Conclusions: Available new evidence, published since 1999, suggests that physiotherapy intervention that comprises early progressive mobilization is beneficial for adult patients in the ICU in terms of its positive effect on functional ability and its potential to reduce ICU and hospital length of stay. These new findings suggest that early progressive mobilization should be implemented as a matter of priority in all adult ICUs and an area of clinical focus for ICU physiotherapists.
Conclusions: Patients in whom AKI develops during ICU admission have significantly increased risks of death that extend beyond their high ICU mortality rates. These increased risks of death continue for at least 2 years after the index ICU admission.
The concept of frailty, as a marker of biologic age and physiologic reserve, may have direct relevance to critical care, and clearly identifies a population at greater risk of adverse events, morbidity, and mortality. Its recognition in critical care settings may enable improved prognostication and shared decision-making and identify vulnerable subgroups with specific needs who might benefit from targeted follow-up.
Delivery of palliative care in the ICU will be hampered until studies incorporate outcomes that are: responsive to and reflective of variations in care, and multi-faceted (with patient-centered components) to reflect the multi-dimensional nature of palliative care and the varied needs of different stakeholders.
Older ICU survivors from a single center who required post-acute facility care had a high burden palliative care needs and a high six-month mortality. The in-hospital post-critical acute care period should be targeted for palliative care assessment and intervention.
Conclusions: Persistent organ failure is associated with an increase in the rate of limitations in life support independent of the absolute magnitude of Sequential Organ Failure Assessment score, and this association strengthens during the first weeks of treatment. During the first 5 days after acute lung injury onset, limitations were significantly more common in medical ICUs than surgical ICUs.
Conclusion: No escalation of care designation occurs in a significant proportion of ICU decedents shortly before death. Some interventions are more likely to be limited than others using a no escalation of care approach.
Rescue Therapy With Noninvasive Ventilation in Do-Not-Intubate Patients in Acute Respiratory Failure: What Is the Best Device Among Face Masks?
Conclusion: Implementation of effective delirium screening is feasible but requires attention to implementation methods, including a change in the current ICU culture that believes delirium is inevitable or a normal part of a critical illness, to a future culture that views delirium as a dangerous syndrome which portends poor clinical outcomes and which is potentially modifiable depending on the individual patients circumstances.
Conclusions: The presence of any predictors of adverse outcomes was associated with mortality and decreased ventilator-free days at day 28. The lack of improvement in the Pao2/Fio2 and Sequential Organ Failure Assessment score was independently associated with mortality in the multivariate analysis.