The negative effect of initial high-dose methylprednisolone and tapering regimen for ARDS
The efficacy of corticosteroid use in acute respiratory distress syndrome (ARDS) remains controversial. Generally, short-term high-dose corticosteroid therapy is considered to be ineffective in ARDS. On the other hand, low-dose,... read more
Continuous or Intermittent Feeding: Pros and Cons
Although there are limited studies investigating the safety and efficacy of an intermittent rather than continuous feeding regimen in critically ill adults, there are several theoretical advantages. Further studies should... read more
Sex-specific Differences in Survival After Out-of-hospital Cardiac Arrest
This nationwide, population-based observational study in Japan included 386,535 adult patients aged ≥ 18 years with out-of-hospital cardiac arrest (OHCA). In all these patients, resuscitation was attempted by EMS personnel... read more
Long-term Health Consequences of Under- and Over-feeding in PICU
Energy is essential for the treatment and recovery of children admitted to Pediatric Intensive Care Units (PICU). There are significant immediate and long-term health consequences of both under- and over-feeding in this population.... read more
Predictive Utility of DNI in Patients with MOF After Severe Traumatic Injury
Post-injury multiple organ failure (MOF) is the result of a systemic uncontrolled inflammatory response and it is the one of leading cause of late post-injury mortality. Delta neutrophil index (DNI) may serve useful marker... read more
Terlipressin for Septic Shock Patients
Catecholamines are commonly used in septic shock but face limitations of their hypo-responsiveness and adverse events due to high dose. Terlipressin is a synthetic vasopressin analog with greater selectivity for the V1-receptor.... read more
The Poor Man’s Tox Screen: ECG Findings in the Acute Overdose
In the middle of a busy ED shift the tech runs up to you with an ECG. Just prior to signing the top "No STEMI" you think: "wait, why do the QRS complexes look like that?" You walk back to triage with the tech to see a... read more
Time-Course of Clinical Physiologic Variables in ARDS Patients Undergoing ECMO
In patients undergoing extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS), it is unknown which clinical physiologic variables should be monitored to follow the evolution of lung injury... read more
A Multidisciplinary Idea to STEP UP Resuscitation Effectiveness
Non-technical skills and human factors are increasingly recognized as critical ingredients in the success or failure of acute care delivery in a number of high stakes clinical domains. This is reflected in the evolution of... read more
Clustering Algorithms Usage in Critical Care Research Unravel Patient Heterogeneity
Critically ill patients constitute the most heterogeneous population in the hospital, with the highest rates of acute and chronic multi-morbidity. Daily, two critically ill patients are admitted to the ICU with the same... read more
Few Ideas on How Nurses Can Recover After Difficult Shifts
Most medical professionals agree that a nursing career can be constantly stressful. It comes with the territory of caring for those who are ill and injured. On an average day, well-trained nurses are more than capable of... read more
Hemodynamic Monitoring in the ECMO Patient
Hemodynamic monitoring in extracorporeal membrane oxygenation (ECMO) patients requires familiarity with the underlying pathophysiology and circulatory mechanics of extracorporeal flow. This review discusses the various monitoring... read more
Clinical Impact and Assessment Tools Capable of Identifying Delirium in Cardiac Arrest Survivors
This review aims to describe the clinical impact and assessment tools capable of identifying delirium in cardiac arrest survivors and providing strategies aimed at preventing and treating delirium. Patient factors leading... read more
State-Mandated Protocolized Sepsis Care Associated with Decrease in Sepsis Mortality
Beginning in 2013, New York State implemented regulations mandating that hospitals implement evidence-based protocols for sepsis management, as well as report data on clinical outcomes to the state government. This study... read more
Age and Decisions to Limit Life Support for Patients with ALI
The purpose of this study was to estimate the association between patient age and the rate of new limitations in the use of life support, independent of daily organ dysfunction status, following acute lung injury (ALI) onset. 490... read more
Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial
The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more
Fragility Index Calculator
The fragility index is a measure of the robustness (or fragility) of the results of a clinical trial. The fragility index is a number indicating how many patients would be required to convert a trial from being statistically... read more
Fluid Resuscitation with PPD Attenuates Crush Injury-related AKI and Improves Survival
In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD)... read more
Emergency Department Hyperoxia Associated with Increased Mortality in Mechanically Ventilated Patients
Emergency Department exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation... read more
Moving Vulnerable Patients Around Hospital Can Increase Infections
Researchers at Overlook Medical Center released a report stating that transporting patients increases the risk of hospital-acquired infections. The study focused on ICU patients being treated for strokes, aneurysm ruptures... read more
ARDS Survivors Often Leave ICU with Prolonged PICS
Patients who survive acute respiratory distress syndrome (ARDS) often leave ICU with debilitating mental, physical, or cognitive problems that may limit their quality of life. These challenges are called post-intensive care... read more
Speedy sepsis care slows in-hospital mortality
Sepsis and septic shock patients treated within 3 hours had lower in-hospital mortality rates than those treated between hours 3 and 12, based on data from nearly 50,000 adult patients. The findings were presented at an international... read more
