Does Preoperative Troponin Level Impact Outcomes Following Coronary Artery Bypass Grafting?
As a marker of myocardial injury, troponin level correlates with adverse outcomes following myocardial infarction (MI). We hypothesized that patients with higher preoperative troponin level would have increased morbidity... read more
Nominate Your Sepsis Hero!
Sepsis Alliance is excited to announce Sepsis Heroes, the organization's annual fundraising gala, will be returning on September 13, 2018 in New York City. The annual event, timed to coincide with Sepsis Awareness Month,... read more
Virtual Reality to Improve Cognitive Alterations in ICU
More than 30 percent of patients who survive an episode of critical illness presents brain alterations that go beyond those of the disease that has led to the admission to intensive care (ICU). As a result of this cerebral... read more
Delirium a Dreaded Scourge Underdiagnosed in Hospitals
Pain medications, infections, medical illnesses, ventilators, dehydration or withdrawing from alcohol can be risk factors for delirium. Hospitals are one of the biggest culprits. They're noisy, busy and not conducive to getting... read more
Unexplained Mortality Differences Between Septic Shock Trials
Although the definition of septic shock has been standardized, some variation in mortality rates among clinical trials is expected. Insights into the sources of heterogeneity may influence the design and interpretation of... read more
When Should Nutritional Support Be Implemented in a Hospitalized Patient?
At the time of admission to the hospital, malnutrition is already present in over 20% of patients. Hospitalized patients are particularly susceptible to developing malnutrition because of increased catabolic states in acute... read more
Fluid, Electrolyte and Acid-Base Physiology
With a strong focus on problem solving and clinical decision making, Fluid, Electrolyte, and Acid-Base Physiology is your comprehensive, go-to guide on the diagnosis and management of fluid, electrolytes, and acid-base disorders.... read more
RRT in the Critically Ill Child
Although renal replacement therapy (RRT) is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated... read more
Ten False Beliefs in Neurocritical Care
1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain injury (TBI). 4. The threshold to treat... read more
Tracheotomy in the ICU: Guidelines from a French Expert Panel
Tracheotomy is widely used in intensive care units (ICUs), albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of... read more
Papers of the Month March 2018
Gavin Denton and I get together again to review a couple of recent papers that have some bearing on our practice. Welcome to the Papers of the month. This month we cover Check Up- Position- “A Multicenter, Randomized Trial... read more
Lower EGS Mortality Among Hospitals with Higher-Quality Trauma Care
Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to nonmodifiable patient... read more
In ICUs, a Furry Friend to Comfort Patients
Amid the monitor alarms and life-and-death conversations on the intensive care unit, Tucker, a very mellow Labrador retriever, rolled onto his back at the nurses' station. Delighted staff surrounded the dog, cooing and scratching... read more
Impact of Nighttime RRT Activation on Outcomes of Hospitalized Patients with Acute Deterioration
Acutely deteriorating ward patients assessed by an RRT at nighttime had a higher risk of in-hospital mortality. This work identifies important shortcomings in health service provision and quality of care outside daytime hours,... read more
Medication Errors Occur in Nearly Half of ICU Transfers
Almost 50% of patients transferred from the intensive care unit (ICU) to a non-ICU location experience a medication error at the time of transition of care, according to new data. While the majority of these errors did, in... read more
Tomorrow’s ICU
Johns Hopkins clinicians and engineers are creating a model for a safer, less costly and more productive clinical unit that can be adopted anywhere. With clinicians spending less time on documenting and gathering supplies,... read more
Resetting the Circadian Clock Might Boost Metabolic Health
This Medical News feature discusses the role of circadian clock in regulating metabolism. Over the past 20 years, scientists have assembled a clearer picture of the circadian clocks that keep human physiology tuned to the... read more