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
Antibiotic Therapy for Severe CAP in the ICU
Researchers have assessed the impact antibiotic therapy on short (hospital) and long-term (6 months) outcomes of ICU patients with severe community-acquired pneumonia. Community-acquired pneumonia (CAP) remains one of the... read more
Social and Economic Problems of ICU Survivors Identified by a Structured Social Welfare Consultation
Despite over a decade of trials, no outpatient intervention has demonstrated any measurable improvement in the poor health-related quality of life (HRQoL) patients experience following critical illness [1, 2]. One novel avenue... read more
Heterogeneity of Treatment Effect by Baseline Risk of Mortality in Critically ill Patients
Randomised controlled trials (RCTs) enrolling patients with sepsis or acute respiratory distress syndrome (ARDS) generate heterogeneous trial populations. Non-random variation in the treatment effect of an intervention due... read more
How Should ECMO Initiation and Withdrawal Decisions Be Shared?
Extracorporeal membrane oxygenation (ECMO) is a new technology used to rescue patients with severe circulatory or respiratory failure and help bridge them to recovery or to definitive therapies like device implantation or... read more
Immunotherapy Effects on Sepsis
A randomised controlled multicentre trial assessed for the first time the safety and pharmacokinetics of an antiprogrammed cell death-ligand 1 (anti–PD-L1) immune checkpoint inhibitor (BMS-936559; Bristol-Myers Squibb,... read more
Disinfection Devices in ICU Sinks Dramatically Reduce Superbugs
Putting disinfection devices onto the siphons of sinks can help manage multidrug-resistant Pseudomonas aeruginosa colonization in intensive care units, according to a study published in Journal of Hospital Infection. Researchers... read more
AACN Procedure Manual for High Acuity, Progressive, and Critical Care
The AACN Procedure Manual for High Acuity, Progressive, and Critical Care, 7th Edition, authored by the American Association of Critical-Care Nurses, is the authoritative reference to procedures performed in high acuity,... read more
AKI and Subsequent Frailty Status in Survivors of Critical Illness
Acute kidney injury in survivors of critical illness predicted worse frailty status 3 and 12 months postdischarge. These findings have important implications on clinical decision making among acute kidney injury survivors... read more
Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms
The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more
Economic Evaluation of vv-ECMO for Severe ARDS
Venovenous extracorporeal membrane oxygenation (vv-ECMO) is increasingly being used to support patients with severe acute respiratory distress syndrome (ARDS), but its cost-effectiveness is unknown. The cost-utility of vv-ECMO... read more
ECMO Use in Cardiogenic Shock
Increasing age is a well-recognized risk factor for in-hospital mortality in patients receiving extracorporeal membrane oxygenation (ECMO) for cardiogenic shock, but the shape of this relationship is unknown. Age is linearly... read more
Safety of Patient Mobilization and Rehabilitation in the ICU
Patient mobilization and physical rehabilitation in the ICU appears safe, with a low incidence of potential safety events, and only rare events having any consequences for patient management. Heterogeneity in the definition... read more
Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock
In this study, administration of high-dose ascorbic acid significantly decreased the requirement for vasopressor's dose and duration in surgical critically ill patients with septic shock. Several mechanisms including anti-oxidant,... read more
Evidence-Based Practice in Nursing & Healthcare
Enhance your clinical decision-making capabilities and improve patient outcomes through evidence-based practice. Develop the skills and knowledge you need to make evidence-based practice (EBP) an integral part of your clinical... read more
One Nation Under Stress
In an eye-opening new film, Dr Sanjay Gupta explores the link between stress and the continuing fall in US life expectancy. In the documentary, which premiered on HBO, Gupta speaks with scientists, affected individuals and... read more
