Articles: intensive-care-units.
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Intensive care medicine · Dec 2024
Randomized Controlled Trial Multicenter StudyEFFECT of daily antiseptic bathing with octenidine on ICU-acquired bacteremia and ICU-acquired multidrug-resistant organisms: a multicenter, cluster-randomized, double-blind, placebo-controlled, cross-over study.
Antiseptic bathing has garnered attention in an effort to reduce hospital-acquired infections. Previous studies have shown the efficacy of antiseptic bathing in high-risk environments, such as intensive care units (ICUs), using chlorhexidine. In this study we aimed to evaluate the effectiveness of octenidine as a potential alternative due to its established popularity and widespread use in Europe. ⋯ Antiseptic bathing with octenidine may be effective in preventing ICU-acquired primary bacteremia, particularly due to Gram-positive bacteria and common skin commensals.
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Randomized Controlled Trial
Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness-implementation, cluster-randomized trial.
Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes to poor health outcomes for children hospitalized with these illnesses, including longer recovery time/hospital stay, higher rates of intensive care unit transfer, and increased risk of hospital readmission. A prior single-center study at a children's hospital tested a multicondition clinical pathway intervention (simultaneous implementation of multiple pathways for multiple pediatric conditions) and demonstrated improved clinician guideline adherence and patient health outcomes. This intervention has not yet been studied in community hospitals, which face unique implementation barriers. ⋯ This hybrid trial will lead to a comprehensive understanding of how to pragmatically and sustainably implement a multicondition pathway intervention in community hospitals and an assessment of its effects. Enrollment began in July 2022 and is projected to be completed in September 2024. Primary analysis completion is anticipated in March 2025, with reporting of results following.
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Journal of critical care · Dec 2024
Randomized Controlled TrialContinuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial.
This study evaluated the clinical utility of continuous glucose monitoring system (CGMS) in critically ill patients. ⋯ Compared with conventional POCM, CGMS did not decrease the 28-day mortality in critically ill participants with diabetes or stress-induced hyperglycemia. But CGMS may improve the glycemic control and may be increasingly used in critically ill patients.
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Journal of critical care · Dec 2024
Randomized Controlled TrialHeliox ventilation in elderly, hypertensive ICU patients improves microcirculation: A randomized controlled study.
Conventional mechanical ventilation has adverse impacts on the hemodynamics of elderly, hypertensive ICU patients. Limited studies have addressed ways to ameliorate these negative effects. This study aimed to determine whether heliox ventilation could improve the hemodynamics, especially microcirculation, of elderly, hypertensive patients undergoing mechanical ventilation. ⋯ Heliox ventilation improves blood pressure and microcirculation in elderly hypertensive patients and may resolve the limitations of traditional nitrogen‑oxygen ventilation.
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Critical care medicine · Dec 2024
Randomized Controlled TrialEfficacy of Virtual Visitation in ICU During COVID-19 Pandemic: The ICU Visits Randomized Controlled Trial.
This study aimed to demonstrate the impact of virtual visits on the satisfaction of family members and the anxiety and depression of patients in the ICU during the COVID-19 pandemic. ⋯ In the COVID-19 pandemic era, virtual visits to ICU patients helped reduce depression and anxiety levels of patients and increase the satisfaction of their family members. Enhancing access to virtual visits for family members and developing a consistent approach may improve the quality of care during another pandemic.