Critical Care
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ICU Staff Report Severe Moral Distress, But Resources Are Underused
Unresolved ethical concerns not only cause individual moral distress, but can also change the staff relationships and clinical cohesiveness.
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Ethical Guidance for Research on Dying or Recently Deceased ICU Patients
There are no authoritative international ethical guidelines governing research on dying or recently deceased individuals. A group of investigators sought to start a conversation about challenges and potential solutions. They developed a preliminary framework for the ethical conduct of research with imminently dying patients.
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Progress on Pediatric Readiness in EDs Continues
The pandemic slowed progress and not all emergency departments fully adhere to national guidelines, but continuous improvement is evident.
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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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New Diagnostic Tools Expected to Revamp Sepsis Care
An expert panel agreed a test is needed to indicate the severity of dysregulated host immune response. Although there was some uncertainty over which patients would benefit most from such a test, the panel agreed the sepsis test should be conducted at triage and produce results in less than 30 minutes.
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Fewer Delays in Sepsis Treatment via Provider in Triage Model
However, more research is needed to identify which key elements of this process can be reliably replicated using cost-effective resources to balance liabilities and risks.
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Quality Improvement Project Aims to Decelerate Aggressive Hypertension Treatment
Although there might be good intentions behind administering intravenous antihypertensive medication, staff should remain mindful of possible consequences.