Failures in the Respectful Care of Critically Ill Patients
Care that is inadequately respectful to patients and families in the setting of critical illness is prevalent but does not appear to be associated with clinical characteristics. The incidence of such emotional harms is nuanced,... read more
Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions
From 2008 to 2015, total acute care utilization for the treatment of low-acuity conditions and associated spending per member in the United States increased, and utilization of non-ED acute care venues increased rapidly.... read more
Time-limited Trial of Intensive Care Treatment
In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition,... read more
Better: A Surgeon’s Notes on Performance
The struggle to perform well is universal: each of us faces fatigue, limited resources, and imperfect abilities in whatever we do. But nowhere is this drive to do better more important than in medicine, where lives may be... read more
Commencing out of bed rehabilitation in critical care – what influences clinical decision-making?
These results confirm previous observational reports that the presence of an endotracheal tube (ETT) remains a major obstacle to the provision of rehabilitation for critically ill patients. Despite rehabilitation being effective... read more
New antibiotics and antimicrobial combination therapy for the treatment of gram-negative bacterial infections
Only few new molecules have an adequate activity against MDR gram-negative pathogens, especially carbapenemase-producer strains. Among these, ceftozolane/tazobactam has been recently approved for clinical use. Other compounds,... read more
Measuring Sleep in the Intensive Care Unit: A Critical Appraisal of the Use of Subjective Methods
Research using questionnaires to assess sleep is commonplace in light of practical barriers to polysomnography or other measures of sleep. A methodologically sound approach to tool development and testing is crucial to gather... read more
Identifying Distinct Subgroups of ICU Patients: A Machine Learning Approach
Identifying subgroups of ICU patients with similar clinical needs and trajectories may provide a framework for more efficient ICU care through the design of care platforms tailored around patients' shared needs. However,... read more
Epidemiology and Changes in Mortality of Sepsis After the Implementation of Surviving Sepsis Campaign Guidelines
This is a prospective, multicenter, observational study performed during a 5-month period in 2011 in a network of 11 intensive care units (ICUs). We compared our findings with those obtained in the same ICUs in a study conducted... read more
New Guideline Aids in Diagnosing Idiopathic Pulmonary Fibrosis
A new international guideline has been developed to help physicians diagnosis idiopathic pulmonary fibrosis (IPF), a rare and often fatal lung disease whose cause is unknown. IPF is the most common and deadly form of a group... read more
Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI
Among critically ill patients with Acute Kidney Injury (AKI), early Renal Replacement Therapy (RRT) compared with delayed initiation of RRT reduced mortality over the first 90 days. Further multicenter trials of this intervention... read more
Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Among patients with severe secondary mitral regurgitation, the rate of death or unplanned hospitalization for heart failure at 1 year did not differ significantly between patients who underwent percutaneous mitral-valve repair... read more
Haemoglobin concentration and volume of intravenous fluids in septic shock in the ARISE trial
Haemoglobin concentration decreases during resuscitation from septic shock, and has a significant but weak association with the volume of intravenous fluids administered. Median (IQR) haemoglobin concentration at baseline... read more
No Requirement for Targeted Theophylline Levels for Diuretic Effect of Aminophylline in Critically Ill Children
Aminophylline administration provided a measure of increased diuresis, regardless of dosage, and theophylline trough levels. Therefore, achieving a prescribed therapeutic trough level may not be necessary for full diuretic... read more
The Danger Within Us: America’s Untested, Unregulated Medical Device Industry and One Man’s Battle to Survive It
In THE DANGER WITHIN US, award-winning journalist Jeanne Lenzer brings these horrifying statistics to life through the story of one working class man who, after his "cure" nearly kills him, ends up in a battle for justice... read more
Model Improves Prediction of Mortality Risk in ICU Patients
MIT researchers have developed a machine-learning model that groups patients into subpopulations by health status to better predict a patient’s risk of dying during their stay in the ICU. This technique outperforms "global"... read more
It Makes No Difference – Glucocorticoids for the Treatment of Septic Shock
The administration of a continuous infusion of hydrocortisone to a general population of patients in septic shock on mechanical ventilation cannot be recommended at this time. The authors conclusion that glucocorticoids do... read more
ECMO for Severe ARDS
Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more
Diagnosis and Treatment of Clostridium difficile Infection
Clostridium difficile infection (CDI) is less common than antibiotic-associated diarrhea and irritable bowel syndrome. There is significant concern about overdiagnosis and subsequent overtreatment of CDI with increasing use... read more
Finding Out What Matters to Our Patients
Do you spend time finding out what the "why" is for your patient? Have you considered it’s not what is the matter with the patient but what matters to the patient? What the patient thinks their purpose is? Or at the very... read more
SOS Asynchronies: Do We Need Help?
Synchrony between the patient and the ventilator is defined as the appropriate interaction between the two, where the ventilator recognizes patient’s effort and provides support for breathing at the right time—that is,... read more
Gender Disparities Among Adult Recipients of Bystander CPR in the Public
Males had an increased likelihood of receiving Bystander Cardiopulmonary Resuscitation (BCPR) compared with females in public. BCPR improved survival to discharge, with greater survival among males compared with females.... read more
