Nitrous Oxide Avoidance for Patients Undergoing Major Surgery
Avoidance of nitrous oxide and the concomitant increase in inspired oxygen concentration decreases the incidence of complications after major surgery, but does not significantly affect the duration of hospital stay. The... read more
Approach to the Critically Ill Poisoned Patient
Toxicology histories are notoriously unreliable. Any available medical records, especially medication lists. Timing & amount of ingestions. Immediate vs. sustained-release formulations. Consider inquiring specifically... read more
Longitudinal Respiratory Subphenotypes in COVID-19 Patients with ARDS
COVID-19-related ARDS has no consistent respiratory subphenotype. Patients diverged from a fairly homogenous to a more heterogeneous population, with trajectories of ventilatory ratio and mechanical power being the most discriminatory.... read more
Suboptimal COVID-19 Vaccination Coverage Implications in Florida and Texas
In July, 2021, another wave of COVID-19 began in the USA as the highly infectious delta (B.1.617.2) SARS-CoV-2 variant drove outbreaks predominantly affecting states with relatively low vaccination coverage. Some US states... read more
Ambulation Alone Not Effective Prophylaxis for Venous Thromboembolism
Our systematic review failed to find high-quality evidence to suggest that ambulation alone is an appropriate or effective prophylaxis for venous thromboembolism. Although some studies suggest that ambulation may reduce... read more
Understanding Brain Injury in Pediatric ECMO
Brain injury is frequent in extracorporeal membrane oxygenation patients, although the majority of survivors have favorable neurocognitive outcomes. More research is needed in order to understand the etiology of such... read more
A Novel Anatomic Landmark to Target the LV During Chest Compressions in Cardiac Arrest
A novel area of compression over the left sternal border at the inter-nipple line would result in compressions over the LV in nearly three-quarters of our study participants. Future research should investigate whether... read more
ECMO for COVID-19
Mortality after ECMO for patients with COVID-19 worsened during 2020. These findings inform the role of extracorporeal membrane oxygenation (ECMO) in COVID-19 for patients, clinicians, and policy makers. In 2020, 4,812... read more
Scripts for Subconjunctival Hemorrhage, Fainting and Syncope, and Viral Illness
Many parts of the ED encounter interfere with patient or family comprehension, not the least of which is the ED's noisy, hurried environment. But other factors affect what they understand and remember about the encounter—their... read more
Dexamethasone 12 mg vs. 6 mg for COVID-19 Patients with Severe Hypoxia
Among patients with COVID-19 and severe hypoxia, dexamethasone 12 mg did not result in statistically significantly more days alive without life support at 28 days than dexamethasone 6 mg. However, the confidence interval... read more
Waveform Capnography in the Intubated Patient
Waveform capnography is emerging as a standard monitoring tool to improve safety among intubated patients. Failure to use waveform capnography contributed to >70% of ICU-related airway deaths in the NAP4 audit. Capnography... read more
Validation of RSBI Displayed by the Ventilator vs. Standard Technique in Patients with Readiness for Weaning
The ventilator significantly overestimates the RSBI value compared to the standard technique by Wright spirometer. The average RSBI vent value among 5 time points (0, 15, 30, 45, and 60 s) was found to best correlate with... read more
Hypocalcemia in Jaundiced Neonates Receiving Phototherapy
Hypocalcemia is a common complication of phototherapy. Serum calcium levels should be monitored in all the full-term neonates receiving phototherapy. Hyperbilirubinemia was present in 23.3% of neonates admitted to the... read more
Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Acute Pain Management
Evidence supports the use of ketamine for acute pain in a variety of contexts, including as a stand-alone treatment, as an adjunct to opioids, and, to a lesser extent, as an intranasal formulation. Contraindications for... read more
Continuous Positive Airway Pressure and Pronation Outside the ICUs in COVID-19 ARDS
Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the intensive care unit setting during the pandemic. Of 90... read more
Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest
Low levels of brain injury markers in blood are associated with good neurological outcome after CA. Incorporating biomarkers into neuroprognostication may help prevent premature withdrawal of life-sustaining therapy. Retrospective... read more
Higher vs. Lower PEEP in ARDS Patients
In our meta-analysis of RCTs, higher positive end-expiratory pressure (PEEP), compared with lower PEEP, was not associated with mortality in patients without acute respiratory distress syndrome (ARDS) receiving invasive mechanical... read more
Precision Medicine and Heterogeneity of Treatment Effect in Therapies for ARDS
Acute respiratory distress syndrome (ARDS) is a clinically heterogenous syndrome, rather than a distinct disease. This heterogeneity at least partially explains the difficulty in studying treatments for these patients... read more
Venous Thromboembolism Prophylaxis in Critically Ill Adults
Among critically ill adults, compared to control, low molecular weight heparin (LMWH) reduces incidence of deep venous thrombosis (DVT) while UFH and mechanical compressive devices may reduce risk of DVT. LMWH is probably... read more
Corticosteroids and RCTs Against the Supposed Undervaluation of Real Data Evidence
Possibly, the future of research and clinical practice is not conceived as a confrontation between Randomized control trial (RCT) and observational studies, but rather as the sum of knowledge between RCTs and its clinical... read more
Therapeutic Anticoagulation vs. Usual Care in Noncritically Ill COVID-19 Patients
Among noncritically ill patients with COVID-19 infection, therapeutic anticoagulation with heparin improved the proportion of patients who survived without need for organ support. Therapeutic anticoagulation was associated... read more
We studied how to reduce airborne COVID spread in hospitals. Here’s what we learnt
Melbourne’s second wave of COVID-19 last year, which led to a lockdown lasting more than 100 days, provided us with many lessons about controlling transmission. Some of these are pertinent as New South Wales endures its... read more
