NIH ACTIV trial of blood thinners pauses enrollment of critically ill COVID-19 patients

Three clinical trial platforms working together to test the effects of full doses of anticoagulants (blood thinners) in COVID-19 patients have paused enrollment for one group of patients. Among critically ill COVID-19... read more

Long-Term Sustainability and Acceptance of Antimicrobial Stewardship in Intensive Care

An antimicrobial stewardship program implemented over a decade resulted in sustained suggestion and acceptance rates. These findings support the need for a persistent presence of audit-and-feedback over time with more frequent... read more

ICU Delirium-Prediction Models: A Systematic Review

Although most ICU delirium-prediction models have relatively good performance, they have limited applicability to clinical practice. Most models were static, making predictions based on data collected at a single time-point,... read more

Acinetobacter Baumannii Native Valve Infective Endocarditis

This report underlines the severe nature of A. baumannii infections, which are still associated with a prolonged hospital stay, and increased morbidity, mortality, and medical costs. Infective endocarditis caused by Acinetobacter... read more

The Ventilator Book

If you need something that teaches you both the concepts of mechanical ventilation and how to manage patients with respiratory failure, this is the book for you. The Ventilator Book is written to be read in the ICU or Emergency... read more

The Ventilator Book

Two-Step Imputation and AdaBoost-Based Classification for Early Prediction of Sepsis on Imbalanced Clinical Data

Sepsis is a life-threatening response to infection that causes tissue damage, organ failure, and death. Effective early prediction of sepsis would improve patients’ diagnosis and reduce the cost associated with late-stage... read more

Family satisfaction in a neuro trauma ICU

The purpose of this quality improvement initiative was to evaluate satisfaction of family members of patients in a neuro trauma ICU (NTICU). Adult patients (age 18+) admitted to the NTICU for at least 24 hours between... read more

Doppler Echocardiographic Indices in Critically Ill Patients Under Mechanical Ventilation

Doppler Echocardiographic Indices Are Specific But Not Sensitive to Predict Pulmonary Artery Occlusion Pressure in Critically Ill Patients Under Mechanical Ventilation. The objective of this study was to prospectively... read more

Weaning the patient: between protocols and physiology

Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review... read more

ICU Workers Are Quitting Due To Crushing Stress From COVID-19 Surge

As hospitals struggle in Los Angeles County, Intensive Care Unit nurses confront tough choices: remain in the coronavirus trenches for patients and colleagues, or quit when you are overwhelmed? The massive surge in coronavirus... read more

America Is Running Out of Nurses

In normal times, there are some 50,000 travelling nurses in the United States. Most are full-time gig workers who move from job to job, usually staying in one place for thirteen weeks. (That length is a holdover from old... read more

Lipid Mediators in Critically Ill Patients: A Step Towards Precision Medicine

In this review, we provide an overview of the role of fatty acid-derived lipid mediators as endogenous regulators of the inflammatory, anti-inflammatory and pro-resolving response and future directions for use of clinical... read more

Genetic Mechanisms of Critical Illness in COVID-19

Host-mediated lung inflammation is present, and drives mortality, in critical illness caused by COVID-19. Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development. Here... read more

Improved Oxygenation After Prone Positioning May Be a Predictor of Survival in Patients With ARDS

We found a significant difference in the Pao2:Fio2 ratio after the first prone positioning between ICU survivors and nonsurvivors. The improvement in oxygenation after the first prone positioning was a significant predictor... read more

Nurses’ knowledge and practices of physical restraints in ICU

The mean scores of nurses' knowledge and practices were 61.5 (SD = 12.1) and 57.4 (SD = 9.7), respectively. More than half of nurses had poor knowledge of PR use and incorrect practice of implementing PR (51.5% and 60.5%,... read more

Clinical characteristics of critically ill patients with COVID-19

In this study of critical patients infected by SARS-CoV-2 in a high-complexity hospital, the majority were comorbid elderly men, a large percentage required invasive mechanical ventilation, and ICU mortality was 25%. Design... read more

ECG Pointers: Cocaine and ST Elevation

This ECG comes from a 21-year-old male with a history of cocaine abuse.  When I say ‘history’, I mean that he just snorted some cocaine and now he has chest pain.  He looks uncomfortable and sweaty, and keeps... read more

Risk factors and events in the adult ICU associated with pain as self-reported at the end of the intensive care unit stay

The short-term and long-term consequences of the most frequent painful procedures performed in the ICU are unclear. This study aimed to identify the risk factors associated with pain-related discomfort perceived by critically... read more

Will the asthma revolution fostered by biologics also benefit adult ICU patients?

Asthma exacerbations are inflammatory events that rarely result in full hospitalization following an ER visit. Unfortunately, certain patients require prolonged support, including occasional external lung support through... read more

Caring for the Sickest COVID-19 Patients: An ICU Story

In an article for the latest issue of Stanford Medicine magazine, I provide a glimpse into the journey Free and his front-line Stanford Health Care colleagues took -- from Day 1 through the following weeks and months -- to... read more

Fishman’s Pulmonary Diseases and Disorders

Since 1980, Fishman's Pulmonary Diseases and Disorders has delivered unparalleled coverage of pulmonary medicine and the underlying basic and applied science upon which clinical practice is based. The Fifth Edition, with... read more

Fishman’s Pulmonary Diseases and Disorders

Surgery guidance updated for hospitals struggling with capacity constraints

Four healthcare groups again updated their guidance for hospitals to maintain essential surgeries during the COVID-19 pandemic. The American Hospital Association, American College of Surgeons, American Society of Anesthesiologists... read more