The Latest in Critical Care, 4/1/24 (Issue #36)
Early mobilization in the ICU: is it safe? Higher vs. lower oxygenation targets in Covid-19 (HOT-COVID trial); Calling B.S. on central lines’ complication rates
How safe is early mobilization in the ICU?
Providing physical therapy early in the ICU is a recommended practice that appears to prevent ICU-related weakness at the time of discharge, based on limited evidence. Any longer-term benefits remain unknown, due to a paucity of research. “Early mobilization” has no standard definition, but can include ambulating patients on ventilators or
Higher vs. lower oxygenation targets in Covid-19 (HOT-COVID trial)
Published in January 2021, the HOT-ICU trial found no difference in mortality (42.9% vs 42.4%) among 2928 hypoxemic patients in European ICUs receiving at least 10L/min oxygen, regardless of whether they were randomized to a high (PaO2 90 mmHg) or low (PaO2 60 mmHg) oxygenation target. Nor were there any significant between-group differences in need for…
One in 33 central-line placements results in major complications?
A new paper in JAMA Internal Medicine overstates the risks of central venous catheter placements, asserting that 3% of CVC placements result in either arterial puncture, pneumothorax, bloodstream infection, or deep venous thrombosis, within 3 days. Let’s take a look at the methods they used to arrive at this surprising finding.