The Case of the Dying Soldiers: Practical Applications of Pharmacology Concepts in Critical Care
Pharmacokinetics and pharmacodynamics are very important when it comes to treating critically ill or critically injured patients. However, when we teach this topic we usually present things using complex equations and explanations... read more
Delirium in ICU Prevented With Nocturnal Administration of Dexmedetomidine
Low-dose dexmedetomidine administered at night to critically ill adults reduced the incidence of delirium during intensive care unit (ICU) stays and patient-reported sleep quality remained unchanged, according to a study... read more
Weaning from the Ventilator and Extubation in ICU
Current research is focusing on preventing extubation failure, especially in the most challenging cases. The use of weaning protocols – written or computerized – attempts to early identify patients who are able to breathe... read more
Diagnosis of Sepsis from a Drop of Blood by Measurement of Spontaneous Neutrophil Motility in a Microfluidic Assay
Current methods for the diagnosis of sepsis have insufficient precision, causing regular misdiagnoses. Microbiological tests can help to diagnose sepsis, but are usually too slow to have an impact on timely clinical decision-making.... read more
Left Ventricular Unloading During Veno-Arterial ECMO
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is widely used in cardiogenic shock. It provides systemic perfusion, but left ventricular (LV) unloading is suboptimal. Using a closed-loop, real-time computer model... read more
Excess dietary zinc worsens Clostridium difficile infection
The consumption of dietary supplements and cold therapies containing high concentrations of zinc is now being called into question, following research that suggests it may worsen Clostridium difficile infection. The findings... read more
The Use of Bolus-Dose Vasopressors in the Emergency Department
While bolus-dose vasopressors are commonly used in critical care medicine and anesthesiology to treat patients with hypoperfusion, its application in emergency medicine is minimal with little penetration into daily care.... read more
Emergency Management of Intracerebral Hemorrhage – The Golden Hour
There is a kind of self-fulfilling prognostic pessimism when it comes to Intracerebral Hemorrhage. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome... read more
Comparing Effects Between Music Intervention and Aromatherapy on Anxiety of Patients Undergoing Mechanical Ventilation in the ICU
Music and aromatherapy interventions were both effective for ICU patients. The effects of music intervention were greater than that of aromatherapy; both interventions maintained the effects for at least 30 min. The Music... read more
Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage
This guideline provides timely, evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. Utilizing the GRADE methodology, the committee developed... read more
Reducing contamination rates in urine samples
Contamination is thought to be a significant problem. Depending on which study you look at, the rates of urine contamination can be 17% or upwards. The standard method of midstream urine collection is for the healthcare professional... read more
Is It CHF? Sepsis? Something Else?
A 59-year-old morbidly obese woman with a history of congestive heart failure presented with three days of intermittent chest discomfort. She characterized it as heartburn—a mid-epigastric burning sensation radiating up... read more
The Encore: A Memoir in Three Acts
The remarkable true story of acclaimed opera singer Charity Tillemann-Dick, who received not one but two double lung transplants and went from struggling to draw a single breath to singing at the most prestigious venues in... read more
When to Withdraw Resuscitation in the ED
When can and should we withdraw from continuing resuscitation in the Emergency Department? We are here to save lives. I would argue the Emergency Medicine is a very pure expression of a Doctor's role: we meet a patient, we... read more
One-Year Outcomes in Patients With ARDS
Poor functional recovery after invasive mechanical ventilation for acute respiratory distress syndrome is common. Helmet noninvasive ventilation may be the first intervention that mitigates the long-term complications that... read more
Indicators of ICU Capacity Strain
We identified and characterized 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains. Future work should aim to evaluate their implementation into practice and assess their value for evaluating... read more
Risk of Recurrence After Surviving Severe Sepsis
Risk of recurrence after surviving severe sepsis is substantial regardless of patient characteristics or infection sites. Further research is necessary to find underlying mechanisms for the high risk of recurrence in these... read more
What’s Your Doctor Reading? How Social Media is Disrupting Medical Education
Traditionally, research would be presented at conferences, discussed at meetings, and gradually incorporated into international guidelines and textbooks. It would then filter down into clinical practice, years after its original... read more
Creating a “Manageable Cockpit” for Clinicians
For many clinicians, the work of health care has become undoable. The "cockpit" where physicians and other health professionals work now consists of a cacophony of warning alerts, pop-up messages, mandatory tick boxes, a... read more
Empiric Antibiotics Tend To Be Prolonged in ICU
Using antibiotics in critically ill patients is very much walking a tightrope. No one wants to miss an infection in a patient who could go downhill quickly, but no one wants to overuse these precious drugs, either.... read more
Johns Hopkins Investigators Unravel Biological Roots of Pulmonary Hypertension
Working with cells that line the innermost layer of the blood vessels, Johns Hopkins investigators say they have made a leap forward in understanding the underlying biology behind pulmonary hypertension, a dangerous type... read more
Biomarkers for Prediction of RRT in AKI
Acute kidney injury (AKI) frequently occurs in critically ill patients and often precipitates use of renal replacement therapy (RRT). However, the ideal circumstances for whether and when to start RRT remain unclear. We performed... read more
