Registration is now open for The Impact of Pet and Music Therapy on the Critically Ill, the latest webcast from the Society of Critical Care Medicine’s (SCCM) Project Dispatch series. Music and animals have a distinct ability to improve a patient’s mood and outlook. Anxiety among patients in the intensive care unit (ICU) is often understandably heightened. Patients are confronted with unfamiliar surroundings and intrusive procedures, including being on mechanical ventilation. Music and pet therapy are two integrative approaches that may alleviate such anxiety and reduce sedation frequency and intensity. In this webcast, expert faculty will share their unique experiences with integrative therapies for patients and families in the ICU.
Linda Chlan, PhD, RN, FAAN, will review the results of her randomized clinical trial published in the Journal of the American Medical Association: “Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support.” She will highlight how music can be used to reduce the common patient symptom of anxiety and the subsequent reduction of sedative exposure in mechanically ventilated patients. Erika Gonzalez, MSN, RN, CCRN, will discuss her critical care unit’s implementation of music and pet therapy.
Understand the key obstacles and challenges to establishing such programs
Apply similar strategies in your institution
Evaluate your program’s success
This webcast will take place on Wednesday, June 25, 2014, at 12:00 p.m. Central Time.
This webcast was organized by the Society of Critical Care Medicine’s Project Dispatch. Project Dispatch aims to improve the quality, efficacy, accessibility, and cost-effectiveness of healthcare in the United States by developing and distributing resources for critical care clinicians focused on patient-centered research. This project is supported by grant number R18HS21940 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality.
The detrimental effects of hyperglycemia in critically ill patients has been well described in the literature. However, the benfefits of maintaining normoglycemia using insulin infusions has been controversial. In 2009, The New England Journal of Medicine published a study by the NICE-SUGAR Study Investigators that appeared to answer the question about risks and benefits of intensive insulin therapy. Studying more than 6,000 subjects, the authors showed an increase in mortality in critically ill adults who underwent intensive glucose control, compared to those who underwent conventional control of their blood sugars. Interestingly, in the same year, a pediatric study was published in Lancet by Vlasselaers et al that demonstrated a decrease in mortality and length of pediatric intensive care unit (PICU) stay in those patients who had intensive glucose control, compared to the conventional therapy. Though it should be noted that while this study randomized 700 children, it was a single-center trial whose subjects were primarily children who had undergone cardiac surgery (around 75%).
In this study by Macrae et al, the authors randomized more than 1,300 critically ill children from 13 centers to undergo either tight glucose control (maintaining blood glucose levels between 72-126 mg/dl) or conventional therapy (infusing insulin only in patients whose blood glucose levels were over 216 mg/dl until they dropped to 180 mg/dl). The authors recruited children between the ages of 36 weeks of corrected gestational age and 16 years of age. Like the the Vlasselaers study, a predominance of subjects underwent cardiac surgery compared to other reasons for PICU admission (around 60% and 40%, respectivley). The aims of this study were to assess whether tight glycemic control could reduce morbidity and mortality rates and associated costs for critically ill children compared to conventional therapy.
The presence of acute kidney injury (AKI) and fluid overload can adversely affect outcomes in children with critical illness. Continuous renal replacement therapy (CRRT) is one therapeutic modality that can improve outcomes in these patients. However, the trigger when to initiate this therapy is not known. There are studies suggesting that degree of fluid overload may be such a trigger but this does not seem to provide the entire answer. In adults, some studies have suggested that early initiation of CRRT in critically ill patients can improve outcomes compared to late initiation, although there is a paucity of evidence in children. The authors of this study sought to assess the effect timing of CRRT has on mortality in critically ill children.
Severe sepsis and septic shock are major healthcare problems, affecting millions of people around the world each year, killing one in four (and often more), and increasing in incidence. Similar to polytrauma, acute myocardial infarction, or stroke, the speed and appropriateness of therapy administered in the initial hours after severe sepsis develops are likely to influence outcome.
During the Society of Critical Care Medicine’s (SCCM) webcast, What’s New in the Third Edition of the SSC Guidelines?, R. Phillip Dellinger, MD, MCCM, and Christa A. Schorr, RN, MSN, FCCM, will discuss the additions to the latest update of the Surviving Sepsis Campaign guidelines and the rationale for the changes. The webcast will be held Wednesday, May 29, from 1:00 p.m. to 2:00 p.m. Central Time.
Register online today. Registration is complimentary for all participants. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888. This event is part of SCCM’s newest webcast series, which outlines strategies for successful implementation of the SSC recommendations. Previous webcasts, now available free of charge, are available for download at www.survivingsepsis.org.
Programs are supported by the Gordon and Betty Moore Foundation: