Stories Category: Intensive Care
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
No Benefits For Using 4-Factor Prothrombin Complex Concentrate (4F-PCC) in Trauma Patients
Early administration of 4-factor prothrombin complex concentrate (4F-PCC) was of no benefit to patients with trauma at risk of massive transfusion, the randomized PROCOAG trial from France showed. Among over 300 patients... read more
ICU Precision Diagnosis with Metagenomic Sequencing
Despite promising results, metagenomics remains underutilized in the ICU. Several factors still limit its inclusion in routine critical care, including the lack of definitive clinical trials testing its utility, few laboratories... read more
Strategies for Mechanical Ventilation in Patients with Brain Injury
Although direct data to guide mechanical ventilation in brain-injured patients is accumulating, the current evidence base remains limited. Ventilatory considerations in this population should be extrapolated from high-quality... read more
Multifaceted Early Mobility Intervention Impact for Critically Ill Children
This study will examine whether a multifaceted strategy to optimize early mobility affects the duration of mechanical ventilation, delirium incidence, and functional outcomes in critically ill children. This study will... read more
