Abnormal Saline and the History of Intravenous Fluids

Abnormal Saline and the History of Intravenous Fluids

Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more

Early Interventions for the Prevention of Posttraumatic Stress Symptoms in Survivors of Critical Illness

Early Interventions for the Prevention of Posttraumatic Stress Symptoms in Survivors of Critical Illness

Despite a paucity of high-quality clinical investigations, the preponderance of evidence to date suggests that 1) posttraumatic stress disorder among survivors of critical illness may be preventable and 2) early interventions... read more

A Randomized Trial of a Family-Support Intervention in ICUs

A Randomized Trial of a Family-Support Intervention in ICUs

Family-support intervention in ICUs increased patient comfort and reduced costs. Among critically ill patients and their surrogates, a family-support intervention delivered by the interprofessional ICU team did not significantly... read more

Temporal Biomarker Profiles and Their Association with ICU Acquired Delirium

Temporal Biomarker Profiles and Their Association with ICU Acquired Delirium

While there are differences in markers (adiponectin and several brain proteins) between patients with and without delirium, the development of delirium is not preceded by a change in the biomarker profile of inflammatory... read more

A 10-year review of total hospital onset ICU bloodstream infections at an Academic Medical Center

A 10-year review of total hospital onset ICU bloodstream infections at an Academic Medical Center

Across all ICUs, the rates of primary BSIs progressively fell from 2.11/1000 patient days in FY05 to 0.32/1000 patient days in FY14; an 85.0% decrease (P<0.0001). Secondary BSIs also progressively decreased from 3.56/1000... read more

Cook County ICU: 30 Years of Unforgettable Patients and Odd Cases

Cook County ICU: 30 Years of Unforgettable Patients and Odd Cases

An inside look at one of the nation's most famous public hospitals, Cook County, as seen through the eyes of its longtime Director of Intensive Care, Dr. Cory Franklin. Readers will be riveted by stories of strange medical... read more

Muscle Weakness and 5-Year Survival in ARDS Survivors

Muscle Weakness and 5-Year Survival in ARDS Survivors

At hospital discharge, >1/3 of Acute Respiratory Distress Syndrome (ARDS) survivors had muscle weakness. Greater strength at discharge and throughout follow-up was associated with improved 5-year survival. In patients with... read more

Dr. Ultrasound and Mr. Hyde: my confessions as an educator and ICU geek

Dr. Ultrasound and Mr. Hyde: my confessions as an educator and ICU geek

I think most people in our field have had some or all of these thoughts. I feel guilty thinking them and certainly have a hard time verbalizing to other team members. Point of Care Ultrasound (POCUS) has swept the medical... read more

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction... read more

Medicaid Expansion Associated with Decline in ICU Stays

Medicaid Expansion Associated with Decline in ICU Stays

Medicaid expansion was associated with an early increase in insurance rates among hospitalized patients and a decline in ICU utilization rates among patients hospitalized with ACSCs. Further work is needed to explore whether... read more

Pushing Pressors in the Periphery

The mantra of the Broome Docs site is "bringing great care, out there." And today's topic goes right to the heart of that theme. It is one of my pet topics – so apologies in advance if the rant is too long or detailed.... read more

The burdens of survivorship: an approach to thinking about long-term outcomes after critical illness

The burdens of survivorship: an approach to thinking about long-term outcomes after critical illness

Internationally accepted approaches to the study of functioning and disability can inform critical care practitioners and scholars in their study of functional limitations, disability, and quality of life after critical illness... read more

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Genomics and Pharmacogenomics of Sepsis: So Close and Yet So Far

Sapru et al. show in this issue of Critical Care that variants of thrombomodulin and the endothelial protein C receptor, but not protein C, are associated with mortality and organ dysfunction (ventilation-free and organ failure-free... read more

Assessment of Clinical Criteria for Sepsis

Assessment of Clinical Criteria for Sepsis

The Third International Consensus Definitions Task Force defined sepsis as "life-threatening organ dysfunction due to a dysregulated host response to infection." The performance of clinical criteria for this sepsis definition... read more