A Better Way of Connecting Multiple Patients to a Single Ventilator

This differential multi-ventilation setup yields increased safety, monitoring and control for each connected patient. In an ideal world, no one treating patients with Acute Respiratory Distress Syndrome (ARDS) would have... read more

A Comparison of Albumin and Saline for Fluid Resuscitation in the ICU

In this randomized trial, we found that the use of 4 percent albumin or normal saline for intravascular volume resuscitation in a heterogeneous population of patients in the ICU resulted in equivalent rates of death from... read more

1 Million Ventilators Project

We need to develop a strategic reserve of 1,000,000+ emergency ventilators ASAP. These don't need to be fancy medical ventilators, they just need to work. In a pandemic, the limited existing ventilator supply and stockpile... read more

Splitting Ventilators to Provide Titrated Support to a Large Group of Patients

COVID-19 can out-strip the number of mechanical ventilators available to us. This has led to interest in using a single ventilator to support multiple patients. This post will review the theory and evidence regarding this... read more

Lung Ultrasonography Features of COVID-19 Pneumonia

As lung abnormalities may develop before clinical manifestations and nucleic acid detection, experts have recommended early chest computerized tomography (CT) for screening suspected patients. The high contagiousness... read more

COVID-19 Airway Management – The Role of Simulation

Health services around the world are faced with the challenge of preparing for the impact of COVID-19 on their communities as we all prepare for a potential global pandemic. I see a great role for simulation in process... read more

Decrease Delirium in Older ICU Adults Using Music

Researchers from the Regenstrief Institute and Mayo Clinic are leading the first study to test whether exposure to music can decrease delirium in older adults who are receiving mechanical ventilation in the Intensive Care... read more

ICU Risk Factors and Outcomes for Each Delirium Subtype

Although included studies reported on many subtype-specific risk factors (hypoactive, hyperactive) and outcomes, heterogeneity in reporting and methodological quality limited the generalizability of the results and the evidence... read more

Respiratory Support for Patients with COVID-19 Infection

Coronavirus disease 2019 (COVID-19) has affected more than 50 countries so far this year. Xiaobo Yang and colleagues described in their single-centered, retrospective, observational study that 52 of 710 patients with confirmed... read more

Flow-controlled Ventilation Enhances Lung Aeration

Lung-protective ventilation for acute respiratory distress syndrome (ARDS) aims for providing sufficient oxygenation and carbon dioxide clearance, while limiting the harmful effects of mechanical ventilation. This study... read more

Validation of Neuromuscular Blocking Agent Use in ARDS

The use of Neuromuscular Blocking Agents (NMBA) could significantly decrease mortality in moderate-to-severe acute respiratory distress syndrome (ARDS) patients and decrease the incidence of barotrauma during mechanical ventilation.... read more

Imaging Changes of Severe COVID-19 Pneumonia in Advanced Stage

The imaging changes of acute stage from a case of 75-year-old male patient with severe COVID-19 pneumonia combined acute respiratory distress syndrome (ARDS), septic shock, and multiple organ dysfunction syndrome (MODS) who... read more

Harmful Effects of Mechanical Ventilation on Neurocognitive Functions

Whether mechanical ventilation (MV) induces neurotoxicity that can trigger or accelerate chronic cognitive disorders is controversial. The relationship between MV and neurocognitive impairment, that persisted at hospital... read more

New Study on Prehospital Airway Control Trial Underway

Emory University Department of Emergency Medicine and Grady Memorial Hospital will take part in a U.S. Department of Defense-funded clinical trial to compare different ways to help people with traumatic injuries breathe. The... read more

Respiratory Drive in the ARDS: Pathophysiology, Monitoring, and Therapeutic Interventions

Neural respiratory drive, i.e., the activity of respiratory centres controlling breathing, is an overlooked physiologic variable which affects the pathophysiology and the clinical outcome of acute respiratory distress syndrome... read more

It’s Insane to Keep Using Mortality As a Primary Endpoint in Critical Care Trials

Mortality is an important endpoint, so we shouldn't ignore mortality trends entirely. However, the vast majority of these will be spurious. Thus, we should generally not change practice due to them. In the history of critical... read more

Coronavirus (2019-nCoV): Evidence Relevant to Critical Care

The 2019 Coronavirus outbreak was declared a global Public Health Emergency by the World Health Organization (WHO) on 30th January 2020. In order to ensure immediate access to relevant systematic reviews, this Cochrane... read more

Ventilatory Support and Mechanical Properties of the Fibrotic Lung Acting as a “Squishy Ball”

The management of the patient with lung fibrosis in the ICU is a challenge for the intensivist. The lack of studies defining the mechanical ventilation strategy, and the different underlying etiologies, make it difficult... read more

Expiratory Muscle Dysfunction in Critically Ill Patients

The expiratory muscles are the "neglected component" of the respiratory muscle pump. Rather as the heart does not comprise only a left ventricle, but also a right one, the respiratory muscle pump is much more than just the... read more

The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation

The focus on long-term consequences of critical illness has intensified with increasing ICU utilization and survivorship. Post Intensive Care Syndrome (PICS) is increasingly recognized and has profound and long-lasting negative... read more

Clinical Decision Support Systems: Future or Present in ICU?

Clinical decision support systems (CDSS) are today, a reality. More complex, useful systems will be developed in the near future, forging CDSS an essential part of ICU monitoring. However, we need to understand the algorithms... read more

Risk Factors for the Development of ARDS in Mechanically Ventilated Adults in Peru

In this study of mechanically ventilated patients, 31% of study participants had acute respiratory distress syndrome (ARDS) at some point during their ICU stay. Optimal lung-protective ventilation was not used in a majority... read more