Articles: intensive-care-units.
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Acta Anaesthesiol Scand · Mar 2025
A descriptive, retrospective single-centre study of air-leak syndrome in intensive care unit patients with COVID-19.
Acute respiratory failure is the predominant presentation of intensive care unit (ICU) patients with COVID-19, and lung protective strategies are recommended to mitigate additional respiratory complications such as air-leak syndrome. The aim of this study is to investigate the prevalence, type, and timing of air-leak syndrome with regards to associated factors and patient outcome in patients with COVID-19 in ICUs at a large Swedish emergency hospital. ⋯ This single-centre cohort study of air leakage into soft tissue in ventilated COVID cases presents findings for associated factors and clinical manifestations, including with different COVID-19 periods and treatments.
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J Pain Symptom Manage · Mar 2025
Navigating Uncertainty during Family Meetings in the Pediatric Cardiac Intensive Care Unit: A Qualitative Investigation of Team Communication and Family Engagement.
Uncertainty is a known barrier to effective communication during family meetings in the pediatric cardiac intensive care unit (CICU), however, limited data has characterized patterns of communication during these meetings, limiting our ability to make best practice recommendations to clinicians. ⋯ Our results encourage clinicians to communicate uncertainty in an unburied and explicit manner, which may reduce the burden on families to engage in effective communication strategies, such as clarifying and summarizing opaquely stated information.
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Eur J Trauma Emerg Surg · Feb 2025
Meta AnalysisEffectiveness of antibiotic prophylaxis in polytrauma patients: a systematic review and meta-analysis.
The use of antibiotic prophylaxis in trauma patients, particularly to prevent ventilator-associated pneumonia (VAP), is debated due to rising antibiotic resistance. Therefore, this systematic review evaluated the safety and effectiveness of antibiotic prophylaxis compared to placebo or standard care on clinical outcomes in adult polytrauma patients. ⋯ The results indicate that antibiotic prophylaxis has no significant effect on mortality and clinical status compared with placebo or standard care in adult polytrauma patients but may reduce the risk of VAP. However, the evidence is outdated and of very low certainty, with insufficient data to draw definitive conclusions regarding efficacy. Therefore, high-quality, up-to-date research is urgently needed to support clinical decision-making, and current interpretations should be treated with caution.
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Nocturnists are the principal means by which hospital medicine groups currently ensure continuous overnight coverage of hospitalized patients within academic medical centers and community hospitals. Yet despite their involvement in most aspects of overnight care, a comprehensive review of the impact of nocturnists in the hospital is absent. Here we examine the physiologic effects of overnight work on clinicians, the quality of medical care delivered by nocturnists in floor and intensive care units, the impact of nocturnist presence on trainee supervision and graduated autonomy in academic settings, and prevalent staffing models. ⋯ Compensation is typically greater for nocturnists, but the role's sustainability and impact on overall group retention remain unknown. Nocturnist programs are essential to provide continuous care of hospitalized patients and meet trainee supervision mandates, yet their full impact on patient and educational outcomes requires further investigation. Future research should aim to optimize staffing models to enhance patient care, trainee education, and clinician well-being.