Asking the same questions will not bring different answers

Funding Information: PP has an unrestricted research grant from ThermoFisher Scientific and Virogates. The other authors state that they have no competing interests.Severe sepsis is a major healthcare problem and the early initiation of antimicrobials is one of the few measures associated with improved outcomes. However, antibiotic overuse is an increasing problem in critical care. Of several potential biomarkers for antibiotic stewardship, procalcitonin represents the most widely studied and validated. In this commentary we address the current literature on the use of biomarkers to guide antimicrobial therapy in the critically ill and discuss its limitations and future directions.publishersversionpublishe

Impact of Subsyndromal Delirium Occurrence and Its Trajectory during ICU Stay

Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2022 by the authors.Despite recent advances in the field, the association between subsyndromal delirium (SSD) in the ICU and poor outcomes is not entirely clear. We performed a retrospective multicentric observational study analyzing mental status during the first 72 h of ICU stay. Of the 681 patients included, SSD occurred in 22.7%. Considering the worst cognitive assessment during the first 72 h, 233 (34%) patients had normal mental status, 124 (18%) patients had SSD and 324 (48%) patients had delirium or coma. SSD was not independently associated with an increased risk of death when compared with normal mental status (OR 95%IC 1.0 vs. 1.35 [0.73–1.49], p = 0.340), but was associated with a longer ICU LOS (7.0 (4–12) vs. 4 (3–8) days, p 23 points. Our findings support the association of SSD with increased ICU LOS, but not with ICU mortality. Monitoring the trajectory of SSD early at ICU admission can help to identify patients with increased risk of conversion from SSD to delirium or coma.publishersversionpublishe

Worldwide clinical intensive care registries response to the pandemic : An international survey

Funding Information: Dr. Kumar is partially supported by Wellcome Trust grant (WT-215522) for his role as National Coordinator, IRIS. Funding Information: Dr. Martin Sigurdsson is supported by Landspitali Science Fund for COVID19 related projects. Funding Information: Drs. Salluh and Soares are supported in part by individual research grants from CNPq and FAPERJ.Peer reviewe

Prognostic factors in cancer patients in the intensive care unit

Intensive care has become important for the treatment of patients with cancer. However, the prognosis of these patients is considered poor a priori and decisions to admit a patient with cancer to the intensive care unit (ICU) are still source of controversy between oncologists and intensivists. The outcome of severely ill cancer patients does not depend solely on the causes that determine the admission to the ICU, but it also depends on cancer- and anticancer-related characteristics, such as performance status and cancer status. The decision-making process of ICU admission and of the appropriateness of advanced life-support requires a thorough evaluation of these characteristics and of the expectancies and wishes of patients and family members. A better understanding of such parameters may be helpful to avoid forgoing intensive care to patients who can potentially benefit from it

Learning systems as a path to improve ICU staff wellbeing

No abstract available