Recent Critical Care News

Upvote Story 6
Surfactant protein D (SP-D) is produced primarily in the lung and is involved in regulating pulmonary surfactants, lipid homeostasis and innate immunity. Circulating SP-D levels in blood are associated with chronic obstructive pulmonary disease (COPD), although causality remains elusive. In 4061 subjects with COPD, we identified genetic variants associated with serum SP-D levels. We then determined whether these variants affected lung tissue gene expression in... Read More | Comment
Upvote Story 7
ICU admissions are ever increasing across the United States. Following critical illness, physical functioning (PF) may be impaired for up to 5 years. We performed a systematic review of randomized controlled trials evaluating the efficacy of interventions targeting PF among ICU survivors. The objective of this study was to identify effective interventions that improve long-term PF in ICU survivors. The only effective intervention to improve... Read More | Comment
Upvote Story 9
Not many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of savvy resuscitationists. Not because we cannot deftly manage shock, or because we are anything but hardy intubators, but because the swiftest way to transform a living patient into a dying patient or... Read More | Comment
Upvote Story 14
TRAUMA is Dr. Cole’s harrowing account of his life spent in the ER and on the battlegrounds, fighting to save lives. In addition to his gripping stories of treating victims of gunshot wounds, stabbings, attempted suicides, flesh-eating bacteria, car crashes, industrial accidents, murder, and war, the book also covers the years during Cole’s residency training when he was faced with 120-hour work weeks, excessive sleep... Read More | Comment
Upvote Story 5
THOSE who anesthetize patients with ketamine (originally given the clinical investigation number CI-581) realize it is a unique pharmacological agent. Ever since its introduction into human clinical anesthesia, ketamine has had a turbulent history. One only has to witness ketamine anesthesia emergence delirium to realize this agent produces unique psychic effects. Nevertheless, the value and safety of ketamine in the anesthetic management of a specific... Read More | Comment
Upvote Story 8
Currently, TBI management is guided by clinical histories and neuroimaging techniques. While these techniques may be advanced, they are more costly than serum analysis, involve exposure to ionizing radiations, and have certain limitations when assessing brain damage severity. The ideal biomarker would stratify patients based on their severity, identifying patients with poorer prognosis and greater need for treatment before the patient’s condition worsens. Read More | Comment
Upvote Story 4
A Novel and Simultaneous Analysis of the Guyton and Rahn Diagrams. Graphical models of physiology are heuristically appealing as they facilitate qualitative conclusions at the bedside of the critically ill. Historically, the Rahn diagram has portrayed the physiology of the lungs, chest wall and respiratory system, while the Guyton diagram has illustrated cardiovascular physiology. As contemporary methods of haemodynamic monitoring, and their predecessors, are inexorably... Read More | Comment
Upvote Story 7
Graduating residents moving on and new interns, fresh out of medical school with their clean and crisp long white coats, moving in. Out with the old, in with the new! The ICU rotation for medicine residents and medical students is stressful under the best of circumstance but always an additional challenge early in July. I remember as a resident, trying to glean from my peers... Read More | Comment
Upvote Story 8
In this multicentre, randomised, double‑blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of serious adverse events. Patients with septic shock recruited from 21 intensive care units in 11 provinces of China were randomised (1:1) to receive either terlipressin (20–160 µg/h with maximum infusion rate of 4... Read More | Comment
Upvote Story 5
Emergency Department exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation period could be particularly injurious, and targeting normoxia from initiation of mechanical ventilation may improve outcome. A total of 688 patients were included. ED normoxia occurred in 350 (50.9%) patients, and 300 (43.6%) had exposure to ED... Read More | Comment
Upvote Story 7
The utility of steroids in sepsis has been debated passionately for decades. There is hope that steroids might improve mortality, but also fear that they could increase infectious complications. Practice varies widely. What does the data truly indicate? This belief is based on the first modern RCT of stress-dose steroids in sepsis by Annane et al. 2002. This study randomized 299 patients with severe vasopressor-refractory... Read More | Comment
Upvote Story 8
In a conversational, easy-to-read style, Avoiding Common Errors in the Emergency Department, 2nd Edition, discusses 365 errors commonly made in the practice of emergency medicine and gives practical, easy-to-remember tips for avoiding these pitfalls. Chapters are brief, approachable, and evidence-based, suitable for reading immediately before the start of a rotation, used for quick reference on call, or read daily over the course of one year... Read More | Comment
Upvote Story 6
In a randomized trial, the routine use of bougies on every DL intubation led to a higher rate of first-pass intubation success. And even allowing for the two-step technique (bougie insertion followed by ET tube insertion), the bougie technique required less total time to intubate the patient, on average, by reducing the time spent guiding the ET tube into the airway. Read More | Comment
Upvote Story 5
Mortality for hypotensive trauma patients undergoing emergency laparotomy have not changed in 20 years. This blog explores the literature and the future! Wait! We’re emergency physicians, why do we care about laparotomies?! Sure, at face value this would appear to have a rather surgical slant to it, but I hope by the end you share my feeling that, as emergency and critical care physicians, this... Read More | Comment