Prehospital On-scene Anesthetist Treating Severe TBI Patients is Associated with Lower Mortality and Better Neurological Outcome
Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury. Only a few studies have focused on the impact of advanced interventions in TBI... read more
Impact of Paralytic Agent on Postintubation Sedation
The aim of this study was to evaluate the difference in the time to postintubation sedation between patients receiving etomidate and either succinylcholine or rocuronium in the prehospital setting. This study suggests... read more
Vitamin Treatment For Sepsis Fails In Large Trial
Hope for an effective and inexpensive treatment for the deadly condition sepsis has dimmed following results of a major new study. Researchers had hoped that a simple treatment involving infusions of vitamin C, vitamin... read more
Finding a New Way to Fight Late-stage Sepsis by Boosting Cells’ Antibacterial Properties
Researchers have developed a way to prop up a struggling immune system to enable its fight against sepsis, a deadly condition resulting from the body's extreme reaction to infection. The scientists used nanotechnology... read more
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor... read more
Effect of Stress Ulcer Prophylaxis on In-Hospital Mortality Among ICU Patients Receiving Invasive Mechanical Ventilation
Among ICU patients requiring mechanical ventilation, a strategy of stress ulcer prophylaxis with use of proton pump inhibitors vs histamine-2 receptor blockers resulted in hospital mortality rates of 18.3% vs 17.5%, respectively,... read more
Sepsis Kills Twice as Many People as Experts Feared
Sepsis, which is triggered by an infection, is the cause of 1 in 5 deaths worldwide. It is thought to have killed 47,860 in 2017 - ranking us 45th worst out of 195 countries. Researchers estimate the condition claimed... read more
Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists
No significant impact of transitions of care observed between individual staff physicians on evidence-based processes of care for mechanically ventilated adult patients. However, transitions were associated with a lower likelihood... read more
Renal Function-Adjusted D-Dimer Levels in Critically Ill Patients With Suspected Thromboembolism
D-Dimer cutoff levels adjusted for renal dysfunction appear feasible and safe assessing thromboembolic disease in critically ill patients. Furthermore, adjusted D-dimer cutoff levels seem reliable in patients with acute kidney... read more
Study Suggests Benefits of Vitamin C for Severe Sepsis
More than 1.7 million Americans develop sepsis every year and incidence of the condition is on the rise. In severe cases, widespread inflammation leads to multiorgan failure and death. Results of a new study hold... read more
Is Intensive Care Becoming an Out-of-hours Acute Palliative Care Service?
First I will define what I conceive medicine to be. In general terms, it is to do away with the sufferings of the sick, to lessen the violence of their diseases, and to refuse to treat those who are overmastered by their... read more
Could the Furosemide Stress Test Clarify Resuscitative Goals?
Imagine that you admit a patient with septic shock. You resuscitate the patient as best you can with inopressors, fluids, and antibiotics. An adequate blood pressure is achieved. A reasonable amount of fluid is administered.... read more
Ventilator Management: Advanced Concepts In Critical Care
Mechanical ventilation is a broad subject that encompasses many factors that must be considered while providing overall resuscitation. It is not as easy as just entering in a rate and tidal volume and pushing start. Critical... read more
If we don’t start looking after our doctors there will be no one to care for our patients
"Would you choose medicine again?" I look into the eager faces of the sixth-formers I've been asked to speak to. Not for the first time, I hesitate before I answer. I love my job – it's a great privilege to be a Registrar... read more
Admissions Trends, Resource Use, and Risk-adjusted Hospital Mortality for Elderly Patients Admitted to ICUs
Over the past two decades, elderly patients have been more commonly admitted to ICU than can be explained solely by the demographic shift. Importantly, as with the wider population, outcomes in elderly patients admitted to... read more
Prognostication with Point-of-Care Echocardiography During Cardiac Arrest (ALS)
This topic was prioritized by the ALS Task Force based on the high prevalence of point-of-care echocardiography during cardiac arrest without recognizing the potential pitfalls for misinterpretation as an adjunct prognostic... read more
Early Psychological Screening of ICU Survivors
Symptoms of post-traumatic stress, anxiety and depression assessed 1 week after ICU stay correlate with 3-month psychological outcome. The HADS and PTSS-10 may be useful aids to identify ICU survivors at high risk for... read more
Lower Glucose Targets Show Improved Mortality in Cardiac Patients
Tighter glucose control while minimizing the risk of severe hypoglycemia is associated with lower mortality among critically ill cardiac patents, new research suggests. Researchers reported in CHEST on the outcomes of... read more
Serum Lactate Level and Mortality in Metformin-associated Lactic Acidosis Requiring RRT
This study suggests that predialysis level of serum lactate level is an important marker of mortality in MALA patients requiring renal replacement therapy (RRT) with a linear dose-response relationship. To better evaluate... read more
Critical Care Opioids Impact in the 21st Century
Critical Care is impacted by opioids in multiple ways. Not only do they form the backbone of managing pain and sedation in the intensive care unit (ICU), the burgeoning opioid epidemic also feeds into opioid-related ICU admissions.... read more
Delay in Antibiotic Administration Is Associated With Mortality Among Septic Shock Patients With Staphylococcus Aureus Bacteremia
The results of this study further support the importance of prompt appropriate antibiotic administration for patients with septic shock. Physicians should consider acting quickly to administer antibiotics with S. aureus... read more
Microcirculation Evolution in Patients on VA-ECMO for Refractory Cardiogenic Shock
Microcirculation is severely impaired in patients with refractory cardiogenic shock requiring venoarterial extracorporeal membrane oxygenation (VA-ECMO). Inability to rapidly restore microcirculation during the first... read more
