Critical Care Medicine

Ruth Kleinpell, David M Ferraro, Ryan C Maves, Sandra L Kane Gill, Richard Branson, Steven Greenberg, Jennifer K Doersam, Rameela Raman, Lewis J Kaplan
IMPORTANCE: Recent reports identify that among hospitalized coronavirus disease 2019 patients, 30% require ICU care. Understanding ICU resource needs remains an essential component of meeting current and projected needs of critically ill coronavirus disease 2019 patients. OBJECTIVES: This study queried U.S. ICU clinician perspectives on challenging aspects of care in managing coronavirus disease 2019 patients, current and anticipated resource demands, and personal stress...
July 2, 2020: Critical Care Medicine
Heidi Tymkew, Traci Norris, Cassandra Arroyo, Marilyn Schallom
OBJECTIVES: To establish cutoff values for making recommendations for discharge to the home setting using standardized physical therapy assessments. DESIGN: Retrospective study. SETTING: Five ICUs at a large academic medical center. PATIENTS: 1,203 ICU patients. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: The Functional Status Score for the ICU and the ICU Mobility Scale were collected during the initial physical therapy assessment, at ICU discharge, and prior to hospital discharge...
July 2, 2020: Critical Care Medicine
Benson J Ouma, John M Ssenkusu, Estela Shabani, Dibyadyuti Datta, Robert O Opoka, Richard Idro, Paul Bangirana, Gregory Park, Moses L Joloba, Kevin C Kain, Chandy C John, Andrea L Conroy
OBJECTIVES: Evaluate the relationship between endothelial activation, malaria complications, and long-term cognitive outcomes in severe malaria survivors. DESIGN: Prospectively cohort study of children with cerebral malaria, severe malarial anemia, or community children. SETTING: Mulago National Referral Hospital in Kampala, Uganda. SUBJECTS: Children 18 months to 12 years old with severe malaria (cerebral malaria, n = 253 or severe malarial anemia, n = 211) or community children (n = 206) were followed for 24 months...
June 30, 2020: Critical Care Medicine
Jen-Ting Chen, Russel Roberts, Melissa J Fazzari, Kianoush Kashani, Nida Qadir, Charles B Cairns, Kusum Mathews, Pauline Park, Akram Khan, James F Gilmore, Anne Rain T Brown, Betty Tsuei, Michele Handzel, Alfredo Lee Chang, Abhijit Duggal, Michael Lanspa, James Taylor Herbert, Anthony Martinez, Joseph Tonna, Mahmoud A Ammar, Drayton Hammond, Lama H Nazer, Mojdeh Heavner, Erin Pender, Lauren Chambers, Michael T Kenes, David Kaufman, April Downey, Brent Brown, Darlene Chaykosky, Armand Wolff, Michael Smith, Katie Nault, Jonathan Sevransky, Michelle N Gong
OBJECTIVES: To characterize the association between the use of physiologic assessment (central venous pressure, pulmonary artery occlusion pressure, stroke volume variation, pulse pressure variation, passive leg raise test, and critical care ultrasound) with fluid and vasopressor administration 24 hours after shock onset and with in-hospital mortality. DESIGN: Multicenter prospective cohort study between September 2017 and February 2018. SETTINGS: Thirty-four hospitals in the United States and Jordan...
June 29, 2020: Critical Care Medicine
Adnan I Qureshi, Hunain Aslam, Werdah Zafar, Wei Huang, Iryna Lobanova, Syed H Naqvi, Kunal Malhotra, Niraj Arora, Premkumar N Chandrasekaran, Farhan Siddiq, Brandi R French, Camilo R Gomez
OBJECTIVES: Acute ischemic stroke patients are at risk of acute kidney injury due to volume depletion, contrast exposure, and preexisting comorbid diseases. We determined the occurrence rate and identified predictors associated with acute kidney injury in acute ischemic stroke patients. SETTING: Multiple specialized ICUs within academic medical centers. DESIGN: Post hoc analysis of pooled data from prospective randomized clinical trials. PATIENTS: Acute ischemic stroke patients recruited within 3 hours or within 5 hours of symptom onset...
June 29, 2020: Critical Care Medicine
Fabrice Petitjeans, Jean-Yves Martinez, Marc Danguy des Déserts, Sandrine Leroy, Luc Quintin, Jacques Escarment
No abstract text is available yet for this article.
