Prevalence and associations of insomnia after COVID-19 infection.

Study Objectives: Sleep disturbances in "long COVID" are common, but the associations between the severity of sleep problems and the severity of COVID infection are unclear. We evaluated the prevalence, persistence, comorbidities, and clinical effects of insomnia following recovery from acute COVID-19 infection in a COVID-specific clinic.

Methods: Inpatients discharged after COVID infection and outpatients referred for persistent post-COVID symptoms were surveyed on insomnia severity (Insomnia Severity Index, ISI), other neuropsychological symptoms, cardiopulmonary symptoms and physiological functions (6 minute walk distance and others), and functional outcome and quality of life (QOL).

The Intensive Care Unit Bundle Board: A Novel Real-Time Data Visualization Tool to Improve Maintenance Care for Invasive Catheters.

Background: Critically ill patients are at greater risk of healthcare-associated infections (HAIs). The use of maintenance bundles helps to reduce this risk but also generates a rapid accumulation of complex data that is difficult to aggregate and subsequently act upon.

Objectives: We hypothesized that a digital display summarizing nursing documentation of invasive catheters (including central venous access devices, arterial catheters, and urinary catheters) would improve invasive device maintenance care and documentation.

Chronic Neurocognitive, Neuropsychological, and Pulmonary Symptoms in Outpatient and Inpatient Cohorts After COVID-19 Infection.

Neuropsychological symptoms associated with post-COVID-19 conditions may prevent patients from resuming normal activities at home or work. We report a retrospective, cross-sectional evaluation of neuropsychological and cardiopulmonary outcomes in 2 groups of patients: outpatients with mild enough infection to be spared from hospitalization and those who required inpatient admission. We hypothesized a dose-response model of post-COVID symptom severity in which persistent consequences would be more severe in those who experienced worse acute infections.

In-Hospital Cardiac Arrest.

This article reviews the epidemiology and management of in-hospital cardiac arrest.

Sounding the Alarm: What Clinicians Need to Know about Physical, Emotional, and Cognitive Recovery After Venoarterial Extracorporeal Membrane Oxygenation.

Objective: We summarize the existing data on the occurrence of physical, emotional, and cognitive dysfunction associated with postintensive care syndrome (PICS) in adult survivors of venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Data Sources: MEDLINE, Cochrane Library, EMBASE, Web of Science, and CINAHL databases were searched.

Study Selection: Peer-reviewed studies of adults receiving VA-ECMO for any reason with at least one measure of health-related quality of life outcomes or PICS at long-term follow-up of at least 6 months were included.

Early Empiric Antibiotic Use in Patients Hospitalized With COVID-19: A Retrospective Cohort Study.

Objective: To investigate temporal trends and outcomes associated with early antibiotic prescribing in patients hospitalized with COVID-19.

Design: Retrospective propensity-matched cohort study using the National COVID Cohort Collaborative (N3C) database.

Setting: Sixty-six health systems throughout the United States that were contributing to the N3C database.

Worse survival in patients with right ventricular dysfunction and COVID-19-associated acute respiratory distress requiring extracorporeal membrane oxygenation: A multicenter study from the ORACLE Group.

Objective: We sought to determine the impact of right ventricular dysfunction on the outcomes of mechanically ventilated patients with COVID-19 requiring veno-venous extracorporeal membrane oxygenation.

Methods: Six academic centers conducted a retrospective analysis of mechanically ventilated patients with COVID-19 stratified by support with veno-venous extracorporeal membrane oxygenation during the first wave of the pandemic (March to August 2020). Echocardiograms performed for clinical indications were reviewed for right and left ventricular function.

A survey of COVID-19 detection and prediction approaches using mobile devices, AI, and telemedicine.

Since 2019, the COVID-19 pandemic has had an extremely high impact on all facets of the society and will potentially have an everlasting impact for years to come. In response to this, over the past years, there have been a significant number of research efforts on exploring approaches to combat COVID-19. In this paper, we present a survey of the current research efforts on using mobile Internet of Thing (IoT) devices, Artificial Intelligence (AI), and telemedicine for COVID-19 detection and prediction.

Outcomes following the use of angiotensin II in patients with postoperative vasoplegic syndrome: A case series.

Catecholamine-resistant postoperative vasoplegic syndrome (PVS) lacks effective treatment modalities. Synthetic angiotensin II was recently approved for the treatment of vasodilatory shock; however, its use in PVS is not well described. We report outcomes in six patients receiving angiotensin II for the treatment of isolated PVS.

Early posthospitalization recovery after extracorporeal membrane oxygenation in survivors of COVID-19.

Objective: We sought to determine the influence of venovenous extracorporeal membrane oxygenation (ECMO) on outcomes of mechanically ventilated patients with COVID-19 during the first 120 days after hospital discharge.

Methods: Five academic centers conducted a retrospective analysis of mechanically ventilated patients with COVID-19 admitted during March through May 2020. Survivors had access to a multidisciplinary postintensive care recovery clinic.

Bronchial Thermoplasty in Patients With Severe Asthma at 5 Years: The Post-FDA Approval Clinical Trial Evaluating Bronchial Thermoplasty in Severe Persistent Asthma Study.

