Hyperoxia and Hypocapnia During Pediatric ECMO

Hyperoxia is common during pediatric extracorporeal membrane oxygenation (ECMO) and associated with mortality. Hypocapnia appears to occur less often and although associated with complications, an association with mortality... read more

Hyperoxia and Hypocapnia During Pediatric ECMO

Arterial Line Placement

Approximately eight million arterial lines are placed in the United States yearly. The main indication for arterial line placement is the need for close hemodynamic monitoring. The second-to-second blood pressure variations... read more

Arterial Line Placement

Update of a Systematic Review of Autoresuscitation After Cardiac Arrest

Although case reports of autoresuscitation are hampered by variability in observation and monitoring techniques, autoresuscitation has now been reported in adults and children, and there appears to be a distinction in timing... read more

Update of a Systematic Review of Autoresuscitation After Cardiac Arrest

Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival

This cohort study uses data from the Get With The Guidelines-Resuscitation registry to investigate the association between tracheal intubation during adult in-hospital cardiac arrest and survival to hospital discharge. In... read more

Tracheal Intubation During Adult In-Hospital Cardiac Arrest and Survival

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe... read more

R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation

Early Hemorrhage Control and Management of Trauma-induced Coagulopathy

Trauma resuscitation should focus on early goal-directed therapy with use of viscoelastic hemostatic assays while initially applying a ratio 1:1:1 driven transfusion therapy (with red blood cells, plasma and platelets) in... read more

Early Hemorrhage Control and Management of Trauma-induced Coagulopathy

Predictors, Prevalence, and Outcomes of Early Crystalloid Responsiveness Among Initially Hypotensive Patients With Sepsis and Septic Shock

Two in three hypotensive sepsis patients were responsive to initial fluid resuscitation. Heart failure, hypothermia, immunocompromise, hyperlactemia, and coagulopathy were associated with the refractory phenotype. Fluid resuscitation... read more

Predictors, Prevalence, and Outcomes of Early Crystalloid Responsiveness Among Initially Hypotensive Patients With Sepsis and Septic Shock

Training Approaches for the Deployment of a Mechanical Chest Compression Device

Pit-crew training, compared with standard training, did not improve team deployment of a mechanical chest device in a simulated cardiac arrest scenario. Twenty teams participated in this study, each comprising three clinicians.... read more

Training Approaches for the Deployment of a Mechanical Chest Compression Device

Physician Genders and the Likelihood of ICU Admission in Hospital with Restricted ICU Bed Capacity

Despite the evidence that the patient gender is an important component in the intensive care unit (ICU) admission decision, the role of physician gender and the interaction between the two remain unclear. We demonstrated... read more

Physician Genders and the Likelihood of ICU Admission in Hospital with Restricted ICU Bed Capacity

The Effect of 6% Hydroxyethyl Starch (130/0.4) On AKI in Pediatric Cardiac Surgery

We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were randomly divided into an hydroxyethyl starch group and a control group. In the starch group,... read more

The Effect of 6% Hydroxyethyl Starch (130/0.4) On AKI in Pediatric Cardiac Surgery

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

We conclude that antibiotic therapy is highly time sensitive, and efforts should be made to deliver this critical therapy as early as possible in sepsis, perhaps extending into the first point of medical contact outside the... read more

Prompt Administration of Antibiotics and Fluids in the Treatment of Sepsis

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

The ADRENAL Trial: Steroids in Septic Shock

Acute Kidney Injury in Sepsis

Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such... read more

Acute Kidney Injury in Sepsis

Initial Crystalloid Resuscitation in Sepsis and Septic Shock

Ludwig Lin, MD, speaks with Daniel E. Leisman, BS, about the article, "Patterns and Outcomes Associated With Timeliness of Initial Crystalloid Resuscitation in a Prospective Sepsis and Septic Shock Cohort," published in Critical... read more

The EM Educator Series: Sepsis in the ED

These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation... read more

The EM Educator Series: Sepsis in the ED

Patient Experiences of Trauma Resuscitation

In this qualitative study that included semistructured interviews and video observations of trauma resuscitation, patients drew satisfaction from trauma team members' demeanor, expertise, and efficiency and valued clear... read more

Patient Experiences of Trauma Resuscitation

Guidelines for Point-of-Care Use of Transesophageal Echocardiography in Cardiac Arrest Resuscitation

In patients with cardiac arrest, transesophageal echocardiography (TEE) may provide greater benefits than transthoracic echocardiography (TTE) for imaging, diagnosis, and prognosis, according to a review paper published in... read more

Guidelines for Point-of-Care Use of Transesophageal Echocardiography in Cardiac Arrest Resuscitation

Post Resuscitation Management of Cardiac Arrest Patients in the Critical Care Environment

There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance... read more

Post Resuscitation Management of Cardiac Arrest Patients in the Critical Care Environment

Intra-Abdominal Hypertension and Abdominal Compartment Syndrome

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome are increasingly recognized in both medical and surgical critically ill patients and are predictive of death and the development of acute kidney injury.... read more

Intra-Abdominal Hypertension and Abdominal Compartment Syndrome

Tissue Edema, Fluid Balance, and Patient Outcomes in Severe Sepsis

Severe sepsis and septic shock remain among the deadliest diseases managed in the intensive care unit. Fluid resuscitation has been a mainstay of early treatment, but the deleterious effects of excessive fluid administration... read more

Tissue Edema, Fluid Balance, and Patient Outcomes in Severe Sepsis

Causes for Pauses During Simulated Pediatric Cardiac Arrest

Pauses in cardiopulmonary resuscitation occurred frequently during simulated pediatric cardiac arrest, with variable duration and underlying causes. A large percentage of pauses were greater than 10 seconds and occurred more... read more

Causes for Pauses During Simulated Pediatric Cardiac Arrest