ECMO, An Issue of Critical Care Clinics
This issue of Critical Care Clinics focuses on Mechanical Circulartory Support. Editors Nitin Puri and Michael Baram have assembled an expert team of authors on topics such as: History of Extracorporeal Membrane Oxygenation... read more
Temporal Trends in Incidence, Sepsis-Related Mortality, and Hospital-Based Acute Care After Sepsis
Owing to increasing incidence and declining mortality, the number of sepsis survivors at risk for hospital readmission rose significantly between 2010 and 2015. The 30-day hospital readmission rates for sepsis declined modestly... read more
Efficacy of Combined Intravenous Thrombolysis and Thrombectomy
Mechanical thrombectomy (MT) improves clinical outcomes in patients with acute ischemic stroke (AIS) caused by a large vessel occlusion. However, it is not known whether intravenous thrombolysis (IVT) is of added benefit... read more
Subsyndromal Delirium and Institutionalization Among Patients With Critical Illness
Subsyndromal delirium occurred in most critically ill patients, and its duration was an independent predictor of institutionalization. Routine monitoring of all delirium symptoms may enable detection of full and subsyndromal... read more
The long sepsis journey in low- and middle-income countries begins with a first step… but on which road?
Infection and sepsis are among the most frequent acute medical conditions worldwide and result in approximately eight million premature deaths each year, most of which occur in low and lower-middle income countries (LMICs).... read more
Videographic Assessment of Pediatric Tracheal Intubation Technique During Emergency Airway Management
Intubators commonly exhibited suboptimal technique during tracheal intubation such as bending deeply at the waist, having their eyes close to the patient's mouth, failing to widely open the patient's mouth, and not elevating... read more
Single-Center Experience With Venovenous ECMO for Influenza-Related ARDS
Influenza-related ARDS has a high mortality rate and patients treated only with mechanical ventilation have worse outcome than those managed with VV ECMO. More liberal use of ECMO should be considered in patients with influenza-related... read more
Updated Version of the Confusion Assessment Method for the ICU
The 2014 updated version of the CAM-ICU is valid according to DSM-5 criteria and reliable regarding inter-observer agreement in a research setting. Delirium remains under-recognized by bedside clinicians. Delirium was diagnosed... read more
Interprofessional Care and Teamwork in the ICU
A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs. "Interprofessional... read more
Procalcitonin Testing to Guide Antibiotic Therapy in Acute Upper and Lower Respiratory Tract Infections
Is the use of procalcitonin for guiding antibiotic decisions in patients with acute upper and lower respiratory tract infections associated with improved clinical outcomes compared with usual care? Among patients with varying... read more
Improving Survival Rates From Sepsis
Sepsis kills more Australians each year than breast cancer and prostate cancer combined. Daily, as many as 20,000 people worldwide are thought to die from this deadly disease. Also known as blood poisoning, sepsis is a life-threatening... read more
Simplifying Mechanical Ventilation
Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of... read more
The Speed of Sound: A New Measure to Single Out High-Risk PE Patients
Predicting which pulmonary embolism patients will do well with oral anticoagulation and which will decompensate is a bit murky, at best. The treatment of pulmonary embolism (PE) has evolved quite a bit in just the past few... read more
Phage Treatment of an Aortic Graft Infected with Pseudomonas Aeruginosa
Another phage therapy success. Bacteria-killing Viruses found in a pond knocked out an antibiotic resistant infection. Management of prosthetic vascular graft infections caused by Pseudomonas aeruginosa can be a significant... read more
A Doctor Without Health Insurance? What Could Go Wrong?
It's probably nothing. That's what I said to myself not long ago when I started feeling lousy. I should know, since I'm a physician. But I learned the hard way that those "nothings" can get serious fast - and without health... read more
NHS ICUs Sending Patients Elsewhere Due to Lack of Beds
Six in ten UK ICUs cannot function normally because they are so short of nurses, a survey has found. Patients whose lives are at risk are being turned away from their local hospitals because of a lack of intensive care beds,... read more
Survival Benefit of a Low Ratio of Visceral to Subcutaneous Adipose Tissue Depends on LDL Clearance vs. Production in Sepsis
Patients with sepsis with a high ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) have increased mortality. Our goal was to investigate the mechanism of this effect, noting that low LDL levels are... read more
Prehospital Antibiotics Improved Some Aspects of Sepsis Care
Training EMS personnel in early recognition of sepsis improved some aspects of care within the acute care chain, but did not reduce mortality, according to results of a randomized trial. Emergency medical service (EMS) personnel... read more
Hyperoxia and Hypocapnia During Pediatric ECMO
Hyperoxia is common during pediatric extracorporeal membrane oxygenation (ECMO) and associated with mortality. Hypocapnia appears to occur less often and although associated with complications, an association with mortality... read more
Pediatric Sepsis Endotypes Among Adults With Sepsis
Recent transcriptomic studies describe two subgroups of adults with sepsis differentiated by a sepsis response signature. The implied biology and related clinical associations are comparable with recently reported pediatric... read more
Outcomes in Patients with Vasodilatory Shock and RRT Treated with Intravenous Angiotensin II
Acute kidney injury (AKI) requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function... read more
Lack of Association of High Backrest With Sacral Tissue Changes in Adults Receiving Mechanical Ventilation
Although higher backrest elevation may be a theoretical risk for integrity of sacral tissues, few data support use of high backrest elevation. Level of backrest elevation is not associated with changes in tissue integrity.... read more
