Opening pressures and atelectrauma in ARDS
Data show that the prerequisites of the open lung strategy are not satisfied using PEEP up to 15 cmH2O and plateau pressure up to 30 cmH2O. For an effective open lung strategy, higher pressures are required. Therefore,... read more
Care that Matters: Quality Measurement and Health Care
Barry Saver and colleagues caution against the use of process and performance metrics as health care quality measures in the United States. There is limited evidence that many "quality" measures - including those... read more
Association of Ratio-Based Massive Transfusion With Survival Among Patients Without Trauma
Association Between Ratio of Fresh Frozen Plasma to Red Blood Cells During Massive Transfusion and Survival Among Patients Without Traumatic Injury. This study reports on the use and benefits of ratio-based blood product... read more
The biggest killer you may not know
It kills more than bowel, breast and prostate cancer combined. A report in 2015 said four in 10 patients being admitted to accident and emergency units were not being reviewed quickly enough and uncovered delays in giving... read more
National ICU Quality Indicators Revisited
The use of QI at a national level is a suitable method to focus on quality in healthcare. Independently of public access to the results, a local or national ICU network will have a lot to gain from engaging in the process... read more
Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin
Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: a subgroup analysis of SOCRATES, a randomised, double-blind, controlled trial. In this prespecified... read more
Cerebral Microbleeds as Predictors of Mortality
Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the... read more
Why the New Sepsis Guideline Changed
Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an... read more
Toward the Ideal Ratio of Patients to Intensivists
More than 5.7 million patients are admitted annually to an intensive care unit (ICU) in the United States, accounting for approximately 20% of all acute care admissions. With the aging population and its increasing comorbidity... read more
No IV Hydration for Contrast Nephropathy? AMACING Trial Challenges a Cornerstone of Prophylaxis
A Dutch study undercutting the established role of hydration in preventing kidney damage during procedures is raising eyebrows. Dutch researchers are calling into question one of the cornerstone practices of cath labs and... read more
Decreased cytokine production by mononuclear cells after severe gram-negative infections
Failure of circulating monocytes for adequate cytokine production is a trait of sepsis-induced immunosuppression; however, its duration and association with final outcome are poorly understood. Defective TNF-α production... read more
Ultrasound Guidance and Other Determinants of Successful Peripheral Artery Catheterization
Margaret Parker, MD, MCCM, speaks with David B. Kantor, MD, PhD, about the article, "Ultrasound Guidance and Other Determinants of Successful Peripheral Artery Catheterization in Critically Ill Children," published in the... read more
Multifaceted educational intervention shortened time to antibiotic administration in children with sepsis
A multifaceted educational intervention shortened time to antibiotic administration in children with severe sepsis and septic shock: ABISS Edusepsis pediatric study. The Surviving Sepsis Campaign (SSC) recommends the administration... read more
Alternative techniques for tracheal intubation
Conventional direct laryngoscopy with the curved Macintosh blade is a fundamental skill for all anaesthetists and has been the cornerstone of airway management for many years. This technique relies on the operator aligning... read more
Pharmacists Can Make a Difference During Influenza Pandemics
Since November 2015, approximately 25% of adults who receive annual seasonal influenza vaccination are immunized in pharmacies or retail health care settings. The growth in vaccine uptake at pharmacies has public health policy... read more
Effects of Neuromuscular Blockers on Transpulmonary Pressures in Moderate to Severe ARDS
Thirty patients were included, 24 with moderate ARDS and 6 with severe ARDS. NMBA infusion was associated with an improvement in oxygenation in both moderate and severe ARDS, accompanied by a decrease in both plateau pressure... read more
Dose-Adjusted DOACs: What Efficacy vs Warfarin?
The direct oral anticoagulants (DOACs) offer distinct advantages over warfarin - among them, dose adjustment is only needed in cases of impaired renal function, advanced age, low body weight, or potential for drug-drug interactions.... read more
New Guidelines for Accurate Diagnosis of C. difficile Infection
Clostridium difficile infection (CDI), a potentially lethal bacterial infection, causes colon inflammation and is responsible for 3,700 deaths in Europe per year. This highly symptomatic infection causes fever, diarrhea,... read more
Longer hospital stays may reduce readmissions, study suggests
A recent study found patients moved to post-acute care facilities have a higher chance of readmission than those kept in the hospital for a longer period of time. Researchers say longer hospital stays may prevent readmission... read more
In Hospital ICUs, AI Could Predict Which Patients Are Likely to Die
With streams of data coming from equipment that monitors patients’ vital signs, the ICU seems the perfect setting to deploy artificially intelligent tools that could judge when a patient is likely to take a turn for the... read more
Using an App to Speed Surgical Recovery
To help patients recover faster from surgery, Rush University Medical Center recently has begun providing patients with a computer app that prompts, monitors, and encourages activities that promote healing. Called SeamlessMD,... read more
Stapled versus hand-sewn
Stapled versus hand-sewn: A prospective emergency surgery study. An American Association for the Surgery of Trauma multi-institutional study. Data from the trauma patient population suggests handsewn (HS) anastomoses are... read more
