Critical care medicine
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Critical care medicine · Jul 2023
ReviewHealth Disparities in Extracorporeal Membrane Oxygenation Utilization and Outcomes: A Scoping Review and Methodologic Critique of the Literature.
To map the scope, methodological rigor, quality, and direction of associations between social determinants of health (SDoH) and extracorporeal membrane oxygenation (ECMO) utilization or outcomes. ⋯ Associations between ECMO utilization and outcomes with SDoH are inconsistent, complicated by population heterogeneity and analytic shortcomings with limited consideration of systemic contributors. Findings and research gaps have implications for measuring, analyzing, and interpreting SDoH in ECMO research and healthcare.
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Critical care medicine · Jul 2023
Multicenter StudyImplementation of Video Laryngoscope Assisted Coaching Reduces Adverse Tracheal Intubation Associated Events in the PICU.
To evaluate implementation of a video laryngoscope (VL) as a coaching device to reduce adverse tracheal intubation associated events (TIAEs). ⋯ Implementation of VL-assisted coaching achieved a high level of adherence across the PICUs. VL use was associated with reduced adverse TIAEs.
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Critical care medicine · Jul 2023
Observational StudyAssociation of Sublingual Microcirculation Parameters and Capillary Refill Time in the Early Phase of ICU Admission.
This observational study was conducted to investigate capillary refill time (CRT) during the early phase of ICU admission in relationship with microvascular flow alteration and outcome in critically ill patients. ⋯ In our ICU population, a single-spot prolonged CRT was independently associated with abnormal microcirculation and increased mortality.
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Critical care medicine · Jul 2023
The Effect of Time to Treatment With Antiarrhythmic Drugs on Survival and Neurological Outcomes in Shock Refractory Out-of-Hospital Cardiac Arrest.
Examining the association of time to treatment (drug or placebo) with survival to hospital discharge and neurologic outcome. ⋯ Survival and favorable neurologic outcomes decreased with longer times to drug administration. Amiodarone improved survival at all time points whereas lidocaine improved survival only at later time points, compared with placebo.
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Critical care medicine · Jul 2023
State-of-the-Art Evaluation of Acute Adult Disorders of Consciousness for the General Intensivist.
To provide a concise review of knowledge and practice pertaining to the diagnosis and initial management of unanticipated adult patient disorders of consciousness (DoC) by the general intensivist. ⋯ Acute adult DoC may be initially comprehensively addressed by the general intensivist using an etiology-driven and team-based approach. Certain clinical conditions, procedural expertise needs, or resource limitations inform transfer decision-making within a complex care facility or to one with greater complexity. Emerging collaborative science helps improve our current knowledge of acute DoC to better align therapies with underpinning etiologies.