CHEST 2011: Embargoed studies highlight new critical care research

(Press-News.org) Georgia Tele-ICU Reduces Transfers and Saves Money
(#1117902, Tuesday, October 25, 3:00 PM Eastern) Historically, critically ill patients in smaller hospitals are less likely to receive guideline-recommended treatments and medications within 24 h. To help correct this lack of care, a level III hospital in Georgia hired a solo board-certified specialist and established a new tele-ICU service. Prior to this program, patients were required to travel as far as 70 miles or more to reach the nearest hospital with interventional capabilities, including cross-state referrals. According to researchers at the Satilla Regional Medical Center in Waycross, Georgia, the tele-ICU collaboration with an intensivist allowed 270 patients to receive care in their hometowns with no deaths. This collaboration also allowed for full compliance with national cardiology measures. Without this service, an estimated 48 patients would have required a minimal cost of $5,000 per transfer, saving the state of Georgia $240,000.

Serum Albumin May Be Used to Determine Type of Shock
(#1104230, Tuesday, October 25, 3:00 PM Eastern) The leading cause of death in critical care units is sepsis, a severe condition that cases blood pressure to drop and the body to go into shock. However, it is often difficult to differentiate septic shock from other types of shock. Researchers from Robert Packer Hospital in Sayre, Pennsylvania and Sanford Health in Fargo, North Dakota studied the effectiveness of determining low serum albumin levels on admission to help differentiate between these types of shock in hospital admissions through the emergency department. Of the 603 patients diagnosed with shock, 49 suffered from septic shock, while 26 had cardiogenic shock and 24 had unspecified shock. Researchers found that the median serum albumin level on admission was lower for patients with septic shock compared with those with cardiogenic shock. Researchers concluded that a low serum albumin level determined at admission is a marker that helps establish the type of shock and that early identification using serum albumin may improve outcomes.

Intensivists Can Reduce Complications and Improve Outcomes in Pediatric Intubations
(#1114419, Wednesday, October 26, 5:30 PM Eastern) In-house intensivist supervision can improve the health and safety of children during emergency intubations, according to a new study. Researchers from Connecticut Children's Medical Center in Hartford compared outcomes between prehospital and posthospital intensive care specialist supervision for pediatric patients. Results showed a twofold decrease in intubation procedure complications after the intensivists joined the staff. In addition, clinically significant oxygen desaturations were reduced from 39% to 18%, and hypotension was reduced from 22% to 5%. No significant differences were noted in the number, frequency, or timing of emergency intubations, or other factors.

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