Words that Heal: ICU Journals at Penn Help Patients and Staff
After years of planning, Penn Presbyterian began offering the journals in January to help prevent post-intensive care syndrome or PICS, a set of physical and emotional problems gaining attention as more people survive an... read more
Fluid Bolus Over 15-20 Versus 5-10 Minutes Each in the First Hour of Resuscitation in Children With Septic Shock
Children receiving fluid boluses over 5–10 minutes each had a higher risk of intubation than those receiving boluses over 15–20 minutes each. Notwithstanding the lack of difference in risk of mortality and the possibility... read more
Airway Pressure-time Curve Profile Detects Tidal Recruitment/Hyperinflation
Airway pressure-time curve profile (stress index) detects tidal recruitment/hyperinflation in experimental acute lung injury. Shape of the Paw-t curve detects tidal recruitment and tidal hyperinflation. Pulmonary computed... read more
Epidemiology of Sepsis in Turkish ICUs
The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms,... read more
Cystic Fibrosis Transmembrane Conductance Regulator Potentiation as a Therapeutic Strategy for Pulmonary Edema
Cystic fibrosis transmembrane conductance regulator potentiation by ivacaftor is a novel therapeutic approach for pulmonary edema. Ivacaftor significantly improved alveolar liquid clearance in isolated pig lung lobes ex vivo... read more
Novel Oral Anticoagulants and Trauma
The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants... read more
Resuscitation of Pulmonary Hypertension and RV Failure
A guide to the initial emergency department management of patients with pulmonary hypertension and right ventricular failure. It is very rare for my to write about pathophysiology, but understanding the pathophysiology of... read more
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
