Critical Care General
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Patient Mortality Not Linked to Intensivist Caseloads
In this retrospective cohort study in the United States from 2018-2020, there was no significant association between intensivist-to-patient ratio and patient mortality and no effect modification by having physicians-in-training, nurse practitioners, and physician assistants present.
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Effectiveness of Aerosolized Bronchodilators in Patients Receiving High-Flow Nasal Cannula Oxygen Therapy
In a prospective, single-center study, bronchodilators delivered in line with a high-flow nasal cannula device improved forced expiratory volume in one second and forced vital capacity in patients with chronic obstructive pulmonary disease exacerbation.
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Older ICU Survivors Often Receive New and Persistent Prescriptions for Sedatives After Discharge
In this population-based cohort study of older intensive care unit survivors, one in 15 of them received a new prescription for a sedative within a week of discharge, and more than half had recurrent prescriptions.
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Videolaryngoscopy for Intubation of Critically Ill Patients
In a large, prospective, multicenter, randomized, pragmatic trial, the use of a video laryngoscope resulted in a higher incidence of successful intubation on the first attempt on critically ill patients in the emergency department and intensive care unit compared to the use of the direct laryngoscope.
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Direct Oral Anticoagulants vs. Warfarin When Treating Renal Dysfunction
A patient-level meta-analysis of five pivotal trials of direct oral anticoagulants (DOACs) vs. warfarin for patients with atrial fibrillation and creatinine clearance levels ranging from normal to 25 mL/min revealed standard-dose DOACs exhibit superior safety and efficacy compared to adjusted-dose warfarin and lower-dose DOACs.
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Patients with COVID-19 on ECMO Therapy Benefit from Early Guided Palliative Care Communication
Patients with severe COVID-19 acute respiratory distress syndrome that require extracorporeal membrane oxygenation support can benefit from implementing palliative care communication early in their treatment course.
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Cultural Sensitivity in End-of-Life Discussions in the Intensive Care Unit
When clinicians treat patients and communicate with families who come from cultures that are different from their own, cultural sensitivity can improve the experience for families.
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Can EEG and fMRI Help Predict Who Will Recover Consciousness After Brain Injury?
In conjunction with serial clinical examinations, electroencephalogram and functional magnetic resonance imaging may be helpful in predicting who will recover consciousness after an acute brain injury. However, in this study, early withdrawal of care leaves much uncertainty regarding the probability of eventual recovery.
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Diltiazem Found to Be Better than Metoprolol in Heart Rate Reduction for Atrial Fibrillation in Heart Failure
In patients with atrial fibrillation and heart failure, intravenous diltiazem results in greater heart rate reduction than metoprolol with a similar safety profile, but further research is needed in this patient population.
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Short-Term Use of Haloperidol Did Not Decrease Risk of Mortality in ICU Patients with Delirium
The use of scheduled intravenous haloperidol in intensive care unit patients with delirium did not result in additional days alive and out of the hospital at 90 days as compared to placebo.