Pain in the PICU: How and What Are We Doing?
Pain management in critically ill children is complex. Epidemiological research is needed to identify how often patients in pediatric intensive care units (PICU) experience pain and the practices being used to lessen pain. Critically... read more
Sepsis: Personalization vs. Protocolization?
The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more
Get Well Soon: History’s Worst Plagues and the Heroes Who Fought Them
A witty, irreverent tour of history's worst plagues―from the Antonine Plague, to leprosy, to polio―and a celebration of the heroes who fought them. In 1518, in a small town in Alsace, Frau Troffea began dancing and... read more
The Hospitalist Role in Treating Opioid Use Disorder
Opioid use disorder, like many of the other conditions we see, is a chronic relapsing remitting medical disease and a risk factor for premature mortality. When a patient with diabetes is admitted with cellulitis, we might... read more
Patients Identify Female Physicians as Doctors Less Than Male Physicians
Patients correctly identify female attending physicians as doctors significantly less frequently than they identify male attending physicians as doctors. Patients correctly identify male nurses as nurses significantly less... read more
Penn Finds a Way to Reduce ICU Doctor Burnout
Reducing the length of rotations in medical ICUs in half also reduces rates of physician burnout in half while additionally improving feelings of fulfillment, according to a new pilot study from Penn Medicine. The results... read more
Variation in Identifying Sepsis and Organ Dysfunction Using Administrative Versus Electronic Clinical Data and Impact on Hospital Outcome Comparisons
Variation in the accuracy of claims data for identifying sepsis and organ dysfunction limits their use for comparing hospitals' sepsis rates and outcomes. Using objective clinical data may facilitate more meaningful hospital... read more
Essentials of Neuroanesthesia and Neurointensive Care
This updated second edition of Gupta and Gelb's Essentials of Neuroanesthesia and Neurointensive Care contains the ideal combination of updated information for the practitioner, presented in easy-to-digest short chapters.... read more
Pharmacotherapy in Neurointensive Care
Neurointensive care medicine has experienced great advancements and developments of neuromonitoring techniques, allowing a better comprehension of acute brain injury early phase pathological mechanisms and an overall improvement... read more
Developmentally Appropriate Coping in the ICU
In this video, Child Life Specialist at Boston Children's Hospital, Kate Huyler, outlines the role of a child life specialist, reviews coping strategies for patients in the ICU, including the use of playtime and behavioral... read more
Manual of Traumatic Brain Injury: Assessment and Management
Now completely revised and updated, Manual of Traumatic Brain Injury: Assessment and Management, Second Edition is a comprehensive evidence-based guide to brain injury diagnosis, treatment, and recovery, delivered in a succinct... read more
Practical Management of Invasive Candidiasis in Critically Ill Patients
The heterogeneity of this patient population necessitated the creation of a mixed working group comprising experts in clinical microbiology, infectious diseases and intensive care medicine, all chosen on the basis of their... read more
Sepsis Sub-phenotypes by Temperature Trajectories
In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Siva Bhavani. They discuss sepsis sub-phenotypes by temperature trajectories. Dr. Bhavani is a senior fellow in Pulmonary and Critical... read more
Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery
Intravenous lidocaine administered during and after cardiac surgery did not reduce postoperative cognitive decline at 6 weeks. Among the 420 allocated subjects who returned for 6-week follow-up, there was no difference in... read more
Sustained reduction of catheter-associated bloodstream infections with enhancement of catheter bundle by chlorhexidine dressings over 11 years
The addition of chlorhexidine dressings to all CVC and arterial lines to an ongoing catheter bundle was associated with a sustained 11-year reduction of all catheter-associated bloodstream infections. This large real-world... read more
Gut Dysmotility in the ICU
Off-label metoclopramide and/or erythromycin administration are effective for upper gastrointestinal dysmotility but have adverse effects. Trials of alternative or novel promotility drugs have not demonstrated superiority... read more
How and Whom to Monitor for Seizures in an ICU
Prevalence of seizures detected by continuous electroencephalography was significantly higher than with routine electroencephalography. Prevalence was particularly high in post convulsive status epilepticus, CNS infection,... read more
I am a male nurse – so what?
For Brett Adamson, becoming a nurse was a gateway into helping the world’s most disadvantaged people. In 2005 Brett began working for the medical humanitarian aid organisation, Médecins Sans Frontières. That year was... read more
The Glutamine Debate in Surgery and Critical Care
Three recent meta-analyses have confirmed traditional glutamine (GLN)-supplemented (or "GLN-Complemented" – providing GLN for completeness of amino acid content) TPN is safe, reduces mortality and improves outcome in surgical... read more
Prevalence and outcome of heparin-induced thrombocytopenia diagnosed under veno-arterial extracorporeal membrane oxygenation
Prevalence of HIT among patients under VA‑ECMO is extremely low at 0.36% with an associated mortality rate of 33.3%, which appears to be in the same range as that observed in patients treated with VA‑ECMO without HIT.... read more
Thiamine Deficiency: Pearls and Pitfalls
Although thiamine would not be isolated until 1911, the clinical syndrome of thiamine deficiency was recognized as far back as 2700 BC, when the term "beriberi", meaning "wasted wasted" was first coined in China. Nearly 5,000... read more
Long-Term Outcome after Prolonged Mechanical Ventilation
Among patients receiving prolonged mechanical ventilation at an LTACH, 53.7% were detached from the ventilator at discharge and 1-year survival was 66.9%. Respiratory strength was well maintained, whereas peripheral strength... read more
