New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality

New Sepsis Definition (Sepsis-3) and Community-acquired Pneumonia Mortality

qSOFA and CRB outperformed SIRS and presented better clinical usefulness as prompt tools for patients with community-acquired pneumonia in the emergency department. Among the tools for a comprehensive patient assessment,... read more

Corticosteroid Therapy for Critically Ill Patients with the MERS

Corticosteroid Therapy for Critically Ill Patients with the MERS

Corticosteroid therapy in patients with Middle East Respiratory Syndrome (MERS) was not associated with a difference in mortality after adjustment for time-varying confounders, but was associated with delayed MERS coronavirus... read more

Algorithm Can Diagnose Pneumonia Better than Radiologists

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

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

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

Accuracy and Applications of Lung Ultrasound to Diagnose VAP

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

Ultrasound-guided Mechanical Ventilation

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

Oral Antibiotics Preferred for Pediatric Pneumonia

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

Traditional vs. Extended Cefepime Infusion in Critically Ill Patients

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

Steroids for severe CAP. Should I?

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

Noninvasive Ventilation in Patients With Hematologic Malignancy

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

The Lactate Dilemma

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

Stress Ulcer Prophylaxis in the ICU (SUP-ICU)

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

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

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

Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration

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

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

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

Rescue Strategy for Treating Severe Carbapenemase-Producing Klebsiella Pneumoniae Infections

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

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