PET-CT in Critically Ill Patients: Diagnosing the Unsuspected

PET-CT precisely detected the deep foci of infection about 48 hours prior to the diagnosis of sepsis. The cases reports suggested the use of this image technique in ICU for patients with sepsis of unknown origin. We admitted... read more

Antithrombotic Therapy for Venous Thromboembolic Disease

This JAMA Clinical Guidelines Synopsis summarizes the American College of Chest Physicians' 2016 recommendations on antithrombotic therapy for venous thromboembolism (VTE). The estimated annual incidence of VTE, defined... read more

“Real-World” Application of Thrombolysis in Cardiac Arrest

In a single center's experience, thrombolytic therapy is used infrequently for the management of cardiac arrest. Thrombolysis during cardiac arrest should be considered on a case-by-case basis and should be utilized only... read more

Superbugs Pose a Dangerous, $65 Billion Threat to the US Health-Care System

A new report released Wednesday from the OECD estimates that antimicrobial resistant infection is on track to kill 30,000 Americans per year by 2050. The financial cost to the 33 developed countries included in the study... read more

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

Caffeine Accelerates Emergence from Isoflurane Anesthesia in Humans

Intravenous caffeine is able to accelerate emergence from isoflurane anesthesia in healthy males without any apparent adverse effects. All randomized participants were included in the analysis. The mean time to emergence... read more

Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals

The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance... read more

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