Frequency and Analysis of Unplanned Extubation in Coronavirus Disease 2019 Patients.

Objectives: To determine if patients with coronavirus disease 2019 had a greater number of unplanned extubations resulting in reintubations than in patients without coronavirus disease 2019.

Design: Retrospective cohort study comparing the frequency of unplanned extubations resulting in reintubations in a group of coronavirus disease 2019 patients to a historical (noncoronavirus disease 2019) control group.

Setting: This study was conducted at Henry Ford Hospital, an academic medical center in Detroit, MI.

Novel combination of impella and extra corporeal membrane oxygenation as a bridge to full recovery in fulminant myocarditis.

A 31-year-old male was transferred to our hospital with severe heart failure due to viral myocarditis. He progressed to multiorgan failure requiring intubation and maximal doses of multiple vasopressors. Circulatory support was provided with an Impella device as a bridge to an extracorporeal membrane oxygenation (ECMO) system.

Sleep in the intensive care unit.

Adequate sleep, in terms of both quantity and quality, is an essential component of any overall health program. Sleep deprivation has serious deleterious effects on any subject, regardless of species. The most obvious and well-documented adverse effects of sleep deprivation are focused on cognitive function, cardiopulmonary function, and the immune system.

Assessment and management of patients with pulmonary disease.

Objective: Often, the critically ill are not optimized in terms of their chronic diseases and are with little physiologic reserves.

Data Sources: This article contains a review of the pathophysiology of the major preexisting and chronic pulmonary disease encountered in the critically ill, such as asthma, emphysematous disease, and chronic bronchitis. It also includes a summary of other significant disease processes such as acute respiratory disease syndrome, cigarette smoking, and pulmonary alveolar proteinosis and the implications of obesity and obstructive sleep apnea.

Clinical practice guidelines for the maintenance of patient physical safety in the intensive care unit: use of restraining therapies--American College of Critical Care Medicine Task Force 2001-2002.

Objective: To develop clinical practice guidelines for the use of restraining therapies to maintain physical and psychological safety of adult and pediatric patients in the intensive care unit.

Participants: A multidisciplinary, multispecialty task force of experts in critical care practice was convened from the membership of the American College of Critical Care Medicine (ACCM), the Society of Critical Care Medicine (SCCM), and the American Association of Critical Care Nurses (AACN).

Evidence: The task force members reviewed the published literature (MEDLINE articles, textbooks, etc.