Thrombolytics for Stroke: The Evidence
Thrombolytics for stroke: undoubtedly the biggest controversy in emergency medicine. Also, the topic of this week’s Emergency Medicine Cases Journal Jam podcast. Rory Spiegel, Anton Helman, and I take a deep dive into the... read more
Aspirin therapy in patients with ARDS is associated with reduced ICU mortality
Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce... read more
Effective Care for High-Need Patients
To advance insights and perspectives on how to better manage the care of the high-need patient population, the National Academy of Medicine, with guidance from an expert planning committee, was tasked with convening three... read more
Sepsis-Associated 30-Day Risk-Standardized Readmissions
One third of sepsis survivors were readmitted and wide variation exists between hospitals. Several demographic and structural factors are associated with this variation. Measures of higher quality in-hospital care were correlated... read more
Analysis of Unplanned Postoperative Admissions to the ICU
Our study is the first diverse analysis of unplanned postoperative ICU admissions in the literature across multiple specialties and practice models. We found an association of advanced age, higher ASA PS class, and duration... read more
Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis
Patients with sepsis having AKI have a higher mortality rate than those with ESRD and non-KI. Hospital and ICU mortality rates for patients with ESRD were similar to non-KI patients. Late AKI compared to early AKI had a higher... read more
Electroencephalography Predicts Poor and Good Outcomes After Cardiac Arrest
The prognostic role of electroencephalography during and after targeted temperature management in postcardiac arrest patients, relatively to other predictors, is incompletely known. We assessed performances of electroencephalography... read more
Rescue Strategy for Treating Severe Carbapenemase-Producing Klebsiella Pneumoniae Infections
Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical... read more
Evaluating Transfusion Strategies
Cancer patients are at increased risk of septic shock. Therefore, Bergamin et al set out to assess whether a restrictive strategy of red blood cell (RBC) transfusion reduces 28-day mortality when compared with a liberal strategy... read more
A Year at the Bedside With Osler
Ask any resident, and he or she will tell you that this oft-quoted meditation from Sir William Osler, the father of modern medicine and guiding light for many an internist, is beautiful in its language yet quaint and seemingly... read more
Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement
Under-reporting of End-of-life Decisions in Critical Care Trials: A Call to Modify CONSORT Statement... read more
State Sepsis Mandates – A New Era for Regulation of Hospital Quality
New York State regulations mandating protocol-based sepsis care may have unintended consequences. Hospitals should have maximal flexibility in deciding how to implement protocol-guided care so that they can respond appropriately... read more
Analgosedation practices and the impact of sedation depth on clinical outcomes among patients requiring mechanical ventilation
Analgesia and sedation are cornerstone therapies for mechanically ventilated patients. Despite data showing that early deep sedation in the intensive care unit influences outcome, this has not been investigated in the emergency... read more
Trials directly comparing alternative spontaneous breathing trial techniques
The effect of alternative spontaneous breathing trial (SBT) techniques on extubation success and other clinically important outcomes is uncertain. Patients undergoing PS (vs T-piece) SBTs appear to be 6% (95% CI 2–10%)... read more
A Randomized Controlled Study to Evaluate the Effect of an Enteral Formulation
A randomized controlled pilot study to evaluate the effect of an enteral formulation designed to improve gastrointestinal tolerance in the critically ill patient - the SPIRIT trial. In this pilot study, we found a high incidence... read more
Muscle Mass and Physical Recovery in ICU: Innovations for targeting of Nutrition and Exercise
New innovative techniques are demonstrating promise to target recovery from PICS utilizing a combination of objective LBM and metabolic assessment, targeted nutrition interventions, personalized exercise interventions for... read more
Frailty and Subsequent Disability and Mortality among Patients with Critical Illness
The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those aged 18 years and older with critical illness is unclear. Frailty is common in critically ill adults aged 18 years and older... read more
