Fever in adult ICUs: an interrupted time series analysis*.

Objectives: Fever is common and associated with increased mortality among patients admitted to adult ICUs, yet recent literature suggests that the incidence of fever may be decreasing. The objective of this study was to determine whether the incidence of fever in adult ICUs changed over time and the factors responsible for the observed change.

Designs: Interrupted time series analysis.

A cohort study of nutrition practices in the intensive care unit following abdominal aortic aneurysm repair.

Introduction: Enteral nutrition within 48 hours of intensive care unit (ICU) admission is recommended for the ICU population. Major vascular surgery patients have a higher incidence of pre- and postoperative malnutrition compared with the general surgical population. Our objectives were to determine if early feeding (within 48 hours of admission) is achievable and well tolerated, identify factors that predict early feeding, and determine if there is an association between early feeding and in-hospital mortality among abdominal aortic aneurysm (AAA) repair patients.

Tele-ICU - a Canadian review.

Based on the learnings and experiences from implementations in the United States, telemedicine may offer certain advantages to help address some of the challenges faced by the Canadian critical care community resulting from staff shortages and increasing demands for quality care. The initial and operating costs of the technology and its impact on direct bedside care are perceived to be significant drivers of resistance to its wide spread implementation. This qualitative review of the available literature summarizes the opportunities and challenges with the potential use of telemedicine to enhance the delivery of critical care services in Canada.

Sequential Organ Failure Assessment in H1N1 pandemic planning.

Objective: The H1N1 pandemic has highlighted the importance of reliable and valid triage instruments. A Sequential Organ Failure Assessment score of >11 has been proposed to exclude patients from critical care resources quoting an associated mortality of >90%. We sought to assess the mortality associated with this Sequential Organ Failure Assessment threshold and the resource implications of such a triage protocol.

Management of febrile critically ill adults: a retrospective assessment of regional practice.

The aim of this study was to report on fever epidemiology and management strategies within a general population of critically ill patients. This was a retrospective cohort study among febrile patients (temperature ≥38.3°C) without acute brain injury admitted to one of four regional adult intensive care units (ICUs).

Telemedicine in the intensive care unit environment--a survey of the attitudes and perspectives of critical care clinicians.

Purpose: This study was conducted to assess the preimplementation knowledge and perceptions of intensive care unit (ICU) clinicians regarding the ability of telemedicine in the ICU environment (Tele-ICU) to address challenges resulting from the shortages of experienced critical care human resources and the drive to improve quality of care.

Methods: An online survey was administered to clinicians from a Canadian multisite critical care department. Qualitative and quantitative analyses were undertaken to identify key positive and negative themes.

Concomitant ceftriaxone and high-concentration intravenous calcium therapy in adult critical care patients: a matched cohort study.

Background: Based on case reports in infants, the safety of concomitant use of ceftriaxone and intravenous calcium in all ages has recently come under challenge. Systematic population-based data to guide clinicians with respect to this risk are, however, lacking.

Objective: To determine whether concomitant administration of ceftriaxone and intravenous calcium was associated with the occurrence of severe cardiorespiratory events or death in critically ill adults.

Systematized Nomenclature of Medicine-Clinical Terms direction and its implications on critical care.

Purpose: The aim of this study was to describe the new advancements in Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) terminology and its applicability to critical care documentation.

Materials And Methods: Narrative review of existing literature published in indexed medical and health informatics journals and of gray literature available on the Internet and personal communication with authors and researchers engaged in SNOMED-CT projects related to critical care are conducted.

Results: Systematized Nomenclature of Medicine-Clinical Terms is a system of comprehensive health and clinical terminology that covers most of the needs of health care documentation.

Occurrence and adverse effect on outcome of hyperlactatemia in the critically ill.

Introduction: Hyperlactatemia is frequent in critically ill patients and is often used as a marker of adverse outcome. However, studies to date have focused on selected intensive care unit (ICU) populations. We sought to determine the occurrence and relation of hyperlactatemia with ICU mortality in all patients admitted to four ICUs in a large regional critical care system.

Information management framework; a model for clinical departments.

The information management system of Department of Critical Care Medicine in Calgary Health Region was modeled using a departmental information management framework. The clinical, administrative, research and educational, decision-making and quality improvement information needs of the department are served by the system.

Time series analysis of use patterns for common invasive technologies in critically ill patients.

Purpose: Critically ill patients are frequently managed with invasive technologies as part of their medical care. Little is known about use patterns. We examined use trends for invasive technologies used in critically ill patients.

The epidemiology of intensive care unit-acquired hyponatraemia and hypernatraemia in medical-surgical intensive care units.

Introduction: Although sodium disturbances are common in hospitalised patients, few studies have specifically investigated the epidemiology of sodium disturbances in the intensive care unit (ICU). The objectives of this study were to describe the incidence of ICU-acquired hyponatraemia and hypernatraemia and assess their effects on outcome in the ICU.

Methods: We identified 8142 consecutive adults (18 years of age or older) admitted to three medical-surgical ICUs between 1 January 2000 and 31 December 2006 who were documented to have normal serum sodium levels (133 to 145 mmol/L) during the first day of ICU admission.

Hospital mortality among adults admitted to and discharged from intensive care on weekends and evenings.

Purpose: Patient care may be inconsistent during off hours. We sought to determine whether adults admitted to or discharged from intensive care units (ICUs) on evenings and weekends have increased mortality rates.

Materials And Methods: All adults admitted to ICUs in the Calgary Health Region, Alberta, Canada, during 2000 to 2006 were included.

Occurrence and outcome of fever in critically ill adults.

Objective: Although fever is common in the critically ill, only a small number of studies have specifically investigated its epidemiology in the intensive care unit (ICU). The objective of this study was to describe the occurrence of fever in the critically ill and assess its effect on ICU outcome.

Design: Retrospective cohort.

Study of clinical course of organ dysfunction in intensive care.

Objective: Multiple organ dysfunction is a common cause of death in intensive care units. We describe the daily course of multiple organ dysfunction measured by the Sequential Organ Failure Assessment score in a population-based cohort of critically ill patients.

Design: Prospective cohort study.