Intensive care medicine
-
Intensive care medicine · Jul 2017
Multicenter StudyHealthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study.
To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. ⋯ This multicenter longitudinal study found that 40% of ARDS survivors reported at least one post-discharge hospitalization during 12-month follow-up. Few patient- or ICU-related variables were associated with hospitalization; however, physical, psychiatric, and quality of life measures at 6-month follow-up were associated with subsequent hospitalization. Interventions to reduce post-ARDS morbidity may be important to improve patient outcomes and reduce healthcare utilization.
-
Intensive care medicine · Jul 2017
Multicenter StudyCritical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries.
As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. ⋯ We did not identify any survival benefit from critical care admission following surgery.
-
Intensive care medicine · Jul 2017
Multicenter StudyThe impact of disability in survivors of critical illness.
To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. ⋯ Disability measured using patient-reported outcomes was prevalent at 6 months after critical illness in survivors and was associated with reduced health-related quality of life. Predictors of moderate or severe disability included a prior history of anxiety or depression, separation or divorce and a longer duration of mechanical ventilation.
-
Intensive care medicine · Jul 2017
Multicenter StudyA multi-faceted strategy to reduce ventilation-associated mortality in brain-injured patients. The BI-VILI project: a nationwide quality improvement project.
We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. ⋯ Adherence to recommendations for low tidal volume, moderate PEEP and early extubation seemed to increase the number of ventilator-free days in brain-injured patients, but inconsistent adoption limited their impact. Trail registration number: NCT01885507.
-
Intensive care medicine · Jul 2017
Multicenter StudyAssociation between mRNA expression of CD74 and IL10 and risk of ICU-acquired infections: a multicenter cohort study.
Intensive care unit (ICU)-acquired infections (IAI) result in increased hospital and ICU stay, costs and mortality. To date, no biomarker has shown sufficient evidence and ease of application in clinical routine for the identification of patients at risk of IAI. We evaluated the association of the systemic mRNA expression of two host response biomarkers, CD74 and IL10, with IAI occurrence in a large cohort of ICU patients. ⋯ Our results suggest that two immune biomarkers, CD74 and IL10, could be relevant tools for the identification of IAI risk in ICU patients.