Optimal Timing of RRT in Patients with AKI in the Context of Sepsis

Among 620 patients enrolled in AKIKI, 494 (80%) had sepsis and 413 (67%) septic shock. This can help to suggest recommendations in septic patients with AKI. AKIKI showed no significant difference in mortality between early... read more

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

Among comatose patients receiving mechanical ventilation, those without clinical, laboratory, or radiologic evidence of bacterial aspiration pneumonia did not require antibiotics. In those with suspected bacterial aspiration... read more

Impact of Telemedicine Monitoring of Community ICUs on Interhospital Transfers

In a regional healthcare system, implementation of a tele-ICU program is associated with an increase in interhospital transfers from less resourced ICUs to the referral center, a trend that is not readily explained by increased... read more

PICU Repeated and Unplanned Readmissions Within 1 Year

Unplanned readmissions occurred in a sizable minority of PICU patients. Patients with complex chronic conditions and particular conditions were at much higher risk for readmission. In this multi-institutional study, we found... read more

Update: Implementation of Antibiotic Stewardship Core Elements

This document provides guidance on practical strategies to implement antibiotic stewardship programs in small and critical access hospitals. It was developed as a collaboration between The Centers for Disease Control and... read more

An Airway Risk Assessment Score for Unplanned Extubation in PICU

Higher Risk Assessment Scores are associated with occurrence rates of unplanned extubation. As a result of a workshop to identify common causes of unplanned extubation, Children's Healthcare of Atlanta developed a scoring... read more

Detecting impaired myocardial relaxation in sepsis with a novel tissue Doppler parameter

Left ventricular diastolic dysfunction is associated with mortality outcomes in severe sepsis and septic shock. There are ongoing issues with diagnosing diastolic dysfunction in this cohort, partly owing to the poor applicability... read more

Recent Developments in Management of Critical Burn Injuries

Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections... read more

High-Observation Protocol Cuts Length of Stay in Head

A high-observation protocol (HOP) appears to optimize clinical care for patients with head and neck cancer undergoing primary surgery, according to a study published online June 20 in Head & Neck. The researchers found... read more

The "Quality Minute" – A New, Brief, and Structured Technique for Quality Improvement Education During the Morbidity and Mortality Conference

The Quality Minute is a brief, structured presentation designed to incorporate quality improvement (QI) education into the surgical morbidity and mortality (M&M) conference. The 6-slide, 5-minute structure makes it easy... read more

Resuscitating Sepsis – How I do it after Albios

Watch "Resuscitating Sepsis - How I do it after Albios" by Luciano Gattinoni.... read more

Frequency of Exacerbations in Patients with COPD

Present treatment strategies to stratify exacerbation risk in patients with chronic obstructive pulmonary disease (COPD) rely on a history of two or more events in the previous year. We aimed to understand year to year variability... read more

Protocol-based Invasive Intracranial Pressure Monitoring in Acute Liver Failure

Acute liver failure (ALF) may result in elevated intracranial pressure (ICP). While invasive ICP monitoring (IICPM) may have a role in ALF management, these patients are typically coagulopathic and at risk for intracranial... read more

Drink Coffee and Live Longer: Cohort Study

A multinational cohort study on coffee drinking and mortality in 10 European countries. Coffee drinking was associated with reduced risk for death from various causes. This relationship did not vary by country. 521, 330 people... read more

Hypoactive vs Hyperactive Delirium

Hypoactive delirium tends to capture less clinical attention than hyperactive delirium. Like all delirium, it can occur in a variety of patients and settings and will consequently be encountered by many groups of doctors.... read more

Intubation During CPR was Associated with Worse Survival and Brain Health

Intubating patients in cardiac arrest is widely considered ideal care. But in this analysis, the patients who were intubated were less likely to survive (16% vs 19%) or have a good functional outcome (~11% vs ~14%). Intubation... read more

How to Remove the Grey Area Between VAP and VAT?

We read with great interest the study performed by Paula Ramirez and colleagues. The study included 71 patients with ventilator-associated pneumonia (VAP) and the authors coined a new term called "gradual VAP".... read more

Low Levels of Physical Activity During Critical Illness and Weaning

Physical rehabilitation can benefit critically ill patients during ICU admission, but routine clinical practice remains inconsistent nor examined in prolonged mechanical ventilation patients transferred to a specialist ventilator... read more

The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores

Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an... read more

The Complexities of Intravenous Fluid Research: Questions of Scale, Volume, and Accumulation

Despite near ubiquity, information regarding fluids consumption at a health care systems level, and patient exposure at an individual level, is surprisingly limited in the medical literature. The epidemiology of the foundational... read more

I’m your Anesthesiologist. Let me explain what that means

Anesthesiologists are the guardian angels of the operating room. Their primary purpose is to keep you alive so you can undergo whatever procedure you need. While we may only meet you shortly before we take you to the operating... read more

A population-based cohort study of rheumatoid arthritis-associated interstitial lung disease

ILD is a serious complication in RA, with a significantly increased mortality compared with a large matched cohort of RA comparisons without ILD. Mortality risks were assessed using Kaplan-Meier mortality curves, and hazard... read more