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
Prospective Assessment of the Feasibility of a Trial of Low Tidal Volume Ventilation for Patients with Acute Respiratory Failure
Use of initial tidal volumes less than 8 ml/kg PBW is common at hospitals participating in the NHLBI PETAL Network. After considering the size and budgetary requirement for a cluster-randomized trial of LTVV vs. usual care... read more
No Bleeding Required: Anemia Detection via Smartphone
Biomedical engineers have developed a smartphone app with the aim of non-invasive detection of anemia. Instead of a blood test, the app uses photos of someone's fingernails taken on a smartphone to determine whether the level... read more
Fluid Responsiveness in a Hemodynamically Unstable Patient
Only half of patients who are hemodynamically unstable will respond to a fluid bolus. There are no historical or physical examination findings that can help us decide whether a patient is a fluid responder, but we must treat... read more
Clinical Performance of Beta-D-Glucan for the Diagnosis of Pneumocystis Pneumonia in Cancer Patients Tested with PCP PCR
Patients negative by both Beta-D glucan (BDG) and PCR were unlikely to have Pneumocystis pneumonia (PCP). In patients with a compatible clinical syndrome for PCP, higher BDG values (>200 pg/mL) were consistently associated... read more
Meaning of Intracranial Pressure-to-Blood Pressure Fisher-Transformed Pearson Correlation-Derived Optimal Cerebral Perfusion Pressure
These mechanistic simulations provide insight into the empiric basis of optimal cerebral perfusion pressure and the significance of PRx and Δ CPP. PRx and optimal cerebral perfusion pressure deviations do not directly reflect... read more
Tigecycline in Critically Ill Patients on Continuous RRT
Despite high dialysability, dialysis clearance displayed only a minor contribution to tigecycline elimination, being in the range of renal elimination in patients without AKI. No dose adjustment of tigecycline seems necessary... read more
Dual Antiplatelet Therapy with Aspirin and Clopidogrel for Acute High Risk Transient Ischemic Attack and Minor Ischemic Stroke
What is the role of dual antiplatelet therapy after high risk transient ischemic attack or minor stroke? Specifically, does dual antiplatelet therapy with a combination of aspirin and clopidogrel lead to a greater reduction... read more
Antimicrobial Exposure and the Risk of Delirium in Critically Ill Patients
First-, second-, and third-generation cephalosporins doubled the odds of delirium after baseline co-morbidities, ICU type, the course of critical care, and other competing antimicrobial and psychotropic medication risks were... read more
Crystalloids vs. Colloids for Fluid Resuscitation in the ICU
This systematic review and meta-analysis, which included only high-level evidence from randomized, controlled trials (RCTs) conducted in intensive care settings, revealed that crystalloids were less effective than colloids... read more
Risk Factors for 1-Year Mortality and Hospital Utilization Patterns in Critical Care Survivors
One in five ICU survivors die within 1 year, with advanced age and comorbidity being significant predictors of outcome, leading to high resource use. Care process factors indicating high system stress were associated with... read more
Caring for Critically Ill Patients with the ABCDEF Bundle
ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge... read more
Effect of a Program Combining Transitional Care and Long-term Self-management Support on Outcomes of Hospitalized Patients With COPD
In a single-site randomized clinical trial of patients hospitalized due to Chronic obstructive pulmonary disease (COPD), a 3-month program that combined transition and long-term self-management support resulted in significantly... read more
More Healthcare Workers Born Outside the USA
The healthcare sector continues to lead the way in hiring. A new study found more than 16% of healthcare professionals surveyed in 2016 were born outside the U.S.... read more
Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold
Long-term mortality rates and HRQoL did not differ in patients with septic shock and anaemia who were transfused at a haemoglobin threshold of 7 g/dl versus a threshold of 9 g/dl. We may reject a more than 3 % increased hazard... read more
Remodeling ICU Care
A new study finding that two antipsychotics were no more effective than placebo for delirium in critical illness spurs discussion about alternative methods for managing that care. Neither haloperidol nor ziprasidone — both... read more
