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
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
