Articles: intensive-care-units.
-
Critical care clinics · Jan 2024
ReviewCurrent and Future Role of Ultrasonography in the Cardiac Intensive Care Unit.
The contemporary practice of ultrasonography in the cardiac intensive care unit integrates the principles of echocardiography with whole-body imaging to create a more expansive paradigm of critical care ultrasonography (CCUS). This article will review the use of CCUS for diagnostic assessment, monitoring, therapeutic guidance, and prognosis.
-
Multicenter Study
Association of Lack of Fear of Dying With New Organ Failure: Results of a Multicenter Prospective Cohort Study.
Patients' anxiety on intensive care unit (ICU) admission is associated with subsequent deterioration. ⋯ Absence of fear of dying is associated with new organ failure within the first 7 days after ICU admission. Fear of dying may protect against subsequent deterioration by mobilizing patients' homeostatic resources. ClinicalTrials.gov Identifier: NCT02355626.
-
Acute gastrointestinal injury (AGI) is very common in critically ill patients, and its severity is positively correlated with mortality. Critically ill patients with digestive and absorption dysfunction caused by AGI face higher nutritional risks, making nutritional support particularly important. ⋯ The use of EN feeding strategies in critically ill patients with AGI remains controversial. The aim of this review was to elaborate on how EN feeding strategies should transition from limited to progressive to open feeding and explain the time window for this transition.
-
Critical care clinics · Jan 2024
ReviewDesign and Execution of Clinical Trials in the Cardiac Intensive Care Unit.
Clinical practice in the contemporary cardiac intensive care unit (CICU) has evolved significantly over the last several decades. With more frequent multisystem organ failure, increasing use of advanced respiratory support, and the advent of new mechanical circulatory support platforms, clinicians in the CICU are increasingly managing patients with complex comorbid disease in addition to their high-acuity cardiovascular illnesses. Here, the authors discuss challenges associated with traditional trial design in the CICU setting and review novel clinical trial designs that may facilitate better evidence generation in the CICU.
-
Critical care clinics · Jan 2024
ReviewThe Changing Epidemiology of the Cardiac Intensive Care Unit.
Coronary care units (CCUs) were originally designed to monitor and treat peri-infarction ventricular arrhythmias but have evolved into highly specialized cardiac intensive care units (CICUs) that provide care to a patient population that is increasingly heterogeneous and complex. Paralleling broader epidemiologic trends, patients admitted to contemporary CICUs are older and have a greater burden of cardiovascular and non-cardiovascular comorbidities. Moreover, contemporary CICU patients have high illness severity and often present with acute noncardiac organ dysfunction. In addition to these shifting demographic patterns, there have been important epidemiologic changes in CICU technologies, multidisciplinary systems of care, and physician staffing and training.