PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children

Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more

PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children

Critical Pediatric Heart Deaths Drop by 24% at Hospitals With Cardiac ICUs

Major complications fall by 12%, time on a ventilator declines by 13% among children in the cardiac ICU at PC4 hospitals As a pediatric cardiology fellow nearly a decade ago, Michael Gaies remembers asking hospital colleagues... read more

Critical Pediatric Heart Deaths Drop by 24% at Hospitals With Cardiac ICUs

Corticosteroids as Adjunctive Therapy in the Treatment of Influenza

Corticosteroid treatment in influenza is associated with increased mortality and hospital-acquired infection, but the evidence relates mainly to high corticosteroid doses and is of low quality with potential confounding by... read more

Corticosteroids as Adjunctive Therapy in the Treatment of Influenza

Triage and Flow Management in Sepsis

Septic patients had a lower priority for ICU admission and longer waiting times for an ICU vacancy than patients with other critical conditions. Overall, this implied a 2.7-fold increased risk of mortality in septic patients. The... read more

Triage and Flow Management in Sepsis

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Use of vasopressor for traumatic hemorrhagic shock was associated with mortality after controlling for biases (trauma severity; volume of fluid resuscitation). Among 236,698 trauma patients, 3,551 were included in the... read more

Use of Vasopressor Increases the Risk of Mortality in Traumatic Hemorrhagic Shock

Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis

In this meta-analysis of 37 RCTs (including 9564 patients), corticosteroid treatment was significantly associated with reduced 28-day mortality, ICU mortality, and in-hospital mortality among patients with sepsis. However,... read more

Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis

Prophylactic Antibiotics After Cardiac Arrest?

This is a multicenter, double-blind, placebo-controlled trial of patients resuscitated from shockable out-of-hospital cardiac arrest.​ Patients were randomized to placebo versus intravenous amoxicillin-clavulanate for two... read more

Prophylactic Antibiotics After Cardiac Arrest?

Epidemiology and Costs of Sepsis in the United States

The highest burden of incidence and total costs occurred in the lowest severity sepsis cohort population. Sepsis cases not diagnosed until after admission, and those with increasing severity had a higher economic burden and... read more

Epidemiology and Costs of Sepsis in the United States

Fluid Resuscitation: Evidence-based Solutions?

Intravenous (IV) fluid prescribing is one of the commonest tasks carried out by junior doctors. I still remember around this time last year when I was fresh out of medical school and had just been let loose on the wards,... read more

Fluid Resuscitation: Evidence-based Solutions?

Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure

The purpose of this trial is to investigate the efficacy and safety of continuous intravenous administration of low dose iloprost versus placebo for 72-hours, in up to a total of 380 patients with septic shock suffering from... read more

Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure

Early vs. Delayed Administration of Norepinephrine in Patients with Septic Shock

This study investigated the incidence of delayed norepinephrine administration following the onset of septic shock and its effect on hospital mortality. Our results show that early administration of norepinephrine in... read more

Early vs. Delayed Administration of Norepinephrine in Patients with Septic Shock

Septic Shock and the Use of Norepinephrine IMCU

Elderly patients with septic shock treated with norepinephrine (NE) displayed a better Intermediate Care Unit (IMCU) survival at the ward and at 30 days than previously expected. Our retrospective chart study did not... read more

Septic Shock and the Use of Norepinephrine IMCU

Development and Assessment of Objective Surveillance Definitions for Nonventilator Hospital-Acquired Pneumonia

These findings suggest that objective surveillance for NV-HAP using electronically computable definitions that incorporate common clinical criteria is feasible and generates incidence, mortality, and adjusted ORs for hospital... read more

Development and Assessment of Objective Surveillance Definitions for Nonventilator Hospital-Acquired Pneumonia

ICU Admission Source as a Predictor of Mortality for Patients With Sepsis

Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients... read more

ICU Admission Source as a Predictor of Mortality for Patients With Sepsis

Acute Liver Failure: Evidence-Based Evaluation and Management

Although acute liver failure (ALF) is a rare clinical presentation in the ED, it carries a high mortality, morbidity, and resource cost. Across the developing world, the underlying etiology is primarily viral, with hepatitis... read more

Acute Liver Failure: Evidence-Based Evaluation and Management

Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination

Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU... read more

Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination

Norepinephrine Shortage and Mortality Among Patients With Septic Shock

Drug shortages in the United States are common, but their effect on patient care and outcomes has rarely been reported. This cohort study evaluated whether a national shortage of norepinephrine in the United States in 2011... read more

Norepinephrine Shortage and Mortality Among Patients With Septic Shock

Transfusions Stuck in an Endless Cycle of Denial

Each publication from Maitland, et al., gives us a glimpse of a greater medical truth, but our view is obstructed by questions about external validity. This group published the landmark FEAST trial that questioned the... read more

Transfusions Stuck in an Endless Cycle of Denial