Quality Improvement and Cost Control KEY POINTS 1 Quality, cost-efficient care requires dedicated, open-minded, and well-trained ICU leaders who are provided with accurate performance data and the power to establish…
General Supportive Care KEY POINTS 1 Failure to systematically review the available database relevant to prior history, events immediately preceding presentation, vital organ performance, and therapy prescribed before and during…
Analgesia, Sedation, and Therapeutic Paralysis KEY POINTS 1 Sedatives should be administered to achieve specific target levels of an objective sedation scale and for most patients, should be interrupted at…
Nutritional Assessment and Support 1 For patients with preexisting nutritional deficiencies, profound hypermetabolic states, or prolonged ICU stays, nutritional support is probably important. By contrast, for patients with normal nutritional…
Pharmacotherapy KEY POINTS 1 It is essential to review the medication list of every patient daily, preferably with a pharmacist specializing in critical care. 2 In choosing a cost-effective course…
Blood Conservation and Transfusion KEY POINTS 1 In hemodynamically stable, nonbleeding patients, reasonable target levels for hemoglobin are 7 to 9 gm/dL and greater than 20,000/mm3 for platelets. Higher levels…
Respiratory Monitoring KEY POINTS 1 Although pulse oximetry is an invaluable clinical tool, it provides a signal-averaged number, the output of which lags behind the actual physiologic value of interest….
Intensive Care Unit Imaging KEY POINTS 1 The value of a portable CXR is critically dependent on obtaining an appropriately penetrated, upright exposure in full inspiration. Consistency of technique from…
Weaning and Discontinuation of Mechanical Ventilation KEY POINTS 1 A continuing need for ventilator assistance may arise from oxygen desaturation of hemoglobin during spontaneous breathing, cardiovascular instability during machine withdrawal,…
Positive End-Expiratory and Continuous Positive Airway Pressure KEY POINTS 1 Adding positive end-expiratory pressure (PEEP) can help maintain patency of collapsed lung units or further distend those that are already…
