Clinical Decision Support for In-Hospital AKI
AKI carries a significant mortality and morbidity risk. Use of a clinical decision support system (CDSS) might improve outcomes. We conducted a multicenter, sequential period analysis of 528,108 patients without ESRD before... read more
Abnormal Saline and the History of Intravenous Fluids
Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more
Why a terminally ill young woman has changed her mind about living
o face each day, Claire Wineland undergoes hours of breathing treatments. It's a reality of living with cystic fibrosis she's come to accept. But last month, as the nebulizer hummed loudly in her La Jolla, California, hotel... read more
Early Interventions for the Prevention of Posttraumatic Stress Symptoms in Survivors of Critical Illness
Despite a paucity of high-quality clinical investigations, the preponderance of evidence to date suggests that 1) posttraumatic stress disorder among survivors of critical illness may be preventable and 2) early interventions... read more
A Randomized Trial of a Family-Support Intervention in ICUs
Family-support intervention in ICUs increased patient comfort and reduced costs. Among critically ill patients and their surrogates, a family-support intervention delivered by the interprofessional ICU team did not significantly... read more
Looking for a Better Way to Treat Hypoxia in the Emergency Department? Reach for High-Flow Nasal Cannula
High-flow nasal cannula should be considered a first-line therapy in all patients with hypoxemic respiratory failure not from cardiogenic pulmonary edema and without concomitant hypercapnia. The high flow rate of HFNC offers... read more
Do We Know Enough to Recommend Corticosteroids in ARDS?
We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more
Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries
In this retrospective secondary analysis of 9 diverse LMIC cohorts that included 6569 hospitalized adults with suspected infection, a qSOFA score greater than or equal to 2 was significantly associated with increased likelihood... read more
Temporal Biomarker Profiles and Their Association with ICU Acquired Delirium
While there are differences in markers (adiponectin and several brain proteins) between patients with and without delirium, the development of delirium is not preceded by a change in the biomarker profile of inflammatory... read more
The Answer My Friend is Blowin’ in your Nose – High Flow Nasal Oxygen
High flow nasal oxygen is a novel device that actively humidifies and heats air to make flows of up to 60 liters a minutes tolerable. These incredibly high flows are important, because in order to provide 100% fiO2 to patients... read more
Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy
The 5-year TACTIC project is a multi-component study, a main focus of which is the development of European-wide clinical trial, entitled "Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy... read more
Whole Blood – More than the Sum of Its Components?
This retrospective analysis was conducted in a US Military population across 6 combat hospitals in Iraq and Afghanistan between January 2004 and October 2007. Patient's transfused at least 1 unit RBCs met inclusion criteria... read more
A 10-year review of total hospital onset ICU bloodstream infections at an Academic Medical Center
Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1000 patient days in FY05 to 0.32/1000 patient days in FY14; an 85.0% decrease (P<0.0001). Secondary BSIs also progressively decreased from 3.56/1000... read more
Cook County ICU: 30 Years of Unforgettable Patients and Odd Cases
An inside look at one of the nation's most famous public hospitals, Cook County, as seen through the eyes of its longtime Director of Intensive Care, Dr. Cory Franklin. Readers will be riveted by stories of strange medical... read more
Muscle Weakness and 5-Year Survival in ARDS Survivors
At hospital discharge, >1/3 of Acute Respiratory Distress Syndrome (ARDS) survivors had muscle weakness. Greater strength at discharge and throughout follow-up was associated with improved 5-year survival. In patients with... read more
Passive Detection of Atrial Fibrillation Using a Commercially Available Smartwatch
In this author interview, Gregory M. Marcus, MD, MAS discusses passive detection of Atrial Fibrillation using a commercially available smartwatch.... read more
Ten Shortcomings of the Current Definition of AKI
Acute kidney injury (AKI) is defined as an abrupt decline in kidney function. Although the kidney has many functions, this "abrupt decline" mostly refers to the glomerular filtration rate (GFR) that cannot... read more
Sepsis patients treated and released from emergency departments do well with outpatient follow-up
National guidelines assume that all patients who're diagnosed with clinical sepsis in an emergency department will be admitted to the hospital for additional care, but new research has found that many more patients are being... read more
Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children
Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion... read more
Dr. Ultrasound and Mr. Hyde: my confessions as an educator and ICU geek
I think most people in our field have had some or all of these thoughts. I feel guilty thinking them and certainly have a hard time verbalizing to other team members. Point of Care Ultrasound (POCUS) has swept the medical... read more
Hot Lights, Cold Steel: Life, Death and Sleepless Nights in a Surgeon’s First Years
This story of Collins' four-year surgical residency traces his rise from an eager but clueless first-year resident to accomplished Chief Resident in his final year. With unparalleled humor, he recounts the disparity between... read more
The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research
TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction... read more
