Short-term vs. Conventional Glucocorticoid Therapy in Acute Exacerbations of COPD

In patients presenting to the emergency department with acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD), 5-day treatment with systemic glucocorticoids was noninferior to 14-day treatment with regard to... read more

Presentations from WSD Supporter Meeting at the World Congress of Intensive Care in Melbourne

On Wednesday, October 16th, 2019, World Sepsis Day Supporters from all around the globe came together at the World Congress of Intensive Care in Melbourne, Australia, for a World Sepsis Day Supporter Meeting. Simon Finfer,... read more

First Portable MRI Scanner for Neuro ICU

Health technology incubator Hyperfine Research and the Yale School of Medicine are testing out a first-of-its-kind, portable MRI scanner in the neuro intensive care unit (ICU). The point-of-care system, designed by Hyperfine,... read more

Designing a Nurse-Delivered Delirium Bundle: What ICU Staff, Survivors, and Their Families Think?

Generally, the bundle was deemed acceptable and deliverable. However, like any complex intervention, component adaptations will be required depending on resources available to the ICU; in particular, involvement of pharmacists... read more

Idiopathic Intracranial Hypertension

A 22 year-old female with a medical history of migraines and obesity who presents to the Emergency Department with a headache. Her headache was gradual in onset, but has progressively worsened and has not been relieved... read more

Effect of Organisational Factors on the Variation in Incidence of Delirium in ICU Patients

The mean incidence of delirium in the ICU was 29%. The organisational factors found including methods of delirium assessment, screening frequency, and hospital type were not related to the reported ICU delirium incidence. A... read more

Early Detection and Monitoring of Cerebral Ischemia Using Calcium-Responsive MRI Probes

The duration of cerebral ischemia is a key factor in determining the severity of brain damage and the course of action. Thus, an accurate and timely observation of the ischemic process is highly critical. Here we present... read more

POCUS Is Not a Magic Bullet

A man in his 50s checked into our ED recently feeling weak, nauseated, and short of breath for two days. He had no significant medical history, and had previously been active and healthy. A fingerstick glucose at triage... read more

Racial and Ethnic Differences in 30-Day Hospital Readmissions Among US Adults with Diabetes

In this study, black patients with diabetes had a significantly higher risk of readmission than members of other racial/ethnic groups. This increased risk was most pronounced among lower-income patients hospitalized in... read more

Healthcare Provider Perceptions of Cardiopulmonary Resuscitation Quality During Simulation Training

Cardiopulmonary resuscitation performance during mock codes does not meet the American Heart Association's quality recommendations. Healthcare providers have poor insight into the quality of cardiopulmonary resuscitation... read more

Management of Peripheral Venoarterial ECMO in Cardiogenic Shock

Extracorporeal membrane oxygenation (ECMO) is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach... read more

Norepinephrine Shortage and Mortality Among Patients With Septic Shock

Drug shortages in the United States are common, but their effect on patient care and outcomes has rarely been reported. This cohort study evaluated whether a national shortage of norepinephrine in the United States in 2011... read more

Echocardiographic Assessment of Pulmonary Artery Occlusion Pressure in Ventilated Patients

TEE accurately predicts invasive PAOP ≤ 18 mmHg in ventilated patients. This further increases its diagnostic value in patients with suspected acute lung injury/acute respiratory distress syndrome. During two consecutive... read more

Renal Outcomes of Vasopressin and Its Analogs in Distributive Shock

In patients with distributive shock, vasopressin and its analogs use is associated with a reduced need for renal replacement therapy and lower acute kidney injury (AKI) incidence. These results are supported by high risk... read more

Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children

The results highlight the heterogeneity in sedation practices among intensivists who care for critically ill children as well as a paucity of sleep promotion and delirium screening in PICUs worldwide. The survey was completed... read more

Antipsychotic Drugs are Not Useful to Reduce Symptoms of Delirium

In patients receiving palliative care, individualized management of delirium precipitants and supportive strategies result in lower scores and shorter duration of target distressing delirium symptoms than when risperidone... read more

Surviving Critical Illness: What Is Next?

This consensus-based framework for PT after hospital discharge aims to improve long-term outcomes for survivors of critical illness. Physical therapists should seek close collaboration with the multidisciplinary team... read more

Transfusions Stuck in an Endless Cycle of Denial

Each publication from Maitland, et al., gives us a glimpse of a greater medical truth, but our view is obstructed by questions about external validity. This group published the landmark FEAST trial that questioned the... read more

Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy

There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more

MODS on Day 1 is a Major Source of Mortality in the PICU

Multiple Organ Dysfunction Syndrome (MODS) present on Day 1 of admission continues to be a major source of morbidity and mortality in the PICU, but risk of poor neurologic outcome may be improved. Further research is... read more

Assessment of Microcirculation in Cardiogenic Shock

The parameter most frequently used to detect tissue malperfusion is serum lactate. Novel, noninvasive methods to quantify microvascular perfusion have the potential to guide treatment in terms of optimizing organ perfusion... read more

Post-ICU Clinics and Peer Support Groups to Reduce PICS

Kyle B. Enfield, MD, and Kimberley J. Haines, PhD, BHSc, discuss implementing post-ICU clinics and peer support groups following critical illness to help reduce the burden of post-intensive care syndrome (PICS). Dr. Haines... read more