Ventilator-associated pneumonia: pathobiological heterogeneity and diagnostic challenges.

Ventilator-associated pneumonia (VAP) affects up to 20% of critically ill patients and induces significant antibiotic prescription pressure, accounting for half of all antibiotic use in the ICU. VAP significantly increases hospital length of stay and healthcare costs yet is also associated with long-term morbidity and mortality. The diagnosis of VAP continues to present challenges and pitfalls for the currently available clinical, radiological and microbiological diagnostic armamentarium.

Quality improvement project to improve adherence to lung protective ventilation guidelines.

Introduction: Lung protective ventilation (LPV) is advocated for all patients requiring mechanical ventilation (MV), for any duration of time, to prevent worsening lung injury. Previous studies proved simple interventions can increase awareness of LPV and disease pathophysiology as well as improve adherence to LPV guidelines.

Objective: To assess the impact of a multi-component LPV quality improvement project (QIP) on adherence to LPV guidelines.

Virtual Post-Intensive-Care Rehabilitation for Survivors of COVID-19: A Service Evaluation.

Aim: The objective of this study is to evaluate the safety, utilisation, and effectiveness of a novel, virtual rehabilitation programme for survivors of SARS‑CoV‑2 infection (COVID-19) and intensive care admission.

Methods: A service evaluation was performed. Adults admitted to a United Kingdom intensive care unit with COVID-19-induced respiratory failure and surviving hospital discharge were invited to an eight-week rehabilitation programme.

Comparing rehabilitation outcomes for patients admitted to the intensive care unit with COVID-19 requiring mechanical ventilation during the first two waves of the pandemic: A service evaluation.

Objectives: To compare rehabilitation outcomes of patients admitted to the intensive care unit with COVID-19 and mechanically ventilated during wave 1 and 2, receiving two different models of physiotherapy delivery.

Methods: Adults admitted to the intensive care unit between October-March 2021 (wave 2) with a confirmed diagnosis of COVID-19 and mechanically ventilated for >24 hours were included. During wave 2, rehabilitation was provided by physiotherapists over five days, with only emergency respiratory physiotherapy delivered at weekends.

Association of Upper Gastrointestinal Surgery of Great Britain and Ireland (AUGIS)/Perioperative Quality Initiative (POQI) consensus statement on intraoperative and postoperative interventions to reduce pulmonary complications after oesophagectomy.

Background: Pulmonary complications are the most common morbidity after oesophagectomy, contributing to mortality and prolonged postoperative recovery, and have a negative impact on health-related quality of life. A variety of single or bundled interventions in the perioperative setting have been developed to reduce the incidence of pulmonary complications. Significant variation in practice exists across the UK.

Rehabilitation Levels in Patients with COVID-19 Admitted to Intensive Care Requiring Invasive Ventilation. An Observational Study.

Patients with severe coronavirus disease (COVID-19) have complex organ support needs that necessitate prolonged stays in the intensive care unit (ICU), likely to result in a high incidence of neuromuscular weakness and loss of well-being. Early and structured rehabilitation has been associated with improved outcomes for patients requiring prolonged periods of mechanical ventilation, but at present no data are available to describe similar interventions or outcomes in COVID-19 populations. To describe the demographics, clinical status, level of rehabilitation, and mobility status at ICU discharge of patients with COVID-19.

Critical appraisal on the impact of preoperative rehabilitation and outcomes after major abdominal and cardiothoracic surgery: A systematic review and meta-analysis.

Background: There has been increasing interest in the prehabilitation of patients undergoing major abdominal surgery to improve perioperative outcomes. This systematic review and meta-analysis aims to evaluate and compare the current literature on prehabilitation in major abdominal surgery and cardiothoracic surgery METHODS: A systematic literature search was conducted for studies reporting prehabilitation in patients undergoing major abdominal and cardiothoracic surgery. Meta-analysis of postoperative outcomes (overall and major complications, pulmonary and cardiac complications, postoperative pneumonia, and length of hospital stay) was performed using random effects models.

Enhancing rehabilitation of mechanically ventilated patients in the intensive care unit: a quality improvement project.

Purpose: Prolonged periods of mechanical ventilation are associated with significant physical and psychosocial adverse effects. Despite increasing evidence supporting early rehabilitation strategies, uptake and delivery of such interventions in Europe have been variable. The objective of this study was to evaluate the impact of an early and enhanced rehabilitation program for mechanically ventilated patients in a large tertiary referral, mixed-population intensive care unit (ICU).