Critical Care Bulletin: December 2014

 

The latest Critical Care bulletin published by the Staff Library Service, East Cheshire NHS Trust is available here.  Topics listed below.

• Monitoring and optimising outcomes of survivors of critical illness
• The experience of communication difficulties in critically ill patients in and beyond intensive care
• Feeding the critically ill patient
• Effectiveness of implementing a wake-up and breathe program on sedation and delirium in the ICU
• Protein in nutrition support: the newborn hero for the critically ill?
• Prehospital treatment of sepsis
• Timing of norepinephrine in septic patients
• Effect of a fever control protocol-based strategy on ventilator-associated pneumonia in severely brain-injured patients
• Incidence, risk factors and outcomes of new-onset atrial fibrillation in patients with sepsis
• Association between vitamin D deficiency and mortality in critically ill adult patients
• A practical approach to goal-directed echocardiography in the critical care setting
• The early antibiotic therapy in septic patients
• Sleep continuity
• Intravenous immunoglobulin for severe sepsis and septic shock
• Sedation assessment in a mobile intensive care unit

Eyes on Evidence for March

This month’s topics in NHS Eyes on Evidence:

Hypoglycaemia and risk of death in critically ill patients

Analysis of data from a large randomised controlled trial suggests that intensive glucose control in critically ill patients is associated with moderate to severe hypoglycaemia, and a higher risk of death.

Effect of telehealth on secondary and emergency care

A large scale trial examines the benefits and effectiveness of telehealth and telecare services in helping patients avoid the need for emergency hospital care.

 

Physical punishment in children and adult mental health

A cross-sectional study investigating a possible link between harsh physical punishment and mental health disorders reports that reducing physical punishment may help to reduce the prevalence of mental health disorders in the general population. It suggests giving parents information about alternative discipline strategies, such as positive reinforcement.

Case studies from the Quality Improvement Productivity and Prevention (QIPP) Collection

The QIPP Collection highlights examples of local best practice, demonstrating how NHS organisations have implemented new practices that have both cut costs and improved quality. We highlight a new example:

• Musculoskeletal physiotherapy and patient self-referral 

NICE accreditation case study: British HIV Association

Chair of the British HIV Association Guidelines Subcommittee, Martin Fisher, talks about the organisation’s experience of the NICE accreditation process.

Accreditation news  
At its January meeting the NICE Accreditation Advisory Committee accredited 2 guidance programmes.

Evidence Updates 
NICE recently published Evidence Updates on:

• Strategies to prevent unintentional injuries among children and young people aged under 15
• Hyperglycaemia in acute coronary syndromes
• Common mental health disorders
• Hypertension.

Referral to an Extracorporeal Membrane Oxygenation Center and Mortality Among Patients With Severe 2009 Influenza A (H1N1): participating in the SWIFT study, Dr J Hunter

Caring for the Critically Ill Patient

ONLINE FIRST

JAMA. Published online October 5, 2011. doi: 10.1001/jama.2011.1471

Referral to an Extracorporeal Membrane Oxygenation Center and Mortality Among Patients With Severe 2009 Influenza A(H1N1)

Context Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients with severe acute respiratory distress syndrome (ARDS), but its role has remained controversial. ECMO was used to treat patients with ARDS during the 2009 influenza A(H1N1) pandemic.

Objective To compare the hospital mortality of patients with H1N1-related ARDS referred, accepted, and transferred for ECMO with matched patients who were not referred for ECMO.

The authors acknowledge the support of NHS Specialised Services of the UK Department of Health for supporting increased capacity to provide extracorporeal membrane oxygenation (ECMO) for adult patients during the 2009 influenza A(H1N1) pandemic and are indebted to the relevant staff at all of the hospitals participating in the SwiFT study.

Fulltext available