Prevalence for Delirium in Stroke Patients
These results underline the importance of delirium screening in stroke patients specifically during the night. Since even short delirious episodes are associated with more complications and increased disability, future studies... read more
Never Underestimate the Simple Things We Do To Our Patients
In this compelling episode, Professor Paul Wischmeyer, shares some of his experiences as a patient in the ICU. Since he was 15 he has endured multiple hospitalizations and ICU stays for his inflammatory bowel disease. This... read more
Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI
In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose... read more
Ron Daniels Responds to Study on Sepsis Mortality Rates
New research presented at this year’s ESICM LIVES conference (the annual meeting of the European Society of Intensive Care Medicine) shows that in rich countries overall, mortality from sepsis has fallen by around a quarter... read more
Imaging platform captures hard-to-track bacterial lung infections in real time
Ahsan Akram and colleagues have created a fluorescent imaging probe that can quickly and accurately detect hard-to-trace Gram-negative bacteria (one of the major bacterial groups) in human lungs within minutes. Their first-in-human... read more
Oxygen Therapy for Acutely Ill Medical Patients
It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation. A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases... read more
Proton-Pump Inhibitor Prophylaxis in the ICU
Critical illness can disrupt local and systemic mechanisms that protect against upper gastrointestinal bleeding, a condition that may be associated with increased mortality, particularly among patients receiving extracorporeal... read more
Chasing Mortality Endpoints is a Fool’s Errand
"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more
Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI
Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more
Dopamine Antagonists in ICU Delirium
Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more
RRT Board Exam: Mechanical Ventilation
There’s nothing better than feeling confident and relaxed on exam day! Knowing that years of late night study sessions and unpaid clinical rotations are coming to an end just feels….well, absolutely fantastic! Of course,... read more
Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD
Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The... read more
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia
Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more
Artificial intelligence system could improve survival for sepsis patients
Researchers supported by the NIHR have created an artificial intelligence system that could help identify the best way to treat patients with sepsis. The system 'learnt' the best treatment strategy for a patient by analysing... read more
Initial Trophic vs Full Enteral Feeding in Patients With Acute Lung Injury
In patients with acute lung injury, compared with full enteral feeding, a strategy of initial trophic enteral feeding for up to 6 days did not improve ventilator-free days, 60-day mortality, or infectious complications but... read more
Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients
In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality,... read more
Decontamination of Oral or Digestive Tract for Patients in the ICU
The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more
Rudeness in Medical Settings Could Kill Patients
A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more
Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients
Sepsis is associated with generalised endothelial injury and capillary leak and has traditionally been treated with large volume fluid resuscitation. Some patients with sepsis will accumulate bodily fluids. The aim of this... read more
Effect of Dexmedetomidine on Mortality and Ventilation in Sepsis Patients
Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. This randomized clinical trial compares... read more
