Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock
Temporary circulatory support (TCS) have become the cornerstone of the management of patients with cardiogenic shock, although the evidence supporting their efficacy is limited. VA-ECMO is considered the first-line option,... read more
Snapshots of Hemodynamics
This new edition reviews recent developments in genetics and molecular biology and new noninvasive measurement techniques that have enabled vast improvements in the measurement and understanding of cardiovascular hemodynamics.... read more
High-Flow Nasal Cannula vs. Noninvasive Ventilation
High-flow conditioned oxygen therapy delivered through nasal cannulae and noninvasive mechanical ventilation (NIV) may reduce the need for reintubation. Therefore, Hernández et al set out to test if high-flow conditioned... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure
Among patients requiring mechanical ventilation in whom a spontaneous breathing trial had failed, early extubation to noninvasive ventilation did not shorten time to liberation from any ventilation. Among 364 randomized... read more
Epidemiology and Costs of Sepsis in the United States
The highest burden of incidence and total costs occurred in the lowest severity sepsis cohort population. Sepsis cases not diagnosed until after admission, and those with increasing severity had a higher economic burden and... read more
Dispatcher-assisted Cardiopulmonary Resuscitation for Traumatic Patients with OHCA
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) was not associated with better outcomes for traumatic out-of-hospital cardiac arrests (OHCA) in achieving a short-term sustained return of spontaneous circulation... read more
Fluid Resuscitation: Evidence-based Solutions?
Intravenous (IV) fluid prescribing is one of the commonest tasks carried out by junior doctors. I still remember around this time last year when I was fresh out of medical school and had just been let loose on the wards,... read more
Biomarkers and Clinical Scores to Identify Patient Populations at Risk of Delayed Antibiotic Administration or Intensive Care Admission
Patients with low severity signs of infection but high MR-proADM concentrations had an increased likelihood of subsequent disease progression, delayed antibiotic administration or ICU admission. Appropriate triage decisions... read more
ECMO in Out-of-Hospital Cardiac Arrest
In a population-based registry, 4% of out-of-hospital cardiac arrests (OHCA) were treated with extracorporeal-CPR, which was not associated with increased hospital survival. Early extracorporeal membrane oxygenation (ECMO)... read more
Population Enrichment for Critical Care Trials
Enrichment reduces heterogeneity and will enhance the sensitivity of future trials. However, enrichment, even when it identifies more homogenous populations, may not be efficient to deploy in trials or clinical practice. Many... read more
SSEP Retains its Value as Predictor of Poor Outcome Following Cardiac Arrest in the Era of Therapeutic Hypothermia
The absence of the somatosensory evoked potential (SSEP) N20 cortical wave remains one of the most reliable early prognostic tools for identifying unfavorable neurologic outcome in the evaluation of patients with severe anoxic-ischemic... read more
Urgent Intubation without Neuromuscular Blocking Agents and the Risk of Tracheostomy
Neuromuscular blocking agents play a significant role in improving the success rate for urgent intubation, although there is limited evidence about the effect on subsequent outcomes, such as the incidence of tracheostomy.... read more
Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure
The purpose of this trial is to investigate the efficacy and safety of continuous intravenous administration of low dose iloprost versus placebo for 72-hours, in up to a total of 380 patients with septic shock suffering from... read more
Hyperoxia in the Critically Ill
Critically ill patients come to the ED all the time and it is almost reflexive to liberally administer oxygen in these acutely ill patients. Many providers may consider supplemental oxygen a harmless and potentially beneficial... read more
When Patients Die in the ICU, Should Their Family Be Allowed to Watch?
In most ICUs, it's standard practice to send relatives out of the room when a patient codes, but a growing body of research—and one doctor's personal experience—suggests relatives should be allowed to witness the medical... read more
Critical: Science and Stories From the Brink of Human Life
Following in the wake of hugely successful medical memoirs such as Do No Harm and Fragile Lives, Critical is an intelligent, compelling and profoundly insightful journey into the world of intensive care medicine and the lives... read more
Effects of Neuromuscular Block Reversal with Sugammadex vs. Neostigmine on Postoperative Respiratory Outcomes After Major Abdominal Surgery
No differences found in pulmonary function in patients reversed with sugammadex or neostigmine in a high-risk population. 126 patients were included in the main analysis. In the neostigmine group (n = 64), mean (95%... read more
How To Prevent Brain-Sapping Delirium In The ICU
After an overwhelming infection sent O'Burke into five-organ failure, he also developed ICU delirium, perhaps related to heavy sedation. An ICU protocol developed at Vanderbilt University Medical Center found that getting... read more
Use of Levosimendan in ICU Settings
Levosimendan has been demonstrated to have potential utility in a range of critical illness scenarios. It must be acknowledged, however, that in each sphere of application, the evidence is incomplete or indicative rather... read more
How Should We Treat Acinetobacter Pneumonia?
The optimal treatment for multidrug-resistant A. baumannii pneumonia has not been established. New therapeutic options are urgently needed. Well designed, randomized controlled trials must been conducted to comprehensively... read more
Early vs. Delayed Administration of Norepinephrine in Patients with Septic Shock
This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. Our results show that early administration of norepinephrine in... read more
Transport of a Prone Position ARDS Patient
Critical care transport of prone acute respiratory distress syndrome (ARDS) patients is a feasible and cost-effective intervention that will help prevent treatment delays and interruptions. A nonphysician critical care... read more
