Alcohol Withdrawal: One Order to Sedate Them All
This is a retrospective cohort study describing 86 admissions to the ICU for alcohol withdrawal between 2011-2015. 86% were treated with benzodiazepines before ICU admission, usually on the general ward. The average dose... read more
Triiodothyronine Replacement in Critically Ill Adults with Non-thyroidal Illness Syndrome
This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness.... read more
Should ICU clinicians follow patients after ICU discharge? No
Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge... read more
Should ICU clinicians follow patients after ICU discharge? Yes
The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the... read more
Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers
From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection. Between January 2014 and February 2016, we recruited 272, 59 and... read more
Organ and Tissue Donation Education for Critical Care Residents
Qualitative data corroborated that residents need more exposure to clinical cases, especially regarding DCD donors. A standardized education curriculum would be beneficial for all residents within the ICU. Developing a better... read more
Hydrocortisone plus Fludrocortisone for Adults with Septic Shock
The use of steroids in critically ill patients continues to be controversial. Whilst there are signals for improved cardiovascular parameters, this did not translate to clear mortality benefits. The most recent of these trials... read more
Abnormal Environmental Light Exposure in the ICU Environment
Patients' environmental light exposure in the intensive care unit is consistently low and follows a diurnal pattern. No effect of nighttime light exposure was observed on melatonin secretion. Inadequate daytime light exposure... read more
Dutch Ambitions on eHealth
Dutch government is encouraging the healthcare sector to expand telehealth (eHealth) services. Dutch government wants eHealth to become more widely available and is encouraging the healthcare sector to develop it further.... read more
High Generic Drug Prices and Market Competition: A Retrospective Cohort Study
Market competition levels were associated with a change in generic drug prices. Such measurements may be helpful in identifying older prescription drugs at higher risk for price change in the future. From 1.08 billion prescription... read more
Positive End-expiratory Pressure and Mechanical Power
Less than 7 cm H2O positive end-expiratory pressure reduced atelectrauma encountered at zero end-expiratory pressure. Above a defined power threshold, sustained positive end-expiratory pressure contributed to potentially... read more
The Gender Gap in Critical Care Medicine: How Are We Doing Globally?
Female enrollment into medical schools is increasing worldwide, but gender disparities persist in certain specialties, especially in critical care medicine. Published data on the scale of this issue is scarce and a recent... read more
CT-based Measurements Beat Framingham Risk Score in Predicting Future CVD Events
Assessment of abdominal aortic calcification using computed tomography (CT) is a highly effective predictor of future heart attack and CVD risk, according to research published in Radiology Oct. 2—more effective even than... read more
Magnesium Sulfate for Rapid Atrial Fibrillation?
Currently, several medications are recommended for the management of atrial fibrillation with rapid ventricular response in the emergency department including calcium channel blockers, beta blockers and digoxin (the optimal... read more
Update on Perioperative Acute Kidney Injury
Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a... read more
How Do Resuscitation Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest Succeed?
Resuscitation teams at hospitals with high IHCA survival differ from non–top-performing hospitals. Our findings suggest core elements of successful resuscitation teams that are associated with better outcomes and form the... read more
The Dreaded Acute Compartment Syndrome
When obtaining intracompartmental pressures, place the catheter within 5cm of the fracture level, with the transducer secured at the level of the measured compartment. Make sure to keep the catheter tip outside of the actual... read more
Do phenylephrine and epinephrine require central access?
Until recently I believed that prolonged vasopressor administration requires a central line, to avoid extravasation. I lumped together all vasopressors, treating them all as equal. I used the occurrence of an extravasation... read more
PTSD Phenomena After Critical Illness
Experiencing critical illness and intensive care can be extremely stressful. Roughly 1 in 5 critical illness survivors have clinically significant post-traumatic stress disorder (PTSD) symptoms in the year after intensive... read more
Stopping ICU delirium by getting patients moving
Doctor says the treatment plan makes a 'massive difference' to those in critical care. Any hospital stay can be traumatic. But 30 percent of patients in intensive care units experience ICU delirium. The rate for... read more
Haloperidol Serum Concentrations in Critically Ill Patients Included in the REDUCE Study
ICU delirium occurs frequently and is associated with unfavorable outcome. A recent delirium prevention study, the REDUCE study, has assessed the efficacy of prophylactic use of haloperidol. In this subset... read more
pH-guided Fluid Resuscitation and BICAR-ICU
The use of bicarbonate is a source of eternal disagreement. Bicarbonate has a shameful history of being abused in situations where it's unhelpful (e.g. cardiac arrest). This has impugned its reputation, giving it an aura... read more
