Prevalence and outcome of heparin-induced thrombocytopenia diagnosed under veno-arterial extracorporeal membrane oxygenation
Prevalence of HIT among patients under VA‑ECMO is extremely low at 0.36% with an associated mortality rate of 33.3%, which appears to be in the same range as that observed in patients treated with VA‑ECMO without HIT.... read more
Thiamine Deficiency: Pearls and Pitfalls
Although thiamine would not be isolated until 1911, the clinical syndrome of thiamine deficiency was recognized as far back as 2700 BC, when the term "beriberi", meaning "wasted wasted" was first coined in China. Nearly 5,000... read more
Long-Term Outcome after Prolonged Mechanical Ventilation
Among patients receiving prolonged mechanical ventilation at an LTACH, 53.7% were detached from the ventilator at discharge and 1-year survival was 66.9%. Respiratory strength was well maintained, whereas peripheral strength... read more
Prediction and Management of Severe Acute Pancreatitis
This volume provides a comprehensive summary of the field, with expert recommendations on prediction and management. It details the recent consensus guidelines (2012) updating the definition of pancreatitis and its complications.... read more
How to Deal with Severe Acute Pancreatitis in the Critically Ill
Management of severe acute pancreatitis (SAP) is multimodal with emphasis on monitoring, adequate fluid resuscitation, avoiding prophylactic use of antibiotics, cause-directed procedures or treatment, and organ support. There... read more
Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy
Epinephrine administration by bolus resulted in transient improvements in cerebral oxygenation and metabolism, whereas continuous epinephrine infusion did not, compared with placebo. Future studies are needed to evaluate... read more
Oxygen Use, Lower Lung Function Seen as Predictors of Death or Transplant in IPF
The use of oxygen at rest is associated with a greater likelihood of death or lung transplant in people with idiopathic pulmonary fibrosis (IPF), a study shows. The results also showed that lower lung function at the start... read more
Defining Sepsis on the Wards
The aim of this study is to look at the prevalence (commonness) of sepsis across acute hospitals (hospitals with an emergency department) across Wales using the currently used and new definitions of sepsis. Sepsis is a major... read more
Ketamine Sedation for Patients With Acute Behavioral Disturbance During Aeromedical Retrieval
Acute behavioural disturbance(ABD), also known as Excited Delirium Syndrome, is a medical emergency with reported mortality of 8-10%. The management of ABD usually involves a judicious combination of de-escalation techniques,... read more
Psychological and Cognitive Impact of Critical Illness
Hot off the presses. Concise book on PICS, PICS-F and FICUS. Neuropsychiatric problems after critical illness are receiving increasing attention, particularly in the critical care medicine literature, but mental health and... read more
Driving Pressure in Airway Pressure Release Ventilation: a fool’s errand?
In this post I will briefly explain and critique their mathematical approach, propose a simpler equation for estimating PEEPi in APRV [based on far fewer physiological assumptions] and finally reaffirm why, in my opinion,... read more
Positive Outcomes, Mortality Rates, and Publication Bias in Septic Shock Trials
Out of 65 eligible septic shock trials, 14 did not have a clearly defined control group (two standards of care were compared) and were excluded. For the 51 remaining trials, control-group mortality ranged between 15.9%... read more
Impact of Hypophosphatemia on Outcome of Patients in ICU
Hypophosphatemia at admission is an independent risk factor for 28-day mortality in general ICU patients. The cohort included 946 patients with a median phosphate concentration of 0.77 mmol/L. Patients with hypophosphatemia... read more
New Approaches Reduces Inappropriate Antibiotic Usage
A UC Davis study of 9 emergency departments and urgent care centers in California and Colorado found educating physicians and patients about safe antibiotic use can cut overuse by 30%. The study, funded under a contract from... read more
