Article
Multidisciplinary Sciences
Taiki Haga, Takaaki Sakaguchi, Takao Kazuta, Takaya Morooka, Junji Maruyama, Naoko Yamaoka, Satoko Miyahara
Summary: This study aimed to evaluate the effectiveness of post-ICU follow-up by a rapid response team (RRT) after congenital heart surgery. The study found that although this follow-up did not reduce unplanned ICU readmission, it improved several clinical outcomes at ICU readmission.
SCIENTIFIC REPORTS
(2022)
Review
Nursing
Stephanie K. Sprogis, Judy Currey, Daryl Jones, Julie Considine
Summary: This review explores the use of the pre-Medical Emergency Team tier of Rapid Response Systems in recognizing and responding to early clinical deterioration in adult ward patients. Findings suggest that there is disparity between clinical practice and pre-MET escalation protocols, and there is a need for further research to understand barriers and facilitators influencing the use of pre-MET strategies targeted at patient deterioration.
INTENSIVE AND CRITICAL CARE NURSING
(2021)
Article
Medicine, General & Internal
Raja M. Chinthamuneedi, Sandeep Phaltane, Meher P. Chinthamuneedi, Srinivas Kondalsamy-Chennakesavan, Benjamin K. Cheung
Summary: This study evaluated the effectiveness of modifications to rapid response team (RRT) activation criteria in preventing RRT activation and the impact on adverse events caused by treatment delays. The results showed that modifications to criteria did not affect the rate of RRT activation but had detrimental effects on patient safety, particularly in medical patients.
INTERNAL MEDICINE JOURNAL
(2023)
Article
Multidisciplinary Sciences
Su Yeon Lee, Jee Hwan Ahn, Byung Ju Kang, Kyeongman Jeon, Sang-Min Lee, Dong Hyun Lee, Yeon Joo Lee, Jung Soo Kim, Jisoo Park, Jae Young Moon, Sang-Bum Hong
Summary: This study retrospectively analyzed cases for which physician-led METs were activated, showing high rates of intervention, such as arterial line insertion and portable ultrasonography, and low ICU transfer rates, suggesting that physician-led METs can help detect deteriorating patients earlier and begin ICU-level management to prevent worsening of the patient's condition.
Article
Medicine, General & Internal
Safoura Sheikh Rezaei, Constantin Gatterer, Patrick Sulzgruber, Felix Hofer, Helene Mittlboeck, Stefan Gavrilovic, Yannick Loyoddin, Michael Wolzt, Robert Schoenbauer, Walter Speidl, Bernhard Richter, Gottfried Heinz, Michael Sponder
Summary: This study aimed to investigate predictors for long-term survival of in-hospital patients with medical emergency team (MET) consultation. The results showed that cardiac arrest-related parameters, patient age, and comorbidities were predictors of survival in these patients.
Article
Emergency Medicine
Anna Adielsson, Christian Danielsson, Pontus Forkman, Thomas Karlsson, Linda Pettersson, Johan Herlitz, Stefan Lundin
Summary: This study conducted in a tertiary university hospital in Sweden analyzed data from 2,601 patients assessed by the MET from 2010 to 2015. Thirteen clinical variables were found to be independently associated with 30-day mortality, leading to the development of a simple risk scoring system for predicting death within 30 days after the MET assessment. The risk score showed good calibration and potential for early identification and treatment of high-risk patients.
BMC EMERGENCY MEDICINE
(2022)
Article
Medicine, General & Internal
Ju-Ry Lee, Youn-Kyung Jung, Sang-Bum Hong, Jin Won Huh
Summary: This study aimed to evaluate the predictors for repeat medical emergency team (MET) activation in deteriorating patients admitted to a general ward. The study found that hematological malignancies and chronic lung disease were high-risk factors for repeat MET activation. Respiratory distress and low oxygen saturation-to-fraction of inspired oxygen ratio, high-flow nasal cannula oxygenation, airway suctioning, noninvasive mechanical ventilation, and vasopressor support at first MET activation were also associated with an increased risk of repeat MET activation.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Cardiac & Cardiovascular Systems
Qiuxia Zhang, Khuan Lee, Zawiah Mansor, Iskasymar Ismail, Yi Guo, Qiao Xiao, Poh Ying Lim
Summary: This study conducted a systematic review to understand the effect of rapid response teams (RRT) on patient outcomes. The results showed that, despite variation in context and intervention type, most studies demonstrated that RRT positively impacts patient outcomes.
