Fluid Responsiveness in Sepsis
Fluid challenge is a common practice in the ICU. It is one of the most important resuscitation manoeuvres of acute circulatory failure management in critically ill patients. Adequate fluid resuscitation is very important... read more
Top 10 Perioperative Applications of Point-of-Care Ultrasound for Anesthesiologists
Anesthesiologists have been leaders in the use of point-of-care (POC) ultrasound for intraoperative transesophageal echocardiography (TEE), and to guide vascular access and regional anesthesia procedures. Recently, anesthesiologists... read more
Excited Delirium: Acute Management in the ED Setting
Excited delirium syndrome is a common yet poorly characterized ED presentation with a wide differential diagnosis. Patients are often identified initially by law enforcement, but attempts to control individuals experiencing... read more
Risk Factors at Index Hospitalization Associated With Longer-term Mortality in Adult Sepsis Survivors
In this cohort study of 94 748 adult sepsis survivors, age, male sex, 1 or more severe comorbidities, prehospitalization dependency, nonsurgical status, acute severity of illness, site of infection, and organ dysfunction... read more
Neuromuscular Blockade for ARDS Was No Help, In Supine Patients
Continuous neuromuscular blockade for severe ARDS became common practice after the ACURASYS trial showed it reduced mortality by an absolute 9%. A larger trial, ROSE, now finds no benefit of the therapy over usual care, but... read more
Unsafe Nursing Ratios Incapacitate EDs, Endanger Patients
It's the evening surge at a busy ED where all beds are occupied. Several admitted patients – including 2 critically ill – are waiting for rooms upstairs. A quick glance reveals a full waiting room with multiple potentially... read more
Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest
Lower pH after out-of-hospital cardiac arrest (OHCA) has been associated with worsening neurologic outcome, with ... read more
Thrombosis and Bleeding in the ICU
ICU patients are high risk of developing thrombotic complications such as deep venous thrombosis (DVT) and pulmonary embolism (PE). Indeed, due to the hypercoagulative state typical for many forms of critical illness associated... read more
Physician Burnout Costs the U.S. Billions of Dollars Each Year
Doctors in the U.S. experience symptoms of burnout at almost twice the rate of other workers, often citing as contributors the long hours, a fear of being sued, and having to deal with growing bureaucracy, like filling out... read more
Multipotent Fetal-derived Cdx2 Cells From Placenta Regenerate the Heart
Researchers at the Icahn School of Medicine at Mount Sinai have demonstrated that stem cells derived from the placenta known as Cdx2 cells can regenerate healthy heart cells after heart attacks in animal models. The extremely... read more
Surgical Critical Care and Emergency Surgery: Clinical Questions and Answers
A unique question-and-answer book for surgical residents and trainees that covers all surgical aspects of critical care and acute or emergency medicine. This is a comprehensive, one-of-a-kind question-and-answer text for... read more
Antibiotics, Immunosuppressive Drugs and the Downfall of the Human Immune System
Today I'll discuss two more factors that can debilitate the human immune system (allowing the microbiome to better cause disease). They are antibiotics (when used too frequently) and immunosuppressive drugs: two of the most... read more
Placards Do Not Improve Hand Hygiene Adherence
Hand hygiene placards posted in a Denver hospital — including one that featured an image of two eyes looking directly at the viewer with a reminder to clean their hands — did not result in measurable improvements in hand... read more
The Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients
The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. A total of 505 patients (equal or greater than 65... read more
Optimizing Respiratory Management in Resource-limited Settings
This review focuses on the emerging body of literature regarding the management of acute respiratory failure (ARF) in low- and middle-income countries (LMICs). The aim is to abstract management principles that are of relevance... read more
Machine-learning System Could Aid Critical Decisions in Sepsis Care
Researchers from MIT and Massachusetts General Hospital (MGH) have developed a predictive model that could guide clinicians in deciding when to give potentially life-saving drugs to patients being treated for sepsis in the... read more
Addressing Shortcomings in Infection and Sepsis Treatment Should Be Top of the Priority List
Hospitals are increasingly facing the challenge of cutting costs while also improving clinical outcomes. This is certainly true in the infectious disease sector, as unrecognized or ineffectively treated bacterial infections... read more
Is Pre-hospital Coagulation Management in Trauma Feasible?
Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more
Describing Organ Dysfunction in the ICU
Multiple organ dysfunction is a common cause of morbidity and mortality in intensive care units (ICUs). Original development of the Sequential Organ Failure Assessment (SOFA) score was not to predict outcome, but to describe... read more
Regeneration of Severely Damaged Lungs Using an Interventional Cross-circulation Platform
The number of available donor organs limits lung transplantation, the only lifesaving therapy for the increasing population of patients with end-stage lung disease. A prevalent etiology of injury that renders lungs unacceptable... read more
Closed ICU Model Linked to 100% Reduction in Several HAIs
A closed intensive care unit model, in which a patient is evaluated and admitted under an intensivist and patient care orders are written by ICU staff, can help reduce rates of several healthcare-associated infections (HAI),... read more
Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With ECMO for a Respiratory Indication
This study seeks to evaluate the association between acute kidney injury (AKI), fluid overload (FO), and mortality in children supported with extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure.... read more
