Antibiotics for the Critically Ill Patient

Antibiotics for the Critically Ill Patient

We spend a lot of time obsessing over the finer details of critical care: which fluid is best? which vasopressor is best? will another liter of fluid help? These details are important, but for a septic patient something... read more

Sepsis Incidence and Mortality are Underestimated in Australian ICU Administrative Data

Sepsis Incidence and Mortality are Underestimated in Australian ICU Administrative Data

When compared with the reference standard — prospective clinical diagnosis — ANZICS CORE database criteria significantly underestimate the incidence of sepsis and overestimate the incidence of septic shock, and also result... read more

Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU

Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU

The majority of included studies indicated that benzodiazepine use in the ICU is associated with delirium, symptoms of posttraumatic stress disorder, anxiety, depression, and cognitive dysfunction. Future well-designed studies... read more

Overuse of troponin? A comprehensive evaluation of testing in a large hospital system

Overuse of troponin? A comprehensive evaluation of testing in a large hospital system

Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more

Blue Collar, Blue Scrubs: The Making of a Surgeon

Blue Collar, Blue Scrubs: The Making of a Surgeon

Blue Collar, Blue Scrubs turns back the clock, taking readers from his days as a construction worker to his entry into medical school, expertly infusing his journey to become a doctor with humanity, compassion, and humor.... read more

Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock

Effect of Thiamine Administration on Lactate Clearance and Mortality in Patients With Septic Shock

Thiamine administration within 24 hours of admission in patients presenting with septic shock was associated with improved lactate clearance and a reduction in 28-day mortality compared with matched controls. Patients who... read more

Procedure Eases Complications Related to Fluid Around Lungs

Procedure Eases Complications Related to Fluid Around Lungs

As people live longer with more advanced stages of cancer or chronic diseases, the longer their complications must be treated. That can include pleural effusions, an unusually large amount of fluid around a person’s lungs... read more

Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia

Corticosteroid Treatment in Critically Ill Patients with Severe Influenza Pneumonia

Administration of corticosteroids in patients with severe influenza pneumonia is associated with increased ICU mortality, and these agents should not be used as co‑adjuvant therapy. A total of 1846 patients with primary... read more

Peripheral Vasopressors: The Myth and the Evidence

Peripheral Vasopressors: The Myth and the Evidence

You are working in a small, rural hospital staffed by one physician and one nurse. There are multiple sick patients, all of whom require your attention, but the sickest is probably the 62 year old female with pneumonia and... read more

Early Lactate Measurements Appear to Improve Results for Septic Patients

Early Lactate Measurements Appear to Improve Results for Septic Patients

The study by Churpek and colleagues was designed to evaluate both the frequency of urgent lactate measurements and their association with clinician interventions and mortality. An elevated lactate level means that a patient's... read more

Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients

Machine Learning Can Reduce Tests, Improve Treatments for ICU Patients

Researchers from Princeton University are using machine learning to design a system that could reduce the frequency of tests and improve the timing of critical treatments for ICU patients. To create the system, the researchers... read more

Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations

Adherence of Newborn-Specific Antibiotic Stewardship Programs to CDC Recommendations

Significant gaps exist between CDC recommendations to improve antibiotic use and antibiotic practices during the newborn period. There is wide variation in point prevalence AURs. Three-quarters of infants who received antibiotics... read more

Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

Influenza vaccination significantly reduced influenza-related hospitalization among patients with Chronic Obstructive Pulmonary Disease (COPD). Initiatives to increase vaccination uptake and early use of antiviral agents... read more

Assessment of the Safety of Discharging Select Patients Directly Home From the ICU

Assessment of the Safety of Discharging Select Patients Directly Home From the ICU

The discharge of select adult patients directly home from the ICU is common, and it is not associated with increased health care utilization or increased mortality. Among the 6732 patients included in the study, 2826 (42%)... read more