What constitutes optimal glucose management in Critical Care?

Glycaemic Control in the EU. Following on from the poster we presented at the Intensive Care Society. We asked Sphere Medical's own Dr Gavin Troughton to present at our launch event. In the below video he goes into more... read more

Haloperidol for the Management of Delirium in Adult ICU Patients

Among critically ill patients, haloperidol administration compared with placebo does not significantly affect short-term mortality, incidence of delirium, ICU length of stay, or delirium or coma-free days. Additionally, there... read more

Insulin-Treated Diabetes Reduces Dysglycemia-Related Mortality in Sepsis

Patients with sepsis and a pre-existing diagnosis of insulin-treated diabetes (ITD) may show a different relationship between hospital mortality and highest glucose levels and glycemic variability in the first 24 hours than... read more

High-frequency Oscillatory Ventilation: Still a Role?

In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. Although not first-line, HFOV remains... read more

Norepinephrine in Septic Shock

Norepinephrine (NE) is both an alpha1- and beta1-agonist, and is therefore able to increase vascular tone and contractility. Recent guidelines recommend NE as the first-line vasopressor in septic shock. However, because septic... read more

A Mixed Methods Exploration of ICU Nurses’ Perception of Handling Oxygen Therapy to Critically Ill Patients

Nurses handle supplementary oxygen to intensive care unit (ICU) patients as part of their daily practice. To secure patients of optimal and safe care, knowledge of nurses' perception of this practice, including influencing... read more

Relationship Between Level of CPR Training, Self-reported Skills, and Actual Manikin Test Performance

As expected, higher levels of BLS training correlated with better cardiopulmonary resuscitation (CPR) quality. However, this study showed that ventilations and hands-on time were the components of CPR that were most affected... read more

How to Improve Worldwide Early Enteral Nutrition Performance in ICUs?

Early enteral nutrition (EEN), typically started within 48 h after ICU admission, is recommended to be superior over delayed enteral nutrition and parenteral nutrition. The ESICM Working Group on Gastrointestinal Function... read more

Dosing Adjuvant Vitamin C in Critically Ill Patients Undergoing CRRT

We read with great interest the recent letter to Critical Care by Marik and Hooper. Vitamin C is increasingly recognized as a crucial compound to alleviate morbidity in critically ill patients. Vitamin C concentrations, however,... read more

Management of the Critically Ill Adult Chimeric Antigen Receptor-T Cell Therapy Patient

Until modifications in chimeric antigen receptor T-cell therapy decrease their toxicities, the intensivist will play a leading role in the management of critically ill chimeric antigen receptor T-cell patients. As this novel... read more

Characterising Risk of In-Hospital Mortality Following Cardiac Arrest Using Machine Learning

Resuscitated cardiac arrest is associated with high mortality; however, the ability to estimate risk of adverse outcomes using existing illness severity scores is limited. Using in-hospital data available within the first... read more

Outcomes of Patients Presenting with Mild ARDS

Hospital mortality in acute respiratory distress syndrome (ARDS) is approximately 40%, but mortality and trajectory in "mild" acute respiratory distress syndrome (classified only since 2012) are unknown, and many cases are... read more

Are “Sniffer” Systems Effective in Detecting ARDS?

Acute respiratory distress syndrome (ARDS) results in substantial mortality but remains underdiagnosed in clinical practice. For this reason, automated "sniffer" systems that analyse electronic records have been developed... read more

Ethical dilemmas in Emergency Medicine

When we talk about triage, we could mean several things. We might mean the triage of patients arriving in the ED to assign clinical priority (because not everyone can be seen instantly); we might mean the triage of patients... read more

Plasma mitochondrial DNA and metabolomic alterations in severe critical illness

Cell-free plasma mitochondrial DNA (mtDNA) levels are associated with endothelial dysfunction and differential outcomes in critical illness. A substantial alteration in metabolic homeostasis is commonly observed in severe... read more

Vitamin C: Should We Supplement?

A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia.... read more

Cricoid Pressure in Airway Management: The IRIS Trial

This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the non-inferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more

The Benefit of Lung-Protective Ventilation in the ED

Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely... read more

Reducing Hospital-Acquired Infections Among the Neurologically Critically Ill

Hospital-acquired infections (HAIs) result in excess morbidity, mortality, and resource consumption. Immobilized, ventilator-dependent ICU patients are at the highest risk of HAI. Despite broad implementation of relevant... read more

ICU Costs Higher for Patients Dying Before Discharge

The high cost of critical care has engendered research into identifying influential factors. However, previous studies have not considered patient vital status at ICU discharge. This is what a new study has found: The largest... read more

A Nurse’s Story

The team of nurses that Tilda Shalof found herself working with in the intensive care unit (ICU) of a big-city hospital was known as "Laura's Line." They were a bit wild: smart, funny, disrespectful of authority, but also... read more

A Nurse’s Story

High-flow Nasal Cannula Oxygen Therapy for AHRF in Patients with CLD

A high-flow nasal cannula (HFNC) is a high-flow oxygen supply device developed in recent years and is increasingly being used to treat acute hypoxemic respiratory failure (AHRF) in intensive care unit (ICU). Patients with... read more