Background: Bronchial thermoplasty is a device-based treatment for subjects ≥ 18 years of age with severe asthma poorly controlled with inhaled corticosteroids and long-acting beta-agonists. The Post-FDA Approval Clinical Trial Evaluating Bronchial Thermoplasty in Severe Persistent Asthma (PAS2) study collected data on patients with severe asthma undergoing this procedure.

Research Question: What are the 5-year efficacy and safety results in patients with severe asthma who have undergone bronchial thermoplasty?

Study Design And Methods: This was a prospective, open-label, observational, multicenter study conducted in the United States and Canada.

Continuous Noninvasive Blood Pressure Monitoring of Beat-By-Beat Blood Pressure and Heart Rate Using Caretaker Compared With Invasive Arterial Catheter in the Intensive Care Unit.

Objective: To examine the accuracy of noninvasively-derived peripheral arterial blood pressure (BP) by the Caretaker device (CT) against invasively measured arterial BP and the fidelity of heart rate variability by CT compared with electrocardiogram (ECG)-derived data.

Design: Prospective cohort study.

Participants: Adult surgical and trauma patients admitted to the intensive care unit.

Transpulmonary Pressure-Guided Lung-Protective Ventilation Improves Pulmonary Mechanics and Oxygenation Among Obese Subjects on Mechanical Ventilation.

Background: Transpulmonary pressure (P) is used to assess pulmonary mechanics and guide lung-protective mechanical ventilation (LPV). P is recommended to individualize LPV settings for patients with high pleural pressures and hypoxemia. We aimed to determine whether P-guided LPV settings, pulmonary mechanics, and oxygenation improve and differ from non-P-guided LPV among obese patients after 24 h on mechanical ventilation.

Physiologic Improvement in Respiratory Acidosis Using Extracorporeal Co Removal With Hemolung Respiratory Assist System in the Management of Severe Respiratory Failure From Coronavirus Disease 2019.

Objectives: About 15% of hospitalized coronavirus disease 2019 patients require ICU admission, and most (80%) of these require invasive mechanical ventilation. Lung-protective ventilation in coronavirus disease 2019 acute respiratory failure may result in severe respiratory acidosis without significant hypoxemia. Low-flow extracorporeal Co removal can facilitate lung-protective ventilation and avoid the adverse effects of severe respiratory acidosis.

Effectiveness of Elastomeric Half-Mask Respirators vs N95 Filtering Facepiece Respirators During Simulated Resuscitation: A Nonrandomized Controlled Trial.

This nonrandomized controlled trial compares the effectiveness of elastomeric half-mask respirators with that of N95 filtering facepiece respirators during cardiopulmonary resuscitation.

A comparison of the effect of weather and climate on emergency department visitation in Roanoke and Charlottesville, Virginia.

Compared with mortality, the impact of weather and climate on human morbidity is less well understood, especially in the cold season. We examined the relationships between weather and emergency department (ED) visitation at hospitals in Roanoke and Charlottesville, Virginia, two locations with similar climates and population demographic profiles. Using patient-level data obtained from electronic medical records, each patient who visited the ED was linked to that day's weather from one of 8 weather stations in the region based on each patient's ZIP code of residence.

Adoption of a dedicated multidisciplinary team is associated with improved survival in acute pulmonary embolism.

Background: Acute pulmonary embolism remains a significant cause of mortality and morbidity worldwide. Benefit of recently developed multidisciplinary PE response teams (PERT) with higher utilization of advanced therapies has not been established.

Methods: To evaluate patient-centered outcomes and cost-effectiveness of a multidisciplinary PERT we performed a retrospective analysis of 554 patients with acute PE at the university of Virginia between July 2014 and June 2015 (pre-PERT era) and between April 2017 through October 2018 (PERT era).

Patient Outcomes With Prevented vs Negative Tests Using a Computerized Clinical Decision Support Tool.

Background: Overtesting and overdiagnosis of infection are suspected to be common. Reducing inappropriate testing through interventions designed to promote evidence-based diagnostic testing (ie, diagnostic stewardship) may improve test utilization. However, the safety of these interventions is not well understood despite the potential risk for missed or delayed diagnoses.

Dynamic data in the ED predict requirement for ICU transfer following acute care admission.

Misidentification of illness severity may lead to patients being admitted to a ward bed then unexpectedly transferring to an ICU as their condition deteriorates. Our objective was to develop a predictive analytic tool to identify emergency department (ED) patients that required upgrade to an intensive or intermediate care unit (ICU or IMU) within 24 h after being admitted to an acute care floor. We conducted a single-center retrospective cohort study to identify ED patients that were admitted to an acute care unit and identified cases where the patient was upgraded to ICU or IMU within 24 h.

Palliative Care and Moral Distress: An Institutional Survey of Critical Care Nurses.

Background: The need for palliative care in the intensive care unit is increasing. Whether gaps and variations in palliative care education and use are associated with moral distress among critical care nurses is unknown.

Objectives: To examine critical care nurses' perceived knowledge of palliative care, their recent experiences of moral distress, and possible relationships between these variables.