Longitudinal Respiratory Subphenotypes in COVID-19 Patients with ARDS

COVID-19-related ARDS has no consistent respiratory subphenotype. Patients diverged from a fairly homogenous to a more heterogeneous population, with trajectories of ventilatory ratio and mechanical power being the most discriminatory.... read more

Continuous Positive Airway Pressure and Pronation Outside the ICUs in COVID-19 ARDS

Continuous positive airway pressure with patient mobilization (including pronation) was effective and safe in patients with ARDS due to COVID-19 managed outside the intensive care unit setting during the pandemic. Of 90... read more

Patients Discharged From the ICU on a Dopamine Infusion

Despite a higher ICU readmission rate, ICU discharge of patients on dopamine infusion was not associated with increased mortality. The hospital mortality rate was comparable in both groups, despite that the median logistic... read more

Impact of ABCDE Bundle Implementation in the ICU on Specific Patient Costs

Full ABCDE bundle implementation resulted in a decrease in total hospital laboratory costs and total hospital laboratory and diagnostic resource utilization while leading to an increase in physical therapy costs. The full... read more

Time Course of Risk Factors Associated with COVID-19 Mortality

The present multicentric study describes 1,260 critically ill patients with COVID-19-associated acute respiratory failure consecutively admitted to 24 Italian ICUs during the first pandemic wave. This study specifically... read more

Variations in End-of-Life Practices in ICUs Worldwide

Limitation of life-sustaining therapies is common worldwide with regional variability. Withholding treatment is more common than withdrawing treatment. Variations in type, frequency, and timing of end-of-life decisions were... read more

Discordance Between Respiratory Drive and Sedation Depth in Critically Ill Patients Receiving Mechanical Ventilation

Sedation depth is not a reliable marker of respiratory drive during critical illness. Respiratory drive can be low, moderate, or high across the range of routinely targeted sedation depth. 56 patients undergoing 197 bedside... read more

Higher ICU Sepsis Case Volume Associated with Significantly Lower Hospital Mortality

In this cohort study of 273,001 patients with sepsis at 231 ICUs in the UK, a higher annual sepsis case volume in the ICU was associated with significantly lower hospital mortality, and this association had no significant... read more

Artificial Intelligence Hold Promise in the ICU

In a 2018 article entitled “Human Cognitive Limitations”, the University of Utah's Alan Morris estimated the number of variables an intensivist has to take into account for a patient on mechanical ventilation. He... read more

Floating Feathers: A Doctor’s Harrowing Experience as a Patient Within Conventional Medicine and an Impassioned Call for the Future of Care in America

Dr. Ross I.S. Zbar spent his career as a plastic surgeon, in the US as well as abroad in developing countries, mending disease- and trauma-related deformities--and he was never hesitant to make his voice heard as an advocate... read more

Floating Feathers: A Doctor’s Harrowing Experience as a Patient Within Conventional Medicine and an Impassioned Call for the Future of Care in America

Intensive care–treated cardiac arrest: a retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs

The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Elderly received less intense treatment. Further efforts are needed... read more

Inhaled Sedation in the ICU: A New Option and Its Technical Prerequisites

Andreas Meiser summarizes the current literature on inhalation sedation of critically ill patients. To meet clinical demands, he describes the development of new devices to administer volatile anesthetics together with common... read more

Inhaled Sedation in the ICU: A New Option and Its Technical Prerequisites

Diaphragm Ultrasonography in ICU: Why, How, and When To Use It?

An overview of the principles and current applications of diaphragm ultrasound and innovative ultrasound-based techniques. In the ICU, ultrasound is starting to be acknowledged as a useful tool for studying the diaphragm.... read more

Multi-task Prediction of Organ Dysfunction in ICUs

The intensive care unit (ICU) of a hospital looks after the most medically vulnerable patients, many of whom require organ support, such as mechanical ventilation or dialysis. While always critical, the demand on ICU services... read more

Managing Rising COVID-19 Cases in ICU

I have been working in intensive care for over 20 years, including a decade as a consultant, and facing winter pressures has always been the norm. However, the past 18 months have been something else. During the winter... read more

Effect of Graded Early Mobilization on Psychomotor Status and Length of ICU Stay in Mechanically Ventilated Patients

This research showed that graded early mobilization was highly effective to improve the motor and psychological status of mechanically ventilated patients and reduce their length of ICU stay. In the control group mean... read more

Prone Positioning and Survival in Mechanically Ventilated Patients with COVID-19

In-hospital mortality was lower in mechanically ventilated hypoxemic patients with coronavirus disease 2019 treated with early proning compared with patients whose treatment did not include early proning. Among 2,338 eligible... read more

Clinical Trials Design Evaluating Sedation in Critically Ill Adults Requiring Mechanical Ventilation

These recommendations are intended to assist researchers in the design, conduct, selection of endpoints, and reporting of clinical trials involving sedative medications and/or sedation protocols for adult ICU patients who... read more

Melatonin for Delirium Prevention in Hospitalized Patients

Melatonin/ramelteon are associated with reduction in delirium incidence in hospitalized patients. However, this effect seems confined to surgical and ICU patients. The optimum dosage and formulation of melatonin, and... read more

Preoperative vena cava filter placement in recurrent cerebral fat embolism following traumatic multiple fractures

Despite scarce evidence, we reckon that Inferior Vena Cava Filter (IVCF) could improve prognosis in selected patients with fat embolism syndrome (FES), especially those presenting high risk factors, after accurately weighing... read more

Multimorbidity on Long-Term Outcomes Following ICU Discharge

This national cohort study has demonstrated increased resource use for critical care survivors in the year following discharge but fails to replicate past findings of increased longer-term mortality. Multimorbidity, lifestyle... read more