Hydrocortisone plus Fludrocortisone for Adults with Septic Shock

Hydrocortisone plus Fludrocortisone for Adults with Septic Shock

The use of steroids in critically ill patients continues to be controversial. Whilst there are signals for improved cardiovascular parameters, this did not translate to clear mortality benefits. The most recent of these trials... 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

Withdrawing vs. Not Offering Cardiopulmonary Resuscitation: Is There a Difference?

In light of the SCC's Cuthbertson v. Rasouli decision, the distinction between withdrawing and not offering a medical treatment is increasingly relevant. Because CPR is a "default" treatment for cardiac arrest, it requires... read more

Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support

Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support

Among ICU patients receiving acute ventilatory support for respiratory failure, patient-directed music (PDM) resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM... read more

SOS Asynchronies: Do We Need Help?

SOS Asynchronies: Do We Need Help?

Synchrony between the patient and the ventilator is defined as the appropriate interaction between the two, where the ventilator recognizes patient’s effort and provides support for breathing at the right time—that is,... read more

Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation

Value of variation index of inferior vena cava diameter in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation

The findings of this study suggest that the ΔIVCD performed moderately well in predicting fluid responsiveness in patients with circulatory shock receiving mechanical ventilation. Overall, 603 patients were included in this... read more

Early Versus Late Initiation of Renal Replacement Therapy in Critically Ill Patients

Early Versus Late Initiation of Renal Replacement Therapy in Critically Ill Patients

Early initiation of renal replacement therapy (RRT) effect on survival and renal recovery of critically ill patients is still uncertain. We aimed to systematically review current evidence comparing outcomes of early versus... read more

Predictors of Return to Work in Survivors of Critical Illness

Predictors of Return to Work in Survivors of Critical Illness

Major trauma, lower GCS and increased hospital length of stay predicted inability to return to work due to health at six-months post-ICU admission. Compared to employed patients, those who had not returned to work reported... read more

Validation and Clinical Implications of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia

Validation and Clinical Implications of the IDSA/ATS Minor Criteria for Severe Community-Acquired Pneumonia

These findings support the use of the IDSA/ATS minor criteria to predict hospital mortality and guide ICU admission in inpatients with Community-Acquired Pneumonia (CAP) who do not require emergency mechanical ventilation... read more

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

In patients requiring intubation from acute salicylate toxicity, hemodialysis should be considered as part of management, as this is associated with decreased mortality. Salicylates are common substances that can be purchased... read more

Ultrasound Non-invasive Measurement of Intracranial Pressure in Neurointensive Care

Ultrasound Non-invasive Measurement of Intracranial Pressure in Neurointensive Care

Of the studied ultrasound nICP methods, ONSD is the best estimator of Intracranial Pressure (ICP). The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique... read more

Oxygenate, Ventilate, Do No Harm

Oxygenate, Ventilate, Do No Harm

Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more

Effect of In-Bed Leg Cycling and Electrical Stimulation of the Quadriceps on Global Muscle Strength in Critically Ill Adults

Effect of In-Bed Leg Cycling and Electrical Stimulation of the Quadriceps on Global Muscle Strength in Critically Ill Adults

In this single-center randomized clinical trial involving patients admitted to the ICU, adding early in-bed leg cycling exercises and electrical stimulation of the quadriceps muscles to a standardized early rehabilitation... read more

Prolonged Glucocorticoid Treatment is Associated with Improved ARDS Outcomes

Prolonged Glucocorticoid Treatment is Associated with Improved ARDS Outcomes

Prolonged methylprednisolone treatment accelerates the resolution of ARDS, improving a broad spectrum of interrelated clinical outcomes and decreasing hospital mortality and healthcare utilization. We conducted two sets of... read more

Inspiratory Muscle Training for ICU Patients

Inspiratory Muscle Training for ICU Patients

Inspiratory muscle weakness is a known consequence of prolonged mechanical ventilation, and there is emerging evidence that specific inspiratory muscle training (IMT) can ameliorate this weakness. Australian researchers recommend... read more

Barriers to implementing expert safety recommendations for early mobilization in ICU during mechanical ventilation

Barriers to implementing expert safety recommendations for early mobilization in ICU during mechanical ventilation

Early mobilization in the intensive care unit (ICU) has been consistently reported as feasible and safe with minimal adverse events; however, invasive mechanical ventilation patients are rarely actively mobilized. An expert... 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