Early Neuromuscular Electrical Stimulation in Addition to Early Mobilization Improves Functional Status and Decreases Hospitalization Days of Critically Ill Patients
CONCLUSIONS: The additional application of early NMES promoted better functional status outcomes on the first day awake and at ICU and hospital discharge. The patients in the EM+NMES group also took fewer days to stand up and had shorter hospital LOS, lower frequency of ICU-acquired weakness, and better muscle strength. Future studies are still necessary to clarify the effects of therapies associated with EM, especially to assess long-term outcomes. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Early Clinical and Electrophysiological Brain Dysfunction Is Associated With ICU Outcomes in COVID-19 Critically Ill Patients With Acute Respiratory Distress Syndrome: A Prospective Bicentric Observational Study*
OBJECTIVES: Describe the prevalence of acute cerebral dysfunction and assess the prognostic value of an early clinical and electroencephalography (EEG) assessment in ICU COVID-19 patients. DESIGN: Prospective observational study. SETTING: Two tertiary critical care units in Paris, France, between April and December 2020. PATIENTS: Adult critically ill patients with COVID-19 acute respiratory distress syndrome. INTERVENTIONS: Neurologic examination and EEG at two time points during the ICU stay, first under sedation and second 4–7 days after sedation discontinuation. MEASUREMENTS AND MAI...
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Lung-Dependent Areas Collapse, Monitored by Electrical Impedance Tomography, May Predict the Oxygenation Response to Prone Ventilation in COVID-19 Acute Respiratory Distress Syndrome
OBJECTIVES: ICUs have had to deal with a large number of patients with acute respiratory distress syndrome COVID-19, a significant number of whom received prone ventilation, which is a substantial consumer of care time. The selection of patients that we have to ventilate in prone position seems interesting. We evaluate the correlation between the percentage of collapsed dependent lung areas in the supine position, monitoring by electrical impedance tomography and the oxygenation response (change in Pao2/Fio2 ratio) to prone position. DESIGN: An observational prospective study. SETTING: From October 21, 20...
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Patient Harm and Institutional Avoidability of Out-of-Hours Discharge From Intensive Care: An Analysis Using Mixed Methods*
CONCLUSIONS: We identified significant limitations in out-of-hours care provision following overnight discharge from ICU. Transfer to the ward before 16:00 should be facilitated where possible. Our work highlights changes to help make day time discharge more likely. Where discharge after 16:00 is unavoidable, support systems should be implemented to ensure the safety of patients discharged from ICU at night. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Catabolism in Critical Illness: A Reanalysis of the REducing Deaths due to OXidative Stress (REDOXS) Trial*
CONCLUSIONS: The catabolic phenotype measured by increased urea-to-creatinine ratio is associated with increased risk of death during prolonged ICU stay and signals the deleterious effects of glutamine administration in the REDOXS study. Urea-to-creatinine ratio is a promising catabolic signature and potential interventional target. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Etiology, Treatments, and Outcomes of Patients With Severe Community-Acquired Pneumonia in a Large U.S. Sample*
OBJECTIVES: Compare the clinical practice and outcomes in severe community-acquired pneumonia (sCAP) patients to those in non-sCAP patients using guideline-defined criteria for sCAP. DESIGN: Retrospective observational cohort study. SETTING: One hundred seventy-seven U.S. hospitals within the Premier Healthcare Database. PATIENTS: Hospitalized adult (≥ 18 yr old) patients with pneumonia. MEASUREMENTS AND MAIN RESULTS: Adult patients (≥ 18 yr old) with a principal diagnosis of pneumonia or a secondary diagnosis of pneumonia paired with a principal diagnosis of sepsis or respiratory failur...
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Preintubation Sequential Organ Failure Assessment Score for Predicting COVID-19 Mortality: External Validation Using Electronic Health Record From 86 U.S. Healthcare Systems to Appraise Current Ventilator Triage Algorithms*
CONCLUSIONS: In a U.S. cohort of over 15,000 ventilated patients with COVID-19, the SOFA score displayed poor predictive accuracy for short-term mortality. Our findings warrant reappraisal of the SOFA score’s implementation and weightage in existing ventilator triage pathways in current U.S. crisis standards of care guidelines. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

The Global Open Source Severity of Illness Score (GOSSIS)*
CONCLUSIONS: GOSSIS-1 is a modern, free, open-source inhospital mortality prediction algorithm for critical care patients, achieving excellent discrimination and calibration across three countries. (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Society of Critical Care Medicine Presidential Address–51st Annual Congress, April 2022
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - June 24, 2022 Category: Emergency Medicine Tags: Presidential Address Source Type: research

Immune Profiling Demonstrates a Common Immune Signature of Delayed Acquired Immunodeficiency in Patients With Various Etiologies of Severe Injury: Erratum
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Erratum Source Type: research

The Fundamentals of Hysteresis and Lung Recruitment in Patients With Acute Respiratory Distress Syndrome
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Sepsis and Resuscitation: The Importance of Time
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Effects of Moderate Hypothermia on Diastolic Functions of Heart
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

The authors reply
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research

Wacker et al, Who Conclude That Vitamin C Monotherapy Failed to Significantly Reduce Mortality in Septic Shock Patients: Beware of Potential Confounding Factors!
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - May 27, 2022 Category: Emergency Medicine Tags: Online Letters to the Editor Source Type: research