Most pediatric ICU physicians don’t use current guidelines to diagnose acute kidney injury

A study by University at Buffalo researchers has shown that physicians in pediatric intensive care units are not using the newest guidelines to diagnose acute kidney injury (AKI) in critically ill children, a practice that... read more

Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study

The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. A multicenter observational cohort study in ten intensive care units (ICU) in France.... read more

Performance of a Modern Glucose Meter in ICU

Performance of a Modern Glucose Meter in ICU and General Hospital Inpatients: 3 Years of Real-World Paired Meter and Central Laboratory Results. Due to accuracy concerns, the Food and Drug Administration issued guidance to... read more

Restricting volumes of resuscitation fluid in adults with septic shock after initial management

A protocol restricting resuscitation fluid successfully reduced volumes of resuscitation fluid compared with a standard care protocol in adult ICU patients with septic shock.... read more

The Association of Early Combined Lactate and Glucose Levels with Subsequent Renal and Liver Dysfunction

Abnormal combined lactate and glucose measurements may provide an early indication of organ dysfunction. In critically ill patients a 'normal' glucose with an elevated lactate should not be considered desirable, as this combination... read more

Standardize ICU Admission Practices to Cut Costs

Hospitals that admitted patients to ICUs more often were more likely to routinely perform invasive procedures and incur higher costs with no commensurate improvement in mortality.... read more

Hospitals with most heart patients in ICU have worse results: Study

Heart attack or heart failure patients are more likely to get worse or die at hospitals that are more likely to treat them in the ICU, a new study suggests.... read more

Glycemic control, mortality, and hypoglycemia in critically ill patients

Network meta-analysis showed no mortality benefit of tight glycemic control in critically ill patients, but fivefold more hypoglycemia versus mild or very mild control. Thirty-six randomized trials (17,996 patients) were... read more

Don’t Just Do Something, Stand There!

An excellent analogy on how doing nothing can be the best option. Penalty kicks in soccer can make fans crumple with anguish or weep with elation. The kicker sends the ball rocketing toward the goal and goalkeepers lunge... read more

Quality Improvement Initiatives in Sepsis in an Emerging Country

This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private... read more

Utility and Diagnostic Accuracy of Bedside Lung Ultrasonography During MET

Lung ultrasonography can be rapidly performed in the majority of patients with MET activation for respiratory deterioration. As an independent diagnostic test, lung ultrasonography is non-inferior to the medical emergency... read more

Preventing Harm in the ICU – Building a Culture of Safety and Engaging Patients and Families

Preventing harm remains a persistent challenge in the ICU despite evidence-based practices known to reduce the prevalence of adverse events. This review seeks to describe the critical role of safety culture and patient and... read more

Technologic Distractions

Summary of Approaches to Manage Alert Quantity With Intent to Reduce Alert Fatigue and Suggestions for Alert Fatigue Metrics. Approaches for managing alert fatigue in the ICU are provided as a result of reviewing tested interventions... read more

Clinicians’ Perception and Experience of Organ Donation From Brain-Dead Patients

ICU clinicians are primarily involved in organ donation after brain death of ICU patients. Their perceptions of organ donation may affect outcomes. Our objective was to describe ICU clinician’s perceptions and experience... read more

Unplugged & Reconnected – Recovering from Burnout

Does your desk ever look like this? Mine does. WAY too often. Insert the piles of papers, books, journals and mail I need to get to on the side also. When I look at this photo, it seems absolutely ridiculous. Why on earth... read more

Noninvasive Ventilation in Patients With Hematologic Malignancy

Two-thirds of patients with Hematologic Malignancy and respiratory failure failed Noninvasive Ventilation (NIV) and required endotracheal intubation, and had high subsequent mortality. Patients who failed NIV had higher Paco2,... read more

Airway Management of The Morbidly Obese Patient

Obesity is a major health care dilemma. All aspects of medical care, including anesthesia, are affected by it. All physiologic systems are altered by obesity, which imparts a higher risk for complications in the perioperative... read more

5-Year Trends of Critical Care Practice and Outcomes

According to researchers in the U.S., analyses of patients, practices, and outcomes from a large geographically dispersed sample of adult ICUs revealed trends of increasing age and acuity, higher rates of adherence to best... read more

Moral Distress in PICU and Neonatal ICU Practitioners

In this single-center, cross-sectional study, we found that moral distress is present in PICU and neonatal ICU health practitioners and is correlated with burnout, uncertainty, and feeling unsupported. The main outcome was... read more

Early Troponin I in Critical Illness and its Association with Hospital Mortality

TnI is an independent predictor of hospital mortality and correlates most highly with the APS component of APACHE II. It does not improve risk prediction. We would not advocate the adoption of routine troponin analysis on... read more

Benzodiazepines and Delirium in ICU Patients

We have learned an extraordinary amount about ICU delirium over the last 2 decades, which is associated with increased duration of mechanical ventilation, length of hospital stay, long-term cognitive impairment, and mortality... read more

An Alternative Consent Process for Minimal Risk Research in the ICU

Seeking consent for minimal risk research in the ICU poses challenges, especially when the research is time-sensitive. Our aim was to determine the extent to which ICU patients or surrogates support a deferred consent process... read more