Volume responsiveness and volume tolerance: a conceptual diagram

Volume responsiveness and volume tolerance: a conceptual diagram

So I know I've be-laboured the point about the difference between volume responsiveness (i.e. will there be significant increase in cardiac output with volume infusion) and volume tolerance (is the volume I am considering... read more

Improving CPR Performance

Improving CPR Performance

Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices.... read more

The Impact of Neonatal Simulations on Trainees Stress and Performance

The Impact of Neonatal Simulations on Trainees Stress and Performance

Neonatal simulations cause significant anticipatory and participatory stress. Despite this, trainees' performance score in simulation was over 80%. Simulated death did not impact performance, magnitude of rise in salivary... read more

PulsePoint Mobile App – Enabling Citizen Superheroes

PulsePoint Mobile App – Enabling Citizen Superheroes

PulsePoint Respond is an enterprise-class, software-as-a-service (SaaS) pre-arrival solution designed to support public safety agencies working to improve cardiac arrest survival rates through improved bystander performance... read more

Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients

Serial Procalcitonin Predicts Mortality in Severe Sepsis Patients

Objectives: To prospectively validate that the inability to decrease procalcitonin levels by more than 80% between baseline and day 4 is associated with increased 28-day all-cause mortality in a large sepsis patient population... read more

Fluid resuscitation in human sepsis: Time to rewrite history

Fluid resuscitation in human sepsis: Time to rewrite history

Fluid resuscitation continues to be recommended as the first-line resuscitative therapy for all patients with severe sepsis and septic shock. The current acceptance of the therapy is based in part on long history and familiarity... read more

Venous congestion: are we adding insult to kidney injury in sepsis?

Venous congestion: are we adding insult to kidney injury in sepsis?

In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of... read more

Pre-hospital therapeutic hypothermia: The RINSE trial

Pre-hospital therapeutic hypothermia: The RINSE trial

Therapeutic hypothermia has had a bit of a rollercoaster ride over the last few years. It was all the rage following three small trials, which initially suggested a significant benefit from cooling patients to 33C following... read more

Meta-analysis confirms EGDT for sepsis is unhelpful and wasteful (PRISM)

Meta-analysis confirms EGDT for sepsis is unhelpful and wasteful (PRISM)

Three large, well-conducted randomized trials around the world (ProCESS, ARISE, and ProMISe) all agreed: use of early goal-directed therapy (EGDT) for sepsis does not improve mortality or any other important clinical outcome.... read more

The Sick and the Dead: Evidence-Based Trauma Resuscitation

The Sick and the Dead: Evidence-Based Trauma Resuscitation

The science of trauma resuscitation has undergone a fairly massive evolution in the past decade. This talk was our attempt to summarize the best-of-the-best in trauma literature from the past several years, and package it... read more

Quantifying the Mortality Impact of Do-Not-Resuscitate Orders in the ICU

Quantifying the Mortality Impact of Do-Not-Resuscitate Orders in the ICU

Do-not-resuscitate status is an independent risk factor for ICU mortality. This may reflect severity of illness not captured by other clinical factors, but the perceptions of the treating team related to do-not-resuscitate... read more

Predicting and measuring fluid responsiveness with echocardiography

Predicting and measuring fluid responsiveness with echocardiography

Echocardiography is an essential tool to predict and measure fluid responsiveness, according to a recent article, which provides a practical guide. Ashley Miller and Justin Mandeville outline the physiological basis of fluid... read more

Updated Guidelines for Sepsis Management

Updated Guidelines for Sepsis Management

In 2017 the Society for Critical Care Medicine updated its guidelines for sepsis management. These new guidelines differ significantly from ones in the past in that they no longer recommend protocolized resuscitation and... read more

Excessive Resource Utilization

Excessive Resource Utilization

Overuse is inconsistent with professionalism because of the associated patient and societal harms and should receive equal attention as adverse events in health systems. Timely communication by inpatient specialists with... read more