EHR-guided Strategy Reduces Postop VTE Events
By incorporating algorithms into the electronic health record (EHR), UPMC was able to realize a "dramatic" 72% reduction in missed doses, from 4,331 missed doses in 2014 to 1,193 in 2015, Dr. Neal told attendees in a session... read more
The Social Media Index as an Indicator of Quality for Emergency Medicine Blogs
The Social Media Index’s correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality. It can play a role in guiding individuals to high-quality... read more
Cardiopulmonary Monitoring of Shock
Shock has potentially reversible causes of morbidity and mortality if appropriately diagnosed and managed. Older methods of invasive monitoring have significant limitations but are still critical for managing shock in certain... read more
Postoperative Renal Dysfunction After Noncardiac Surgery
Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures.... read more
Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?
In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx... read more
Assessment of the adequacy of oxygen delivery
In this article, we review physiologic principles of global oxygen delivery, and discuss the bedside approach to assessing the adequacy of oxygen delivery in critically ill patients. Although there have been technological... read more
No more antipsychotics for delirium? Not so fast!
Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more
Carbonic anhydrase inhibitors in patients with respiratory failure and metabolic alkalosis
In patients with respiratory failure and metabolic alkalosis, carbonic anhydrase inhibitor therapy may have favorable effects on blood gas parameters. In mechanically ventilated patients, carbonic anhydrase inhibitor therapy... read more
Ultrasound as a Screening Tool for Central Venous Catheter Positioning and Exclusion of Pneumothorax
Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule... read more
Sedation and Mobilization during Venovenous Extracorporeal Membrane Oxygenation for ARF
The majority of respondents reported targeting moderate to deep sedation following cannulation, with the use of sedative and opioid infusions. There is considerable variability surrounding early physical therapy and mobilization... read more
Shared Decision Making – The Importance of Diagnosing Preferences
Shared decision making occurs when patients and clinicians reach a formulation about the presenting problem and discuss how to manage it. If there are several reasonable alternatives, the alternatives should be explicitly... read more
Identifying associations between diabetes and ARDS in patients with AHRF
Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of... read more
A retrospective observational study of acquired subglottic stenosis using low-pressure, high-volume cuffed endotracheal tubes
The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic... read more
The Power of Social Media in Medicine and Medical Education
Social media is changing the ways that patients interact with healthcare providers and the healthcare system. It is increasingly common for patients to use information technology to gain access to information and control... read more
The Impact of Frailty on ICU Outcomes
Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information... read more
Angiotensin converting enzyme defects in shock: implications for future therapy
Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more
Antipsychotic Prescribing Patterns During and After Critical Illness
In this study, antipsychotics were used to treat nearly half of all antipsychotic-naïve ICU patients and were prescribed at discharge to 24% of antipsychotic-treated patients. Treatment with an atypical antipsychotic greatly... read more
Differences in attitudes towards end-of-life care among intensivists, oncologists and prosecutors in Brazil
There is great variability in end-of-life care and the legal context may interfere with decisions on limitation of medical treatment. In Brazil, end-of-life care was initially regulated in 2006, but legal controversies still... read more
The Precogs Take On Sepsis
It seems like every week there’s another publicized instance of our impending replacement by artificial intelligence. Big Data, they say, is going to free us of the cognitive burdens of complex thought while maximizing... read more
The impact of age on the innate immune response and outcomes after severe sepsis/septic shock in trauma and surgical ICU patients
Aged, critically ill surgical patients have greater organ dysfunction and incidence of adverse clinical outcomes after sepsis. Biomarker profiles suggest an immunophenotype of persistent immunosuppression and catabolism.... read more
Exploring the Potential Effectiveness of Combining Optimal Nutrition With Electrical Stimulation to Maintain Muscle Health in Critical Illness
This article explores the potential role of nutrition and EMS in maintaining muscle health in critical illness. Within this article, we will evaluate fundamental concepts of muscle wasting and evaluate the effects of EMS,... read more
When health professionals have empathy, patients aren’t the only ones who benefit
What do doctors and religious leaders have in common? At least a couple of big things: individuals in both professions engage with people at some of the most critical moments in their lives and require a high degree of empathy... read more
