High-risk Pulmonary Embolism in the ICU
According to the European guidelines, high-risk pulmonary embolism (PE) is defined as PE associated with hemodynamic instability, including sustained hypotension, cardiogenic shock and/or cardiac arrest. High-risk PE... read more
Diastolic Shock Index and Septic Shock Outcome
Early recognition and resuscitation of patients in septic shock are critical skills for an emergency medicine physician. Many clinical decision-making tools have been developed and validated in their use to identify and... read more
Emergency vs. Delayed Catheterization in Survivors of OHCA
In this randomized clinical trial, for patients who experience an out-of-hospital cardiac arrest (OHCA) without ST-segment elevation on ECG, a strategy of emergency CAG was not better than a strategy of delayed CAG with respect... read more
Inhaled Hydrogen Efficacy on Neurological Outcome Following Brain Ischemia During Post-cardiac Arrest Care
Inhaled molecular hydrogen gas (H2) has been shown to improve outcomes in animal models of cardiac arrest (CA). H2 inhalation is safe and feasible in patients after CA. We investigated whether inhaled H2 would improve outcomes... read more
Mechanical Ventilation from Pathophysiology to Clinical Evidence
This new book aims to give a comprehensive overview of the current challenges and solution posed to the health care professionals who need to use mechanical ventilation to treat their patients. Mechanical ventilation is... read more
Positive or Negative Prognostic Factor for Epidural Hematoma?
To our best knowledge, a typical epidural hematoma (EDP) prognosis is good if it is discovered quickly and managed. Therefore the presence of EDH is considered a positive prognostic sign in the Rotterdam, Stockholm, and the... read more
AHRQ Errors Report was “Outright Unconscionable”
Headlines this winter screamed the bad news: Emergency physicians are literally killing people! "As many as 250,000 people die every year because they are misdiagnosed in the emergency room, with doctors failing to identify... read more
Postextubation Complications vs. Positive-Pressure Suctioning Techniques
Currently available studies that compared post-extubation complications in subjects managed with the positive-pressure and suctioning techniques were summarized. Further high-quality studies with a robust study design and... read more
Tube Thoracostomy in Emergency Department
Using trauma video review we identified significant procedural variability in emergency department tube thoracostomy, mainly that hemodynamic abnormality led to lower proficiency scores and increased malpositioning. Efforts... read more
MACE in Acute Exacerbation of COPD – Troponin I – A Dramatic Predictor
The burden of COPD is rising due to continued exposure to risk factors that trigger lung inflammation and repeated secondary infections thereby contributing to the third leading cause of death globally. More COPD deaths... read more
Troponins for SVT Set the Stage for Patient Harm
Many laboratory tests are routinely ordered for reassurance. We almost always order a hemoglobin and pregnancy test when a patient has syncope, despite knowing the vast majority will be normal. These tests are accurate... read more
Emergency Department Crowding Impact on Lung Protective Ventilation
Obtaining definitive control of the airway, when indicated, is the responsibility of the emergency medicine physician. Traditionally patients were managed on the ventilator with lung volumes of 10 – 15 ml/kg. However,... read more
Haloperidol vs. Placebo for Delirium Treatment in ICU Patients
We found high probabilities of benefits and low probabilities of harm with haloperidol treatment compared with placebo in acutely admitted, adult ICU patients with delirium for the primary and most secondary outcomes. The... read more
Prehospital IV Fluid Management in Severely Injured Trauma Patients
Weak, primarily observational evidence suggests that standard fluid resuscitation has no significant mortality benefit over restricting/withholding IV fluids in the context of severe/hypotensive trauma. This review adds... read more
Antifungal Stewardship in Critically Ill Patients
Antifungal stewardship (AFS) can improve performance measures and decrease antifungal consumption, with no negative impact on outcomes. β-D-glucan (BDG) are helpful to stop unnecessary treatment in patients with IC,... read more
Regular Old Pneumonia Treatment Just Got Better
In 2020, COVID-19 pneumonia became so common that "old-fashioned" bacterial pneumonia suddenly seemed rare. They look very different on x-ray. See if you can spot the differences. A new study from France tipped the scales... read more
Early Calorie and Protein Restriction Associated with Faster Recovery in Ventilated Patients
Compared with standard calorie and protein targets, early calorie and protein restriction did not decrease mortality but was associated with faster recovery and fewer complications. Of 3,044 patients randomly assigned... read more
Hydrocortisone in Severe Community-Acquired Pneumonia
Among patients with severe community-acquired pneumonia being treated in the ICU, those who received hydrocortisone had a lower risk of death by day 28 than those who received placebo. A total of 800 patients had undergone... read more
COVID-19 in Solid Organ Transplant Recipients
Solid Organ Transplant (SOT) recipients are at high risk of severe coronavirus disease-2019. Prior to the availability of vaccination, passive immunotherapies and effective antiviral therapeutics, the outcomes of COVID-19... read more
Optimal Bundle of Recommendations for Sepsis
The aim of this retrospective cohort study was to identify among the Surviving Sepsis Campaign (SSC) guidelines the optimal bundle of recommendations that minimize 28-day mortality. The bundle of six recommendations is... read more
Clinical Cases in Critical Care
In Clinical Cases in Critical Care, the authors explore core clinical topics and basic sciences in a practical and realistic way, and include comprehensive discussions focusing on critically unwell patients with a variety... read more
Elevated BMI Impact on Burn Injury
This study confirms a U-shaped association between body mass index and burn-related mortality along with age, total burn surface area, full-thickness burns, and comorbidities as risk factors. The study included 9,405 adult... read more
