No Reason to Choose Tramadol over Morphine
Tramadol is an opioid, but it does not bind directly to opioid receptors (or it binds so weakly that it might as well not bind at all). Its opioid action is the result of the metabolite O-desmethyltramadol, which means... read more
Impact of Rewarming Rate on the Mortality of Patients with Accidental Hypothermia
In this study, we found that overall, in-hospital mortality rates increase with each 0.5 °C/h decrease in rewarming rate (RR). However, judging from the results of subgroup analyses, the safest RR might differ according... read more
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
5-year Study Shows Predominance of Non-Device-Associated Pneumonia
Among more than 160,000 patients admitted to University of North Carolina hospitals during a recent 5-year period, non-device-associated, or ND, pneumonia was implicated in three of every four nosocomial pneumonia cases,... read more
Critical Pediatric Heart Deaths Drop by 24% at Hospitals With Cardiac ICUs
Major complications fall by 12%, time on a ventilator declines by 13% among children in the cardiac ICU at PC4 hospitals As a pediatric cardiology fellow nearly a decade ago, Michael Gaies remembers asking hospital colleagues... read more
Potential Mechanisms Underlying Centralized Pain and Emerging Therapeutic Interventions
Centralized pain syndromes are associated with changes within the central nervous system that amplify peripheral input and/or generate the perception of pain in the absence of a noxious stimulus. Examples of idiopathic... read more
Incidence of Bloodstream Infections, Length of Hospital Stay, and Survival in Patients With Recurrent CDI Treated With Fecal Microbiota Transplantation or Antibiotics
In a propensity score–matched cohort, patients with recurrent Clostridioides difficile Infection (CDI) treated with fecal microbiota transplantation (FMT) were less likely to develop primary bloodstream infection (BSI). Of... read more
Dottoressa: An American Doctor in Rome
After completing her medical training in New York, Susan Levenstein set off for a one year adventure in Rome. Forty years later, she is still practicing medicine in the Eternal City. In Dottoressa: An American Doctor... read more
In-line Filtration of Intravenous Infusion May Reduce Organ Dysfunction of Adult Critical Patients
In-line filtration with finer 0.2 and 1.2 μm filters may be associated with less organ dysfunction and less inflammation in critically ill adult patients. Comparing fine filter vs control filter cohort, respiratory... read more
That Good Night: Life and Medicine in the Eleventh Hour
As the American born daughter of immigrants, Dr. Sunita Puri knew from a young age that the gulf between her parents' experiences and her own was impossible to bridge, save for two elements: medicine and spirituality. Between... read more
Outcomes of VV ECMO When Stratified by Age
The purpose of this study was to evaluate survival to hospital discharge for patients on venovenous extracorporeal membrane oxygenation (VV ECMO) when stratified by age. We performed a retrospective study at single, academic,... read more
Post-extubation Dysphagia
Despite having the tools and techniques for tracheal intubation for > 4000 years, and performing oral intubation with positive pressure mechanical ventilation for > 50 years, only recently has attention focused on... read more
Intensive Care Unit Telemedicine, An Issue of Critical Care Clinics
This issue of Critical Care Clinics, edited by Dr. Kianoush Kashani in collaboration with Consulting Editor Dr. John Kellum, is focused on Intensive Care Unit Telemedicine. Topics in this issue include: ICU telemedicine... read more
FDA Approves New Pill to Treat Sickle Cell Disease
The Food and Drug Administration on Monday approved a once-daily pill for sickle cell disease that works in an entirely new way — by boosting hemoglobin, the oxygen-carrying molecule found in red blood cells. The novel... read more
When Brains Collide: What Every Athlete and Parent Should Know About the Prevention and Treatment of Concussions and Head Injuries
There is nearly a 20% chance that you or someone close to you will suffer a concussion this year. Whether they are in a car accident, fall off their bike, or suffer a helmet-to-helmet hit at football practice, over 30%... read more
Adaptive Mechanical Ventilation with Automated Minimization of Mechanical Power
Adaptive mechanical ventilation with automated minimization of inspiratory power may lead to more lung-protective ventilator settings when compared with adaptive mechanical ventilation according to Otis' equation. Comparing... read more
Why Understanding Sepsis Endotypes Is Important for Steroid Trials in Septic Shock
Although corticosteroids clearly have beneficial effects on shock duration their impact on patient survival is less clear. The differences in mortality effects seen in past clinical trials could be explained by different... read more
An Ethical Claim for Providing Medical Recommendations in PICU
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one... read more
Family Care Rituals in the ICU to Reduce Symptoms of PTSD in Family Members
Offering opportunities such as family care rituals for family members to be involved with providing care for family members in the ICU was associated with reduced symptoms of post-traumatic stress disorder (PTSD). This... read more
Corticosteroids as Adjunctive Therapy in the Treatment of Influenza
Corticosteroid treatment in influenza is associated with increased mortality and hospital-acquired infection, but the evidence relates mainly to high corticosteroid doses and is of low quality with potential confounding by... read more
Pulmonary Artery Catheters for Adult Patients in ICU
Pulmonary Artery Catheters (PAC) is a diagnostic and haemodynamic monitoring tool but not a therapeutic intervention. Our review concluded that use of a PAC did not alter the mortality, general ICU or hospital LOS, or cost... read more
Practical Trends in Anesthesia and Intensive Care 2018
This book offers an essential guide to managing the most-debated hot topics of practical interest in anesthesia and intensive care. It reviews the state of the art in issues concerning both intensive care medicine and anesthesia,... read more
