Critical care medicine
-
Critical care medicine · Apr 2015
Editorial CommentGet out of bed: immobility in the neurologic ICU.
-
Critical care medicine · Apr 2015
Comparative StudyLung Recruitability Is Better Estimated According to the Berlin Definition of Acute Respiratory Distress Syndrome at Standard 5 cm H2O Rather Than Higher Positive End-Expiratory Pressure: A Retrospective Cohort Study.
The Berlin definition of acute respiratory distress syndrome has introduced three classes of severity according to PaO2/FIO2 thresholds. The level of positive end-expiratory pressure applied may greatly affect PaO2/FIO2, thereby masking acute respiratory distress syndrome severity, which should reflect the underlying lung injury (lung edema and recruitability). We hypothesized that the assessment of acute respiratory distress syndrome severity at standardized low positive end-expiratory pressure may improve the association between the underlying lung injury, as detected by CT, and PaO2/FIO2-derived severity. ⋯ The Berlin definition of acute respiratory distress syndrome assessed at 5 cm H2O allows a better evaluation of lung recruitability and edema than at higher positive end-expiratory pressure clinically set.
-
Critical care medicine · Apr 2015
Comparative Study Observational StudyDifferences in Vital Signs Between Elderly and Nonelderly Patients Prior to Ward Cardiac Arrest.
Vital signs and composite scores, such as the Modified Early Warning Score, are used to identify high-risk ward patients and trigger rapid response teams. Although age-related vital sign changes are known to occur, little is known about the differences in vital signs between elderly and nonelderly patients prior to ward cardiac arrest. We aimed to compare the accuracy of vital signs for detecting cardiac arrest between elderly and nonelderly patients. ⋯ Vital signs more accurately detect cardiac arrest in nonelderly patients compared with elderly patients, which has important implications for how they are used for identifying critically ill patients. More accurate methods for risk stratification of elderly patients are necessary to decrease the occurrence of this devastating event.
-
Critical care medicine · Apr 2015
Comparative StudyClinical and Psychologic Effects of Early Mobilization in Patients Treated in a Neurologic ICU: A Comparative Study.
To determine if an early mobilization protocol increased mobility and improved clinical and psychological outcomes. Currently, there is minimal research on the effects of early mobilization in patients with primary neurologic injury. ⋯ A neurologic ICU early mobility protocol increased highest neurologic ICU mobility and discharge home and decreased length of stay, but did not improve quality metrics or psychological profile.