Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in ICU Patients Without ARDS

In patients in the Intensive Care Unit (ICU) without acute respiratory distress syndrome (ARDS) who were expected not to be extubated within 24 hours of randomization, a low tidal volume strategy did not result in a greater... read more

Effect of High-Flow Nasal Oxygen vs Standard Oxygen on 28-Day Mortality in Immunocompromised Patients With ARF

Among critically ill immunocompromised patients with acute respiratory failure (ARF), high-flow oxygen therapy did not significantly decrease day-28 mortality compared with standard oxygen therapy. Of 778 randomized patients... read more

Angiotensin II For Septic Shock Treatment

Angiotensin II has been studied for many years and has consistently shown to increase MAP. This medication adds a new mechanism of action to the vasopressor arsenal that is already used for septic shock. Angiotensin II should... read more

Identifying At-Risk Patients for Sub-optimal Beta-lactam Exposure in Critically Ill Patients with Severe Infections

Conventional beta-lactam dosing is flawed in critically ill patients. Useful tools such as the MeroRisk Calculator need to be comprehensively evaluated clinically, and if successful should be added into clinical practice... read more

Pretreating red blood cells with nitric oxide may reduce side effect linked to transfusions

A new treatment may diminish a dangerous side effect associated with transfusions of red blood cells (RBCs) known as pulmonary hypertension, an elevated blood pressure in the lungs and heart that can lead to heart failure.... read more

Sedation in the ICU – Good Past – Better Future?

The concepts for good sedation include defining the range of sedation, the need for agents with rapid response that can be easily and rapidly varied in restless and confused patients, various modes of ventilation, continuous... read more

Closed Chest Compressions in Traumatic Cardiac Arrest

This study demonstrated that fluid resuscitation with whole blood is significantly better than resuscitation with compressions alone or with normal saline. It further showed that there was no difference between whole blood... read more

An evaluation of the Swiss staging model for hypothermia using hospital cases and case reports from the literature

The Swiss staging model for hypothermia uses clinical indicators to stage hypothermia and guide the management of hypothermic patients. The proposed temperature range for clinical stage 1 is ... read more

Reversal of Oral Anticoagulation in Patients with Acute Intracerebral Hemorrhage

In light of an aging population with increased cardiovascular comorbidity, the use of oral anticoagulation (OAC) is steadily expanding. A variety of pharmacological alternatives to vitamin K antagonists (VKA) have emerged... read more

Pediatric Hypertension and Hypertensive Emergencies: Recognition and Management in the Emergency Department

Pediatric hypertension generally presents to the ED in 2 forms: (1) the otherwise asymptomatic child with elevated blood pressure, and (2) the child with a true hypertensive emergency. This issue provides recommendations... read more

Approaches to Addressing PICS Among ICU Survivors

Critical illness can be lethal and devastating to survivors. Improvements in acute care have increased the number of intensive care unit (ICU) survivors. These survivors confront a range of new or worsened health states that... read more

Reproducibility Trial Publishes Two Conclusions For One Paper

The British Journal of Anaesthesia's unusual experiment is designed to broaden replicability efforts beyond just methods and results. How deeply an anaesthetist should sedate an elderly person when they have surgery is... read more

The Epidemiology of Symptomatic Catheter-associated Urinary Tract Infections in the ICU

Catheter-associated urinary tract infection (CAUTI) occurs frequently in critical illness with significant morbidity, mortality, and additional hospital costs. The epidemiology of symptomatic ward-acquired CAUTI (within 48... read more

Disease History to Predict Mortality Risk in ICU Patients

Patients in the intensive care unit are highly heterogeneous, and include elderly patients who generally have a long history of disease. Prediction of prognosis can often be difficult because of the severity of patient illness... read more

Diaphragm-protective Mechanical Ventilation

Diaphragm dysfunction is common in mechanically ventilated patients and predisposes them to prolonged ventilator dependence and poor clinical outcomes. Mechanical ventilation is a major cause of diaphragm dysfunction in these... read more

Alternatives to Rapid Sequence Intubation: Contemporary Airway Management with Ketamine

Endotracheal intubation (ETI) is a high-risk procedure commonly performed in emergency medicine, critical care, and the prehospital setting. Traditional rapid sequence intubation (RSI), the simultaneous administration of... read more

Translational Simulation: Not “Where?” But “Why?” A Functional View of In SITU Simulation

Healthcare simulation has been widely adopted for health professional education at all stages of training and practice and across cognitive, procedural, communication and teamwork domains. Recent enthusiasm for in situ simulation—delivered... read more

Impact of Mean Arterial Pressure Fluctuation on Mortality in Critically Ill Patients

The purpose of this study was to investigate the association between mean arterial pressure fluctuations and mortality in critically ill patients admitted to the ICU. The reduced mean arterial pressure fluctuation (within... read more

Environment key battle ground in fight to tackle antibiotic resistance

The environment could be as important a battle ground as the clinic in the global fight against the spread of antibiotic resistance, new research has shown. A study conducted at the University of Exeter Medical School concluded... read more

Cost-effectiveness analysis of initial treatment strategies for mild-to-moderate Clostridium difficile infection in hospitalized patients

A decision-analytic model revealed vancomycin to be cost-effective, compared with metronidazole, for treatment of initial episodes of mild-to-moderate Clostridium difficile infection (CDI) in adult inpatients. From the hospital... read more

Organizational Factors Associated with Target Sedation on the First 48 hours of Mechanical Ventilation

Although light sedation levels are associated with several beneficial outcomes for critically ill patients on mechanical ventilation, the majority of patients are still deeply sedated. Organizational factors may play a role... read more

Outcomes and Costs of Patients Admitted to the ICU Due to Spontaneous Intracranial Hemorrhage

Spontaneous intracranial hemorrhage, including subarachnoid hemorrhage and intracerebral hemorrhage, is associated with significant morbidity and mortality. Although many of these patients will require ICU admission, little... read more