Mechanical Ventilation Strategies for the Surgical Patient
The understanding on the protective roles of tidal volume and PEEP settings against PPCs has rapidly expanded. During intraoperative ventilation, low tidal volumes are protective, the protective role of high levels of PEEP... read more
What Could be More Exciting than Combining Ultrasound and Airway?!
Recently you may have heard The Master of the Critical Care Universe, Scott Weingart put out an episode on The Post Intubation Package. In this episode he briefly mentions using ultrasound during your intubation and commented... read more
Glycaemic Control Targets After TBI
This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more
Vascular Access in Critically Ill Pediatric Patients With Obesity
Severe obesity is associated with decreased overall likelihood of placement of a vascular access device but increased likelihood of peripherally inserted central catheter placement and of device-related complications. Patients... read more
Principles And Practice of Mechanical Ventilation
A comprehensive, authoritative coverage of all the clinical, pharmacological, and technical issues surrounding the use of mechanical ventilation. More than 100 authors, all of whom are at the forefront of research in their... read more
Comparison between a nurse-led weaning protocol and weaning based on physician’s clinical judgment in tracheostomized critically ill patients
In this pilot RCT we demonstrated that a nurse-led weaning protocol from tracheostomy was feasible and safe. A larger RCT is justified to assess efficacy. We enrolled 65 patients, 27 were in the protocol group and 38 in the... read more
The 2018-2023 World Outlook for Sepsis Drugs
This study covers the world outlook for sepsis drugs across more than 190 countries. For each year reported, estimates are given for the latent demand, or potential industry earnings (P.I.E.), for the country in question... read more
An attenuated rate of leg muscle protein depletion and leg free amino acid efflux over time is seen in ICU long-stayers
In critically ill patients with sustained organ failure and in need of a prolonged ICU stay, the initial high rate of skeletal muscle protein depletion was attenuated over time. The distinction between the acute phase and... read more
Evaluation of early administration of simvastatin in the prevention and treatment of delirium in critically ill patients undergoing mechanical ventilation
Delirium in critically ill patients is associated with poor clinical outcomes. Neuroinflammation might be an important mechanism in the pathogenesis of delirium, and since simvastatin has anti-inflammatory properties it might... read more
Predictors of Intubation in Patients With AHRF Treated With a Noninvasive Oxygenation Strategy
In patients with acute hypoxemic respiratory failure breathing spontaneously, the respiratory rate was a predictor of intubation under standard oxygen, but not under high-flow nasal cannula oxygen or noninvasive ventilation.... read more
Dexmedetomidine Prevents AKI After Adult Cardiac Surgery
Perioperative administration of dexmedetomidine in adult patients undergoing cardiac surgery may reduce the incidence of postoperative AKI. Future trials are needed to determine the dose and timing of dexmedetomidine in improving... read more
Discharge Instructions for VTE: A Comprehensive Approach to Medication Management
Discharge instructions for VTE have typically included medication management recommendations related to the use of warfarin. In recent years, however, a growing number of alternatives to warfarin, such as direct oral anticoagulants... read more
What Is PICS and How Does it Affect Patients and Families
Every year, about 6 million people are admitted to intensive care units with a life-threatening illness. As medical technology advances, more people survive conditions that once would have been fatal. However, about half... read more
A Cool Way to Save Trauma Patients
Laboratory research like Dr. Alam's has helped to provide answers to some of these questions and demonstrated the feasibility of rapidly inducing hypothermia for exsanguinating trauma. Assuming that the pilot trial and... read more
Model Identifies Seizure Risk in Critically Ill
For critically ill patients, a model comprising six variables can identify the probability of seizure, according to a study published online Oct. 9 in JAMA Neurology. Aaron F. Struck, M.D., from the University of Wisconsin... read more
An Interprofessional Quality Improvement Initiative to Standardize Pediatric Extubation Readiness Assessment
An interprofessionally developed respiratory therapist–led extubation readiness protocol can be successfully implemented in a busy tertiary care PICU without adverse events. We analyzed data from 398 mechanically ventilated... read more
Importance of Second Antibiotic Doses in ED Sepsis Patients
Most studies evaluating early antibiotic administration in sepsis patients focus on timing of the first dose. We highlight many of these studies in our recent review article on Appropriate Antibiotic Therapy in Emergency... read more
Pressure on NHS Intensive Care at Highest Level Since 2010 Swine Flu Pandemic
Pressures in intensive care units are at their highest level since the 2010 swine flu pandemic,with wards regularly having no spare beds, senior doctors have warned. Figures reported by the NHS this winter show that two-thirds... read more
The Case of the Relative Insufficiency
When it comes to the efficacy of glucocorticoid therapy for the treatment of septic shock, we have existed in a state of ambiguity, torn between the results of two contradictory RCTs. The first, the Annane et al trial published... read more
Is Fever the Normal Temperature of Sepsis
We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated.... read more
Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock
Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more
Adjunctive Glucocorticoid Therapy in Patients with Septic Shock
Among patients with septic shock undergoing mechanical ventilation, a continuous infusion of hydrocortisone did not result in lower 90-day mortality than placebo. We randomly assigned patients with septic shock who were undergoing... read more
