A Review published in Crit_Care analyzes the data of ICU muscle wasting studies and reports that critically ill patients lose nearly 2% of skeletal muscle per day during the first week of ICU admission.
]. A study found that measuring cross-sectional area may be a more reliable proxy for muscle strength and could be used as a biomarker for proximal lower-limb muscle loss and knee extensor weakness during early critical illness in settings where volitional and non-volitional muscle strength measurements are challenging [The incidence rate of ICU-AW was high , and our findings may be an under-representation of the actual prevalence, as this depends upon the diagnostic evaluation used.
Second, the pre-admission baseline characteristics and patient functional state were limited. Consequently, it was not possible to assess the impact on muscle loss by severity of critical illness or pre-existing comorbidities. Finally, the studies inconsistency in assessing outcomes made a meta-analysis of outcomes associated with muscle wasting not possible.
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Mechanical ventilation in patients with cardiogenic pulmonary edema: a sub-analysis of the LUNG SAFE study - Journal of Intensive CareBackground Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Methods Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. Results From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59–78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57–77] vs 74 [64–80] years, p | 0.001) and had lower driving (12 [8–16] vs 15 [11–17] cmH2O, p | 0.001), plateau (20 [15–23] vs 22 [19–26] cmH2O, p | 0.001) and peak (21 [17–27] vs 26 [20–32] cmH2O, p | 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60–1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16–2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06–1.18], p | 0.001) and tidal volume after day 7 (HR 0.69 [0.52–0.93], p = 0.015) were related to survival. Conclusions Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073
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Jeremy Renner thanks ICU staff for 'beginning this journey' during recovery‘Thank you Renowned Medical ICU team for beginning this journey.' ❤️️ Jeremy Renner expresses his gratitude towards the medical staff who have been taking care of him in the ICU.
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Jeremy Renner shares update from ICU after snow plough accident as he turns 52Hollywood actor Jeremy Renner, who turns 52 on 7 January, has shared an update from his bed in ICU following a horror snow plough accident that left him with blunt chest trauma
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Virginia teacher shot by boy, 6, 'showing signs of improvement' but still in critical condition'It is almost impossible to wrap our minds around the fact that a six-year-old brought a loaded handgun to school and shot a teacher; however, this is exactly what our community is grappling with', the mayor of Newport News, Virginiasaid
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