June 29, 2020: Critical Care Medicine
Paul M Vespa, DaiWai M Olson, Sayona John, Kyle S Hobbs, Kapil Gururangan, Kun Nie, Masoom J Desai, Matthew Markert, Josef Parvizi, Thomas P Bleck, Lawrence J Hirsch, M Brandon Westover
OBJECTIVES: To measure the diagnostic accuracy, timeliness, and ease of use of Ceribell rapid response electroencephalography. We assessed physicians' diagnostic assessments and treatment plans before and after rapid response electroencephalography assessment. Primary outcomes were changes in physicians' diagnostic and therapeutic decision making and their confidence in these decisions based on the use of the rapid response electroencephalography system. Secondary outcomes were time to electroencephalography, setup time, ease of use, and quality of electroencephalography data...
June 29, 2020: Critical Care Medicine
Gabriel Parzy, Florence Daviet, Basile Puech, Aude Sylvestre, Christophe Guervilly, Alizée Porto, Sami Hraiech, Kathia Chaumoitre, Laurent Papazian, Jean-Marie Forel
OBJECTIVES: The main objective of the study was to determine the prevalence of venous thromboembolism events in patients infected with severe acute respiratory syndrome coronavirus 2 requiring venovenous extracorporeal membrane oxygenation. The secondary objective was to compare venous thromboembolism events and coagulation variables in patients requiring venovenous extracorporeal membrane oxygenation according to the pathogen. DESIGN: Retrospective observational analysis at a single center...
June 26, 2020: Critical Care Medicine
Russell A Trigonis, Daniel B Holt, Rebecca Yuan, Asma A Siddiqui, Mitchell K Craft, Babar A Khan, Rajat Kapoor, Omar Rahman
OBJECTIVES: One of the defining features of the novel coronavirus disease 2019 infection has been high rates of venous thromboses. The present study aimed to describe the prevalence of venous thromboembolism in critically ill patients receiving different regimens of prophylactic anticoagulation. DESIGN: Single-center retrospective review using data from patients with confirmed severe acute respiratory syndrome coronavirus 2 requiring intubation. SETTING: Tertiary-care center in Indianapolis, IN, United States...
June 26, 2020: Critical Care Medicine
Mark E Mikkelsen, William Vernick, Jacob Gutsche
No abstract text is available yet for this article.
June 26, 2020: Critical Care Medicine
Eugene Yuriditsky, James M Horowitz, Cristian Merchan, Tania Ahuja, Shari B Brosnahan, Lauren McVoy, Jeffrey S Berger
OBJECTIVES: The rate of thromboembolic events among patients with coronavirus disease 2019 is high; however, there is no robust method to identify those at greatest risk. We reviewed thromboelastography studies in critically ill patients with coronavirus disease 2019 to characterize their coagulation states. DESIGN: Retrospective. SETTING: Tertiary ICU in New York City. PATIENTS: Sixty-four patients with coronavirus disease 2019 admitted to the ICU with thromboelastography performed...
June 26, 2020: Critical Care Medicine
Shivesh Prakash, Shailesh Bihari, Russell Laver, Giresh Chandran, Lachlan Kerr, Lambert Schuwirth, Andrew Bersten
OBJECTIVES: Conventionally, simulation-based teaching involves reflection on recalled events (recall-assisted reflection). Instead of recall, video-assisted reflection may reduce recall bias and improve skills retention by contributing to visual memory. Here, we test the hypothesis that when compared with recall, video-assisted reflection results in higher acquisition and retention of skills involved in airway management among junior critical care doctors. DESIGN: Randomized control trial...
June 26, 2020: Critical Care Medicine
Nathan E Brummel, Timothy D Girard, Pratik P Pandharipande, Jennifer L Thompson, Ryan T Jarrett, Rameela Raman, Christopher G Hughes, Mayur B Patel, Alessandro Morandi, Thomas M Gill, E Wesley Ely
OBJECTIVES: Little is known about frailty that develops following critical illness. We sought to describe the prevalence of newly acquired frailty, its clinical course, and the co-occurrence of frailty with disability and cognitive impairment in survivors of critical illness. DESIGN: Longitudinal prospective cohort study. SETTING: Medical and surgical ICUs at five U.S. centers. PATIENTS: Adult patients treated for respiratory failure and/or shock...
