When Breath Becomes Air
A powerful look at a stage IV lung cancer diagnosis through the eyes of a neurosurgeon. When Paul Kalanithi is given his diagnosis he is forced to see this disease, and the process of being sick, as a patient rather than... read more
Weaning the patient: between protocols and physiology
Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review... read more
Increasing suction pressure during endotracheal suctioning increases the volume of suctioned secretions
It may be assumed that 250 mmHg suction pressure, via compliance with open system suction method related procedures, is being more effective and equally safe for secretion cleaning in comparison to the 80 and 150 mmHg suction... read more
Decrease in CPR Initiation During COVID-19 Outbreak
During the COVID-19 period, we observed decreased initiation of CPR by bystanders and first aid providers for BLS, and decreased ALS by the MMT, regardless if subjects were infected with SARS-CoV-2 or not. ROSC rates... read more
Adapting to the COVID-19 Pandemic
Thrust into a pandemic unlike any other, health professionals today must continually adapt to an ever-changing environment. Protocols change at dizzying rates, while the physical and mental demands of our jobs increase... read more
Modifiable Factors Associated With Chronic Pain After Surgery for Distal Radius Fractures
In this study, preoperative pain, time to surgery, and procedure type were modifiable factors associated with chronic pain 1 year after DRF treated with surgery. Adequate pain control in patients with acute DRFs even... read more
ICU Workers Are Quitting Due To Crushing Stress From COVID-19 Surge
As hospitals struggle in Los Angeles County, Intensive Care Unit nurses confront tough choices: remain in the coronavirus trenches for patients and colleagues, or quit when you are overwhelmed? The massive surge in coronavirus... read more
Oral Vitamin K Lowers the International Normalized Ratio More Rapidly
Oral vitamin K lowers INR more rapidly than subcutaneous vitamin K in asymptomatic patients who have supratherapeutic INR values while receiving warfarin. Warfarin therapy was withheld, and 1 mg of vitamin K was given... read more
Natriuretic Peptide–driven Fluid Management during Ventilator Weaning
Our results suggest that a BNP-driven fluid management strategy decreases the duration of weaning without increasing adverse events, especially in patients with left ventricular systolic dysfunction. In a randomized controlled... read more
America Is Running Out of Nurses
In normal times, there are some 50,000 travelling nurses in the United States. Most are full-time gig workers who move from job to job, usually staying in one place for thirteen weeks. (That length is a holdover from old... read more
The Emerging Evidence for a Genetic Susceptibility to Severe COVID-19
A defining feature of the COVID-19 pandemic has been the wide spectrum of clinical presentations, ranging from asymptomatic viremia to life-threatening illness. Factors such as advancing age and co-morbid status have been... read more
Lipid Mediators in Critically Ill Patients: A Step Towards Precision Medicine
In this review, we provide an overview of the role of fatty acid-derived lipid mediators as endogenous regulators of the inflammatory, anti-inflammatory and pro-resolving response and future directions for use of clinical... read more
Genetic Mechanisms of Critical Illness in COVID-19
Host-mediated lung inflammation is present, and drives mortality, in critical illness caused by COVID-19. Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development. Here... read more
Improved Oxygenation After Prone Positioning May Be a Predictor of Survival in Patients With ARDS
We found a significant difference in the Pao2:Fio2 ratio after the first prone positioning between ICU survivors and nonsurvivors. The improvement in oxygenation after the first prone positioning was a significant predictor... read more
Childhood sepsis deadlier for Black patients
In this large, representative analysis of paediatric severe sepsis in the USA, we found evidence of outcome disparities by race or ethnicity and insurance status. Our findings suggest that there might be differential... read more
Evaluation and Treatment of Renal and Perinephric Abscesses
A 30-year-old woman with past medical history of type 2 diabetes presents to the emergency department with 3 days of vague abdominal/back pain, with associated subjective fever, chills, nausea and vomiting. She states she... read more
Impaired peripheral mononuclear cell metabolism in patients at risk of developing sepsis
Dysregulated immune response is a key driver of disease progression in sepsis and known to be associated with impaired cellular metabolism. This association has been studied mostly in the late stage sepsis patients. Here,... read more
Nurses’ knowledge and practices of physical restraints in ICU
The mean scores of nurses' knowledge and practices were 61.5 (SD = 12.1) and 57.4 (SD = 9.7), respectively. More than half of nurses had poor knowledge of PR use and incorrect practice of implementing PR (51.5% and 60.5%,... read more
Endotracheal intubation to reduce aspiration events in acutely comatose patients
Whether intubation results in a reduction in the incidence of aspiration events and whether these are more frequent in patients with low GCS scores are not yet established. The paucity of evidence on this topic makes clinical... read more
Anaesthetists and intensive care doctors are at lower risk of COVID-19 infection compared with other medical staff
Following the first recorded death of an anaesthetist from COVID-19 in the UK in November 2020, a review of available data published in Anaesthesia (a journal of the Association of Anaesthetists) shows that unexpectedly,... read more
Smell test may help spot COVID-19 cases
A scratch-and-sniff screening tool that identifies impaired sense of smell, a common symptom of COVID-19, could help quickly pinpoint cases. Researchers from the University of Colorado in Boulder studied a smell test called... read more
Clinical characteristics of critically ill patients with COVID-19
In this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%. Design... read more
