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181. Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial. Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms.To assess the effect of an ICU diary on the psychological consequences of an ICU hospitalization.Assessor-blinded, multicenter, randomized clinical trial in 35 French ICUs from October 2015 to January 2017 (...) , with follow-up until July 2017. Among 2631 approached patients, 709 adult patients (with 1 family member each) who received mechanical ventilation within 48 hours after ICU admission for at least 2 days were eligible, 657 were randomized, and 339 were assessed 3 months after ICU discharge.Patients in the intervention group (n = 355) had an ICU diary filled in by clinicians and family members. Patients in the control group (n = 354) had usual ICU care without an ICU diary.The primary outcome

2019 JAMA Controlled trial quality: predicted high

182. Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial (Abstract)

Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial Preterm neonates hospitalized in the neonatal intensive care unit undergo frequent painful procedures daily, often without pain treatment, with associated long-term adverse effects. Maternal-infant skin-to-skin contact, or kangaroo care (KC), and sweet-tasting solutions such as sucrose are effective strategies to reduce pain during (...) their neonatal intensive care unit stay. Pain intensity, determined using the Premature Infant Pain Profile, was measured during 3 medically indicated heel lances distributed across hospitalization. Maternal and neonatal baseline characteristics, Premature Infant Pain Profile scores at 30, 60, or 90 seconds after heel lance, the distribution of infants with pain scores suggesting mild, moderate, or severe pain, Neurobehavioral Assessment of the Preterm Infant scores, and incidence of adverse outcomes were

2019 EvidenceUpdates

183. Fresh Red Cells for Transfusion in Critically Ill Adults: An Economic Evaluation of the Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) Clinical Trial (Abstract)

Fresh Red Cells for Transfusion in Critically Ill Adults: An Economic Evaluation of the Standard Issue Transfusion versus Fresher Red-Cell Use in Intensive Care (TRANSFUSE) Clinical Trial Trials comparing the effects of transfusing RBC units of different storage durations have considered mortality or morbidity as outcomes. We perform the first economic evaluation alongside a full age of blood clinical trial with a large population assessing the impact of RBC storage duration on quality-of-life (...) and costs in critically ill adults.Quality-of-life was measured at 6 months post randomization using the EuroQol 5-dimension 3-level instrument. The economic evaluation considers quality-adjusted life year and cost implications from randomization to 6 months. A generalized linear model was used to estimate incremental costs (2016 U.S. dollars) and quality-adjusted life years, respectively while adjusting for baseline characteristics.Fifty-nine ICUs in five countries.Adults with an anticipated ICU stay

2019 EvidenceUpdates

184. Randomized Clinical Trial of an ICU Recovery Pilot Program for Survivors of Critical Illness (Abstract)

Randomized Clinical Trial of an ICU Recovery Pilot Program for Survivors of Critical Illness To examine the effect of an interdisciplinary ICU recovery program on process measures and clinical outcomes.A prospective, single-center, randomized pilot trial.Academic, tertiary-care medical center.Adult patients admitted to the medical ICU for at least 48 hours with a predicted risk of 30-day same-hospital readmission of at least 15%.Patients randomized to the ICU recovery program group were offered (...) a structured 10-intervention program, including an inpatient visit by a nurse practitioner, an informational pamphlet, a 24 hours a day, 7 days a week phone number for the recovery team, and an outpatient ICU recovery clinic visit with a critical care physician, nurse practitioner, pharmacist, psychologist, and case manager. For patients randomized to the usual care group, all aspects of care were determined by treating clinicians.Among the primary analysis of enrolled patients who survived to hospital

2019 EvidenceUpdates

185. The Space GlucoseControl system for managing blood-glucose in critically ill patients in intensive care

strict glucose control system in these patients at the 2 different sites. Study design Prospective non-controlled open clinical investigation. Setting The study was conducted in 2 medical ICUs in tertiary centres in Graz, Austria and Zurich, Switzerland. Outcomes were reported for a period of 6.5 days (SD=3.7). The Space GlucoseControl system for managing blood-glucose in critically ill patients in intensive care (MIB17) © NICE 2018. All rights reserved. Subject to Notice of rights (https (...) shorter in the eMPC group than in the control. Conclusions The authors concluded that, the eMPC algorithm was effective in maintaining tight glycaemic control in severely ill medical ICU patients. Abbreviations: eMPC, enhanced model predictive control; ITT, intention to treat; ICU, intensive care unit; n, number of patients. T T able 8 able 8 Summary of the P Summary of the Pachler et al. (2008) trial outcomes achler et al. (2008) trial outcomes eMPC eMPC Standard Standard care care Analysis Analysis