June 26, 2020: Critical Care Medicine
Curran Hunter Daigle, John E Fiadjoe, Elizabeth K Laverriere, Benjamin B Bruins, Justin L Lockman, Justine Shults, Conrad Krawiec, Ilana Harwayne-Gidansky, Christopher Page-Goertz, Jamie Furlong-Dillard, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: Bag-mask ventilation is commonly used prior to tracheal intubation; however, the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children are not well studied. This study aims to describe prevalence and risk factors for pediatric difficult bag-mask ventilation as well as its association with adverse tracheal intubation-associated events and oxygen desaturation in PICU patients. DESIGN: A retrospective review of prospectively collected observational data from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018...
June 25, 2020: Critical Care Medicine
Anoop Mayampurath, Matthew M Churpek, Xin Su, Sameep Shah, Elizabeth Munroe, Bhakti Patel, Dmitriy Dligach, Majid Afshar
OBJECTIVES: Acute respiratory distress syndrome is frequently under recognized and associated with increased mortality. Previously, we developed a model that used machine learning and natural language processing of text from radiology reports to identify acute respiratory distress syndrome. The model showed improved performance in diagnosing acute respiratory distress syndrome when compared to a rule-based method. In this study, our objective was to externally validate the natural language processing model in patients from an independent hospital setting...
June 25, 2020: Critical Care Medicine
Nikhil Jagan, Lee E Morrow, Ryan W Walters, Robert W Plambeck, Tanner J Wallen, Tej M Patel, Mark A Malesker
OBJECTIVES: Multiple studies have demonstrated an obesity paradox such that obese ICU patients have lower mortality and better outcomes. We conducted this study to determine if the mortality benefit conferred by obesity is affected by baseline serum lactate and mean arterial pressure. DESIGN: Retrospective analysis of prospectively collected clinical data. SETTING: Five community-based and one academic medical center in the Omaha, NE. PATIENTS: 7,967 adults hospitalized with sepsis...
June 25, 2020: Critical Care Medicine
Emanuel Eguia, Corinne Bunn, Sujay Kulshrestha, Talar Markossian, Ramon Durazo-Arvizu, Marshall S Baker, Richard Gonzalez, Faraz Behzadi, Matthew Churpek, Cara Joyce, Majid Afshar
OBJECTIVES: Identification and outcomes in patients with sepsis have improved over the years, but little data are available in patients with trauma who develop sepsis. We aimed to examine the cost and epidemiology of sepsis in patients hospitalized after trauma. DESIGN: Retrospective cohort study. PATIENTS: National Inpatient Sample. INTERVENTIONS: Sepsis was identified between 2012 and 2016 using implicit and explicit International Classification of Diseases, Ninth and Tenth Revision codes...
June 25, 2020: Critical Care Medicine
Bjoern Zante, Sabine A Camenisch, Joerg C Schefold
OBJECTIVES: Data show that family members of ICU patients may have high levels of anxiety, depression, posttraumatic stress disorders, and/or complicated grief. This was previously referred to as post-intensive care syndrome-family. We systematically review randomized controlled trials for post-intensive care syndrome-family. DATA SOURCES: Systematic research in databases (Pubmed, EMBASE, PsycINFO, CINHAL for articles published between January 2000 and October 2019)...
June 25, 2020: Critical Care Medicine
Rui Wang, Bing Sun, Xuyan Li, Xiao Tang, Hangyong He, Ying Li, Xue Yuan, Haichao Li, Huiwen Chu, Zhaohui Tong
OBJECTIVES: Previous studies have suggested that adjusting ventilator settings based on transpulmonary pressure measurements may minimize ventilator-induced lung injury, but this has never been investigated in patients with severe acute respiratory distress syndrome supported with venovenous extracorporeal membrane oxygenation. We aimed to evaluate whether a transpulmonary pressure-guided ventilation strategy would increase the proportion of patients successfully weaned from venovenous extracorporeal membrane oxygenation support in patients with severe acute respiratory distress syndrome...
June 25, 2020: Critical Care Medicine
Nital Patel, Tara L Petersen, Pippa M Simpson, Mingen Feng, Sheila J Hanson
OBJECTIVES: Central venous access devices, including peripherally inserted central catheters and central venous catheters, are often needed in critically ill patients, but also are associated with complications, including central-line associated bloodstream infections and venous thromboembolism. We compared different central venous access device types and these complications in the PICU. DESIGN: Multicenter, cohort study. SETTING: One-hundred forty-eight participating Virtual PICU Systems, LLC hospital PICU sites...
June 24, 2020: Critical Care Medicine
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