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

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

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

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

Management of Refractory Vasodilatory Shock

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

Vasopressors in Sepsis in 2050

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

Personalization of Arterial Pressure in the Perioperative Period

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

Expanding the Differential for Hypotension in the Pediatric Patient

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

Tranexamic Acid For Isolated Penetrating Head Trauma

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

Echocardiography and Lung Ultrasonography for the Assessment and Management of AHF

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

The Shocked Intubation: Definitive Airway Sans Hypotension

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

Postoperative Renal Dysfunction After Noncardiac Surgery

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

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

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

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

Approach to the Critically Ill Child: Shock

Approach to the Critically Ill Child: Shock

If you mainly treat adults or both adults and children like me, then you have probably heard the (very annoying) quote, "kids are not just small adults", and so I won't say it again. Well, I guess I just did, but at least... read more

Magnesium Sulfate for Rapid Atrial Fibrillation?

Magnesium Sulfate for Rapid Atrial Fibrillation?

Currently, several medications are recommended for the management of atrial fibrillation with rapid ventricular response in the emergency department including calcium channel blockers, beta blockers and digoxin (the optimal... read more