Imaging platform captures hard-to-track bacterial lung infections in real time

Ahsan Akram and colleagues have created a fluorescent imaging probe that can quickly and accurately detect hard-to-trace Gram-negative bacteria (one of the major bacterial groups) in human lungs within minutes. Their first-in-human... read more

Proton-Pump Inhibitor Prophylaxis in the ICU

Critical illness can disrupt local and systemic mechanisms that protect against upper gastrointestinal bleeding, a condition that may be associated with increased mortality, particularly among patients receiving extracorporeal... read more

Chasing Mortality Endpoints is a Fool’s Errand

"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more

Dopamine Antagonists in ICU Delirium

Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more

Antipsychotic Drugs Don’t Ease ICU Delirium Or Dementia

Powerful drugs that have been used for decades to treat delirium are ineffective for that purpose, according to a study published online Monday in the New England Journal of Medicine. Antipsychotic medications, such as haloperidol... read more

Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients

In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality,... read more

Decontamination of Oral or Digestive Tract for Patients in the ICU

The study by Wittekamp and colleagues in this issue of JAMA evaluating strategies for decontamination of mechanically ventilated patients in the intensive care unit (ICU) fills an important gap in the evidence regarding these... read more

Rudeness in Medical Settings Could Kill Patients

A recent study paints a grim picture of what rudeness does to doctors and nurses performance. The study, "The Impact of Rudeness on Medical Team Performance: A Randomized Trial," which was published in the September... read more

Should Pediatric Intensive Care Be Centralized? Trent vs. Victoria

The mortality rate is lower among children admitted to specialist pediatric intensive care units (ICUs) than among those admitted to mixed adult and pediatric units in non-tertiary hospitals. In the UK, however, few children... read more

Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical ICU

We instituted several interventions in our trauma and surgical ICU aimed at improving communication and teamwork between RNs and MDs. Informal feedback indicated greater satisfaction among RNs and MDs with the working environment.... read more

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), defined with a PaO2/FiO2 ratio of 100 mmHg... read more

Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics

This issue of Critical Care Clinics focuses on Mechanical Ventilation and Ventricular Assist Devices, with topics including: Targeted management approach to cardiogenic shock; Prevention and treatment of right heart failure... read more

Mechanical Ventilation/Ventricular Assist Devices, An Issue of Critical Care Clinics

When ICU Delirium Leads To Symptoms Of Dementia After Discharge

Doctors have gradually come to realize that people who survive a serious brush with death in the intensive care unit are likely to develop potentially serious problems with their memory and thinking processes. This dementia,... read more

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

ESPEN Guideline on Clinical Nutrition in the ICU

Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk,... read more

ICU Care Improved with Conflict Management Education

Stressful by nature, the intensive care unit (ICU) inevitably faces conflicts due to immediate and cohesive action from physicians, nurses, respiratory therapists, and advanced practitioners. In an effort to help improve... read more

Alcohol Withdrawal: One Order to Sedate Them All

This is a retrospective cohort study describing 86 admissions to the ICU for alcohol withdrawal between 2011-2015. 86% were treated with benzodiazepines before ICU admission, usually on the general ward. The average dose... read more

Triiodothyronine Replacement in Critically Ill Adults with Non-thyroidal Illness Syndrome

This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness.... read more

Should ICU clinicians follow patients after ICU discharge? No

Post-intensive care syndrome (PICS) describes new or worsening impairments of physical, cognitive or mental health resulting from an episode of critical illness and its treatment and lasting after discharge... read more

Should ICU clinicians follow patients after ICU discharge? Yes

The trajectory of recovery from critical illness is often portrayed as a continuum. At one extremity lies an unstable patient dependent on life-sustaining treatments in the intensive care unit. At the... read more

Organ and Tissue Donation Education for Critical Care Residents

Qualitative data corroborated that residents need more exposure to clinical cases, especially regarding DCD donors. A standardized education curriculum would be beneficial for all residents within the ICU. Developing a better... read more