Relationship of at Admission Lactate, Unmeasured Anions, and Chloride to the Outcome of Critically Ill Patients
Four thousand nine hundred one patients were admitted throughout the study period; 1,609 met criteria for metabolic acidosis and 145 had normal acid-base values. The association between at admission lactate, unmeasured anions,... read more
Combined Biomarkers Predict Acute Mortality Among Critically Ill Patients With Suspected Sepsis
Combined biomarkers predict risk for 14-day and total mortality among subjects with suspected sepsis. Serum amyloid P and tissue plasminogen activator demonstrated the best discriminatory ability in this cohort. Fourteen-day... read more
Sedation Practice in ECMO-Treated Patients with ARDS
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective... read more
Metabolic Acidosis: A Guide to Clinical Assessment and Management
This timely volume provides an overview to the causes, effects on systems and clinical approaches of metabolic acidosis. Beginning with a basic understanding of the physiology, pathophysiology and development of this disease,... read more
Noninvasive ventilation for avoidance of reintubation in patients with various cough strength
The aim of this study was to assess whether prophylactic noninvasive ventilation (NIV) would benefit patients with various cough strengths.... read more
Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care
Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestseller The Checklist Manifesto. A Johns Hopkins surgeon and professor of public health, he can testify to the amazing power of modern... read more
The Effect of Adhesive Tape vs. Endotracheal Tube Fastener in Critically Ill Adults
The optimal securement method of endotracheal tubes is unknown but should prevent dislodgement while minimizing complications. The use of an endotracheal tube fastener might reduce complications among critically ill adults... read more
From In Shock to True Connection with Our Patients
If you work in healthcare and haven't read the book "In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope" I really hope you will. In the meantime listen to intensivist and best-selling author Dr Rana... read more
Mapping Sources of Noise in an ICU
Excessive noise in hospitals adversely affects patients' sleep and recovery, causes stress and fatigue in staff and hampers communication. The World Health Organization suggests sound levels should be limited to 35 decibels.... read more
A Positive Fluid Balance is an Independent Prognostic Factor in Patients with Sepsis
Intravenous fluid administration is an essential component of sepsis management, but a positive fluid balance has been associated with worse prognosis. We analyzed whether a positive fluid balance and its persistence over... read more
Evaluation of Medetomidine-ketamine and Atipamezole for Reversible Anesthesia of Free-ranging Gray Wolves
Twenty-eight anesthetic events were carried out on 24 free-ranging Scandinavian gray wolves (Canis lupus) by darting from a helicopter with 5 mg medetomidine and 250 mg ketamine during winter in 2002 and 2003. Mean±SD doses... read more
Anticoagulant Reversal
Ranjit Deshpande, MD, and Mark D. Cipolle, MD, PhD, FCCM, discuss Dr. Cipolle's talk from the 48th Critical Care Congress on what's new in anticoagulant reversal. Tune in to hear about the hottest topics and current research.... read more
ED Door-to-Antibiotic Time and Long-term Mortality in Sepsis
Delays in ED antibiotic initiation time are associated with clinically important increases in long-term, risk-adjusted sepsis mortality. This study investigated the association of door-to-antibiotic time with long-term mortality... read more
PERFECT Protocol: Volume-based Feeding in Ventilated Adults
Underfeeding in critical illness is common and associated with poor outcomes. Researchers in the UK designed a before-and-after study to evaluate the safety, efficacy and clinical outcomes associated with volume-based feeding... read more
This Is Going to Hurt: Secret Diaries of a Junior Doctor
Welcome to 97-hour weeks. Welcome to life and death decisions. Welcome to a constant tsunami of bodily fluids. Welcome to earning less than the hospital parking meter. Wave goodbye to your friends and relationships. Welcome... read more
Sedation in ICU patients – Need for Standardized Protocols
A Johns Hopkins-led study on sedation practices in critically ill patients in a resource-limited setting finds that deep sedation, agitation, and benzodiazepines were independently associated with worse clinical outcomes.... read more
Just as in Life and Medicine, Time Is the Biggest Challenge in Writing
For Matt Morgan, writing is a means to relieve work stress and turn it into something useful. In his first book, which will soon be published with Simon & Schuster, he shares stories from the intensive care unit, one of the... read more
Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again
Medicine has become inhuman, to disastrous effect. The doctor-patient relationship--the heart of medicine--is broken: doctors are too distracted and overwhelmed to truly connect with their patients, and medical errors and... read more
Reducing Emergency Department Length of Stay
An interdisciplinary team of front-line physicians, nurses, medical assistants, and executives assembled and used value stream mapping to assess the entire ED care process, from patient arrival to admission or discharge.... read more
Also Human: The Inner Lives of Doctors
From ER and M*A*S*H to Grey's Anatomy and House, the medical drama endures for good reason: we're fascinated by the people we must trust when we are most vulnerable. In Also Human, vocational psychologist Caroline Elton introduces... read more
Time To Stop Labeling Physicians As Providers
Back when I was in business school, I interviewed for a job at a health care consulting firm. During one of the interviews, a partner there told me that there isn't too much difference between running a hospital and running... read more
Tidal Volume Strategies for those without ARDS
This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more
