ICM Pulse videos keep you informed about the most relevant publications in Intensive Care Medicine.
Can rest after a spontaneous breathing trial reduce reintubation?
In some countries, current clinical practice allows patients to rest after the effort of breathing without the ventilator and while waiting the physician’s order to proceed to extubation. In some studies, investigators reconnected patients to the ventilator for a period after successful spontaneous breathing trials to determine whether minute ventilation recovery was a predictor of extubation outcome, and inadvertently enabled patients to rest for some hours before extubation.
This ICM Pulse discusses a study that focused on examining the role of rest after the effort of a successful spontaneous breathing trial and showed that rest for one hour after a successful spontaneous breathing trial reduces reintubation.
Fernandez et al. Reconnection to mechanical ventilation for 1 h after a successful spontaneous breathing trial reduces reintubation in critically ill patients: a multicentre randomised controlled trial. Intensive Care Med, Nov 2017, Vol 43, Iss 11, pp 1660-1667 DOI: 10.1007/s00134-017-4911-0.
Effect of a condolence letter on relatives post-ICU grief symptoms
This ICM Pulse discusses a multicentre randomised clinical trial which included 242 patients and assessed the effect of utilising a hand written condolence letter to relieve grief symptoms in family members of patients who died in ICU.
The investigators found that this type of intervention failed to reduce grief symptoms and may have may have worsened depression and PTSD-related symptoms. The findings do not support the sending of a condolence letter to bereaved relatives as the sole, routine post-ICU intervention.
Kentish-Barnes N et al. Effect of a condolence letter on grief symptoms among relatives of patients who died in the ICU: a randomised clinical trial. Intensive Care Med; Volume 43, Issue 4, pp 473–484; DOI: 10.1007/s00134-016-4669-9
A Family Information Brochure
This ICM Pulse discusses the website and brochure of the www.intensiva.it project, which showed how they improved communication with ICU patient’s families:
1) Improved communication based on generalisable tools, including a brochure and website, was associated with a better understanding of prognosis and treatments being provided, without necessarily increasing the ICU staff’s workload.
2) Post-traumatic stress symptoms in relatives seemed to be reduced with provision of information by brochure and website and were also correlated with female sex, higher education, spousal relationship, and patients’ death.
G Mistraletti et al. A Family Information Brochure and Dedicated Website to Improve the ICU Experience for Patients’ Relatives: An Italian Multicentre Before-And-After Study. Intensive Care Med 43 (1), 69-79
Incidence of severe sepsis and septic shock
SepNet Critical Care Trials Group. Incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study. Intensive Care Med., ORIGINAL, December 2016, 42:1980 – 1989, DOI 10.1007/s00134-016-4504-3
Physical declines in ARDS survivors
Elizabeth R. Pfoh, Amy W. Wozniak, Elizabeth Colantuoni, Victor D. Dinglas, Pedro, A. Mendez-Tellez, Carl Shanholtz, Nancy D. Ciesla, Peter J. Pronovost and Dale M. Needham. Physical declines occurring after hospital discharge in ARDS survivors: a 5-year longitudinal study. Intensive Care Med., ORIGINAL, December 2016, 42:1557–1566, DOI 10.1007/s00134-016-4530-1
ECLAIR STUDY: Avoiding invasive MV with ECCO2R?
Let’s explore the feasibility and safety of avoiding invasive mechanical ventilation (IMV) by using extracorporeal CO2 removal (ECCO2R) in ICU patients in this short video summary from ICM…
Stephan Braune, Annekatrin Sieweke, Franz Brettner, Thomas Staudinger, Michael Joannidis, Serge Verbrugge, Daniel Frings, Axel Nierhaus, Karl Wegscheider, Stefan Kluge. The feasibility and safety of extracorporeal carbon dioxide removal to avoid intubation in patients with COPD unresponsive to noninvasive ventilation for acute hypercapnic respiratory failure (ECLAIR study): multicentre case–control study. Intensive Care Medicine, Original, Volume 42, Issue 9 / September, 2016; Pages 1437 – 1444
Implementation of an intensivist-led Rapid Response Team?
Take 3 minutes to discover this ICM Pulse video highlighting the key points and conclusion of the Jung et al. study:
Boris Jung, Aurelien Daurat, Audrey De Jong, Gerald Chanques, Martin Mahul, Marion Monnin, Nicolas Molinari, Samir Jaber. Rapid response team and hospital mortality in hospitalised patients. Intensive Care Medicine, Seven-Day Profile Publication; Volume 42, Issue 4/April, 2016, Pages 494 – 504