Non-invasive Ventilation for the Management of AHRF due to Exacerbation of COPD
Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of... read more
Are We Creating Survivors or Victims in Critical Care?
Delivering targeted nutrition to improve outcomes. Over the last 10 years, we are proud of the fact we have finally begun to reduce in-hospital mortality following severe sepsis in some countries worldwide. Further, mortality... read more
Palliative Care in Advanced HF Makes a Big Difference in Rare Controlled Trial
Patients with end-stage heart failure who received palliative care from an interdisciplinary team, along with usual evidence-based care, significantly improved in functional, psychosocial, and spiritual well-being compared... read more
Heart Rate Variability in Critical Care Medicine
Heart rate variability (HRV) has been used to assess cardiac autonomic activity in critically ill patients, driven by translational and biomarker research agendas. Several clinical and technical factors can interfere with... read more
Clinical Experience With IV Angiotensin II Administration
Angiotensin II is an endogenous hormone with vasopressor and endocrine activities. This is a systematic review of the safety of IV angiotensin II. Adverse events associated with angiotensin II were infrequent; however, exacerbation... read more
Sepsis Prediction in Critically Ill Patients by Platelet Activation Markers on ICU Admission
Platelets have been involved in both immune surveillance and host defense against severe infection. To date, whether platelet phenotype or other hemostasis components could be associated with predisposition to sepsis in critical... read more
Should All Massively Transfused Patients Be Treated Equally?
Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This... read more
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
