ICU Management & Practice, Volume 18 - Issue 1, 2018 CO2 in the critically ill CO2 exerts potent effects on lung biology that could be clinically relevant in critically ill patients, in particular those with acute respiratory distress syndrome (ARDS). The impact of hypercapnia on outcome in these patients is yet to be determined. The physiological effects of hypercapnia are increasingly well understood, but the literature remains confusing. Importan...

Editor's Note July 16, 2019 Government Regulation of Sepsis Care Demetrios N. Kyriacou JAMA. 2019;322(3):250-251. doi:10.1001/jama.2019.9230 Sepsis is estimated to affect more than 30 million people and cause an estimated 6 million deaths worldwide every year. Although new medical treatments are continually being proposed and tested, the greatest reduction in sepsis-related deaths over the past few decades has come from the early recog...

Editorial July 16, 2019 Psychological Consequences of Admission to the ICU： Helping Patients and Families Louise Rose, Fiona Muttalib, Neill K. J. Adhikari JAMA. 2019;322(3):213-215. doi:10.1001/jama.2019.9059 For most patients and their families, admission to the intensive care unit (ICU) is an unanticipated event that causes substantial psychological distress. For patients, short- and long-term consequences include delirium, anxiety, depressi...

Original Investigation  Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis Jeremy M. Kahn, Billie S. Davis, Jonathan G. Yabes, et al JAMA. 2019;322(3):240-250. doi:10.1001/jama.2019.9021 Abstract Importance 背景 Beginning in 2013, New York State implemented regulations mandating that hospitals implement evidence-based protocols for sepsis management, ...

Original Investigation | Caring for the Critically Ill Patient Effect of an ICU Diary on Posttraumatic Stress Disorder Symptoms Among Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial Maité Garrouste-Orgeas, Cécile Flahault, Isabelle Vinatier, et al JAMA. 2019;322(3):229-239. doi:10.1001/jama.2019.9058 Abstract Importance 背景 Keeping a diary for patients while they are in the intensive ca...

ICU Management & Practice, Volume 19 - Issue 1, 2019 Technology innovations in delivering accurate nutrition Preventing malnutrition and enforcing nutritional guidelines An overview of the key obstacles for the enforcement of nutritional guidelines and innovative approaches that can be used to overcome these obstacles. Recent studies suggest that nutritional guidelines across the majority of intensive care units (ICUs) are not being implemented (Benda...

Original Investigation | Caring for the Critically Ill Patient Effect of Flexible Family Visitation on Delirium Among Patients in the Intensive Care Unit: The ICU Visits Randomized Clinical Trial Regis Goulart Rosa, Maicon Falavigna, Daiana Barbosa da Silva, et al JAMA. 2019;322(3):216-228. doi:10.1001/jama.2019.8766 Abstract Importance 背景 The effects of intensive care unit (ICU) visiting hours remain uncert...

ICU Management & Practice, Volume 19 - Issue 2, 2019 Big Data and hidden subtypes of sepsis Results of a study conducted by the University of Pittsburgh School of Medicine suggests that sepsis is not one condition, but many conditions that could benefit from different treatments. The findings are published in JAMA and were presented at the American Thoracic Society's Annual Meeting. Sepsis is the number one killer of hospitalised patients and is a life-t...

COMMENT|ONLINE FIRST Testing the waters: a new test for hypotonic polyuria Ewout J Hoorn Lancet Published: July 11, 2019 DOI:https://doi.org/10.1016/S0140-6736(19)31414-X Three disorders can cause water diuresis (hypotonic polyuria): primary polydipsia, central diabetes insipidus, and nephrogenic diabetes insipidus. These causes of hypotonic polyuria are difficult to differentiate, especially the partial forms of central diabetes insipidus from primary polydip...

C. auris in the ICU - a global challenge Candida auris (C. auris) is a type of fungus first isolated in 2009; since then there have numerous infection episodes and outbreaks in different regions of the world. In the U.S. alone, 560 cases of C. auris infections have been reported as at 31 January 2019. Overall, most of those affected were critically ill adults, with risk factors for invasive fungal infections, such as immunosuppression, surgery, or in...