Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with ARDS

Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with ARDS

An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome.... read more

Identifying barriers to delivering the ABCDE bundle to minimize adverse outcomes for mechanically ventilated patients

Identifying barriers to delivering the ABCDE bundle to minimize adverse outcomes for mechanically ventilated patients

Improved outcomes are associated with the Awakening, Breathing Coordination, Delirium and Early mobility/exercise (ABCDE) bundle; however, implementation issues are common. As yet, no study has integrated the barriers to... read more

Extra Corporeal Carbon Dioxide Removal

Extra Corporeal Carbon Dioxide Removal

In patients with chronic obstructive airway disease and hypercapneic acidosis, who are failing non-invasive ventilation, does extra corporeal carbon dioxide removal compared to non-invasive ventilation alone, reduce the... read more

Spontaneous Breathing during Mechanical Ventilation. Risks, Mechanisms, and Management

Spontaneous Breathing during Mechanical Ventilation. Risks, Mechanisms, and Management

Spontaneous respiratory effort during mechanical ventilation has long been recognized to improve oxygenation, and because oxygenation is a key management target, such effort may seem beneficial. Also, disuse and loss of peripheral... read more

Pricey Technology Is Keeping People Alive Who Don’t Want to Live

Pricey Technology Is Keeping People Alive Who Don’t Want to Live

As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial,... read more

Family Responses to Prognostic Information in Chronic Critical Illness

Family Responses to Prognostic Information in Chronic Critical Illness

Prognostic disclosure by skilled clinician communicators evokes a repertoire of responses from surrogates for the chronically critically ill. Recognition of these response patterns may help all clinicians better communicate... read more

Use of ‘tidal volume challenge’ to improve the reliability of pulse pressure variation

Use of ‘tidal volume challenge’ to improve the reliability of pulse pressure variation

Fluid loading is usually the first step in the resuscitation of patients with acute circulatory failure. Fluid responsiveness is defined as the ability of the left ventricle to increase its stroke volume in response to fluid... read more

Anesthesiologists Found Underreporting Medication Errors

Anesthesiologists Found Underreporting Medication Errors

Medication errors are apparently significantly underreported by anesthesia providers, at least at certain institutions. These recent findings may reflect a culture of underreporting or fear of punitive action, despite the... read more

Mechanical Ventilation: Which Patients Benefit from High PEEP?

Mechanical Ventilation: Which Patients Benefit from High PEEP?

Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital... read more

Clinical review: The ABC of weaning failure

Clinical review: The ABC of weaning failure

About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing... read more

Vitamin D and outcomes in adult critically ill patients

In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings. Seven... read more

An Educational Intervention Optimizes the Use of Arterial Blood Gas Determinations Across ICUs

An Educational Intervention Optimizes the Use of Arterial Blood Gas Determinations Across ICUs

The large scale implementation of guidelines for ABG use reduced the number of inappropriately ordered ABG determinations over seven different multidisciplinary ICUs, without negatively impacting patient care. We saw a reduction... read more

Delirium: Thinking Clearly About a Foggy Issue

Delirium: Thinking Clearly About a Foggy Issue

Benzodiazepines are one of the leading causes of delirium. These drugs are already falling out of favor in critical care settings for other reasons; they are not easily titratable, and research suggests they can prolong a... read more

Assessing Postoperative Pulmonary Complications After Noncardiothoracic Surgery

Assessing Postoperative Pulmonary Complications After Noncardiothoracic Surgery

In this multicenter study in 1202 American Society of Anesthesiologists physical status 3 patients undergoing noncardiothoracic surgery requiring 2 hours or more of general anesthesia with mechanical ventilation, at least... read more