Procalcitonin does not curb antibiotic use for lower respiratory tract infection
In the Procalcitonin Antibiotic Consensus Trial (ProACT), the use of a procalcitonin-guided antibiotic prescription guideline did not result in less exposure to antibiotics than did usual care among patients presenting to... read more
Internal Medicine Board Review E-Book: Certification and Recertification
Don't gamble on the most important exam of your career... ace the boards with The Johns Hopkins Internal Medicine Board Review! Brought to you from the birthplace of Internal Medicine and regarded as the most effective review... read more
To transfuse or not transfuse: an intensive appraisal of red blood cell transfusions in the ICU
A restrictive transfusion threshold is recommended in nearly all critically ill patients. This is at least noninferior to more liberal transfusion practice; in addition, a restrictive threshold has shown improved outcomes... read more
Feasibility, Safety, and Utility of Advanced Critical Care Transesophageal Echocardiography Performed by Pulmonary/Critical Care Fellows in a Medical ICU
Critical care transesophageal echocardiography is feasible, safe, and has clinical utility. It can be safely and effectively performed by fellows within the context of their critical care training with faculty supervision.... read more
Mobile Devices Are Reservoirs for the Transmission of Nosocomial Pathogens
Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Hundred percent contamination was found in mobile phones and hands of HCWs indicating... read more
Neutrophil Extracellular Traps Are Elevated in Patients with Pneumonia-related ARDS
Bronchoalveolar neutrophil extracellular trap concentration was not significantly associated with mechanical ventilation duration in pneumonia-related ARDS. The acute respiratory distress syndrome (ARDS) is the most severe... read more
Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections
In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of... read more
Research Ethics and Informed Consent in Critical Care
Research studies in critically ill populations pose many unique regulatory and ethical challenges that have implications for study design and execution. The life-threatening nature of conditions being studied and the urgency... read more
European Guideline on Managing Post-traumatic Bleeding: 5th Edition
An updated guideline on the management of significant bleeding and coagulopathy following major trauma has been released by the pan-European, multidisciplinary Task Force for Advanced Bleeding Care in Trauma. The document,... read more
Ascorbic Acid, Corticosteroids, and Thiamine in Sepsis
The combination of thiamine, ascorbic acid, and corticosteroids is a promising new therapy for sepsis resuscitation but currently lacks robust evidence to support its widespread use. The potential effectiveness of this medication... read more
Ketamine In Acute and Chronic Pain Management
The view of chronic pain as a symptom of a disease, rather than a disease state itself, has contributed to neglect in treating this condition. Although it is generally acknowledged that patients with chronic pain use significantly... read more
Occupational Therapy for Delirium Management in Elderly Patients without Mechanical Ventilation in an ICU
Delirium has negative consequences such as increased mortality, hospital expenses and decreased cognitive and functional status. This research aims to determine the impact of occupational therapy intervention in duration,... read more
Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education
This new edition reviews recent developments in genetics and molecular biology and new noninvasive measurement techniques that have enabled vast improvements in the measurement and understanding of cardiovascular hemodynamics.... read more
Machine Learning for the Prediction of Volume Responsiveness in Patients with Oliguric AKI in Critical Care
Excess fluid balance in acute kidney injury (AKI) may be harmful, and conversely, some patients may respond to fluid challenges. This study aimed to develop a prediction model that can be used to differentiate between volume-responsive... read more
Neutrophil Extracellular Traps (NETs) Exacerbate Severity of Infant Sepsis
Neutrophil extracellular traps (NETs) are innate defense mechanisms that are also implicated in the pathogenesis of organ dysfunction. However, the role of NETs in pediatric sepsis is unknown. This study reveals a hitherto... read more
Oxygen Therapy in Acute Resuscitation
At present, evidence is lacking to support routine liberal oxygen administration in acutely ill patients and, in most circumstances, a reasonable approach is to titrate supplemental oxygen to achieve an arterial oxygen saturation... read more
Characteristics, risk factors and outcomes of Clostridium difficile infections in Greek ICU
Clostridium difficile is one of the major causes of diarrhea among critically ill patients and its prevalence increases exponentially in relation to the use of antibiotics and medical devices. We sought to investigate the... read more
Diagnosis and Management of Acute Exacerbations of COPD – Pharmacology CME
As more and more patients present to the ED with symptoms that suggest an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) –worsening dyspnea, cough and sputum production – emergency clinicians can... read more
Meaningful Experiences and End-of-life Care in the ICU
The purpose of this study was to provide a comprehensive exploration of nurses' meaningful experiences of providing end-of-life care to patients and families in the intensive care unit (ICU). This study utilised an interpretive... read more
Noninvasive Ventilation as Acute Therapy
Noninvasive ventilation (NIV) is widely used in ICU patients to treat or to prevent acute respiratory failure (ARF). Whereas its physiological effects are clearly beneficial in hypercapnic patients, it could be deleterious... read more
Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery
Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortality. Intraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured... read more
Insidious Harm of Medication Diluents as a Contributor to Cumulative Volume and Hyperchloremia
This study identified that medication diluents contribute substantially to the total IV volume received by critically ill patients. Saline as the primary medication diluent compared with dextrose 5% in water is associated... read more
