NEJM Evidence’s Post

https://lnkd.in/giQaM2pt P: in mechanically ventilated ICU patients I: do PPIs (pantoprazole 40mg) C: compared to placebo O: reduce the risk of clinically important digestive bleeding Answer: Yes 1% vs 3.5% (Absolute Risk Reduction : 2.5; NNT:40)

#ewifacts - tunneled indwelling catheter as an effective alternative to multiple punctures for chronic ascites 💧 A literature review by Caldwell in 2018 examined retrospective and prospective studies from the last 15 years in which a tunnelled indwelling catheter (IPC) was implanted in patients with malignant and non-malignant ascites. The literature review comprises a total of 14 studies with 957 patients (687 malignant/270 cirrhotic). The results of the studies 📝 confirm that tunneled indwelling catheters have high continuity and low infection and dysfunction rates. In addition, home drainage with a tunnelled catheter allows to reduce the burden on patients and nursing staff. Access the study here: https://lnkd.in/e_dfxKXH ewimed offers the PleurX™ catheter as a solution for the treatment of ascites or pleural effusion. The catheter is implanted during a minimally invasive procedure, allowing patients to be discharged from hospital within a short period of time, offering them more quality of life. Find out more about the tunnelled catheter here: https://lnkd.in/eHqYvM52 #ewimed #ewimedswitzerland #medicaltechnology #ascites #catheter #drainage #patient #qualityoflife

🎓 Throughout #LIVES2024 we continued offering multiple Intensive Care educational workshops! 🔹 Advanced Critical Care Echocardiography 🔹 Airway Management in the Critically ill 🔹 Antimicrobial Stewardship for Severe Infections (AMS) 🔹 ECLS/ECMO (joint with EuroELSO European Chapter of ELSO) 🔹 Mechanical Ventilation 🔹 Renal Replacement Therapy in the ICU #WeAreICU #TogetherICU

ICU patients are at high risk for prescribing cascades (e.g. involving opioids, psychotropics, & PPIs). Acute medications started in the ICU, are often no longer needed at discharge from the ICU. However a systematic review shows 10-60% of patients continued to use medications that were deemed clinically inappropriate even after ICU discharge. #Deprescribing is "critical" in these patients! 🔍 How can we best tackle this problem? Read this overview article here: https://buff.ly/3yarJb9 Burry, Lisa Richard S Bourne Also check out our Deprescribing Guidelines & Algorithms: https://lnkd.in/ggwJhCCy

🎯 Deprescribing and ICU Pharmacy ICU might not feel like the natural home of deprescribing, but #pharmacists in #ICU have an important role to play in supporting a person's health team in delivering the best medicines care. Three tips which would help me in my role as a pharmacist in community when medication is started in ICU.. 1️⃣ Communicate 🗣️ 2️⃣ Communicate 📝 3️⃣ Also, communicate 😁 If the INDICATION and PLAN FOR REVIEW for medication is clear, it really supports GP and community based pharmacy teams to avoid #overprescribing and maximise patient safety.

Really useful infographic on #ICU #deprescribing So many opportunities to deprescribe medications during and after an ICU stay 🔴ICU 🔵Hospital 🏥 Ward 🟢Community Care Medicines review & reconciliation at each transition of care and early after hospital 🏥 discharge ⤵️

Six million ICU patients suffer annually from ICU Associated Weakness (ICUAW), a condition that often arises in critically ill patients requiring immobilization and/or ventilatory support. Multiple factors can prolong or intensify the severity of ICUAW, but the combined effect is rapid and sustained loss of muscle mass and function impairing recovery.   The compounded impact of ICUAW is an increase ICU and hospital stays, delayed weaning from mechanical ventilation, risk of additional complications, longer rehabilitation time and diminished quality of life. Major additional costs, as much as $41 billion annually, are associated with ICUAW.  

What is the relative effect of lower versus higher oxygenation targets on the mortality rate of critically ill patients in the intensive care unit (ICU)? 🔥 Critically ill adult ICU patients ≥18 years of age with lower versus higher oxygenation targets did not differ in terms of mortality, serious adverse events, the need for renal replacement therapy, mechanical ventilation-free days through day 28, or ICU length of stay. However, oxygenation targets among the included studies were extremely heterogeneous. 🔥No conclusion can be drawn regarding the effect of oxygenation targets on outcomes due to heterogeneity in included studies. https://buff.ly/3U3bYKW #ICU #CriticalCare

Read some of the latest in ACP Hospitalist: http://ow.ly/HWg750Ill7m 🔸 Q&A: A peek at your peers 🔸 Coding Corner: Clarifying criteria for acute respiratory failure 🔸 High-sensitivity troponin-based pathway safe, effective for chest pain patients without CAD 🔸 Inappropriate CAP diagnosis common in hospitalized adults 🔸 Lower oxygen target led to better outcomes in ICU patients with COVID-19

📢 📢 Hot off the press - new study on the MAC System! 📢 📢 Venous thromboembolism, or VTE, is a leading preventable cause of death in hospitalized patients. Unfortunately, fewer than half of patients receive appropriate preventive treatment. A new study in the American Journal of Nursing (AJN) highlights the potential of The MAC System to improve patient outcomes and reduce the risk of VTE. Researchers found The MAC System to be clinically useful for both preventing VTE and enhancing patient comfort, which in turn can promote adherence. Increased adherence may lead to improved patient mobility, impacting a number of other in-hospital quality outcomes. Compared with the current standard of care, The MAC System demonstrated significantly longer wear time, with more patients wearing it for at least 18 hours per day. This study underscores our drive to rethink the standard of care for VTE prevention. https://hubs.ly/Q02YXTNF0 #VTEPrevention #PatientOutcomes #PatientCare #PatientSafety #PatientMobility