At the Root: Defining and Halting Progression of Early COPD

Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder with varying presentations and progression, but limited disease-modifying therapies. Trajectories of lung function decline in COPD differ significantly... read more

The Practice of Respect in the ICU

Although "respect" and "dignity" are intuitive concepts, little formal work has addressed their systematic application in the ICU setting. After convening a multidisciplinary group of relevant experts, we undertook a review... read more

Intravenous Iron, Not Oral, Improves Functional Capacity in HF Patients

The oral iron supplement failed to be absorbed, while the successful IV formulation is not without significant logistical and cost issues. In one study testing a convenient and easy-to-use oral iron supplement, investigators... read more

Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing

In a survey of participants in clinical trials, most believe the potential benefits of data sharing outweigh potential negative consequences and are willing to share their data. Less than 8% of respondents felt that the potential... read more

Automated System Detects Risk of VAP

Approximately 50 percent of all patients receiving mechanical ventilator support develop ventilator-associated pneumonia (VAP). Researchers at Massachusetts General Hospital (MGH) have developed an automated system for identifying... read more

Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries

In this retrospective secondary analysis of 9 diverse LMIC cohorts that included 6569 hospitalized adults with suspected infection, a qSOFA score greater than or equal to 2 was significantly associated with increased likelihood... read more

Ten Shortcomings of the Current Definition of AKI

Acute kidney injury (AKI) is defined as an abrupt decline in kidney function. Although the kidney has many functions, this "abrupt decline" mostly refers to the glomerular filtration rate (GFR) that cannot... read more

Sepsis patients treated and released from emergency departments do well with outpatient follow-up

National guidelines assume that all patients who're diagnosed with clinical sepsis in an emergency department will be admitted to the hospital for additional care, but new research has found that many more patients are being... read more

The use of echocardiographic indices in defining and assessing right ventricular systolic function in critical care research

TAPSE seemed to be the most popular index in the last 2–3 years. Many studies used combinations of indices but, apart from cor pulmonale, we could not find a consistent pattern of RV assessment and definition of RV dysfunction... read more

Effect of Use of a Bougie vs Endotracheal Tube and Stylet on First-Attempt Intubation Success Among Patients With Difficult Airways Undergoing Emergency Intubation

In this emergency department, use of a bougie compared with an endotracheal tube + stylet resulted in significantly higher first-attempt intubation success among patients undergoing emergency endotracheal intubation.... read more

Diagnostic Workup, Etiologies and Management of Acute Right Ventricular Failure

Right Ventricular (RV) function evaluation is key in the critically-ill patients for hemodynamic management, as fluid optimization, vasopressor strategy and respiratory support. RV failure may be diagnosed by the association... read more

ECMO in Sepsis

In this episode, Zack talks with Heidi Dalton about ECMO use in Sepsis. This is another controversial area with pediatric literature showing strong results while the adult results have been less impressive. Heidi has been... read more

Being Mortal: Medicine and What Matters in the End

Through eye-opening research and gripping stories of his own patients and family, Gawande reveals the suffering this dynamic has produced. Nursing homes, devoted above all to safety, battle with residents over the food they... read more

Being Mortal: Medicine and What Matters in the End

Time of Admission to the PICU and Mortality

Margaret Parker, MD, MCCM, speaks with Michael C. McCrory, MD, MS, about the article, "Time of Admission to the PICU and Mortality," published in the October 2017 issue of Pediatric Critical Care Medicine. Dr. McCrory discusses... read more

Human limb skeletal muscle wasting and architectural remodeling during five to ten days intubation and ventilation in critical care

Using ultrasound, we have been able to demonstrate that muscle thickness and architecture of vastus lateralis undergo rapid changes during the early phase of admission to a critical care environment. Muscle loss in critically... read more

Limiting Sedation for Patients with ARDS

Current evidence supports the use of protocol-based, light-sedation strategies in critically ill patients with ARDS. Further research into sedation management specifically in ARDS populations is needed. Deep sedation strategies... read more

Cystic Fibrosis Transmembrane Conductance Regulator Potentiation as a Therapeutic Strategy for Pulmonary Edema

Cystic fibrosis transmembrane conductance regulator potentiation by ivacaftor is a novel therapeutic approach for pulmonary edema. Ivacaftor significantly improved alveolar liquid clearance in isolated pig lung lobes ex vivo... read more

Weaning from the Ventilator and Extubation in ICU

Current research is focusing on preventing extubation failure, especially in the most challenging cases. The use of weaning protocols – written or computerized – attempts to early identify patients who are able to breathe... read more

Risk of Recurrence After Surviving Severe Sepsis

Risk of recurrence after surviving severe sepsis is substantial regardless of patient characteristics or infection sites. Further research is necessary to find underlying mechanisms for the high risk of recurrence in these... read more

What’s Your Doctor Reading? How Social Media is Disrupting Medical Education

Traditionally, research would be presented at conferences, discussed at meetings, and gradually incorporated into international guidelines and textbooks. It would then filter down into clinical practice, years after its original... read more

Johns Hopkins Investigators Unravel Biological Roots of Pulmonary Hypertension

Working with cells that line the innermost layer of the blood vessels, Johns Hopkins investigators say they have made a leap forward in understanding the underlying biology behind pulmonary hypertension, a dangerous type... read more

The Emerging Role of the Microbiota in the ICU

The importance of the intestinal and lung microbiotas is often overlooked on the ICU. Currently, we can explore the microbiome using a vast array of techniques, giving us 'meta' libraries of data, which has allowed researchers... read more