Should We Manage All Septic Patients Based on a Single Definition?
It is indisputable from the biological and clinical perspectives that not all cases of sepsis are the same. On the contrary, most have great many differences, that is, different portals of entry, clinical manifestations,... read more
Neural Breathing Pattern and Patient-Ventilator Interaction During Neurally Adjusted Ventilatory Assist and Conventional Ventilation in Newborns
Patient-ventilator interaction appears to be improved with neurally adjusted ventilatory assist. Analysis of the neural breathing pattern revealed a reduction in central apnea during neurally adjusted ventilatory assist use.... read more
More Than a Tick Box: Medical Checklist Development, Design, and Use
Despite improving patient safety in some perioperative settings, some checklists are not living up to their potential and complaints of "checklist fatigue" and outright rejection of checklists are growing. Problems reported... read more
Human Airway Branch Variation and COPD
Susceptibility to chronic obstructive pulmonary disease (COPD) beyond cigarette smoking is incompletely understood, although several genetic variants associated with COPD are known to regulate airway branch development. We... read more
ECMO for Severe Middle East Respiratory Syndrome Coronavirus
Extracorporeal membrane oxygenation (ECMO) use, as a rescue therapy, was associated with lower mortality in MERS patients with refractory hypoxemia. The results of this, largest to date, support the use of ECMO as a rescue... read more
Train Of Four Monitoring
A peripheral nerve stimulator, also called the "train of four", is used to assess nerve function in patients receiving neuromuscular blocking agents (AKA paralytic medications). It is commonly seen used in critical care... read more
Hypothermia in Sepsis – The CASS Trial
Sepsis and especially septic shock (no matter what definition you use) is a recipe for multi-organ dysfunction and poor prognosis. In the past few years, we saw a lot of failed attempts trying to find something that could... read more
A Qualitative Exploration of the Discharge Process and Factors Predisposing to Readmissions to the ICU
Severe illness predisposes ICU patients to readmission, especially when goals of care were not adequately addressed. Communication, premature discharge, and other factors, mostly unrelated to the patient were also perceived... read more
TBI Outcomes in an LMIC Tertiary Care Centre and Performance of Trauma Scores
This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery.... read more
Fluid Management in Cardiac Surgery
Perioperative fluid management in cardiac surgery patients may have changed in the last few years in European centers. Balanced crystalloids now seem to be the preferred solutions, followed by synthetic colloids (mainly gelatins)... read more
Business of Critical Care and Value/Performance Building
New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care... read more
High Frequency Percussive Ventilation Increases Alveolar Recruitment in Early ARDS
High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing... read more
AACN Essentials of Critical Care Nursing
Endorsed by the American Association of Critical-Care Nurses (AACN) and written by top clinical experts in critical care nursing, this textbook covers all the must-know details on the care of adult, critically ill patients... read more
Perceptions of Risk and Safety in the ICU
This study drew on cognitive research, specifically theories of cognitive dissonance, psychological safety, and situational awareness to explain how professionals' cognitive processes impacted on ICU behaviors. Our results... read more
Prevalence of Anxiety and Depression Symptomatology in Adolescents Faced With the Hospitalization of a Loved One in the ICU
ICU experience is linked to anxiety and depression symptomatology in family members of patients. Minors may be forbidden from visiting. To bring practices in line with evidence, we determined the prevalence of anxiety and... read more
Rivaroxaban Lowers Cardiovascular Risk But Increases Bleeding Risk
In 27,395 patients with stable atherosclerotic disease, the addition of 2.5 mg rivaroxaban twice daily to aspirin therapy reduced the rates of cardiovascular death, stroke, or nonfatal MI, at the cost of increased major bleeding... read more
Diagnostic Stewardship for Healthcare-Associated Infections
Healthcare-associated infections (HAIs) are associated with increased morbidity and mortality, prolonged hospital stays, and unnecessary cost. The financial stakes of HAIs for hospitals were underscored in 2008 when the Centers... read more
Developing the Role of the Critical Care Pharmacist
The evolution of the critical care pharmacist — from lone practitioner to integral multidisciplinary team member. Pharmacists keen on a career in critical care need to understand that this is a complicated area and that... read more
I survived sepsis eight times. But can care workers spot this deadly illness?
Care staff are increasingly likely to see sepsis, but there is no standard training to make them aware of the symptoms to look out for in clients. There is a golden hour for the treatment of sepsis, when someone can be saved... read more
Characteristics and Outcomes of ICU Survivors
A significant number of intensive care unit survivors evaluated 3 months after discharge had psychological, respiratory, motor, and socioeconomic problems; these findings highlight that strategies aimed to assist critically... read more
Confessions of a Surgeon
Confessions of a Surgeon: The Good, the Bad, and the Complicated... Life Behind the O.R. Doors. As an active surgeon and former department chairman, Dr. Paul A. Ruggieri has seen the good, the bad, and the ugly of his profession.... read more
Quality Improvement Initiative to Reduce PICU Noise Pollution
Substantial noise pollution exists in our PICU, and utilizing the pediatric delirium bundle led to a significant noise reduction that can be perceived as half the loudness with hourly nighttime average dB meeting the EPA... read more
