Journal of critical care
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The purpose was to describe aspiration pneumonia in the context of other lung infections and aspiration syndromes and to distinguish between the main scenarios commonly implied when the terms aspiration or aspiration pneumonia are used. Finally, we aim to summarize current evidence surrounding the diagnosis, microbiology, treatment, risks, and prevention of aspiration pneumonia. ⋯ Aspiration pneumonia is a disease with a distinct pathophysiology. In the modern era, aspiration pneumonia is rarely solely an anaerobic infection. Antibiotic treatment is largely dependent on the clinical scenario. Several measures may help prevent aspiration pneumonia.
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Journal of critical care · Feb 2015
ReviewThe spectrum of psychocognitive morbidity in the critically ill: A review of the literature and call for improvement.
The objective of the study is to review the cognitive and psychiatric dysfunction experienced by critically ill patients during and after hospitalization. ⋯ We propose a paradigm change highlighting the need for interventions focused on early psychological support applied in parallel with stabilization of physiologic status in the ICU.
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Journal of critical care · Dec 2014
ReviewMitochondrial DNA neutrophil extracellular traps are formed after trauma and subsequent surgery.
Neutrophil extracellular traps (NETs) have not been demonstrated after trauma and subsequent surgery. Neutrophil extracellular traps are formed from pure mitochondrial DNA (mtDNA) under certain conditions, which is potently proinflammatory. We hypothesized that injury and orthopedic trauma surgery would induce NET production with mtDNA as a structural component. ⋯ Neutrophil extracellular traps formed after major trauma and subsequent surgery contain mtDNA and represent a novel marker of heightened innate immune activation. They could be considered when timing surgery after trauma to prevent systemic NET-induced inflammatory complications.
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Journal of critical care · Dec 2014
Review Meta AnalysisProlonged vs intermittent infusion of piperacillin/tazobactam in critically ill patients: A narrative and systematic review.
The purpose of this study is to review the rationale of prolonged (ie, extended or continuous) infusion of piperacillin/tazobactam (PIP/TAZ) in critically ill patients and to perform a systematic review that compare the effectiveness of prolonged infusion with intermittent bolus of PIP/TAZ. ⋯ Pharmacokinetic/pharmacodynamic studies provide a robust rationale to prefer prolonged above intermittent infusion of PIP/TAZ. However, although some studies suggest a better outcome in critically ill patients receiving prolonged infusion, the level of evidence is moderate.
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Journal of critical care · Dec 2014
ReviewA systematic review of teamwork in the intensive care unit: What do we know about teamwork, team tasks, and improvement strategies?
Teamwork is essential for ensuring the quality and safety of health care delivery in the intensive care unit (ICU). This article addresses what we know about teamwork, team tasks, and team improvement strategies in the ICU to identify the strengths and limitations of the existing knowledge base to guide future research. ⋯ Team research is burgeoning in the ICU, yet low-hanging fruit remains that can further advance the science of teams in the ICU if addressed. Constructs must be defined, and theoretical frameworks should be referenced. The functional characteristics of tasks should also be reported to help determine the extent to which study results might generalize to other contexts of work.