Thromboelastography-based Anticoagulation Management During ECMO
Thromboelastography (TEG) seems to be safely used to guide anticoagulation management during ECMO. Its use was associated with the administration of lower heparin doses compared to a standard of care aPTT-based protocol.... read more
Immediate interruption of sedation compared with usual sedation care in critically ill postoperative patients
This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements... read more
Surfactant protein D is a causal risk factor for COPD
Surfactant protein D (SP-D) is produced primarily in the lung and is involved in regulating pulmonary surfactants, lipid homeostasis and innate immunity. Circulating SP-D levels in blood are associated with chronic obstructive... read more
Interventions to Improve the Physical Function of ICU Survivors
ICU admissions are ever increasing across the United States. Following critical illness, physical functioning (PF) may be impaired for up to 5 years. We performed a systematic review of randomized controlled trials evaluating... read more
The Shocked Intubation: Definitive Airway Sans Hypotension
Not many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of... read more
Taming the Ketamine Tiger
THOSE who anesthetize patients with ketamine (originally given the clinical investigation number CI-581) realize it is a unique pharmacological agent. Ever since its introduction into human clinical anesthesia, ketamine has... read more
The utility of biomarkers in traumatic brain injury clinical management
Currently, TBI management is guided by clinical histories and neuroimaging techniques. While these techniques may be advanced, they are more costly than serum analysis, involve exposure to ionizing radiations, and have certain... read more
Predicting the Haemodynamic Response to Prone Positioning
A Novel and Simultaneous Analysis of the Guyton and Rahn Diagrams. Graphical models of physiology are heuristically appealing as they facilitate qualitative conclusions at the bedside of the critically ill. Historically,... read more
Top 10 Tips for New Interns to Survive and Thrive the ICU Rotation
Graduating residents moving on and new interns, fresh out of medical school with their clean and crisp long white coats, moving in. Out with the old, in with the new! The ICU rotation for medicine residents and medical students... read more
Terlipressin vs. Norepinephrine As Infusion in Patients With Septic Shock
In this multicentre, randomised, double‑blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of... read more
Avoiding Common Errors in the Emergency Department
In a conversational, easy-to-read style, Avoiding Common Errors in the Emergency Department, 2nd Edition, discusses 365 errors commonly made in the practice of emergency medicine and gives practical, easy-to-remember tips... read more
What’s the Bleeding Problem with Trauma Laparotomies?!
Mortality for hypotensive trauma patients undergoing emergency laparotomy have not changed in 20 years. This blog explores the literature and the future! Wait! We're emergency physicians, why do we care about laparotomies?!... read more
Short People Have Higher Risk Of Dying In The ICU
Researchers of a new study have found a link between a patient's height and odds of survival in the intensive care unit (ICU) of the hospital. The study, published in the journal Intensive Care Medicine on Dec. 23, show that... read more
Patient-tailored Triage Decisions by Anesthesiologist-staffed Prehospital Critical Care Teams
The primary objective was to estimate the incidence of patients in the Central Denmark Region triaged to bypass the local emergency department without being part of a predefined fast-track protocol. The secondary objective... read more
Principles of Fluid Management and Stewardship in Septic Shock
There are only four major indications for fluid administration in the critically ill: resuscitation, maintenance, replacement and nutrition (enteral or parenteral). In this review, a conceptual framework is presented looking... read more
Continuous EEG Monitoring Remains Underused in Critically Ill
A retrospective cross-sectional study found that despite the fact that continuing electroencephalography (cEEG) use was associated with lower in-hospital mortality in critically ill patients, cEEG is underutilized. Experts... read more
Thinking, Fast and Slow
Winner of the National Academy of Sciences Best Book Award "Thinking, Fast and Slow" takes us on a groundbreaking tour of the mind and explains the two systems that drive the way we think. System 1 is fast, intuitive, and... read more
Effect of Levocarnitine vs Placebo as an Adjunctive Treatment for Septic Shock
In this dose-finding, phase 2 adaptive randomized trial, patients with septic shock and moderate organ dysfunction were treated early in the course of illness with low (6 g), medium (12 g), or high (18 g) doses of levocarnitine... read more
A Familiar Story: Delirium in the Acute Care Setting
A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate,... read more
Ultrasound-Guided Peripheral Intravenous Access
Obtaining intravenous (IV) access is a basic necessity in the emergency department. So what do you do when you are unable to place a peripheral IV, and your go-to external jugular line is not an option? You certainly do not... read more
You Can Get Sick From Germs on Hospital Floors
When you enter the hospital, probably the last thing that you’re thinking about is the floors. However, an emerging body of research suggests that hospital floors are covered with bacteria and could serve as a potential... read more
Healthcare Providers Should Be Ready for Nerve Agent Attacks
Recent attacks in the UK and elsewhere using powerful nerve agents show that U.S. healthcare providers don't need to be near a battlefield to find themselves dealing with similar emergencies, researchers argue in a commentary... read more
