In patients where hypercapnic acidosis could not be managed with lung protective mechanical ventilation, extracorporeal techniques may be used. Newer, minimally invasive low volume venovenous extracorporeal devices are currently being investigated for managing hypercapnia associated with low and ultra-low volume mechanical ventilation.

We evaluated the impact of an experiential learning strategy on both the adherence to the use of bundles and the incidence of ventilator-associated pneumonia in critically ill adult patients.

Longitudinal, quasi-experimental interrupted time-series study in a tertiary teaching hospital in Buenos Aires, Argentina. Successive measurements were made before and after the intervention was implemented between January 2016 and December 2018. Our main exposure was experiential learning, which was based on a combination of play activities, simulation models, knowledge and attitude competencies, role-playing and feedback. The adherence to the bundle for the care of mechanically ventilated critically-ill adult patients and the occurrence of ventilator-associated pneumonia were the main outcomes of interest. We used generalized linear models including time as a linear spline to estimate the effect of the experiential learning strategy both on the adherence to the bundle of care and the occurrence of ventilator-assocint during long-term follow-up.

The implementation of experiential learning strategies improves the adherence to bundles in the care of mechanically ventilated critically ill adult patients. Such strategies also decrease the incidence rate of ventilator-associated pneumonia. Both effects appear to remain constant during long-term follow-up.

The experiences and satisfaction of family members of patients are important indicators of healthcare quality in the intensive care unit. The family satisfaction in the intensive care unit (FS-ICU-24) questionnaire, developed in Canada and now validated in the UK, is becoming the gold standard measure to evaluate family members’ satisfaction with the intensive care unit. To inform future use of the UK FS-ICU-24 to evaluate quality improvement strategies aimed at improving family satisfaction with the intensive care unit, we set out to explore the extent to which the 24-scored items and domains of the UK FS-ICU-24 reflect common suggestions and priorities for quality improvement self-reported as important to family members in the UK.

Two data sources were thematically analysed – (1) open-text responses from family members who completed the UK FS-ICU-24 in a large observational cohort study; (2) a set of quality improvement activities generated by patients, family members and staff through experience-based co-design in a mixed-methods’ intensive care unit quality improvement study. Sodium oxamate price Summarised themes were then mapped to the 24-scored items and domains of the UK FS-ICU-24 to assess coverage by the UK FS-ICU-24.

We found a good degree of coverage between the topics and themes identified as important to family members with the 24-scored items and domains of the UK FS-ICU-24.

Our study confirms the face validity of the UK FS-ICU-24 and indicates that its inclusion as an outcome measure for evaluating quality improvement strategies aimed at improving family satisfaction with the intensive care unit is appropriate.

Our study confirms the face validity of the UK FS-ICU-24 and indicates that its inclusion as an outcome measure for evaluating quality improvement strategies aimed at improving family satisfaction with the intensive care unit is appropriate.

To evaluate the impact of pressure-regulated volume control (PRVC/VC+) use on delivered tidal volumes in patients with acute respiratory distress syndrome (ARDS) or at risk for ARDS.

Retrospective study of mechanically ventilated adult patients with severe sepsis or septic shock.

A total of 272 patients were divided into patients with recognized ARDS, patients without ARDS, and patients with unrecognized ARDS. Over 90% of patients were ventilated with PRVC on admission, resulting in delivered tidal volumes significantly higher than set tidal volumes among all groups at all time points, even after ARDS recognition (

 < 0.001). Tidal volumes were lower for patients with pulmonary sepsis as compared to those with a nonpulmonary origin (

 < 0.001).

Using PRVC promotes augmented delivered tidal volumes, often in excess of 6 mL/kg ideal body weight. Correct recognition of ARDS and having pulmonary sepsis improves compliance with low-stretch protocol ventilation.

Using PRVC promotes augmented delivered tidal volumes, often in excess of 6 mL/kg ideal body weight. Correct recognition of ARDS and having pulmonary sepsis improves compliance with low-stretch protocol ventilation.

Critical care is widely perceived, both within and outside of the speciality, as unremitting and emotionally burdensome. There is a perception of a higher risk to medical staff of burnout than other specialities. Critical care also has considerable emotional and professional rewards. We sought to examine this balance between emotional reward and stress in UK critical care consultants registered with the Faculty of Intensive Care Medicine.

We conducted a Wellbeing survey of the Faculty of Intensive Care Medicine consultant membership utilising the Professional Quality of Life (Pro-QOL) survey tool. The survey was conducted as part of the Annual Workforce Census.

In sum, 799 members completed the Pro-QOL survey, making this one of the largest surveys of physician wellbeing in critical care medicine. Data were analysed in accordance with the Pro-QOL manual.

The results demonstrate moderate risk for burnout and secondary traumatic stress, but this is balanced by moderate compassion satisfaction. No association was demonstrated between age, sex, or size of critical care unit worked in. Further follow-up of this consultant group is warranted to better understand risk factors for burnout and for future mitigation of these risk factors whilst also enhancing the positive aspects of working as a consultant in critical care medicine.

The results demonstrate moderate risk for burnout and secondary traumatic stress, but this is balanced by moderate compassion satisfaction. No association was demonstrated between age, sex, or size of critical care unit worked in. Further follow-up of this consultant group is warranted to better understand risk factors for burnout and for future mitigation of these risk factors whilst also enhancing the positive aspects of working as a consultant in critical care medicine.