Noninvasive Ventilation Through the Helmet Can Be Used For Early Mild and Moderate ARDS

Debating data have been published as regards the beneficial or deleterious effect of spontaneous breathing (SB) in comparison to controlled mechanical ventilation (CMV) during acute respiratory failure. Spontaneous breathing... read more

Post-discharge Impact of Healthcare-associated Infections in a Developing Country

The impact of healthcare-associated infections (HCAIs) on in-hospital mortality, morbidity, length-of-stay, and costs has been extensively reported. However, few studies have focused on the follow-up of HCAI-affected subjects... read more

Withholding or Withdrawing of Life-sustaining Therapy in Older Adults Admitted to the ICU

The most important patient variables associated with the instigation of Life-sustaining Therapy (LST) limitation were acute admission, frailty, age, admission SOFA score and country. LST limitation was identified in 1356/5021... read more

Critical Care Study Guide: Text and Review

Critical care medicine is a dynamic and exciting arena where complex pathophysiologic states require extensive knowledge and up-to-date clinical information. An extensive knowledge of basic pathophysiology, as well as awareness... read more

Critical Care Study Guide: Text and Review

Using Propensity Scoring Analyses in Critical Care Research

Observational studies are a common and important aspect of critical care research. A key challenge in the design of observational studies is the control of confounding. Confounding arises when the groups being compared in... read more

Impact of Weekly Case-based Tele-education on Quality of Care in a Limited Resource Medical ICU

Limited critical care subspecialty training and experience is available in many low- and middle-income countries, creating barriers to the delivery of evidence-based critical care. We hypothesized that a structured tele-education... read more

Early Protocolized Versus Usual Care Rehabilitation for Pediatric Neurocritical Care Patients

A protocol for early personalized rehabilitation by physical therapy, occupational therapy, and speech and language therapy in pediatric neurocritical care patients could be safely implemented and led to more ICU-based treatment... read more

Measuring Lactate vs. Capillary Refill in Guiding Resuscitation in Shock

Capillary refill is as least as good as measuring lactate in guiding resuscitation efforts in septic shock. Moreover, using a lactate-driven resuscitation strategy led to use of more pressors and more IV fluid administration... read more

Serotonin Syndrome

Serotonin syndromes comes up a lot in critical care medicine. Sometimes we are admitting patients because of a primary diagnosis of serotonin syndrome. Other times we are afraid of causing serotonin syndrome ourselves, due... read more

Midazolam Dose Optimization in Critically Ill Pediatric Patients with ARF

This work leveraged available knowledge on non-heritable and heritable factors affecting midazolam pharmacokinetic in pediatric subjects with primary respiratory failure requiring mechanical ventilation, providing the basis... read more

Artificial Liver Support in Acute and Acute-on-Chronic Liver Failure

Liver support systems such as MARS and TPE may temporarily improve systemic hemodynamics and the degree of encephalopathy. However, TPE is the only procedure that improves survival in patients with ALF. The role of TPE in... read more

It Is Important to Talk About Death

Changes to the rules on organ donation will "reframe" the way people talk about death, a top critical care doctor said today. Dr Matt Morgan said the introduction of "deemed consent" in Wales almost four years ago – a similar... read more

Antibiotics for Sepsis

Antibiotics for Sepsis - Does Each Hour Really Count? Or is it Incestuous Amplification? - by Prof Mervyn Singer "Each hour's delay in initiating antibiotics costs lives" is a doctrine that has attained quasi religious status.... read more

Similar Metabolic, Innate Immunity, and Adipokine Profiles in Adult and Pediatric Sepsis vs. SIRS

Sepsis presents with similar profiles in adult and pediatric patients, characterized by enhanced inflammatory hormonal response and by repressed innate immunity, metabolism, and myocardial contractility. These features early... read more

A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients

Hemodynamic therapy aimed at achieving supranormal values for the cardiac index or normal values for mixed venous oxygen saturation does not reduce morbidity or mortality among critically ill patients. A total of 10,726 patients... read more

Early Prediction of Prognosis in Elderly Acute Stroke Patients

Acute stroke has a high morbidity and mortality in elderly population. Baseline confounding illnesses, initial clinical examination, and basic laboratory tests may impact prognostics. In this study, we aimed to establish... read more

Evaluation of a Safer Opioid Prescribing Protocol (SOPP) for Patients Being Discharged From a Trauma Service

The aims of this study were to evaluate the effects on opioid medication prescribing, patient opioid safety education, and prescribing of naloxone following implementation of a Safer Opioid Prescribing Protocol (SOPP) as... read more

Association of Age With Short-term and Long-term Mortality Among Patients Discharged From ICUs in France

Results of this study suggest that aging was associated with an increased risk of mortality in the 3 years after hospital discharge that included an ICU admission, with a sharp increase in those 80 years and older. However,... read more

Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes

In this systematic review that included 93 reports of Randomized Clinical Trials (RCTs) from 6 high-impact journals, positive spin of statistically nonsignificant primary outcomes was found in 57% of abstracts and 67% of... read more

Clinician Perception of a Machine Learning–Based Early Warning System Designed to Predict Severe Sepsis and Septic Shock

In general, clinical perceptions of Early Warning System 2.0 were poor. Nurses and providers differed in their perceptions of sepsis and alert benefits. These findings highlight the challenges of achieving acceptance of predictive... read more

In-hospital Mortality Associated with the Misdiagnosis or Unidentified Site of Infection at Admission

Rapid detection, early resuscitation, and appropriate antibiotic use are crucial for sepsis care. Accurate identification of the site of infection may facilitate a timely provision of appropriate care. We aimed to investigate... read more

The Rise of the Healthcare Administrator

Here's some food for thought: The number of physicians in the United States grew 150 percent between 1975 and 2010, roughly in keeping with population growth, while the number of healthcare administrators increased 3,200... read more