Oxalate Nephropathy Following Vitamin C Intake within ICU

Compelling evidence obtained from in-vitro and animal studies suggest that vitamin C, a circulating antioxidant, may be a valuable adjunctive therapy in critically-ill patients. Data from humans are more conflicting.... read more

Evaluating Delivery of Low Tidal Volume Ventilation in Six ICUs Using Electronic Health Record Data

Despite low mean tidal volume in the cohort, a significant percentage of patients were exposed to a prolonged duration of high tidal volumes which was correlated with higher mortality. Detailed ventilator records in the... read more

Lung Recruitability in Severe ARDS Requiring ECMO

Significant variability in potential for lung recruitment in patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO). 47 adults with severe ARDS requiring ECMO... read more

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Procalcitonin-guided (PCT) antibiotic therapy fails to decrease the mortality or length of stay (LOS) of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce... read more

The Role of the Physician Assistant in Critical Care

Since inception in the mid-1960s, the Physician Assistant (PA) profession has grown to become an integral part of healthcare delivery. As the name implies, PAs were historically seen as assistants to the physician, helping... read more

Intensive vs. Conventional Glucose Control in Critically Ill Patients

n this large, international, randomized trial, we found that intensive glucose control increased mortality among adults in the ICU: a blood glucose target of 180 mg or less per deciliter resulted in lower mortality than did... read more

Balanced Crystalloids vs. Saline in Critically Ill Adults

Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal... read more

Biomarker Profiles of Coagulopathy and Alveolar Epithelial Injury in ARDS

Coagulopathy and alveolar epithelial injury were observed in both patients with direct common risk factors (dARDS) and with idiopathic or immune-related diseases (iARDS). However, their biomarker profiles were significantly... read more

Obstructive Sleep Apnea, Positive Airway Pressure Treatment and Postoperative Delirium

Obstructive sleep apnea (OSA) is common among older surgical patients, and delirium is a frequent and serious postoperative complication. Emerging evidence suggests that OSA increases the risk for postoperative delirium.... read more

Cardiovascular Dynamics in Critically Ill Patients

Although widely used among physicians and frequently present in the literature, the words "stable" and "unstable" to describe cardiovascular dynamics in critically ill patients can have different meanings to different people... read more

The Healer’s Power

Although the physician's use and misuse of power have been discussed in the social sciences and in literature, they have never been explored in medical ethics until now. In this book, Dr. Howard Brody argues that the... read more

The Healer’s Power

Detection, Treatment of Dyspnea Inconsistent in ICU

Although the prevalence of dyspnea was at least as high as that of pain, the detection and treatment of moderate to severe dyspnea were more inconsistent than for pain among critically ill patients in the ICU, according to... read more

Adjunctive Corticosteroid Treatment in Septic Shock

Interest in the role of the adrenal cortex in the recovery from an infection dates back nearly 100 yr. More than six decades of research on the role of corticosteroid supplementation as an adjunctive treatment for sepsis... read more

Emergency Department Intubation Success With Succinylcholine vs. Rocuronium

In this large observational series, there was no association between paralytic choice and first-pass rapid sequence intubation success or peri-intubation adverse events. There were 2,275 rapid sequence intubations facilitated... read more

The Language of Kindness

Christie Watson spent twenty years as a nurse, and in this intimate, poignant, and remarkably powerful book, she opens the doors of the hospital and shares its secrets. She takes us by her side down hospital corridors to... read more

The Language of Kindness

Derivation and Validation of Plasma Endostatin for Predicting Renal Recovery from AKI

Plasma endostatin shows a useful value for predicting failure to recover from acute kidney injury (AKI). The predictive ability can be greatly improved when endostatin is combined with the Sequential Organ Failure Assessment... read more

Effect of a Sepsis Educational Intervention on Hospital Stay

Adherence to a bundle strategy is low following an educational intervention. However, when patients are managed after instruction in guideline recommendations, hospital stay may be significantly reduced. The main cause... read more

Implications of Heterogeneity of Treatment Effect for Reporting and Analysis of Randomized Trials in Critical Care

Randomized clinical trials (RCTs) are conducted to guide clinicians' selection of therapies for individual patients. Currently, RCTs in critical care often report an overall mean effect and selected individual subgroups.... read more

Use of Machine Learning to Analyze Routinely Collected ICU Data

The rate of publication of studies using machine learning to analyze routinely collected ICU data is increasing rapidly. The sample sizes used in many published studies are too small to exploit the potential of these methods.... read more

Prehospital cardiopulmonary resuscitation duration and neurological outcome after out-of-hospital cardiac arrest among children by location of arrest

A longer prehospital EMS CPR duration is independently associated with a lower proportion of patients with a favorable neurological outcome. The association between prehospital EMS CPR duration and neurological outcome... read more

Clinical Examination for the Prediction of Mortality in the Critically Ill

Clinical examination has reasonable discriminative value for assessing 90-day mortality in acutely admitted ICU patients. In our study population, a single, protocolized clinical examination had similar prognostic abilities... read more

Psychological Consequences of ICU Admission

For most patients and their families, admission to the intensive care unit (ICU) is an unanticipated event that causes substantial psychological distress. For patients, short- and long-term consequences include delirium,... read more