Three months after a long ICU stay, most survivors could drive safely, but fewer than half had started

The edition in brief

In a UK cohort of 33 adults who had at least 72 hours of mechanical ventilation or ECMO, a licensing-approved driving assessment about 12 weeks after discharge judged 79% fit to drive a standard vehicle, yet only 45% had resumed. Of the seven judged unfit, mostly for physical reasons, four were driving again within a year after adaptations or retraining, and 97% rated the assessment very good or excellent. A historical review in Intensive Care Medicine argues that landmark critical care trials have taught as much about what to reduce or avoid as about what to add. In a secondary analysis of 147,498 emergency patients in the DETECT Hep C trial, those preferring a language other than English were offered hepatitis C testing less often under targeted screening, but not under universal screening. A Spanish trial of 110 sedated ventilated adults found a 60-minute headphone music session lowered serum cortisol by about 1.6 μg/dL. A network meta-analysis of 21 trials found no nursing add-on clearly beat usual care for ICU delirium. The pearl covers the basics of delirium prevention.