, Vadi S, Bluethgen A, Martin-Loeches I, Sakr Y, Vincent JL; ICON investigators..; Chest. 2017 May 5. pii: S0012-3692(17)30820-6
BACKGROUND: Many critically ill patients who die will do so after a decision has been made to withhold/withdraw life-sustaining therapy. Our objective was to document the characteristics of intensive care unit (ICU) patients with a decision to withhold/withdraw life-sustaining treatment, including the types of supportive treatments used, patterns of organ dysfunction, and international differences, including gross national income (GNI).
Martinell L, Nielsen N, Herlitz J, Karlsson T, Horn J, Wise MP, Undén J, Rylander C.; Crit Care. 2017 Apr 13;21(1):96.
BACKGROUND: Early identification of predictors for a poor long-term outcome in patients who survive the initial phase of out-of-hospital cardiac arrest (OHCA) may facilitate future clinical research, the process of care and information provided to relatives. The aim of this study was to determine the association between variables available from the patient's history and status at intensive care admission with outcome in unconscious survivors of OHCA.
2017 May - New drugs, new toxicities: severe side effects of modern targeted and immunotherapy of cancer and their management
Kroschinsky F, Stölzel F, von Bonin S, Beutel G, Kochanek M, Kiehl M, Schellongowski P; Intensive Care in Hematological and Oncological Patients (iCHOP) Collaborative Group..; Crit Care. 2017 Apr 14;21(1):89.
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.