Tag: resuscitation
Initial Arterial pH as a Predictor of Neurologic Outcome After Out-of-hospital Cardiac Arrest
Lower pH after out-of-hospital cardiac arrest (OHCA) has been associated with worsening neurologic outcome, with ... read more
Is Pre-hospital Coagulation Management in Trauma Feasible?
Coagulation management remains a formidable challenge in severely bleeding trauma patients. A strong rationale suggests starting treatment of trauma-induced coagulopathy in the pre-hospital phase. The burden of trauma is... read more
Characteristics, Management, and In-hospital Mortality Among Patients with Severe Sepsis in ICU in Japan
Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed... read more
Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms
The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more
Outcomes of Critically Ill Patients Who Received Cardiopulmonary Resuscitation
Although overall survival of ICU patients was 15.9%, patients requiring pressors and who experienced a CPA in an ICU were half as likely to survive to discharge and to be discharged home than patients not taking pressors.... read more
The Great Debate Between Balanced and Unbalanced Crystalloids Continues
This meta-analysis contributes very little to the current discussion mainly because of the heterogeneity of included studies. The use of fluid type in different pathologies isn't really what we need, but rather tailored use... read more
The EXACT Protocol
The EXACT protocol: a multi-centre, single-blind, randomised, parallel-group, controlled trial to determine whether early oxygen titration improves survival to hospital discharge in adult OHCA patients. This study will determine... read more
No-Shitters, Boldface, and the Resus QRH
In an amazing lecture; Joe Novak, ED doc and former combat aviator; spoke about the need for memorized boldface actions and then the availability of a quick reference handbook (QRH) for the next steps. But where are either... read more
Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections
In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of... read more
Ascorbic Acid, Corticosteroids, and Thiamine in Sepsis
The combination of thiamine, ascorbic acid, and corticosteroids is a promising new therapy for sepsis resuscitation but currently lacks robust evidence to support its widespread use. The potential effectiveness of this medication... read more
Machine Learning for the Prediction of Volume Responsiveness in Patients with Oliguric AKI in Critical Care
Excess fluid balance in acute kidney injury (AKI) may be harmful, and conversely, some patients may respond to fluid challenges. This study aimed to develop a prediction model that can be used to differentiate between volume-responsive... read more
Oxygen Therapy in Acute Resuscitation
At present, evidence is lacking to support routine liberal oxygen administration in acutely ill patients and, in most circumstances, a reasonable approach is to titrate supplemental oxygen to achieve an arterial oxygen saturation... read more
Management of Refractory Vasodilatory Shock
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory... read more
Critical Care Controversies: The REBEL vs The SKEPTIC at #SMACC 2019
On the last day of the last SMACC conference, Dr. Ken Milne (The SGEM) and I had a cage match debating four critical care controversies. It was all done in good fun with both of us taking our opportunities to poke a little... read more
Sepsis and Septic Shock – What Matters from EM Cases Course
In this podcast Dr. Sara Gray, intensivist and emergency physician, co-author of The CAEP Sepsis Guidelines, answers questions such as: How does one best recognize occult septic shock? How does SIRS, qSOFA and NEWS compare... read more
ECMO Global Trends and Use in Cardiopulmonary Resuscitation
In this video, Dr. Ravi Thiagarajan, Chief of the Division of Cardiac Critical Care at Boston Children's Hospital, and Professor of Pediatrics at Harvard Medical School, outlines past and present trends in ECMO use across... read more
Monitoring the Relationship Between Changes in Cerebral Oxygenation and Electroencephalography Patterns During Cardiopulmonary Resuscitation
Real-time monitoring of cerebral oxygenation and function during cardiac arrest resuscitation is feasible. Although voltage suppression is the commonest electroencephalography pattern, other distinct patterns exist that may... read more
Extravascular Lung Water as a Target for Intensive Care
Extravascular lung water (EVLW) remains a useful guide for monitoring pulmonary edema (PO) and vascular permeability in sepsis, acute respiratory distress syndrome (ARDS), and heart failure. In addition, EVLW has a prognostic... read more
Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock
Among patients with septic shock, a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not reduce all-cause 28-day mortality. Among 424 patients... read more
Should We Stop Trending Lactate in Septic Shock?
There may be a tendency to cement guideline recommendations into our collective minds as inalienable and sacrosanct – as if carved onto stone tablets and brought down to us from the heights of Mount Sinai. Thoughtful medicine,... read more
Hypertriglyceridemic pancreatitis: Can we defuse the bomb?
Hypertriglyceridemia causes ~9% of pancreatitis, the third most common cause after alcohol and gallstones. It is a risk factor for severe pancreatitis, making it more frequent among ICU patients with pancreatitis. I see... read more
Hoopla Aside, hs-cTnI is Not Catching Missed Mis
We have been searching for a tool to identify myocardial infarction patients who are truly safe for discharge ever since Pope, et al., found that we were discharging two percent of patients with MIs from the emergency department.... read more