Article
Critical Care Medicine
Marcio Manozzo Boniatti, Melina Silva de Loreto, Geris Mazzutti, Igor Gorski Benedetto, Josiane Franca John, Lia Andrade Zorzi, Marcius Conceicao Prestes, Marina Vercoza Viana, Moreno Calcagnotto dos Santos, Thais Crivellaro Dutra Buttelli, Wagner Nedel, Diego Silva Leite Nunes, Guilherme Brauner Barcellos, Jeruza Lavanholi Neyeloff, Jose Miguel Dora, Thiago Costa Lisboa
Summary: This retrospective cohort study aimed to evaluate the frequency of rapid response team (RRT) calls by time of day and their association with in-hospital mortality. The study found that nighttime RRT calls were not associated with worse outcomes than daytime calls, but a decrease in the number of calls and higher mortality was observed during nursing handover periods.
JOURNAL OF CRITICAL CARE
(2023)
Article
Medicine, General & Internal
Meor Azraai, Jeanette H. Pham, Wenye F. Looi, Daniel Wirth, Ashley S. L. Ng, Umesh Babu, Bharat Saluja, Andy K. H. Lim
Summary: The study found that the most common triggers for MET calls in psychiatric wards were reduced Glasgow Coma Scale, tachycardia and hypotension, and the most frequent diagnosis was drug adverse effects or toxidrome. Patients returning from day leave require special attention, and drug adverse effects remain a challenging issue, with hypoxic older patients with cardiovascular comorbidity at higher risk of death.
Article
Critical Care Medicine
Stephanie K. Sprogis, Judy Currey, Daryl Jones, Julie Considine
Summary: The study aimed to describe the structure and processes of the pre-MET RRS tier in an acute care setting. Findings revealed that while the structures and processes were largely consistent with national guidelines, there were internal inconsistencies in preMET activation criteria and unclear recommendations for modifying criteria.
AUSTRALIAN CRITICAL CARE
(2021)
Article
Critical Care Medicine
Stephanie K. Sprogis, Judy Currey, Daryl Jones, Julie Considine
Summary: This study aimed to explore clinicians' use of the pre-MET tier. Observations identified multiple gaps between pre-MET policy and clinicians' use, highlighting the need for optimization and addressing system-based barriers to recognizing and responding to pre-MET deterioration.
AUSTRALIAN CRITICAL CARE
(2023)
Article
Medicine, General & Internal
Erin Tuttle, Xuan Wang, Ariel Modrykamien
Summary: Emergency department patient boarding is associated with increased hospital mortality and length of stay. This study examines the impact of an Intensive Care team in the ED on sepsis mortality and ICU length of stay. The results showed that the ICU team in the ED did not reduce hospital mortality, but was associated with prolonged ICU length of stay. Compliance with SEP-1 bundle was associated with reducing ICU length of stay in septic patients. Overall, implementing an ICU team in the ED did not result in a reduction of mortality or ICU length of stay.
INTERNAL AND EMERGENCY MEDICINE
(2023)
Article
Clinical Neurology
Timothy Morgenthaler, Emily A. Linginfelter, Peter C. Gay, Sandra E. Anderson, Daniel Herold, Virginia Brown, Joseph M. Nienow
Summary: As more patients rely on mechanical or electronic technologies for treatment, medical device recalls can have significant impacts on patients, causing anxiety, extra costs, and interruptions of care. Having an established and well-organized medical device recall plan in place allows for a rapid and effective response, reducing the burden on healthcare providers and alleviating patient anxiety through clear communication.
