Failure of Non-invasive Ventilation in Patients with Acute Lung Injury

A high failure rate of the initial non-invasive positive pressure ventilation (NIPPV) therapy has been observed in medical critically ill patients with acute lung injury (ALI). Unless the underlying shock, metabolic acidosis... read more

Failure of Non-invasive Ventilation in Patients with Acute Lung Injury

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

Cognitive impairment (CI) is an important but an under-recognized extra-pulmonary feature of chronic obstructive pulmonary disease (COPD). It is related to the burden of disability, worse health outcomes and impaired self-management.... read more

Cognitive impairment in chronic obstructive pulmonary disease: disease burden, determinants and possible future interventions

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?

Hyperoxia in the Critically Ill

Critically ill patients come to the ED all the time and it is almost reflexive to liberally administer oxygen in these acutely ill patients. Many providers may consider supplemental oxygen a harmless and potentially beneficial... read more

Hyperoxia in the Critically Ill

Noninvasive Ventilation in Pneumonia-induced Early Stage Mild ARDS

Treatment with noninvasive ventilation (NIV) did not reduce the need for intubation among patients with pneumonia-induced early mild acute respiratory distress syndrome (ARDS), despite the improved PaO2/FIO2 observed with... read more

Noninvasive Ventilation in Pneumonia-induced Early Stage Mild ARDS

Oxygen Treatment in Intensive Care and Emergency Medicine

Hypoxemia should certainly be avoided, but the fact that the liberal administration of oxygen to patients in intensive care units and emergency rooms tends to increase morbidity and mortality implies the advisability of a... read more

Oxygen Treatment in Intensive Care and Emergency Medicine

Worse outcomes with video laryngoscopy in ICU

When used in intensive care units, video laryngoscopy did not improve the chances of successful intubation on the first try, compared with direct laryngoscopy, and was associated with a significantly higher risk of severe... read more

Noninvasive Ventilation Through the Helmet Can Be Used For Early Mild and Moderate ARDS

Debating data have been published as regards the beneficial or deleterious effect of spontaneous breathing (SB) in comparison to controlled mechanical ventilation (CMV) during acute respiratory failure. Spontaneous breathing... read more

Noninvasive Ventilation Through the Helmet Can Be Used For Early Mild and Moderate ARDS

High-flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure

In patients with nonhypercapnic acute hypoxemic respiratory failure, treatment with high-flow oxygen, standard oxygen, or noninvasive ventilation did not result in significantly different intubation rates. There was a significant... read more

High-flow Oxygen Through Nasal Cannula in Acute Hypoxemic Respiratory Failure

ECMO in the Critical Trauma Patient

Growing evidence suggests the potential use of Extracorporeal membrane oxygenation (ECMO) for the treatment of refractory respiratory failure in adults, but the clinical benefit in polytraumatic patients is not clear. The... read more

ECMO in the Critical Trauma Patient

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Among the 401... read more

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Fluid Management in Acute Respiratory Distress Syndrome

In this video, Dr. Stacey Valentine discusses fluid management in acute respiratory distress syndrome (ARDS), including the evidence supporting fluid-restrictive strategies. Both acute lung injury and its more severe form,... read more

Fluid Management in Acute Respiratory Distress Syndrome

Partial Pressure of Oxygen and Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients

Following out-of-hospital cardiac arrest (OHCA), patients regularly suffer from post cardiac arrest syndrome including symptoms of anoxic brain injury and reperfusion-related damage. Hyperoxemia or hypoxemia exposure occurred... read more

Partial Pressure of Oxygen and Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients

High-frequency Oscillatory Ventilation: Still a Role?

In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. Although not first-line, HFOV remains... read more

High-frequency Oscillatory Ventilation: Still a Role?

Adjunct and Rescue Therapies for Refractory Hypoxemia

Prone position, inhaled nitric oxide, high frequency oscillation, extra corporeal life support. The mortality of severe acute respiratory distress syndrome (ARDS), deļ¬ned with a PaO2/FiO2 ratio of 100 mmHg... read more

Adjunct and Rescue Therapies for Refractory Hypoxemia

Navigating Medical Emergencies – An interactive guide to patient management

This free eBook presents emergent clinical situations and the core tasks required of healthcare professionals needing to recognize, navigate and safely manage them. It's really about how to perform the ABCs while protecting... read more

Navigating Medical Emergencies – An interactive guide to patient management

Prone Positioning for a Morbidly Obese Patient with ARDS

Since the description in the 1970s of external positive end-expiratory pressure for acute respiratory distress syndrome (ARDS), the optimum level of external positive end-expiratory pressure remains unresolved. In the 1990s,... read more

Prone Positioning for a Morbidly Obese Patient with ARDS

ECMO for Severe ARDS

Mr. Jackson is a 36-year-old man whom you are caring for in the intensive care unit (ICU). Before this hospitalization, he was healthy and took no medications. He has never smoked, and he drinks three or four beers every... read more

ECMO for Severe ARDS

Chest Radiography vs. Lung Ultrasound for Identification of ARDS

For the identification of acute respiratory distress syndrome (ARDS) using the Berlin definition, both chest radiography and lung ultrasound were equally related to mortality. The Berlin definition using lung ultrasound helped... read more

Chest Radiography vs. Lung Ultrasound for Identification of ARDS

High Flow Nasal Cannula (HFNC) – Part 1: How It Works

The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups. I first started using it as a pediatric intensive... read more

High Flow Nasal Cannula (HFNC) – Part 1: How It Works

Non-invasive Ventilation in the ED: Whom, When, How?

Timely use of NIV in the ED may decrease the need for invasive ventilation and its associated complications. The appropriate device, interface and patient selection are, therefore, key components of NIV success. Once the... read more

Non-invasive Ventilation in the ED: Whom, When, How?