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Early active mobilization has been shown to mitigate ICU-acquired weakness, reduce disability and, most importantly, reduce mortality. This Concise Critical Appraisal describes a recent article published in the New England Journal of Medicine about mobilization during mechanical ventilation that reevaluates the effects of sedation minimization and daily physiotherapy on serious adverse events and mortality at 180 days.
With the average rate of daily new cases of COVID-19 on the rise, and the delta and omicron variants causing concern, the Society of Critical Care Medicine (SCCM) asked members in states with high rates of infection to share their experience and advice. Here are some of their insights.
Fifteen-year-old Rowen Cartmill played basketball for Westside Christian High School’s freshman team on January 8, 2022. Three days later, he was in the pediatric intensive care unit (ICU) at Randall Children’s Hospital in Portland, Oregon, intubated, sedated, and paralyzed, and on extracorporeal membrane oxygenation (ECMO).
Is there an association between fluid accumulation (FA) and adverse outcomes in critically ill pediatric patients, and is there a threshold FA associated with these outcomes? This Concise Critical Appraisal explores a retrospective cohort study of PICU patients over a 5-year period that found that FA was common among critically ill mechanically ventilated children within the first 7 days of admittance. Higher FA was associated with adverse outcomes; however; only greater than 20% FA was associated with worse outcomes.
Social media star and comedian Dr. Glaucomflecken, aka ophthalmologist William E. Flanary, MD, along with his wife, Kristin Flanary, MA, shared social media insights as well as his experience as an ICU patient during his presentation of the Peter Safar Honorary Lecture, “Wife and Death: Featuring Dr. and Lady Glaucomflecken,” on January 22, 2023, at the Society of Critical Care Medicine’s (SCCM) 2023 Critical Care Congress in San Francisco, California.
SCCM President Vinay M. Nadkarni, MD, MS, FCCM, provides an update on the SCCM emergency response efforts for the Türkiye-Syria Earthquake.
With the advancement and increasing popularity of artificial intelligence (AI) systems, researchers have begun studying how to apply the technical capabilities of AI to the intensive care unit (ICU). This Concise Critical Appraisal explores how ICU AI systems could replace traditional monitoring systems and clinical risk assessment tools with computers that use multidimensional and multidomain data patterns to enhance patient care, predict outcomes, and seamlessly extract and interpret clinical information.
Implicit bias is an unconscious negative view of a group of people that can compromise relationships and, in the case of the medical community, stand in the way of good healthcare. Learn how to approach and mitigate implicit bias.
The first outcomes of VIRUS were recently published in Critical Care Medicine. More than 20 manuscripts are being prepared for publication during the next several months. Additionally, sites have been invited to submit ancillary study ideas drawing on registry data. Of the 150 proposed, more than 60 have been approved. Join the registry today and contribute to this important data collection.
As a bedside nurse in the intensive care unit (ICU), I did not have much understanding of the financial impact my care was having on the patients and my hospital. I have since graduated with a master’s degree in nursing as a clinical nurse specialist and achieved a doctorate of nursing practice. Since moving into an operations role nearly three years ago, I have seen the financial impacts of care to which I had been oblivious for the first part of my career. I ask myself: How do I advocate for the best patient care while balancing costs to ensure a financially healthy organization? The answer: The ICU Liberation campaign.
The medical community has faced many challenges as a result of the COVID-19 pandemic, including ensuring continued medical education in the face of social distancing guidelines and the increased workloads of faculty and trainees. This Concise Critical Appraisal explores an article published in ATS Scholar that sought to outline distance learning options and develop a practical framework for transitioning content to a virtual platform.
SCCM President Greg S. Martin, MD, MSc, FCCM, provides an update on the SCCM relief efforts in Haiti.
This Concise Critical Appraisal explores an article in The Lancet Respiratory Medicine that evaluated the efficacy of awake prone positioning to prevent intubation or death in patients with severe COVID-19. This meta-trial used a new study design that allowed for the combination of six simultaneous national randomized, controlled, open-label trials.
Joanna L. Stollings, PharmD, FCCP, FCCM, and Devin N. Holden, PharmD, BCPS, BCCCP, summarize how pharmacists can play an important role in the development and implementation of each element of the ICU Liberation Bundle (A-F).
Ake Grenvik, MD, PhD, MCCM, a founding member of the Society of Critical Care Medicine (SCCM) and one of the earliest pioneers of critical care, died on September 5, 2021. He was 92.
This Concise Critical Appraisal delves into the impact of respiratory syncytial virus (RSV) and explores a recent trial that led to U.S. Food and Drug Administration approval of the first RSV vaccine. The Adult Respiratory Syncytial Virus (AReSVi-006) clinical trial is an ongoing, international, randomized, placebo-controlled trial that assesses the safety and effectiveness of a single dose of an RSV vaccine in nearly 25,000 patients.
SCCM President Vinay M. Nadkarni, MD, MS, FCCM, provides an overview on how the Society is prioritizing and rethinking ease, comfort, and cost of access to the Critical Care Congress when selecting future sites.
Before Michael J. Waxman, MBA, MD, FCCM, heads out to teach an FCCS course, he goes into his attic, where his simulation and teaching equipment is stored. He selects what he needs among the mannequins, defibrillators, ventilators, and other supplies, packs it all into his car, and hits the road.
Invasive bedside procedures (IBPs) require a high degree of familiarity and skillful expertise. Yet effective and thorough bedside training can be haphazard or unattainable. Chest published a systematic review and meta-analysis that highlights gaps in research on IBP training in critical care. The study included four focus groups of pulmonary and critical care medicine faculty and fellows from four U.S. medical centers. The focus groups identified traits, behaviors, and context as common themes of effective teachers. This Concise Critical Appraisal takes a deep dive into the study and the takeaways for experts and novices seeking to improve procedural knowledge and increase patient safety.
Sepsis continues to affect Americans and hospital patients across the United States. The Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million adult Americans develop sepsis each year1; this is more than the entire population of Phoenix, the fifth-largest city in the country.2 Approximately 270,000 of these patients die from sepsis.