Vitamin C: Should We Supplement?

A short course of intravenous vitamin C in pharmacological dose seems a promising, well tolerated, and cheap adjuvant therapy to modulate the overwhelming oxidative stress in severe sepsis, trauma, and reperfusion after ischemia.... read more

Septic Shock: Innovative Treatment Options in the Wings

Septic Shock: Innovative Treatment Options in the Wings

Vitamin C, angiotensin-II, and methylene blue are emerging options on the cutting edge of refractory septic shock treatment that require more investigation, but nevertheless appear promising, Rishi Rattan, MD, said at the... read more

Angiotensin converting enzyme defects in shock: implications for future therapy

Angiotensin converting enzyme defects in shock: implications for future therapy

Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more

Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

Effect of Human Recombinant Alkaline Phosphatase on 7-Day Creatinine Clearance in Patients With Sepsis-Associated AKI

In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose... read more

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD

Among adults with COPD at high risk of exacerbation treated with inhaled corticosteroids, the addition of low-dose theophylline, compared with placebo, did not reduce the number COPD exacerbations over a 1-year period. The... read more

Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management

Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management

The treatment of choice for a pneumothorax is a chest tube, and when the small pig-tail catheter doesn’t do the job, the answer is to replace it with a larger bore – right? Not so fast. The exact mechanism of REPE is... read more

Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers

Early PREdiction of Sepsis Using Leukocyte Surface Biomarkers

From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection. Between January 2014 and February 2016, we recruited 272, 59 and... read more

Positive End-expiratory Pressure and Mechanical Power

Positive End-expiratory Pressure and Mechanical Power

Less than 7 cm H2O positive end-expiratory pressure reduced atelectrauma encountered at zero end-expiratory pressure. Above a defined power threshold, sustained positive end-expiratory pressure contributed to potentially... read more

Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI

Effect of Early vs Delayed Initiation of RRT on Mortality in Critically Ill Patients With AKI

Among critically ill patients with Acute Kidney Injury (AKI), early Renal Replacement Therapy (RRT) compared with delayed initiation of RRT reduced mortality over the first 90 days. Further multicenter trials of this intervention... read more

Predicting the Requirement for RRT in Intensive Care Patients with Sepsis

Predicting the Requirement for RRT in Intensive Care Patients with Sepsis

Sepsis is one of the most frequent causes of acute kidney injury (AKI) in critically ill patients, with initial organ impairment often followed by dysfunction in other systems. Renal dysfunction may therefore represent one... read more

S1PR2 deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis

S1PR2 deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis

Sphingosine-1-phosphate receptor 2 (S1PR2) deficiency decreased macrophage pyroptosis and improved survival in E. coli sepsis. These beneficial effects were attributed to the decreased caspase-11 activation of S1PR2-deficient... read more

Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms

Initial Inflammatory Profile in Community-acquired Pneumonia Depends on Time since Onset of Symptoms

Time since symptom onset modifies the systemic inflammatory profile at Community-acquired Pneumonia (CAP) diagnosis. This information has relevant clinical implications for management, and it should be taken into account... read more

Increased Early Systemic Inflammation in ICU-Acquired Weakness

Increased Early Systemic Inflammation in ICU-Acquired Weakness

The main objective is to investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness.... read more

Music Helps Prevent Delirium in Elderly Critical Care Patients

Music Helps Prevent Delirium in Elderly Critical Care Patients

A randomized controlled trial demonstrates that music intervention to prevent delirium among older patients is one of few strategies that provide support in a critical care setting. This study builds on non-pharmacologic... read more

Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?

Natriuretic Peptides: A Role in Early Septic Acute Kidney Injury?

Acute kidney injury (AKI) is a common complication of critical illness and is associated with significant morbidity, mortality, and financial cost. Sepsis is the leading association of acute kidney injury in the intensive... read more

Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis

Vascular Effects of Adrenomedullin and the Anti-Adrenomedullin Antibody Adrecizumab in Sepsis

Sepsis remains a major scientific and medical challenge, for which, apart from significant refinements in supportive therapy, treatment has barely changed over the last few decades. During sepsis, both vascular tone and vascular... read more

Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors

Mechanical Ventilation Induces Desensitization of Lung Axl Tyrosine Kinase Receptors

These data suggest that lung endothelial cell overdistention activates ion channels, and the resultant influx of Ca2+ inactivates Axl. Downstream inactivation of Axl by stretch was not anticipated; preventing this would be... read more