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

qSOFA Performance Score as Prognostic Tool in Infected Patients Outside the ICU

A positive qSOFA score had high specificity outside the ICU in early detection of in-hospital mortality, acute organ dysfunction, and ICU admission, but low sensitivity may have limitations as a predictive tool for adverse... read more

Ideas for Future Intensive Care

Progress toward determining the true worth of ongoing practices or value of recent innovations can be glacially slow when we insist on following the conventional stepwise scientific pathway. Moreover, a widely accepted but... read more

Withdraw Life-Sustaining Treatments for Patients with Severe TBI

The decision to withdraw life support from patients with severe brain injuries is very difficult. In a study conducted in Canadian Medical Association Journal, critical care physicians were asked about the decision-making... read more

Early Neuromuscular Blockade in the ARDS

Among patients with moderate-to-severe ARDS who were treated with a strategy involving a high PEEP, there was no significant difference in mortality at 90 days between patients who received an early and continuous cisatracurium... read more

Detection of Brain Activation in Unresponsive Patients with Acute Brain Injury

A dissociation between the absence of behavioral responses to motor commands and the evidence of brain activation in response to these commands in EEG recordings was found in 15% of patients in a consecutive series of patients... read more

Subanesthetic Ketamine Infusions for the Management of Pediatric Pain in Non‐critical Care Settings

Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non‐critical care settings. Our five‐year experience using low‐dose ketamine infusions highlights an acceptable side... read more

Effective Sepsis Detection with Peripheral Blood Monocyte Distribution

This study evaluated the diagnostic accuracy of peripheral blood monocyte distribution width alone and in combination with white blood cells (WBCs) count for early sepsis detection in the emergency department. An monocyte... read more

Venous Doppler and Veno-Cardiac Coupling

Concepts have been clanging around my head since I participated in Philippe Rola's sedulous Hospitalist & Resuscitationist Conference in Montreal. Initially, the abstractions of ventriculo-arterial coupling, Guytonian physiology... read more

Metabolic sepsis resuscitation: the evidence behind Vitamin C

Sepsis resuscitation generally focuses on hemodynamics. Rivers of ink have been spilled writing about oxygen delivery and fluid responsiveness. This is clearly important, but it's possible that our focus on easily... read more

Effect of an ICU Diary on PTSD Symptoms Among Patients Receiving Mechanical Ventilation

Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms. Among 657 patients who were randomized completed the trial. At 3 months, significant... read more

What Happens After a Positive Screen for Depression and PTSD in the Outpatient Burn Clinic?

Multiple reports have demonstrated a wide prevalence of both depression and post traumatic stress disorder (PTSD) within 1 year of burn injury. The purpose of this study is to determine outcomes of burn patients after a positive... read more

Sedatives in Neurocritical Care

Extrapolating the findings from studies in the general ICU population suggests to reserve deep continuous sedation in the neuro-ICU for specific indications. Although an improved understanding of cerebral physiological changes... read more

Low-value Clinical Practices in Acute Injury Care

This study fills a major knowledge gap on medical procedure overuse in acute injury care. Results will inform research priorities and the development of metrics to measure overuse. This knowledge will provide a solid basis... read more

Telehealth and Patient Outcomes

Ranjit Deshpande, MD, and Donna Lee Armaignac, PhD, APRN, CCNS, CCRN, discuss maximizing positive patient care outcomes through telemedicine. Dr. Armaignac presented on this topic at the Society's 48th Critical Care Congress.... read more

Phenotyping: Need to Identify Subgroups of ARDS Patients

The consensus definitions of acute respiratory distress syndrome (ARDS) mainly rely on feasible clinical criteria, which help to group patients together for inclusion in clinical trials and for clinical management. This generates... read more