Critical care medicine
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Critical care medicine · Jun 2024
Randomized Controlled TrialEarly Mobilization Using a Mobile Patient Lift in the ICU: A Randomized Controlled Trial.
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Critical care medicine · Jun 2024
Observational StudyAssociations Between Family-Assessed Quality-of-Dying-and-Death Latent Classes and Bereavement Outcomes for Family Surrogates of ICU Decedents.
To examine associations between family surrogates' bereavement outcomes and four previously determined quality of dying and death (QODD) latent classes (high, moderate, poor-to-uncertain, and worst). ⋯ The four distinct QODD latent classes were significantly associated with ICU family surrogates' bereavement outcomes, suggesting targets to improve end-of-life care quality in ICUs.
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Critical care medicine · Jun 2024
Observational StudyHospital Variation in Epinephrine Administration Before Defibrillation for Cardiac Arrest Due to Shockable Rhythm.
Contrary to advanced cardiac life support guidelines that recommend immediate defibrillation for shockable in-hospital cardiac arrest (IHCA), epinephrine administration before first defibrillation is common and associated with lower survival at a "patient-level." Whether this practice varies across hospitals and its association with "hospital-level" IHCA survival remains unknown. The purpose of this study was to determine hospital variation in rates of epinephrine administration before defibrillation for shockable IHCA and its association with IHCA survival. ⋯ Administration of epinephrine before defibrillation in shockable IHCA is common and varies markedly across U.S. hospitals. Hospital rates of epinephrine administration before defibrillation were associated with a significant stepwise decrease in hospital rates of risk-adjusted survival. Efforts to prioritize immediate defibrillation for patients with shockable IHCA and avoid early epinephrine administration are urgently needed.
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Critical care medicine · Jun 2024
Observational StudyBarriers and Facilitators to End-of-Life Care Delivery in ICUs: A Qualitative Study.
To understand frontline ICU clinician's perceptions of end-of-life care delivery in the ICU. ⋯ Standardized work system communication tasks may improve end-of life discussion processes between clinicians and families.