Is Tranexamic Acid Going to CRASH the Management of TBI?

In the recent CRASH-3 randomized trial, early administration of tranexamic acid (TXA) was associated with a non-significant reduction of head injury-related 28-day mortality in patients with isolated traumatic brain injury... read more

Is Tranexamic Acid Going to CRASH the Management of TBI?

Ultrasound-based Clinical Profiles for Predicting the Risk of Intradialytic Hypotension in Critically Ill Patients on Intermittent Dialysis

In critically ill patients on intermittent hemodialysis, the absence of hypervolemia as assessed by lung and vena cava ultrasound predisposes to intradialytic hypotension and suggests alternative techniques of hemodialysis... read more

Ultrasound-based Clinical Profiles for Predicting the Risk of Intradialytic Hypotension in Critically Ill Patients on Intermittent Dialysis

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors. Specific levels of absolute hypotension, but not relative... read more

Preoperative Risk and the Association between Hypotension and Postoperative AKI

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the... read more

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Septic Shock and the Use of Norepinephrine IMCU

Elderly patients with septic shock treated with norepinephrine (NE) displayed a better Intermediate Care Unit (IMCU) survival at the ward and at 30 days than previously expected. Our retrospective chart study did not... read more

Septic Shock and the Use of Norepinephrine IMCU

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Hypotension thresholds that provoke renal injury, myocardial injury, and mortality in critical care patients remain unknown. We primarily sought to determine the relationship between hypotension and a composite of myocardial... read more

Association Between Mean Arterial Pressure and AKI and a Composite of Myocardial Injury and Mortality in Postoperative Critically Ill Patients

Reduced Level of Arousal on Hospital Admission

Reduced level of arousal on hospital admission may be a strong predictor of in-hospital mortality. Most evidence was of low quality. Reduced level of arousal is highly specific to delirium, better formal detection of hypoactive... read more

Reduced Level of Arousal on Hospital Admission

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

Recent studies suggest that hypotension thresholds in current guidelines might be too low for older patients due to arterial stiffening, possibly leading to insufficient fluid resuscitation. We compared intravenous (IV) fluid... read more

The association between intravenous fluid resuscitation and mortality in older emergency department patients with suspected infection

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

In isolation of other medication, a hemodynamic response to IV acetaminophen has a higher prevalence in critically ill children with cardiac disease than previously thought and justifies controlled studies in the perioperative... read more

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock

In this study, administration of high-dose ascorbic acid significantly decreased the requirement for vasopressor's dose and duration in surgical critically ill patients with septic shock. Several mechanisms including anti-oxidant,... read more

Effect of High-dose Ascorbic Acid on Vasopressor’s Requirement in Septic Shock

Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery

Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortality. Intraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured... read more

Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery

Management of Refractory Vasodilatory Shock

Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory... read more

Management of Refractory Vasodilatory Shock

Vasopressors in Sepsis in 2050

Vasopressors are used in sepsis when hypotension is assumed to be mainly due to a decreased arterial tone. However, the appropriate time to initiate vasopressors is not clearly defined, and fluid administration is most... read more

Vasopressors in Sepsis in 2050

Personalization of Arterial Pressure in the Perioperative Period

This review aims to discuss recent findings on the relationship between intraoperative arterial hypotension and organ dysfunction in surgical patients and examines the available evidence for personalizing blood pressure (BP)... read more

Personalization of Arterial Pressure in the Perioperative Period

Expanding the Differential for Hypotension in the Pediatric Patient

As many ED practitioners are aware, food allergies are common in the first 2 years of life, with a prevalence cited between 1-10% of the population. Most food allergies are IgE-mediated hypersensitivity reactions. Food protein-induced... read more

Expanding the Differential for Hypotension in the Pediatric Patient

Tranexamic Acid For Isolated Penetrating Head Trauma

An aeromedical crew was dispatched to a local emergency department to transport a fourteen year-old female with self-inflicted gunshot wound to the head to a tertiary pediatric trauma hospital. The patient was previously... read more

Tranexamic Acid For Isolated Penetrating Head Trauma

Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF

Echocardiography is increasingly recommended for the diagnosis and assessment of patients with severe cardiac disease, including acute heart failure (AHF). Echocardiography and LUS can assist in the rapid assessment of patients... read more

Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF

The Shocked Intubation: Definitive Airway Sans Hypotension

Not many aspects of Emergency Medicine define our specialty better than resuscitation, and few concepts exemplify resuscitation better than shock and intubation. Yet few words together strike greater fear in the minds of... read more

The Shocked Intubation: Definitive Airway Sans Hypotension

Postoperative Renal Dysfunction After Noncardiac Surgery

Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures.... read more

Postoperative Renal Dysfunction After Noncardiac Surgery

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI

Among patients with severe traumatic brain injury (TBI), early prophylactic hypothermia compared with normothermia did not improve neurologic outcomes at 6 months. These findings do not support the use of early prophylactic... read more

Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe TBI

Effect of Targeted Polymyxin B Haemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level

In adult patients with septic shock and high circulating endotoxin activity, does the use of polymyxin B hemoperfusion therapy significantly decrease 28-day mortality? Among patients with septic shock and high endotoxin activity,... read more

Effect of Targeted Polymyxin B Haemoperfusion on 28-Day Mortality in Patients With Septic Shock and Elevated Endotoxin Level