Intensive care in severe malaria: Report from the task force on tropical diseases by the WFSICCM

Intensive care in severe malaria: Report from the task force on tropical diseases by the WFSICCM

Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P... read more

Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms

Diagnostic Accuracy of Chest Radiograph, and When Concomitantly Studied Lung Ultrasound, in Critically Ill Patients With Respiratory Symptoms

This meta-analysis demonstrates that chest radiograph has a low sensitivity and reasonable specificity compared with CT for detecting lung pathology in critically ill patients. The studies also investigating lung ultrasound,... read more

Oxygenate, Ventilate, Do No Harm

Oxygenate, Ventilate, Do No Harm

Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more

The Effect of Alcohol Consumption on the Risk of ARDS

The Effect of Alcohol Consumption on the Risk of ARDS

Chronic high alcohol consumption significantly increases the risk of ARDS. This finding suggests that patients admitted to hospital should be screened for chronic alcohol use. Seventeen observational studies (177,674 people)... read more

Prolonged Glucocorticoid Treatment is Associated with Improved ARDS Outcomes

Prolonged Glucocorticoid Treatment is Associated with Improved ARDS Outcomes

Prolonged methylprednisolone treatment accelerates the resolution of ARDS, improving a broad spectrum of interrelated clinical outcomes and decreasing hospital mortality and healthcare utilization. We conducted two sets of... read more

Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors

Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors

These data suggest that lung endothelial cell overdistention activates ion channels, and the resultant influx of Ca2+ inactivates Axl. Downstream inactivation of Axl by stretch was not anticipated; preventing this would be... read more

Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric ARDS Mortality

Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric ARDS Mortality

Patients with PARDS managed with lower PEEP relative to FiO2 than recommended by the ARDSNet model had higher mortality. Clinical trials targeting PEEP management in PARDS are needed. This was a multicenter, retrospective... read more

Low Tidal Volume Ventilation in ARDS

Low Tidal Volume Ventilation in ARDS

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Allan Walkey. They discuss low tidal volume ventilation in ARDS. Dr. Walkey is the chair of the Early Career Professional Working Group... read more

Timing of Renal Support and Outcome of Septic Shock and ARDS

Timing of Renal Support and Outcome of Septic Shock and ARDS

Early RRT initiation strategy was not associated with any improvement of 60-day mortality in patients with severe acute kidney injury and septic shock or Acute Respiratory Distress Syndrome (ARDS). Unnecessary and potentially... read more

The Efficacy of ECMO for Severe ARDS

The Efficacy of ECMO for Severe ARDS

The H1N1 epidemic demonstrated that extracorporeal membrane oxygenation (ECMO) use in the most critically ill patients with acute respiratory distress syndrome (ARDS) resulted in a substantial decrease in mortality. The CESAR... read more

Management and Outcomes of ARDS Patients With and Without Comorbid Conditions

Management and Outcomes of ARDS Patients With and Without Comorbid Conditions

Half the patients with acute respiratory distress syndrome (ARDS) had major comorbidities, which were associated with severe ARDS, multiple organ dysfunction, and day‑28 mortality. These findings do not support the exclusion... read more

Immunocompromised Patients with ARDS

Immunocompromised Patients with ARDS

Immunosuppression is frequent in patients with acute respiratory distress syndrome (ARDS), and infections are the main risk factors for ARDS in these immunocompromised patients. Their management differs from that of immunocompetent... read more

Do We Know Enough to Recommend Corticosteroids in ARDS?

Do We Know Enough to Recommend Corticosteroids in ARDS?

We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more

Muscle Weakness and 5-Year Survival in ARDS Survivors

Muscle Weakness and 5-Year Survival in ARDS Survivors

At hospital discharge, >1/3 of Acute Respiratory Distress Syndrome (ARDS) survivors had muscle weakness. Greater strength at discharge and throughout follow-up was associated with improved 5-year survival. In patients with... read more

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction... read more

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Sapru et al. show in this issue of Critical Care that variants of thrombomodulin and the endothelial protein C receptor, but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free... read more

Harrison’s Pulmonary and Critical Care Medicine

Harrison’s Pulmonary and Critical Care Medicine

Featuring a superb compilation of chapters related to pulmonary and critical care topics, this concise, full-color clinical companion delivers the latest knowledge in the field backed by the scientific rigor and authority... read more