In this RCT, critically ill intubated patients were randomized to early exercise and mobilization, or standard care. Independent functional status at the time of hospital discharge occurred in 59% of the early mobilization group, compared to 35% of the control group. The early mobilization group also had fewer delirium days (2 vs 4) and more ventilator-free ICU days (24 vs 21) in 28 day f/u. This confirms our suspicion that earlier mobilization is beneficial, regardless of the severity of the illness, and should be routinely implemented (abstract).
My patient was a 69 year old lady with metastatic small cell lung cancer. She was on experimental chemotherapy and was admitted from clinic with worsening lower extremity edema and a new oxygen requirement. She underwent a chest and abdominal CT that revealed new pulmonary masses, tumor and a mass invading her right pulmonary artery, […]
The large multi-center ICU trial randomized ICUs to 1 of 3 strategies: MRSA screening/isolation, MRSA screening/isolation/decolonization, or global decolonization (5 days BID nasal mupiricin and daily chlorhexidine bathing). The hazard ratios for MRSA isolates in the 3 groups were 0.92, 0.75, 0.63 respectively. The hazard ratios for any bloodstream infection in the 3 groups were […]
This trial found no difference in patient outcomes (mortality or LOS) if admitted during a time of 24/7 intensivist coverage, or during a time with only daytime intensivist coverage (with home call at night) in a medical ICU. This study does not show a patient benefit to a 24/7 intensivist staffing model in an academic […]