Recent Critical Care News

Upvote Story 7
Although administration of clonidine is often associated with bradycardia and hypotension, these complications do not seem clinically significant in a mixed PICU population with a high degree of disease severity. Clonidine may have a vasoactive-inotropic sparing effect. The primary endpoints were the prevalences of bradycardia and hypotension. Secondary endpoints were changes in heart rate, blood pressure, Vasoactive-Inotropic Score, COMFORT Behavior score (a sedation scoring scale),... Read More | Comment
Upvote Story 7
The Annual Update compiles reviews of the most recent developments in experimental and clinical intensive care and emergency medicine research and practice in one comprehensive reference book. The chapters are written by well recognized experts in these fields. The book is addressed to everyone involved in internal medicine, anesthesia, surgery, pediatrics, intensive care and emergency medicine. Prof. Vincent is Professor of intensive care at the... Read More | Comment
Upvote Story 4
Seventy-six physicians responded to the study cases (228 clinical cases resolved). Among the respondents, 28 (37%) were female, 64 (84%) were EPs, and the mean age was 37±8 years. The mean NUDs, respectively, when physicians had OCD, OLD, and both were 2.9±1.8, 2.2±1.7, 2.2±1.8 (p = 0.02). Ultrasound data and ultrasound frequency of use were the only variables related to the NUD. Higher frequency of ultrasound use by... Read More | Comment
Upvote Story 5
Physician shortages and mounting student-loan debt are encouraging the growth of three-year medical school programs. The effort to build three-year medical school programs is one element in the movement to modernize medical education, offering a challenge to the four-year model that has been entrenched for a century. Developing flexible, competency-based pathways—tailoring the time required in medical school to the ability and clinical background of the... Read More | Comment
Upvote Story 6
The implementation of ultrasound protocols during catheter placement has demonstrated multiple advantages that increase accuracy and allow medical teams to reduce operative time, potential complications, and procedure costs. The wide use of lung and cardiac ultrasound in perioperative medicine enables earlier diagnosis of some acute complications, allowing prompt intervention and control of damage. The application of this algorithm optimizes the use of bedside ultrasound as... Read More | Comment
Upvote Story 4
Over the years, IV magnesium has been studied for the treatment of rapid AF in several clinical situations, most prominently in post-cardiac surgery patients. However, there are also studies in ED and cardiology patients, both as a primary therapy and as an adjunct. In fact, two meta-analyses from 2007 evaluated the data (mostly the same studies). Both concluded that magnesium is safe and effective in... Read More | Comment
Upvote Story 9
Thiamine administration within 24 hours of admission in patients presenting with septic shock was associated with improved lactate clearance and a reduction in 28-day mortality compared with matched controls. Patients who received IV thiamine supplementation within 24 hours of hospital admission were identified and compared with a matched cohort of patients not receiving thiamine. The primary objective was to determine if thiamine administration was associated... Read More | Comment
Upvote Story 11
The results of this study will inform ICU nurses about the effects, strengths and limitations of prompting relatives to author a diary for the patient. This will allow the diary intervention to be tailored to the individual needs of patients and relatives. The intervention consists of a hard-cover notebook that will be given to a close relative to write a diary for the critically ill... Read More | Comment
Upvote Story 4
The Michel–Weinbaum steady-state Starling principle has important consequences for clinical practice. The hope that biophysical intravascular colloid therapy with albumin or plasma substitutes can deliver plasma volume support without causing oedema is in vain. The rational approach is to use isotonic salt solutions to support the ECF volume, while care is taken to avoid harmful capillary hypertension. In current practice, a judicious infusion of norepinephrine... Read More | Comment
Upvote Story 10
Objective data and expert guidance on managing critically ill patients in unique question-based chapters that focus on best practices. Now thoroughly updated by Drs. Clifford S. Deutschman, Patrick J. Neligan, and nearly 200 critical-care experts, this highly regarded title remains the only book of its kind that provides a comprehensive framework for translating evidence into practice, making it a valuable resource for both residents and... Read More | Comment
Upvote Story 15
The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%) were female; median age, 56 years (interquartile range, 41-67 years); 922 (14%) were discharged directly home, with significant variation found between hospitals (range, 4.4%-44.0%). The primary outcome was readmission... Read More | Comment
Upvote Story 5
The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups. I first started using it as a pediatric intensive care fellow, but had little knowledge of how it actually worked. I noticed a few years after using it successfully in children, mainly with severe bronchiolitis, that we... Read More | Comment
Upvote Story 4
Coronary epicardial and microvascular vasomotor dysfunction is not a predominant feature of spontaneous coronary artery dissection. Endothelial dysfunction is not implicated as the principal underlying mechanism. A total of 10 patients with prior angiographically confirmed spontaneous coronary artery dissection were referred for coronary endothelial function testing. The median coronary flow reserve was 2.8 (interquartile range (IQR) 2.3, 3.6). This was a single center, retrospective study... Read More | Comment
Upvote Story 7
Despite having a powerful effect on restoring spontaneous circulation after out-of-hospital cardiac arrest, epinephrine produced only a small absolute increase in survival with no increase in favorable functional recovery as compared with placebo. We now must ponder whether additional treatments after a return of spontaneous circulation could improve functional recovery, whether drug use should differ on the basis of cardiac rhythm, and whether lower doses... Read More | Comment
Upvote Story 25
Gently dismantling the myth of medical infallibility, Dr. Atul Gawande’s Complications: A Surgeon’s Notes on an Imperfect Science is essential reading for anyone involved in medicine – on either end of the stethoscope. Medical professionals make mistakes, learn on the job, and improvise much of their technique and self-confidence. Gawande’s tales are humane and passionate reminders that doctors are people, too. Read More | Comment