Decontamination of Oral or Digestive Tract for Patients in the ICU
The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more
Rudeness in Medical Settings Could Kill Patients
A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more
Fluid overload, de-resuscitation, and outcomes in critically ill or injured patients
Sepsis is associated with generalised endothelial injury and capillary leak and has traditionally been treated with large volume fluid resuscitation. Some patients with sepsis will accumulate bodily fluids. The aim of this... read more
Effect of Dexmedetomidine on Mortality and Ventilation in Sepsis Patients
Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. This randomized clinical trial compares... read more
Implementing a bedside assessment of respiratory mechanics in patients with ARDS
Implementing a systematic respiratory mechanics test leads to frequent individual adaptations of ventilator settings and allows improvement in oxygenation indexes and reduction of the risk of overdistention at the same time.... read more
Policies That Limit Emergency Department Visits and Reimbursements Undermine the Emergency Care System
Emergency department (ED) visit rates in the United States have been rising over the past 2 decades, outpacing population growth.1 These visits are portrayed in the lay press as unnecessary visits that must be reduced or... read more
Effect of Targeted Polymyxin B Haemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level
In adult patients with septic shock and high circulating endotoxin activity, does the use of polymyxin B hemoperfusion therapy significantly decrease 28-day mortality? Among patients with septic shock and high endotoxin activity,... read more
Conflicts of interest disclosure forms and management in critical care clinical practice guidelines
The current conflicts of interest (COIs) disclosure forms of selected professional societies provide more attention to financial disclosures and COIs and less attention to detecting and managing intellectual COIs, while rarely... read more
Effect of Bronchodilation, Exercise Training, and Behavior Modification on Symptoms and Physical Activity in COPD
Tiotropium/olodaterol, with or without ExT, improved EET in patients with Chronic Obstructive Pulmonary Disease (COPD) taking part in an SMBM program. Combination bronchodilation, with or without ExT, did not provide additional... read more
An Incurable Disease Is On The Rise In California, And Scientists Say Climate Change Could Cause It To Spread To Much Of The Western US
A fungus that thrives in dry soil and warm weather has caused a record number of infections in California. Experts fear climate change will cause it to spread across the western US. Valley fever, a fungal disease that infects... read more
Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria
The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children... read more
Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management
The treatment of choice for a pneumothorax is a chest tube, and when the small pig-tail catheter doesn’t do the job, the answer is to replace it with a larger bore – right? Not so fast. The exact mechanism of REPE is... read more
Mentorship Malpractice
The word mentorship evokes strong emotional and intellectual chords. In formal parlance, mentorship has been defined as "a dynamic, reciprocal relationship in a work environment between an advanced-career incumbent (mentor)... read more
Stronger evidence for vitamin C use in sepsis treatment
A new meta-analysis reveals a positive correlation between incorporating vitamin C in the treatment of sepsis and favorable patient outcomes. Results of the meta-analysis showed a marked reduction in mortality and duration... read more
