Diaphragm-protective Mechanical Ventilation
Diaphragm dysfunction is common in mechanically ventilated patients and predisposes them to prolonged ventilator dependence and poor clinical outcomes. Mechanical ventilation is a major cause of diaphragm dysfunction in these... read more
Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine
Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of... read more
Translational Simulation: Not “Where?” But “Why?” A Functional View of In SITU Simulation
Healthcare simulation has been widely adopted for health professional education at all stages of training and practice and across cognitive, procedural, communication and teamwork domains. Recent enthusiasm for in situ simulation—delivered... read more
Impact of Mean Arterial Pressure Fluctuation on Mortality in Critically Ill Patients
The purpose of this study was to investigate the association between mean arterial pressure fluctuations and mortality in critically ill patients admitted to the ICU. The reduced mean arterial pressure fluctuation (within... read more
Environment key battle ground in fight to tackle antibiotic resistance
The environment could be as important a battle ground as the clinic in the global fight against the spread of antibiotic resistance, new research has shown. A study conducted at the University of Exeter Medical School concluded... read more
Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients
A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more
Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation
Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role... read more
Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage
Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little... read more
Fluid Responsiveness in Sepsis
Fluid challenge is a common practice in the ICU. It is one of the most important resuscitation manoeuvres of acute circulatory failure management in critically ill patients. Adequate fluid resuscitation is very important... read more
Top 10 Perioperative Applications of Point-of-Care Ultrasound for Anesthesiologists
Anesthesiologists have been leaders in the use of point-of-care (POC) ultrasound for intraoperative transesophageal echocardiography (TEE), and to guide vascular access and regional anesthesia procedures. Recently, anesthesiologists... read more
Excited Delirium: Acute Management in the ED Setting
Excited delirium syndrome is a common yet poorly characterized ED presentation with a wide differential diagnosis. Patients are often identified initially by law enforcement, but attempts to control individuals experiencing... read more
Risk Factors at Index Hospitalization Associated With Longer-term Mortality in Adult Sepsis Survivors
In this cohort study of 94 748 adult sepsis survivors, age, male sex, 1 or more severe comorbidities, prehospitalization dependency, nonsurgical status, acute severity of illness, site of infection, and organ dysfunction... read more
Neuromuscular Blockade for ARDS Was No Help, In Supine Patients
Continuous neuromuscular blockade for severe ARDS became common practice after the ACURASYS trial showed it reduced mortality by an absolute 9%. A larger trial, ROSE, now finds no benefit of the therapy over usual care, but... read more
Unsafe Nursing Ratios Incapacitate EDs, Endanger Patients
It's the evening surge at a busy ED where all beds are occupied. Several admitted patients – including 2 critically ill – are waiting for rooms upstairs. A quick glance reveals a full waiting room with multiple potentially... read more