The ADRENAL Trial: Steroids in Septic Shock

The ADRENAL Trial: Steroids in Septic Shock

Randomized clinical trials evaluating the efficacy of adjunctive corticosteroids in septic shock have shown conflicting evidence of clinical relevance. Two trials in particular looked at lower dose hydrocortisone (200mg/day)... read more

Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults

Supplemental Parenteral Nutrition vs. Usual Care in Critically Ill Adults

This individually titrated supplemental PN strategy applied over 7 days significantly increased energy delivery when compared to usual care delivery. Clinical and functional outcomes were similar between the two patient groups.... read more

Glycaemic Control Targets After TBI

Glycaemic Control Targets After TBI

This meta-analysis of intensive glycaemic control shows no association with reduced mortality in TBI. Intensive glucose control showed a borderline significant reduction in the risk of poor neurological outcome, but markedly... read more

Importance of Second Antibiotic Doses in ED Sepsis Patients

Importance of Second Antibiotic Doses in ED Sepsis Patients

Most studies evaluating early antibiotic administration in sepsis patients focus on timing of the first dose. We highlight many of these studies in our recent review article on Appropriate Antibiotic Therapy in Emergency... read more

Is Fever the Normal Temperature of Sepsis

Is Fever the Normal Temperature of Sepsis

We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated.... read more

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock

Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock

Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6 h. Lower blood pressure targets were not associated with patient‑important adverse events... read more

TBI Outcomes in an LMIC Tertiary Care Centre and Performance of Trauma Scores

TBI Outcomes in an LMIC Tertiary Care Centre and Performance of Trauma Scores

This observational study of patients sustaining moderate or severe TBI in Sri Lanka (a LMIC) reveals only 46% of patients were alive at 6 months after ICU discharge and only 20% overall attained a good (GOSE 7 or 8) recovery.... read more

Diagnostic Stewardship for Healthcare-Associated Infections

Diagnostic Stewardship for Healthcare-Associated Infections

Healthcare-associated infections (HAIs) are associated with increased morbidity and mortality, prolonged hospital stays, and unnecessary cost. The financial stakes of HAIs for hospitals were underscored in 2008 when the Centers... read more

What is the Role of Benchmarking for Intensive Care?

Although the evaluation of a single intensive care unit (ICU) over time can produce insightful results, self-reflection can lead to excessive optimism or criticism. Benchmarking against other ICUs can provide ICU staff and... read more

When Do Confounding by Indication and Inadequate Risk Adjustment Bias Critical Care Studies?

In critical care observational studies, when clinicians administer different treatments to sicker patients, any treatment comparisons will be confounded by differences in severity of illness between patients. We sought to... read more

Social Determinants of Health: A Missing Link in Emergency Medicine Training

Social Determinants of Health: A Missing Link in Emergency Medicine Training

The health of a population depends upon several factors, including disease, public health initiatives, and the social determinants of health (SDH). These factors often converge in the emergency department (ED) where the impact... read more

Effect of a National Standard for Deteriorating Patients on Intensive Care Admissions Due to Cardiac Arrest in Australia

Effect of a National Standard for Deteriorating Patients on Intensive Care Admissions Due to Cardiac Arrest in Australia

The main objective of this study is to assess whether a national standard for improving care of deteriorating patients affected ICU admissions following cardiac arrests from hospital wards. Introducing a national standard... read more

Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products

Chloride and Other Electrolyte Concentrations in Commonly Available 5% Albumin Products

This study is the first to identify and document a statistically significant variability in the chloride concentration of available 5% albumin products. This study has also informed a pilot randomized controlled trial examining... read more

Six-month Outcome of Immunocompromised Severe ARDS Patients Rescued by ECMO

Six-month Outcome of Immunocompromised Severe ARDS Patients Rescued by ECMO

Recently diagnosed immunodeficiency is associated with a much better prognosis in ECMO-treated severe ARDS. However, low 6-month survival of our large cohort of immunocompromised patients supports restricting ECMO to patients... read more