Search Tag: critical illness

ICU Management

New ESPEN Guidelines for Nutrition in the Critically Ill: Help, What Happened!?

2019 26 Sep

ESPEN guidelines for nutrition in critical illness have shifted from optimistic anticipative nutritional pharmacotherapy towards cautious and balanced metabolic support. This important new orientation in ICU nutrition management is a consequence of recent strong RCT-based evidence.   Introduction   Recently, the new ESPEN guidelines for critically... Read more

ICU Management

Patient support needs following critical illness

2019 29 May

The number of patients who are admitted into the ICU and those who survive their stay continues to increase. However, patients who survive the ICU often suffer from chronic and life-changing physical, psychosocial and cognitive changes, often referred to as the “Post Intensive Care Syndrome.” This can have a significant impact on patient-reported... Read more

ICU Management

PERFECT protocol: volume-based feeding in ventilated adults

2019 16 Apr

Underfeeding in critical illness is common and associated with poor outcomes. Researchers in the UK designed a before-and-after study to evaluate the safety, efficacy and clinical outcomes associated with volume-based feeding (VBF) compared to rate-based feeding (RBF) in a single intensive care unit (ICU). The prospective before-and-after study... Read more

ICU Management

Assessing cognitive function in ICU survivors

2019 16 Apr

New research from Canada demonstrates that a web-based patient-administered neurocognitive test battery can identify domain-specific cognitive impairment in critical illness survivors. Results show that web-based cognitive testing – i.e., Cambridge Brain Sciences (CBS) – is both feasible and able to detect subtle changes in cognitive domains similar... Read more

ICU Management

Facilitating patient-centred decisions about serious illness care

2019 06 Feb

Patient autonomy is the overriding ethical principle guiding medical decision making in the United States. This autonomy-driven model assumes an informed patient who fully understands the implications of available treatment choices and can identify those most aligned with their values and goals. However, there is increasing recognition that this... Read more

ICU Management

Vitamin D and critical illness

2018 30 Oct

Vitamin D deficiency – usually defined as 25(OH)D levels below 20ng/ml – is common in critical illness with prevalence between 40-70%. Many observational studies have shown a link between low vitamin D levels and poor clinical outcomes in critically ill adults and children, including excess mortality and morbidity such as acute kidney injury, acute... Read more

ICU Management

Volume 18 - Issue 3, 2018

2018 16 Oct

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ICU Management

Quality of life after discharge from an ICU

2018 10 Oct

Quality of life (QoL) after critical illness is becoming increasingly important as survival improves. A systematic review, conducted by University of Oxford researchers, reveals that patients surviving critical illness had worse health‐related QoL when compared with population norms.  "Quality of life incompletely recovered after hospital discharge.... Read more

ICU Management

Improving the long-term outcomes after critical illness

2018 22 Aug

Heterogeneity in studies of survivors of critical illness limits knowledge of outcomes in this patient population. Conceptual models of outcomes developed in other fields can be used to better understand outcomes after critical illness, says Nathan E. Brummel, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center, Center for Quality... Read more

ICU Management

Practice variation in managing AF during critical illness

2018 24 Apr

Atrial fibrillation (AF) is the most common arrhythmia encountered in the intensive care unit. Pre-existing AF is highly prevalent among older patients with chronic conditions who are at risk for critical illness, while new-onset AF can be triggered by accelerated atrial remodelling and arrhythmogenic triggers encountered during critical illness. However,... Read more