Routine Neuroimaging: Understanding Brain Injury in Pediatric Extracorporeal Membrane Oxygenation*
OBJECTIVES: This project aims to describe brain injuries on routine neuroimaging in a large single-center neonatal and pediatric cohort supported by extracorporeal membrane oxygenation. The study also aims to examine the association of these injuries with neurocognitive outcomes in survivors and identify laboratory findings associated with neurologic injury. DESIGN: Retrospective observational single-center cohort study. SETTING: Tertiary care PICU. PATIENTS: Pediatric patients with noncardiac indications for extracorporeal membrane oxygenation supported by venoarterial or venovenous extracorporeal...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research

Effect of a Multicomponent Sepsis Transition and Recovery Program on Mortality and Readmissions After Sepsis: The Improving Morbidity During Post-Acute Care Transitions for Sepsis Randomized Clinical Trial*
CONCLUSIONS: In a multisite randomized clinical trial of patients hospitalized with sepsis, patients provided with a 30-day program using a nurse navigator to provide best practices for postsepsis care experienced a lower proportion of either mortality or rehospitalization within 30 days after discharge. Further research is needed to understand the contextual factors associated with successful implementation. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Descriptive Epidemiology and Outcomes of Nonventilated Hospital-Acquired, Ventilated Hospital-Acquired, and Ventilator-Associated Bacterial Pneumonia in the United States, 2012–2019
CONCLUSIONS: Both hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia remain associated with significant mortality and cost in the United States. Our analyses confirm that of all three conditions, ventilated hospital-acquired bacterial pneumonia carries the highest risk of death. In contrast, ventilator-associated bacterial pneumonia remains most costly. Nonventilated hospital-acquired bacterial pneumonia survivors were most likely to require a readmission within 30 days of discharge. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Increased Incidence of Ventilator-Acquired Pneumonia in Coronavirus Disease 2019 Patients: A Multicentric Cohort Study*
OBJECTIVES: Little is known about the epidemiology of ventilator-acquired pneumonia among coronavirus disease 2019 patients such as incidence or etiological agents. Some studies suggest a higher risk of ventilator-associated pneumonia in this specific population. DESIGN: Cohort exposed/nonexposed study among the REA-REZO surveillance network. SETTING: Multicentric; ICUs in France. PATIENTS: The coronavirus disease 2019 patients at admission were matched on the age, sex, center of inclusion, presence of antimicrobial therapy at admission, patient provenance, time from ICU admission to mechanical ven...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

The Coronavirus Disease 2019 Pandemic Impacts Burnout Syndrome Differently Among Multiprofessional Critical Care Clinicians—A Longitudinal Survey Study
OBJECTIVES: To determine the impact of coronavirus disease 2019 on burnout syndrome in the multiprofessional ICU team and to identify factors associated with burnout syndrome. DESIGN: Longitudinal, cross-sectional survey. SETTING: All adult ICUs within an academic health system. SUBJECTS: Critical care nurses, advanced practice providers, physicians, respiratory therapists, pharmacists, social workers, and spiritual health workers were surveyed on burnout in 2017 and during the coronavirus disease 2019 pandemic in 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Burnout syndr...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

A Simple Risk Score for Predicting Neurologic Outcome in Out-of-Hospital Cardiac Arrest Patients After Targeted Temperature Management*
OBJECTIVES: Although several risk factors for outcomes of out-of-hospital cardiac arrest patients have been identified, the cumulative risk of their combinations is not thoroughly clear, especially after targeted temperature management. Therefore, we aimed to develop a risk score to evaluate individual out-of-hospital cardiac arrest patient risk at early admission after targeted temperature management regarding poor neurologic status at discharge. DESIGN: Retrospective observational cohort study. SETTING: Two large academic medical networks in the United States. PATIENTS: Out-of-hospital cardiac ar...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Improving Timeliness of Antibiotic Administration Using a Provider and Pharmacist Facing Sepsis Early Warning System in the Emergency Department Setting: A Randomized Controlled Quality Improvement Initiative*
CONCLUSIONS: In this single-center randomized quality improvement initiative, the display of an electronic health record–based sepsis early warning system–triggered flag combined with electronic health record–based pharmacist notification was associated with shorter time to antibiotic administration without an increase in undesirable or potentially harmful clinical interventions. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Race Does Not Impact Sepsis Outcomes When Considering Socioeconomic Factors in Multilevel Modeling
CONCLUSIONS: Our study demonstrates that race is not an independent risk factor for sepsis mortality, as well as sepsis-related length of stay. We should expand our inquiry into determinants of sepsis outcomes by including socioeconomic variables. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Prognostic and Predictive Biomarkers in Patients With Coronavirus Disease 2019 Treated With Tocilizumab in a Randomized Controlled Trial*
CONCLUSIONS: Multiple biomarkers prognostic for clinical outcomes were confirmed in COVACTA. Ferritin was identified as a predictive biomarker for the effects of tocilizumab in the COVACTA patient population; high ferritin levels were associated with better clinical outcomes for tocilizumab compared with placebo at day 28. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Should We Prolong the Observation Period for Neurological Recovery After Cardiac Arrest?*
CONCLUSIONS: Up to 9.6% of cardiac arrest patients with favorable outcomes recover consciousness after the recommended 7 days of observation, indicating the observation time of 7 days seems justified but longer duration may be needed. The results of the culturally and clinically isolated population may limit the application to other population. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Physical Rehabilitation in the ICU: A Systematic Review and Meta-Analysis*
CONCLUSIONS: Physical rehabilitation in the ICU improves physical function and reduces ICU and hospital length of stay. However, it does not appear to impact other outcomes. (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Epidemiology and Outcomes of Critically Ill Children at Risk for Pediatric Acute Respiratory Distress Syndrome: A Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology Study*
In this study, we aimed to characterize the frequency and outcomes of children meeting “at risk for pediatric acute respiratory distress syndrome” criteria as defined by the Pediatric Acute Lung Injury Consensus Conference. DESIGN: Planned substudy of the prospective multicenter, international Pediatric Acute Respiratory Distress Syndrome Incidence and Epidemiology study conducted during 10 nonconsecutive weeks (May 2016–June 2017). SETTING: Thirty-seven international PICUs. PATIENTS: Three-hundred ten critically ill children meeting Pediatric Acute Lung Injury Consensus Conference “at-risk for...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Association Between Pandemic Coronavirus Disease 2019 Public Health Measures and Reduction in Critical Care Utilization Across ICUs in Alberta, Canada
OBJECTIVES: The coronavirus disease 2019 pandemic has disrupted critical care services across the world. In anticipation of surges in the need for critical care services, governments implemented “lockdown” measures to preserve and create added critical care capacity. Herein, we describe the impact of lockdown measures on the utilization of critical care services and patient outcomes compared with nonlockdown epochs in a large integrated health region. DESIGN: This was a population-based retrospective cohort study. SETTING: Seventeen adult ICUs across 14 acute care hospitals in Alberta, Canada. PATI...
Source: Critical Care Medicine - February 23, 2022 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Standardized Care Is Better Than Individualized Care for the Majority of Critically Ill Patients: Erratum
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 1, 2022 Category: Emergency Medicine Tags: Online Errata Source Type: research

Orange You Wishing There Were Definitive Randomized Controlled Trials Already?: Erratum
No abstract available (Source: Critical Care Medicine)
Source: Critical Care Medicine - February 1, 2022 Category: Emergency Medicine Tags: Online Errata Source Type: research