Vasodilatory Shock in the ICU and the Role of Angiotensin II
With the approval and release of angiotensin II, a new vasoactive agent is now available to utilize in these patients. Overall, the treatment for vasodilatory shock should not be a one-size fits all approach and should be... read more
Predicting Mortality in Patients Undergoing VA-ECMO After CABG
Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score... read more
Adherence to Guidelines for the Management of Donors After Brain Death
Guideline adherence to an expert panel predefined care set in brain death (DBD) donor management proved moderate leaving substantial room for improvement. An importance-performance analysis can be used to improve implementation... read more
Artificial Intelligence in the ICU
ICU doctors are often required to analyse large volumes of complex, heterogeneous data to make life-critical decisions. Artificial Intelligence (AI), if used effectively, could reduce this burden by transforming data into... read more
Many Doctors Have Distorted Perceptions of the Value of Medical Tests
In 2014, the Canadian Task Force on Preventive Health Care recommended against the prostate-specific antigen (PSA) test used to screen for prostate cancer in healthy men, concluding that it results in substantial harms via... read more
A New ICU Equipment Diagram… But is it Art?
It is well established that the Arts have a clear contribution to make in the delivery of an improved healthcare experience for patients, service users and staff. Southmead Hospital (part of North Bristol NHS Trust) has a... read more
Shock: Roadside to Resus
If you're involved in the care of critically unwell patients then you will frequently encounter patients who are shocked. The European Society of Intensive Care Medicine defines shock as; "Life-threatening, generalized... read more
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
