Should fecal microbial transplantation be used in the ICU?
FMT has become an attractive option to mitigate multiple organ dysfunction in the ICU. This article discusses the physiology, rationale, early experience, and expectations for such therapy in the critically ill patient. The... read more
Is Hemoglobin Good for Cerebral Oxygenation and Clinical Outcome in Acute Brain Injury?
Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Ventilation
This complex randomized, controlled trial failed to demonstrate that early extubation to non-invasive ventilation reduced the total time of mechanical ventilation. I will continue to extubate early and will use non-invasive... read more
Septic Shock and the Use of Norepinephrine IMCU
Elderly patients with septic shock treated with norepinephrine (NE) displayed a better Intermediate Care Unit (IMCU) survival at the ward and at 30 days than previously expected. Our retrospective chart study did not... read more
Long-term Cognitive Impairment and Delirium in ICU
ICU delirium was positively associated with impaired information processing speed and executive functioning at six-months post-discharge for this cohort. Testing for cognitive impairment with RBANS and TMT should be considered... read more
The Effect of Early Mobilization in Critically Ill Patients
This study indicated that early mobilization was effective in preventing the occurrence of ICU-AW, shortening the length of ICU and hospital stay, and improving the functional mobility. However, it had no effect on the ICU... read more
Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm
Among patients with coma who had been resuscitated from cardiac arrest with nonshockable rhythm, moderate therapeutic hypothermia at 33°C for 24 hours led to a higher percentage of patients who survived with a favorable... read more
Vitamin C for Sepsis
Dr. Alpha A. Fowler of Virginia Commonwealth University presented findings from the CITRIS-ALI trial that studied the role of vitamin C in patients with septic ARDS. The findings were presented @ESICM in Berlin and have just... read more
Quality Metrics For The Evaluation of RRS
A consensus process was used to develop ten metrics for better understanding the course and care of deteriorating ward patients. Others are proposed for further development. Consensus emerged that core outcomes for... read more
Recombinant Thrombomodulin on Neutrophil Extracellular Traps in Murine Intestinal Ischemia-Reperfusion
Recombinant thrombomodulin improved the survival of male mice with intestinal ischemia–reperfusion injury. These findings suggest that histone and neutrophil extracellular trap accumulation exacerbate remote liver injury... read more
XueBiJing Injection vs. Placebo for Critically Ill Patients with Severe Community-Acquired Pneumonia
In critically ill patients with severe community-acquired pneumonia, XueBiJing injection led to a statistically significant improvement in the primary endpoint of the pneumonia severity index as well a significant improvement... read more
Optimizing Therapy of Bloodstream Infection Due to Extended-spectrum β-lactamase-producing Enterobacteriaceae
Carbapenems should be used in patients with serious infections; alternatives could be used individually, particularly for definitive treatment of patients with milder presentations. Meropenem and imipenem are the drugs... read more
ED Management of Smoke Inhalation Injury in Adults
When treating patients who have suffered injury in a fire, managing their airway is as critical as treating their burns. Following on the February 2018 issue on Thermal Burns, this issue reviews strategies for diagnosing... read more
Early Prognostication of Neurological Outcome by HRV in Adults with Out-of-Hospital Sudden Cardiac Arrest
The present data indicate that heart rate variability (HRV) analysis could be useful for early prognostication for comatose patients during hypothermic TTM within 24 h after ROSC. The value of HRV as a prognosticator... read more
Neuropharmacotherapy in Critical Illness
The field of research related to neurocritical care has grown significantly in recent years, and the clinical demands for current and dependable expertise has followed suit. It can be a challenge for the neurocritical practitioner... read more
Development and Assessment of Objective Surveillance Definitions for Nonventilator Hospital-Acquired Pneumonia
These findings suggest that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted ORs for hospital... read more
Why We Sleep: Unlocking the Power of Sleep and Dreams
A New York Times bestseller and international sensation, this stimulating and important book is a fascinating dive into the purpose and power of slumber. Walker is a Professor of Neuroscience and Psychology and the director... read more
ICU Admission Source as a Predictor of Mortality for Patients With Sepsis
Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients... read more
Acute Liver Failure: Evidence-Based Evaluation and Management
Although acute liver failure (ALF) is a rare clinical presentation in the ED, it carries a high mortality, morbidity, and resource cost. Across the developing world, the underlying etiology is primarily viral, with hepatitis... read more
Corticosteroids for Children with Septic Arthritis
Researchers conducted a review of the effects of corticosteroids given in addition to antibiotics to children with septic arthritis. Evidence was sought until April 2018. After searching for all relevant studies, reviewers... read more
Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination
Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU... read more
Impact of timing of continuous intravenous anesthetic drug treatment on outcome in refractory status epilepticus
Patients with refractory status epilepticus (RSE) treated with continuous intravenous anesthetic drugs (cIVADs) may benefit from early initiation of such therapy. When cIVADs are applied in RSE, prescribing them early... read more