JOURNAL OF CLINICAL SLEEP MEDICINE
(2022)
Article
Anesthesiology
Yassin Eddahchouri, Roel Peelen, Mats Koeneman, Hugo R. W. Touw, Harry van Goor, Sebastian J. H. Bredie
Summary: Continuous vital sign monitoring using wearable monitors linked wirelessly to hospital systems was associated with a reduction in unplanned ICU admissions and rapid response team calls.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Article
Cardiac & Cardiovascular Systems
Johanna Helmersson-Karlqvist, Miklos Lipcsey, Johan Arnlov, Max Bell, Bo Ravn, Alain Dardashti, Anders Larsson
Summary: This observational study compared different equations for estimating glomerular filtration rate (GFR) in critical ill patients and found that cystatin C, alone or in combination with creatinine, had a higher predictive value for long-term cardiovascular mortality risk assessment compared to creatinine alone. Using cystatin C for GFR estimation in critically ill patients can improve long-term risk prediction for cardiovascular death.
Article
Clinical Neurology
Jakob Pansell, Max Bell, Peter Rudberg, Ola Friman, Charith Cooray
Summary: This study evaluated an ultrasound protocol for measuring optic nerve sheath diameter and compared two different measurement methods. The results showed excellent inter- and intra-rater reliability and low risk of inter-rater bias when using this protocol. ONSDext demonstrated higher reliability than ONSDint. Corrections for eyeball diameter and optic nerve diameter can be reliably performed.
JOURNAL OF NEUROIMAGING
(2022)
Article
Respiratory System
Pontus Hedberg, John Karlsson Valik, Suzanne van der Werff, Hideyuki Tanushi, Ana Requena Mendez, Fredrik Granath, Max Bell, Johan Martensson, Robert Dyrdak, Olof Hertting, Anna Farnert, Anders Ternhag, Pontus Naucler
Summary: This study found that SARS-CoV-2 infection is associated with more severe outcomes compared to other respiratory viruses. Despite specific patient and clinical characteristics at admission, it is difficult to discriminate between the two overall.
Article
Public, Environmental & Occupational Health
Maria-Pia Hergens, Max Bell, Per Haglund, Johan Sundstrom, Erik Lampa, Joanna Nederby-Ohd, Maria Rotzen Ostlund, Thomas Cars
Summary: This observational study based on the real-time Covid-19 monitoring framework provides insights into the risk factors associated with mortality, hospitalization, and ICU admission in Covid-19 infections. Kidney failure, diabetes, obesity, heart failure, and ischemic heart disease increase the risk of mortality and hospitalization, while atrial fibrillation and hypertension do not. The study also suggests that triage processes affect the ICU admission risk, as certain comorbid conditions are associated with lower ICU admission.
EUROPEAN JOURNAL OF EPIDEMIOLOGY
(2022)
Article
Multidisciplinary Sciences
Michael J. Blackowicz, Max Bell, Jorge Echeverri, Kai Harenski, Marcus E. Broman
Summary: The study compares the healthcare costs associated with using the TherMax blood warmer unit integrated with the PrisMax system to prevent hypothermia during CRRT. The results show that using the TherMax device lowers the risk of hypothermia, leading to lower costs, lower risk of hypothermia-related mortality, and superior cost-effectiveness.
Article
Critical Care Medicine
Jakob Pansell, Robert Hack, Peter Rudberg, Max Bell, Charith Cooray
Summary: This study evaluated the Neurological Pupil index (NPi) as a noninvasive screening tool for elevated intracranial pressure (ICP), and found that NPi within a certain range can rule out the possibility of elevated ICP while also aiding in estimating the probability of elevated ICP. The results suggest that NPi is of great significance for clinical decision-making.
