Critical care medicine
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Critical care medicine · Apr 2015
Review Meta AnalysisNoninvasive Ventilation and Survival in Acute Care Settings: A Comprehensive Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Noninvasive ventilation is increasingly applied to prevent or treat acute respiratory failure, but its benefit on survival is still controversial for many indications. We performed a metaanalysis of randomized controlled trials focused on the effect of noninvasive ventilation on mortality. ⋯ This comprehensive metaanalysis suggests that noninvasive ventilation improves survival in acute care settings. The benefit could be lost in some subgroups of patients if noninvasive ventilation is applied late as a rescue treatment. Whenever noninvasive ventilation is indicated, an early adoption should be promoted.
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Critical care medicine · Apr 2015
ReviewUltrasound for the Assessment of Peripheral Skeletal Muscle Architecture in Critical Illness: A Systematic Review.
To critically evaluate and summarize identified evidence for the use of ultrasound to measure peripheral skeletal muscle architecture during critical illness. ⋯ Ultrasound provides clinical utility for assessing the trajectory of change in peripheral skeletal muscle architecture during critical illness, supplementing more detailed characterization, albeit rarely used, from muscle biopsy analysis. Adoption of standardized operating protocols for measurement will facilitate future meta-analysis of data.
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Critical care medicine · Apr 2015
Characteristics and Outcomes of Patients Admitted to ICU Following Activation of the Medical Emergency Team: Impact of Introducing a Two-Tier Response System.
To determine the impact of introducing a two-tier system for responding to deteriorating ward patients on ICU admissions after medical emergency team review. ⋯ The introduction of a two-tier response to clinical deterioration increased ICU admissions triggered by cardiorespiratory criteria, whereas admissions triggered by more subjective criteria decreased. The overall ICU mortality for patients admitted following medical emergency team review decreased, suggesting that the two-tier system led to earlier recognition of reversible pathology or a decision not to escalate the level of care.
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Critical care medicine · Apr 2015
Editorial CommentThe evidence is in: noninvasive ventilation saves lives.