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Even in climate-controlled health care units, the outside temperature can influence the indoor temperature, and these changes may impact the incidence of multidrug-resistant organisms, or MRDOs, researchers reported in Infection Control & Hospital Epidemiology. “It remains unclear why seasonality and associations with high temperatures are detected even in hospitals or hospital units with climate control,” Dayanna Conislla Limaylla, MSc, from the post-graduate program in collective health at São Paulo State University, and colleagues wrote. “To fill these gaps in our knowledge, we conducted a prospective ecological study in a teaching hospital in Brazil.” Read More
An often-cited study at Johns Hopkins Hospital found that there is a daily average of 350 alarms per bed in hospital critical care units. That means that all day (and night) long, critical care nurses are fielding hundreds of audible alarms from infusion pumps, cardiac monitors, ventilators, and other bedside machines. These nearly constant alarms compete for a nurse’s attention and are not prioritized by criticality. Worst of all, the majority of the messages aren’t relevant or actionable. All the noise can lead to deadly consequences should a caregiver become desensitized and assume an alarm is false or misdirected. Read More
Critically ill patients who have higher levels of wakefulness and the same depth of sleep in both the left and right hemispheres of their brains are more likely to experience successful weaning from mechanical ventilation, according to a study published in the American Journal of Respiratory and Critical Care Medicine. “Patients under mechanical ventilation in intensive care units frequently suffer from severe sleep deprivation and, as a consequence, exhibit abnormal patterns of sleep or wakefulness, which explain in part the frequent development of delirium,” Laurent Brochard, MD, PhD, director of the critical care medicine division at the University of Toronto. Read More
Sepsis remains the most common cause of vasodilatory shock worldwide. The mainstay of haemodynamic treatment of septic shock is fluid resuscitation followed by vasopressors where fluids alone are insufficient to achieve target blood pressure.This article, published in the journal Critical Care, proposes the concept of “broad spectrum vasopressors” as a new approach to the initial management of septic shock. Based on this strategy, patients with septic shock are started on multiple vasopressors with a different mechanism of action simultaneously while the vasopressor sensitivity is assessed. Read More