Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

Transfusion Strategies for Acute Upper Gastrointestinal Bleeding

As compared with a liberal transfusion strategy, a restrictive strategy significantly improved outcomes in patients with acute upper gastrointestinal bleeding. We enrolled 921 patients with severe acute upper gastrointestinal... read more

Inadvertent direct pulmonary artery catheterization complicating the effort for subclavian venous cannulation and central venous catheter placement

Inadvertent direct pulmonary artery catheterization complicating the effort for subclavian venous cannulation and central venous catheter placement

Subclavian access is commonly used in the intensive care unit (ICU) for central venous catheterization. Many complications have been reported during the placement of central venous catheters including pneumothorax, hemothorax,... read more

Clinical and Pathophysiologic Aspects of ECMO-associated Hemorrhagic Complications

Clinical and Pathophysiologic Aspects of ECMO-associated Hemorrhagic Complications

Extracorporeal membrane oxygenation (ECMO) is increasingly used to treat severe cases of acute respiratory or cardiac failure. Hemorrhagic complications represent one of the most common complications during ECMO, and can... read more

Thrombosis and Bleeding in ECMO without Anticoagulation

Thrombosis and Bleeding in ECMO without Anticoagulation

Extracorporeal membrane oxygenation (ECMO) causes both thrombosis and bleeding. Major society guidelines recommend continuous, systemic anticoagulation to prevent thrombosis of the ECMO circuit, though this may be undesirable... read more

TEG for Hypocoagulable Patients with Non-Traumatic Bleeding

TEG for Hypocoagulable Patients with Non-Traumatic Bleeding

Thromboelastogram (TEG) has been extensively studied in trauma and surgical patients, but has not been well studied in nontraumatic bleeding, nor has its use been well evaluated in the emergency department. This study... read more

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19

Gastrointestinal Complications in Critically Ill Patients With and Without COVID-19

This study found a higher rate of gastrointestinal complications, including mesenteric ischemia, in critically ill patients with COVID-19 compared with propensity score–matched patients without COVID-19, suggesting a distinct... read more

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

Timing of Endoscopy for Acute Upper Gastrointestinal Bleeding

In patients with high risk upper GI bleeding, who were treated with pre-endoscopy PPI and were not in persistent shock, an endoscopy performed at a median of 10 hours vs. a median of 25 hours post presentation did not reduce... read more

Critical Care and Hospitalist Medicine Made Ridiculously Simple

Critical Care and Hospitalist Medicine Made Ridiculously Simple

A fundamental and thorough guide to the treatment of hospitalized patients in critical care situations, "Critical Care and Hospitalist Medicine Made Ridiculously Simple" provides both introductory information as well as a... read more

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Enteral Fluid Resuscitation? The WHO to the rescue in the ED/ICU?

Prior to the 1970's, restricting oral intake was a "cornerstone" therapy of diarrheal illness, due to the pervasive belief that the GI tract needed time to heal and recover before resuming normal function. This was felt... read more

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

Tranexamic Acid in TBI – CRASH-3 Trial Treatment

The CRASH-3 trial is a multi-centre, randomised, placebo-controlled trial of the effects of tranexamic acid on death and disability in patients with traumatic brain injury (TBI). Patients with reactive pupils and/or mild... read more

Low-flow Assessment of Current ECMO/ECCO2R Rotary Blood Pumps and the Potential Effect on Hemocompatibility

Low-flow Assessment of Current ECMO/ECCO2R Rotary Blood Pumps and the Potential Effect on Hemocompatibility

The role of blood pumps in contributing to adverse effects at the lower blood flow rates used during ECCO2R is shown here to be significant. Current rotary blood pumps should be used with caution if operated at blood... read more

Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents

Epidemiology of Clinically Relevant Bleeding in Critically Ill Adolescents

Clinically Relevant Bleeding (CRB) is common in critically ill adolescents who are at high risk of venous thromboembolism (VTE). Admission after trauma or surgery can be used to stratify the risk of CRB in this population.... read more

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation

The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more

Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients

Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients

In this updated systematic review, we were able to refute a relative change of 20% of mortality. The occurrence of GI bleeding was reduced, but we lack firm evidence for a reduction in clinically important GI bleeding. The... read more