2014 National Institute for Health and Clinical Excellence - Advice

186. A musical intervention for respiratory comfort during noninvasive ventilation in the ICU Full Text available with Trip Pro

intervention group, 38 in the sensory deprivation group and 39 in the control group). Median (interquartile range (IQR)) change in respiratory discomfort was 0 (-1; 1) between the musical intervention and control groups (p=0.7). Between groups comparison did not evidence any significant variation of respiratory parameters across time or health-related quality of life (HRQoL) at day-90. The Peri-traumatic Distress Inventory (PDI) at intensive care unit (ICU) discharge was reduced in musical intervention (...) A musical intervention for respiratory comfort during noninvasive ventilation in the ICU Discomfort associated with noninvasive ventilation (NIV) may participate in its failure. We aimed to determine the effect of a musical intervention on respiratory discomfort during NIV in patients with acute respiratory failure (ARF).An open-label, controlled trial was performed over three centres. Patients requiring NIV for ARF were randomised to either a musical intervention group (where they received

2019 EvidenceUpdates

187. Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial Full Text available with Trip Pro

Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing delirium severity among ICU patients.A randomized pragmatic clinical trial.Medical, surgical (...) , and progressive ICUs of three tertiary care hospitals.A total of 351 critically ill patients.A multicomponent PMD bundle consisting of reducing the exposure to 20 definite anticholinergic medications and benzodiazepines and prescribing low-dose haloperidol.The primary outcomes were delirium/coma-free days, measured through the Richmond Agitation-Sedation Scale and the Confusion Assessment Method for the ICU (CAM-ICU), and delirium severity, measured through Delirium Rating Scale-Revised-98 and the CAM-ICU-7

2019 EvidenceUpdates

188. Mupirocin for Staphylococcus aureus Decolonization of Infants in Neonatal Intensive Care Units Full Text available with Trip Pro

Mupirocin for Staphylococcus aureus Decolonization of Infants in Neonatal Intensive Care Units : media-1vid110.1542/5849573989001PEDS-VA_2018-1565Video Abstract BACKGROUND AND OBJECTIVES: Staphylococcus aureus (SA) is the second leading cause of late-onset sepsis among infants in the NICU. Because colonization of nasal mucosa and/or skin frequently precedes invasive infection, decolonization strategies, such as mupirocin application, have been attempted to prevent clinical infection, but data

2019 EvidenceUpdates

189. Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit (Abstract)

Deprescribing in the Pharmacologic Management of Delirium: A Randomized Trial in the Intensive Care Unit Benzodiazepines and anticholinergics are risk factors for delirium in the intensive care unit (ICU). We tested the impact of a deprescribing intervention on short-term delirium outcomes.Multisite randomized clinical trial.ICUs of three large hospitals.Two hundred adults aged 18 years or older and admitted to an ICU with delirium, according to the Richmond Agitation-Sedation Scale (...) and the Confusion Assessment Method for the ICU (CAM-ICU). Participants had a contraindication to haloperidol (seizure disorder or prolonged QT interval) or preference against haloperidol as a treatment for delirium, and were excluded for serious mental illness, stroke, pregnancy, or alcohol withdrawal. Participants were randomized to a deprescribing intervention or usual care. The intervention included electronic alerts combined with pharmacist support to deprescribe anticholinergics

2019 EvidenceUpdates

190. Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. (Abstract)

Sound reduction management in the neonatal intensive care unit for preterm or very low birth weight infants. Infants in the neonatal intensive care unit (NICU) are subjected to stress, including sound of high intensity. The sound environment in the NICU is louder than most home or office environments and contains disturbing noises of short duration and at irregular intervals. There are competing auditory signals that frequently challenge preterm infants, staff and parents. The sound levels (...) . To evaluate the effects of sound reduction on short-term medical outcomes (bronchopulmonary dysplasia, intraventricular haemorrhage, periventricular leukomalacia, retinopathy of prematurity).2. To evaluate the effects of sound reduction on sleep patterns at three months of age.3. To evaluate the effects of sound reduction on staff performance.4. To evaluate the effects of sound reduction in the neonatal intensive care unit (NICU) on parents' satisfaction with the care.We searched the Cochrane Central

2015 Cochrane

191. Exercise rehabilitation following intensive care unit discharge for recovery from critical illness. Full Text available with Trip Pro

