🧵 FRAILTY after surgery: Does it still matter in the ICU?
We studied 216,922 postop ICU patients across 🇦🇺 to find out.
Here’s what we learned 👇
#ICU#Frailty#PerioperativeCare#CriticalCare
ICUの酸素療法95~95%くらいがいいかも、というSRをAJRCCMに出版できました。
今井先生おめでとうございます。
Comparison of Oxygenation Targets in Critically Ill Adults: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials https://t.co/LtCDTHR8CQ
What constitutes End-of-Life practice in Australia?
"Culture, ethics and clinical practicefor intensivists managing end of life care:an Australian perspective"
🆓🔓https://t.co/lN10atw4v2
🧠 Sedation in the ICU – are volatile anaesthetics a better option?
In recent years, volatile anaesthetics (e.g., sevoflurane) have gained attention as alternatives to intravenous (IV) sedation in ICU patients.
They offer some theoretical advantages:
✅ Rapid awakening (exhaled via lungs)
✅ Possibly protective for lungs and diaphragm
But are they safe? Do they really improve outcomes?
Our team conducted a meta-analysis of 21 RCTs (n = 2,367) comparing volatile vs. IV sedation in critically ill adults receiving mechanical ventilation.
We found that volatile sedation was associated with increased mortality: RR 1.17 [95% CI 1.02–1.35]
⚠️ While volatile agents may facilitate faster extubation, current evidence does not support routine use in ICU patients.
Use should be limited to selected patients where benefits are likely to outweigh potential risks.
🔗 Open-access paper @Crit_Care:
https://t.co/yirDfWM7y8
Dexmed as primary sedatives:
- SPICE-III ➡️ No mortality benefit, ?merit in older MV patient
- 🆕A2B no difference in early extubation
Dexmed as an adjunct:
- DahLIA➡️early extubation in agitated MV pt
- DESIRE ➡️ no mortality benefit in septic pt on MV
Is renin the next big thing in ICU patient management? The concepts are intriguing, and I look forward to implementing them in my patient management one day. 🎩 tip to the authors including @YukiKotani5, @giovannilandoni, and @KhannaAshishCCM.
https://t.co/wtiQFg1wGN
🆕 Published in Intensive Care Medicine 📘
What do older adults truly value after critical illness?
A survey of 3,410 seniors in Japan found many care more about reducing burden on family, financial impact, and dignity — not just survival.
🔗 https://t.co/kfMGtc7MW9
1. Caregiver’s burden
2. Financial impact
3. Toileting function
4. Independent daily activity
5. Normal swallowing
🧑🔬A survey of healthy volunteers (>75yo) from Japan
💡Identified top 5 pt-centred outcomes post ICU discharge
🆕 letter at @yourICM
https://t.co/EjwihyEjlb
🧓🏽🛌 Frailty matters—even after surgery.
In this multicentre ICU cohort 🇦🇺(n=216k), frailty (CFS 5–8) was associated with significantly shorter 4-year survival 🕰️💔
🚨 New in BJA:
🔗 https://t.co/IGJ7uXL2YO
@BJAJournals
🧵 FRAILTY after surgery: Does it still matter in the ICU?
We studied 216,922 postop ICU patients across 🇦🇺 to find out.
Here’s what we learned 👇
#ICU#Frailty#PerioperativeCare#CriticalCare