Journal of critical care
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Journal of critical care · Oct 2020
ReviewConflicts of interest in the context of end of life care for potential organ donors in Australia.
End-of-life (EOL) care has become an integral part of intensive care medicine and includes the exploration of possibilities for deceased organ and tissue donation. Donation physicians are specialist doctors with expertise in EOL processes encompassing organ and tissue donation, who contribute significantly to improvements in organ and tissue donation services in many countries around the world. ⋯ These obligations are complementary and provide a unique skillset to care for dying patients and their families in the ICU. In this paper we review current controversies around EOL care in the ICU, including the use of palliative analgesia and sedation specifically with regards to withdrawal of cardiorespiratory support, the usefulness of the so-called doctrine of double effect to guide ethical decision-making, and the management of potential or perceived conflicts of interest in the context of dual professional roles.
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Journal of critical care · Oct 2020
Multicenter StudyClinical course after identification of new-onset atrial fibrillation in critically ill patients: The AFTER-ICU study.
Epidemiological information is lacking after identification of new-onset atrial fibrillation (AF) in critically ill patients. This study aimed to describe the clinical course after the identification of new-onset AF. ⋯ Although the proportion of patients with AF continued to decrease with various treatments, these patients had high risk of death. Further research to assess the management of new-onset AF in critically ill patients is warranted.
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Journal of critical care · Oct 2020
Randomized Controlled TrialEffect of in-bed cycling on acute muscle wasting in critically ill adults: A randomised clinical trial.
To examine whether in-bed cycling assists critically ill adults to reduce acute muscle wasting, improve function and improve quality of life following a period of critical illness. ⋯ In-bed cycling did not reduce muscle wasting in critically ill adults, but this study provides useful effect estimates for large-scale clinical trials.
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Journal of critical care · Oct 2020
ReviewThe role of suvorexant in the prevention of delirium during acute hospitalization: A systematic review.
To assess the efficacy and safety of suvorexant for the prevention of delirium during acute hospitalization. ⋯ Based on the reviewed literature, suvorexant has shown positive outcomes in the prevention of delirium during an acute hospitalization. Larger trials comparing the efficacy of suvorexant to other sleep modulating options are necessary to further delineate its role for the prevention of delirium.
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Journal of critical care · Oct 2020
Observational StudyPsychotropic medication use in former ICU patients with mental health problems: A prospective observational follow-up study.
To describe the extent to which patients with mental health problems after admission to an Intensive Care Unit (ICU) initiate and use psychotropic medication. ⋯ Former ICU patients with mental health problems were almost four times more likely to use psychotropic medication than former ICU patients without these problems. Future research should investigate whether mental health problems are properly diagnosed and treated in former ICU patients.