Exercise rehabilitation following intensive care unit discharge for recovery from critical illness. Skeletal muscle wasting and weakness are significant complications of critical illness, associated with degree of illness severity and periods of reduced mobility during mechanical ventilation. They contribute to the profound physical and functional deficits observed in survivors. These impairments may persist for many years following discharge from the intensive care unit (ICU) and can markedly (...) influence health-related quality of life. Rehabilitation is a key strategy in the recovery of patients after critical illness. Exercise-based interventions are aimed at targeting this muscle wasting and weakness. Physical rehabilitation delivered during ICU admission has been systematically evaluated and shown to be beneficial. However, its effectiveness when initiated after ICU discharge has yet to be established.To assess the effectiveness of exercise rehabilitation programmes, initiated after ICU

2015 Cochrane

192. Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality. (Abstract)

Specialist teams for neonatal transport to neonatal intensive care units for prevention of morbidity and mortality. Maternal antenatal transfers provide better neonatal outcomes. However, there will inevitably be some infants who require acute transport to a neonatal intensive care unit (NICU). Because of this, many institutions develop services to provide neonatal transport by specially trained health personnel. However, few studies report on relevant clinical outcomes in infants requiring (...) ), conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials.randomised, quasi-randomised or cluster randomised controlled trials.neonates requiring transport to a neonatal intensive care unit.transport by a specialist team compared to a non-specialist team.any of the following outcomes - death; adverse events during transport leading to respiratory compromise; and condition on admission to the neonatal intensive care unit.The

2015 Cochrane

193. Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial (Abstract)

Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial To assess the impact of early triggered palliative care consultation on the outcomes of high-risk ICU patients.Single-center cluster randomized crossover trial.Two medical ICUs at Barnes Jewish Hospital.Patients (n = 199) admitted to the medical ICUs from August 2017 to May 2018 with a positive palliative care screen indicating high risk for morbidity or mortality.The medical ICUs were randomized (...) to intervention or usual care followed by washout and crossover, with independent assignment of patients to each ICU at admission. Intervention arm patients received a palliative care consultation from an interprofessional team led by board-certified palliative care providers within 48 hours of ICU admission.Ninety-seven patients (48.7%) were assigned to the intervention and 102 (51.3%) to usual care. Transition to do-not-resuscitate/do-not-intubate occurred earlier and significantly more often

2019 EvidenceUpdates

194. Intensive care use and mortality among patients with ST elevation myocardial infarction: retrospective cohort study. Full Text available with Trip Pro

Intensive care use and mortality among patients with ST elevation myocardial infarction: retrospective cohort study. To evaluate the effect of intensive care unit (ICU) admission on mortality among patients with ST elevation myocardial infarction (STEMI).Retrospective cohort study.1727 acute care hospitals in the United States.Medicare beneficiaries (aged 65 years or older) admitted with STEMI to either an ICU or a non-ICU unit (general/telemetry ward or intermediate care) between January 2014 (...) and October 2015.30 day mortality. An instrumental variable analysis was done to account for confounding, using as an instrument the additional distance that a patient with STEMI would need to travel beyond the closest hospital to arrive at a hospital in the top quarter of ICU admission rates for STEMI.The analysis included 109 375 patients admitted to hospital with STEMI. Hospitals in the top quarter of ICU admission rates admitted 85% or more of STEMI patients to an ICU. Among patients who received ICU

2019 BMJ

195. Effect of Treating Parents Colonized With Staphylococcus aureus on Transmission to Neonates in the Intensive Care Unit: A Randomized Clinical Trial. (Abstract)

Effect of Treating Parents Colonized With Staphylococcus aureus on Transmission to Neonates in the Intensive Care Unit: A Randomized Clinical Trial. Staphylococcus aureus is a leading cause of health care-associated infections in the neonatal intensive care unit (NICU). Parents may expose neonates to S aureus colonization, a well-established predisposing factor to invasive S aureus disease.To test whether treating parents with intranasal mupirocin and topical chlorhexidine compared with placebo

2019 JAMA

196. Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit

Initiation Strategies for Renal-Replacement Therapy in the Intensive Care Unit PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

197. Incidence and associated factors of difficult tracheal intubations in pediatric ICUs: a report from National Emergency Airway Registry for Children: NEAR4KIDS

Incidence and associated factors of difficult tracheal intubations in pediatric ICUs: a report from National Emergency Airway Registry for Children: NEAR4KIDS PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

198. Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit: The SPLIT Randomized Clinical Trial

Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit: The SPLIT Randomized Clinical Trial PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

199. Multi-institutional Profile of Adults Admitted to Pediatric Intensive Care Units

Multi-institutional Profile of Adults Admitted to Pediatric Intensive Care Units PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

200. Pediatric Index of Cardiac Surgical Intensive Care Mortality Risk Score for Pediatric Cardiac Critical Care

Pediatric Index of Cardiac Surgical Intensive Care Mortality Risk Score for Pediatric Cardiac Critical Care PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2016 PedsCCM Evidence-Based Journal Club

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