Intensive care medicine
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Intensive care medicine · Jun 2015
ReviewMechanical ventilation during extracorporeal life support (ECLS): a systematic review.
In patients with acute respiratory distress syndrome (ARDS), extracorporeal life support (ECLS) has been utilized to support gas exchange and mitigate ventilator-induced lung injury (VILI). The optimal ventilation settings while on ECLS are unknown. The purpose of this systematic review is to describe the ventilation practices in patients with ARDS who require ECLS. ⋯ Reduction in the intensity of mechanical ventilation in patients with ARDS supported by ECLS is common, suggesting that clinicians may be focused on reducing VILI after ECLS initiation. Future investigations should focus on establishing the optimal ventilatory strategy for patients with ARDS who require ECLS.
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Intensive care medicine · Jun 2015
Multicenter StudyFeasibility and utility of the use of real time random safety audits in adult ICU patients: a multicentre study.
The two aims of this study were first to analyse the feasibility and utility (to improve the care process) of implementing a new real time random safety tool and second to explore the efficacy of this tool in core hospitals (those participating in tool design) versus non-core hospitals. ⋯ Real time safety audits improved the care process and adherence to the clinical practice guidelines and proved to be most useful in situations of high care load and in patients with more severe disease. The effect was greater in core hospitals.
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Intensive care medicine · Jun 2015
Multicenter StudyMultinational development and validation of an early prediction model for delirium in ICU patients.
Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention. ⋯ Patients' delirium risk for the complete ICU length of stay can be predicted at admission using the E-PRE-DELIRIC model, allowing early preventive interventions aimed to reduce incidence and severity of ICU delirium.
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Intensive care medicine · Jun 2015
Long-term neuropsychological outcomes in children and adolescents after cardiac arrest.
Research into neuropsychological functioning of survivors of cardiac arrest (CA) in childhood is scarce. We sought to assess long-term neuropsychological functioning in children and adolescents surviving CA. ⋯ Long-term neuropsychological assessment of CA survivors showed significant weaknesses, but also relatively intact functioning. As deficits in IQ, memory and executive functioning have significant impact on the child, long-term follow-up and neuropsychological support of CA survivors is warranted.
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Intensive care medicine · Jun 2015
A clinical prediction model to identify patients at high risk of death in the emergency department.
Rapid assessment and intervention is important for the prognosis of acutely ill patients admitted to the emergency department (ED). The aim of this study was to prospectively develop and validate a model predicting the risk of in-hospital death based on all available information available at the time of ED admission and to compare its discriminative performance with a non-systematic risk estimate by the triaging first health-care provider. ⋯ The use of the prediction model can facilitate the identification of ED patients with higher mortality risk. The model performs better than a non-systematic assessment and may facilitate more rapid identification and commencement of treatment of patients at risk of an unfavourable outcome.