Algorithm Can Diagnose Pneumonia Better than Radiologists

Stanford researchers have developed a deep learning algorithm that evaluates chest X-rays for signs of disease. In just over a month of development, their algorithm outperformed expert radiologists at diagnosing pneumonia.... read more

Algorithm Can Diagnose Pneumonia Better than Radiologists

Hospital Factors May Influence NIV Outcomes Even in Low-Evidence Use

Strong evidence supports use of noninvasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure – i.e., strong evidence conditions (SECs). A new study of... read more

Hospital Factors May Influence NIV Outcomes Even in Low-Evidence Use

Accuracy and Applications of Lung Ultrasound to Diagnose VAP

Lung ultrasound (LUS) is an accurate tool to diagnose community-acquired pneumonia. However, it is not yet an established tool to diagnose ventilator-associated pneumonia (VAP). Small subpleural consolidations and dynamic... read more

Accuracy and Applications of Lung Ultrasound to Diagnose VAP

Ultrasound-guided Mechanical Ventilation

Point-of-care ultrasound (POCUS) is now a tool used worldwide, integrating clinical assessment of the critically ill. In this review, we focus on lung, diaphragm and cardiac ultrasound in the management of the mechanically... read more

Ultrasound-guided Mechanical Ventilation

Oral Antibiotics Preferred for Pediatric Pneumonia

Children with complicated pneumonia should be discharged from the hospital with oral instead of intravenous (IV) antibiotics when possible, according to a new study. The results showed no significant differences in treatment... read more

Oral Antibiotics Preferred for Pediatric Pneumonia

Traditional vs. Extended Cefepime Infusion in Critically Ill Patients

Patients with Pseudomonas aeruginosa bacteremia or pneumonia had a reduced 28-day all-cause mortality and length of stay in the ICU when administered an extended infusion of cefepime.... read more

Traditional vs. Extended Cefepime Infusion in Critically Ill Patients

Steroids for severe CAP. Should I?

Steroids. I always have mixed feelings about them. It's a Love & Hate relationship inside my head. On one hand I cannot stand those who claim steroids are the critical care's Holy Grail. Steroids for sepsis, ARDS, trauma,... read more

Steroids for severe CAP. Should I?

Noninvasive Ventilation in Patients With Hematologic Malignancy

Two-thirds of patients with Hematologic Malignancy and respiratory failure failed Noninvasive Ventilation (NIV) and required endotracheal intubation, and had high subsequent mortality. Patients who failed NIV had higher Paco2,... read more

Noninvasive Ventilation in Patients With Hematologic Malignancy

The Lactate Dilemma

After a long and exhausting discussion with an inferior human being, a cardiologist, which happens to be an old friend, I decided to write some thoughts about lactate. So, I'll do like I do in my lectures, which is state... read more

The Lactate Dilemma

Stress Ulcer Prophylaxis in the ICU (SUP-ICU)

Stress ulcer prophylaxis (SUP) is standard of care in the intensive care unit (ICU), however the quantity and quality of evidence is low and potential harm has been reported. The aim of the SUP-ICU trial is to asses the overall... read more

Stress Ulcer Prophylaxis in the ICU (SUP-ICU)

Role of Preventability in Redefining Failure to Rescue Among Major Trauma Patients

Failure to rescue (FTR) is defined as death after a major complication and has been adopted as a measure of quality in surgical patients. Current definitions of FTR are limited because they do not account for the influence... read more

Role of Preventability in Redefining Failure to Rescue Among Major Trauma Patients

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

Among comatose patients receiving mechanical ventilation, those without clinical, laboratory, or radiologic evidence of bacterial aspiration pneumonia did not require antibiotics. In those with suspected bacterial aspiration... read more

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

Aspirin therapy in patients with ARDS is associated with reduced ICU mortality

Acute respiratory distress syndrome (ARDS) is a common clinical syndrome with high mortality and long-term morbidity. To date there is no effective pharmacological therapy. Aspirin therapy has recently been shown to reduce... read more

Aspirin therapy in patients with ARDS is associated with reduced ICU mortality

Rescue Strategy for Treating Severe Carbapenemase-Producing Klebsiella Pneumoniae Infections

Recent reports have suggested the efficacy of a double carbapenem (DC) combination, including ertapenem, for the treatment of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) infections. We aimed to evaluate the clinical... read more

Rescue Strategy for Treating Severe Carbapenemase-Producing Klebsiella Pneumoniae Infections

Withholding Pantoprazole for Stress Ulcer Prophylaxis in Critically Ill Patients

A decreased frequency of upper gastrointestinal bleeding and a possible association of proton pump inhibitor use with Clostridium difficile and ventilator-associated pneumonia have raised concerns recently. The Reevaluating... read more

Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. Disability outcomes after... read more

Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

COPD can increase risk of developing sepsis

People with COPD have a higher than average risk of developing lung infections, such as pneumonia, which then puts them at higher risk for developing sepsis. Sepsis and septic shock can result from an infection anywhere in... read more

COPD can increase risk of developing sepsis

Humidification During Mechanical Ventilation: A Systematic Review

Mechanical ventilation (MV) suppresses the mechanisms that heat and moisturise inhaled air; hence, humidification is mandatory during MV. However, a systematic review published in the journal Critical Care finds no clear... read more

Humidification During Mechanical Ventilation: A Systematic Review

The impact of oral care on oral health status and prevention of VAP in critically ill patients

Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections which increase mortality rate and length stay of hospitalization. Oral care would not only improve patient’s oral health and well-being,... read more

The impact of oral care on oral health status and prevention of VAP in critically ill patients

Plasma metabolomics for the diagnosis and prognosis of H1N1 influenza pneumonia

Metabolomics is a tool that has been used for the diagnosis and prognosis of specific diseases. The purpose of this study was to examine if metabolomics could be used as a potential diagnostic and prognostic tool for H1N1... read more

Plasma metabolomics for the diagnosis and prognosis of H1N1 influenza pneumonia

Early Palliative Care in Advanced Illness

As the on-call pulmonary critical care fellow, I listened to a family member plead with me to "do right by Mama." The emergency department team consulted me for possible intensive care unit (ICU) admission on a... read more

Early Palliative Care in Advanced Illness

Value-Based Reforms and the Hospital Readmission Reduction Program

In this longitudinal study of 2837 US hospitals between 2008 and 2015, we found that participation in 1 or more Medicare value-based reforms - including the Meaningful Use of Electronic Health Records program, the Accountable... read more

Value-Based Reforms and the Hospital Readmission Reduction Program