NEUROCRITICAL CARE
(2022)
Article
Anesthesiology
Arman Valadkhani, Ragnar Henningsson, Johan L. Nordstrom, Anna Granstrom, Linn Hallqvist, Carl Magnus Wahlgren, Bengt Peterzen, Julia Eriksson, Max Bell, Anil Gupta
Summary: This pilot study found no significant difference in postoperative complications or incidence of new myocardial injury between patients receiving different oxygen concentrations. Larger, prospective studies are needed to confirm these findings.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2022)
Article
Critical Care Medicine
Lui G. Forni, Michael Joannidis, Antonio Artigas, Max Bell, Eric Hoste, Olivier Joannes-Boyau, Kianoush Kashani, Jay Koyner, Thomas Rimmele, Jing Shi, Marlies Ostermann, Lakhmir S. Chawla, John A. Kellum, Sapphire Investigators
Summary: This study aimed to evaluate the predictive role of biomarkers associated with renal stress and markers of glomerular function in acute kidney injury (AKI). The results showed that biomarkers of renal stress performed better than those associated with glomerular function. Combining renal stress biomarkers with serum creatinine improved the accuracy of predicting AKI.
JOURNAL OF CRITICAL CARE
(2022)
Article
Clinical Neurology
Jakob Pansell, Max Bell, Peter Rudberg, Ola Friman, Charith Cooray
Summary: There is no consensus on whether to measure ONSD internally or externally for estimating ICP. Adjustments for eye diameter and optic nerve diameter have been suggested to improve the accuracy of ONSD measurements.
JOURNAL OF NEUROIMAGING
(2023)
Article
Medicine, General & Internal
Max Bell, Maria-Pia Hergens, Stefan Fors, Per Tynelius, Antonio Ponce de Leon, Anton Lager
Summary: This study investigates the impact of COVID-19 on adults in Stockholm, Sweden. The research finds that being male, having comorbidities, higher age, and being born outside of Sweden increase the risk of hospitalization and death. Lower education and income are also associated with a higher risk of death from COVID-19. The study also highlights that high population density and a high percentage of foreign-born inhabitants increase the risk of hospitalization. Additionally, neighborhood deprivation contributes to individual risks and is linked with hospitalization and death.
Article
Public, Environmental & Occupational Health
Max Bell, Anders Ekbom, Marie Linder
Summary: A nested case-control study was conducted among atrial fibrillation patients in Stockholm to assess the impact of anticoagulation on the risk of hospitalization, ICU admission, and death in COVID-19 cases. The study found that the use of antithrombotic medications was associated with a lower risk of hospitalization and death. This highlights the importance of continued anticoagulation therapy for vulnerable patients with arrhythmias who are at risk of COVID-19 infection.
EUROPEAN JOURNAL OF EPIDEMIOLOGY
(2023)
Article
Biochemistry & Molecular Biology
Aleksandra Havelka, Anders O. Larsson, Johan Martensson, Max Bell, Michael Hultstrom, Miklos Lipcsey, Mats Eriksson
Summary: This study evaluated the health and economic implications of using calprotectin as a predictive tool for initiating antibiotic therapy in critically ill patients. The results showed that using calprotectin predictively could reduce hospital stay and mortality rate, thus having a significant cost-saving and life-saving impact on the healthcare system.
Article
Anesthesiology
A. Valadkhani, A. Gupta, M. Bell
Summary: Elevated perioperative myocardial injury is significantly associated with an increased risk of non-cardiac complications within 30 days after index surgery in patients undergoing vascular surgery. However, pre-operative high-sensitivity cardiac Troponin T or N-terminal pro-B-type natriuretic peptide did not appear to predict non-cardiac complications. Larger studies are needed to confirm these findings.
PERIOPERATIVE MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Alexander Moore, Max Bell
Summary: This study compared the performance of XGBoost and logistic regression in predicting the risk of myocardial infarction. The results showed that the XGBoost model was more accurate in identifying individuals who later suffered a myocardial infarction. Additionally, the study demonstrated how SHAPley values can be used to visualize and interpret the predictions made by XGBoost models.
CLINICAL MEDICINE INSIGHTS-CARDIOLOGY
(2022)
Article
Hematology
Daniel Hertzberg, Marten Renberg, Jesper Nyman, Max Bell, Claire Rimes Stigare
Summary: The first wave of the COVID-19 pandemic in Sweden led to a significant increase in RRT demand in ICUs, resulting in staffing and equipment shortages, changes in CRRT protocols, and increased use of IHD and PD. The impact on patient outcomes should be evaluated for future surge capacity planning.
BLOOD PURIFICATION
(2022)
