Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure
The purpose of this trial is to investigate the efficacy and safety of continuous intravenous administration of low dose iloprost versus placebo for 72-hours, in up to a total of 380 patients with septic shock suffering from... read more
Hyperoxia in the Critically Ill
Critically ill patients come to the ED all the time and it is almost reflexive to liberally administer oxygen in these acutely ill patients. Many providers may consider supplemental oxygen a harmless and potentially beneficial... read more
When Patients Die in the ICU, Should Their Family Be Allowed to Watch?
In most ICUs, it's standard practice to send relatives out of the room when a patient codes, but a growing body of research—and one doctor's personal experience—suggests relatives should be allowed to witness the medical... read more
Critical: Science and Stories From the Brink of Human Life
Following in the wake of hugely successful medical memoirs such as Do No Harm and Fragile Lives, Critical is an intelligent, compelling and profoundly insightful journey into the world of intensive care medicine and the lives... read more
Effects of Neuromuscular Block Reversal with Sugammadex vs. Neostigmine on Postoperative Respiratory Outcomes After Major Abdominal Surgery
No differences found in pulmonary function in patients reversed with sugammadex or neostigmine in a high-risk population. 126 patients were included in the main analysis. In the neostigmine group (n = 64), mean (95%... read more
How To Prevent Brain-Sapping Delirium In The ICU
After an overwhelming infection sent O'Burke into five-organ failure, he also developed ICU delirium, perhaps related to heavy sedation. An ICU protocol developed at Vanderbilt University Medical Center found that getting... read more
Use of Levosimendan in ICU Settings
Levosimendan has been demonstrated to have potential utility in a range of critical illness scenarios. It must be acknowledged, however, that in each sphere of application, the evidence is incomplete or indicative rather... read more
How Should We Treat Acinetobacter Pneumonia?
The optimal treatment for multidrug-resistant A. baumannii pneumonia has not been established. New therapeutic options are urgently needed. Well designed, randomized controlled trials must been conducted to comprehensively... read more
Early vs. Delayed Administration of Norepinephrine in Patients with Septic Shock
This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. Our results show that early administration of norepinephrine in... read more
Transport of a Prone Position ARDS Patient
Critical care transport of prone acute respiratory distress syndrome (ARDS) patients is a feasible and cost-effective intervention that will help prevent treatment delays and interruptions. A nonphysician critical care... read more
Should fecal microbial transplantation be used in the ICU?
FMT has become an attractive option to mitigate multiple organ dysfunction in the ICU. This article discusses the physiology, rationale, early experience, and expectations for such therapy in the critically ill patient. The... read more
Is Hemoglobin Good for Cerebral Oxygenation and Clinical Outcome in Acute Brain Injury?
Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Ventilation
This complex randomized, controlled trial failed to demonstrate that early extubation to non-invasive ventilation reduced the total time of mechanical ventilation. I will continue to extubate early and will use non-invasive... read more
Septic Shock and the Use of Norepinephrine IMCU
Elderly patients with septic shock treated with norepinephrine (NE) displayed a better Intermediate Care Unit (IMCU) survival at the ward and at 30 days than previously expected. Our retrospective chart study did not... read more
